Development and Evaluation of Support for Tobacco Recovery Training for Community Health Workers, Peer Support Specialists, and Other Front-Line Providers.

BACKGROUND

Health and mental health systems are increasingly employing community health workers and peer support specialists to expand service reach and effectiveness, yet role definitions and competency standards vary widely. Little is known about how to train or prepare these professionals to collaborate with health care teams, engage peers and community members, and address complex health and mental health needs. Tobacco use remains a leading cause of illness and death in the United States and disproportionately impacts people with low incomes and people with mental health conditions, including substance use disorders. Support for Tobacco Recovery Training (STaRT) was developed to provide brief but comprehensive training to support engagement in evidence-based tobacco treatment. This study describes STaRT's development and evaluates knowledge, reach, and satisfaction among graduates during its first 2 years.

METHODS

We developed STaRT using a community-engaged process with peer specialists, behavioral health professionals, and academic partners. The final program includes 8 self-paced online modules emphasizing recovery-oriented language, communication strategies, evidence-based treatment, and resource navigation. We collected demographics and a knowledge assessment at baseline, and a post-knowledge assessment and evaluation upon training completion. We used descriptive statistics to summarize demographics and evaluation items and a choropleth map of trainees demonstrates reach. We evaluated change in knowledge using a paired samples t-test.

RESULTS

From November 2023 through October 2025, 256 trainees graduated from STaRT. Trainees were primarily women (83%) and worked across diverse settings, including public health, mental health, community health, and social service settings. Mean knowledge scores increased from 83% to 97% (P < .01). Trainees represented 46/105 counties, with reach ranging from 1 to 43 graduates/100 000 population. Program satisfaction was high (mean 4.6/5).

CONCLUSIONS

STaRT is a feasible, scalable, and peer-informed training model that improves knowledge and expands the tobacco recovery workforce. Findings suggest strong potential for implementation and adaptation beyond Kansas.