Federally Qualified Health center-level characteristics associated with sustaining tobacco screening and treatment in the United States, 2020-2024.

OBJECTIVES

We examined factors associated with sustaining tobacco screening and treatment at Federally Qualified Health Centers (FQHCs), 2020 through 2024.

METHODS

We analyzed 2020-2024 Uniform Data System data for 1354 FQHCs with complete data. The primary outcome was sustained treatment, defined as meeting the ≥80% tobacco screening/treatment benchmark each year. Logistic models estimated associations between center characteristics (patient composition, receipt of special population funding, rurality) and performance.

RESULTS

Centers served a median of 13,739 patients. The mean proportion of patients with incomes ≤200% federal poverty level was 60.0%, the mean covered by Medicaid was 43.9%, and the mean uninsured was 21.5%. Less than half of the centers (41.6%, n = 563/1354) sustained ≥80% tobacco screening/treatment performance across all study years; the odds increased with greater patient volume (OR = 1.45, 95%CI:1.26,1.68), higher proportions of Hispanic patients (OR = 2.23, 95%CI:1.22, 4.08), and higher proportions of patients ≤200% of federal poverty level (OR = 2.79, 95%CI:1.53, 5.06). Centers with higher proportions of Black patients (OR = 0.42, 95%CI:0.23, 0.76) and those that received homeless population funding (OR = 0.61, 95%CI:0.45, 0.84) had lower odds of sustained performance.

CONCLUSIONS

Patient volume and composition were associated with sustained tobacco treatment performance which may reflect differences in organizational capacity.