Implementation of Community Health Worker Support for Tobacco Cessation: A Mixed-Methods Study.

Greater participant engagement with community health workers (CHWs) (e.g., visit number, duration) was associated with higher tobacco abstinence rates in a two-year intervention for adults with serious mental illness and tobacco use disorder.Interviews with participants, CHWs, and primary care providers (PCPs) indicated that CHWs built trust, facilitated health behavior change, helped participants overcome adverse social determinants of health and other barriers to obtaining effective tobacco use disorder treatment.Training and supervision were perceived to be essential to CHW effectiveness; CHWs and PCPs suggested insufficient integration of CHWs into psychiatric rehabilitation and healthcare teams as an addressable implementation barrier.