Evaluation of a Train-the-trainer Program to Build Capacity for Training Tobacco Treatment Specialists

UMMS Affiliation

Center for Tobacco Treatment Research and Training, Division of Preventive and Behavioral Medicine; UMass Worcester Prevention Research Center

Publication Date


Document Type



Behavioral Medicine | Community Health | Community Health and Preventive Medicine | Health Services Administration | Medical Education | Preventive Medicine | Public Health Education and Promotion | Substance Abuse and Addiction


Introduction: Tobacco treatment specialists (TTSs) and high quality TTS training programs are needed to improve access to evidence-based tobacco dependence treatment. To meet this demand, the University of Massachusetts (UMass) Medical School developed the Train the Trainer in Tobacco Treatment (T4) program to build a cadre of trainers to deliver the accredited UMass TTS training programs. This paper reports on the feasibility and quality of TTS trainings led by Certified UMass TTS Trainers (Trainer-led) compared with trainings led by UMass staff (On-site).

Methods: Data were collected between September 2014 and June 2017. Feasibility included the number of Trainers, Trainer-led programs and participants. Quality compared participant exam results and evaluations of the two training program types.

Results: Fifty-three Trainers were certified during 2014-2017, and conducted 26 TTS trainings with 351 participants. There were no significant differences in participant mean exam scores [On-site=86.33 (SD=7.83); Trainer-led=86.15 (SD=8.47)], and a similar percentage of participants obtained a passing score on the exam (On-site 94.4%, Trainer-led 94.0%). There were no significant differences in increased self-efficacy in delivering effective tobacco treatment services [On-site=2.92, Trainer-led=2.93; p=0.52 (3-point Likert scale, 1=not at all, 3=a great deal)] or in overall satisfaction with the training [On-site=3.84; Trainer-led=3.81; p=.072 (4-point Likert scale, 1=very dissatisfied, 4=very satisfied)].

Conclusions: The Trainer-led model expanded the number of UMass-trained TTSs with equivalent participant knowledge and perceived improvement in ability to deliver effective tobacco dependence treatment compared to the gold-standard training model. It offers a potentially more accessible option for training TTSs compared to the On-site model.

Implications: Train the Trainer in Tobacco Treatment (T4) has increased the capacity to deliver high quality training to healthcare providers who might not otherwise have access to an accredited Tobacco Treatment Specialist training program. Certified Trainers effectively identified potential participants and delivered training that was equivalent in quality to the standard UMass TTS Core Training program. There were no significant differences between the training models in two critical measures: 1) participant exam scores, and 2) participants' rating of improvement in their ability to deliver effective tobacco dependence treatment. Organizations can now choose from two equally effective models for delivering TTS training based on their unique needs and training populations.


nicotine dependence, health personnel, tobacco, likert scale, evidence-based practice, dissatisfaction

DOI of Published Version



Nicotine Tob Res. 2018 Jun 25. pii: 5043467. doi: 10.1093/ntr/nty125. [Epub ahead of print] Link to article on publisher's site

Journal/Book/Conference Title

Nicotine and tobacco research : official journal of the Society for Research on Nicotine and Tobacco

Related Resources

Link to Article in PubMed

PubMed ID