As part of a two-year initiative funded by the California Tobacco-Related Disease Research Program (TRDRP), Family Health Centers of San Diego (FHCSD) and UC San Diego partnered to improve access to evidence-based tobacco cessation services for low-income and underserved populations. Using a Community-Partnered Participatory Research approach, the project engaged patients, providers, clinical staff, and community advisors to better understand barriers to tobacco treatment and co-develop a comprehensive suite of cessation services tailored to the needs of the communities served by FHCSD. Insights gathered through interviews, stakeholder feedback, and community engagement activities informed enhancements to electronic health record workflows, provider and staff training, and proactive referrals to Kick It California, creating tools and processes that could be integrated into routine primary care practice rather than operating as a stand-alone program.
Through pilot implementation, the research team demonstrated the feasibility and acceptability of these approaches within a large Federally Qualified Health Center while gaining valuable insight into patient engagement, provider workflows, and opportunities to reduce disparities in access to tobacco treatment. A central goal of the project was to develop practical, sustainable solutions that could be incorporated into existing clinic operations and scaled across healthcare settings serving similar populations. The infrastructure, workflows, and lessons learned from this pilot informed the development of Enhanced Multicomponent Proactive Navigator-Assisted Cessation of Tobacco Use in Low-Income Patients (EMPACT-Us) and have continued to shape new strategies to support patients and healthcare teams across the tobacco care continuum. This work has also contributed to subsequent initiatives focused on increasing engagement in lung cancer screening and promoting the early detection of lung cancer among individuals at elevated risk due to tobacco use, extending the impact of the project beyond tobacco cessation alone.