Using Continuous Quality Improvement Tools to Promote Tobacco Cessation Among Primary Caregivers in a Home Visiting Program in Alabama




Matthew Fifolt, Julie Preskitt, Heather H. Johnson, Elisabeth Johns, Karen Askov Zeribi, and MaryCatherine Arbour

Brief Type

Journal Publication


  • Parents as Teachers (PAT)


Alabama’s Maternal, Infant, and Early Childhood Home Visiting–funded program was one of 10 state teams accepted to participate in the first wave of the Federal Home Visiting Program State and Territory Continuous Quality Improvement Practicum. This article reports methods and results of Alabama’s continuous quality improvement (CQI) project and lessons learned in developing CQI capabilities among state and local public health practitioners. The Alabama team tracked CQI data weekly for the duration of the practicum using an annotated run chart. Participants included 20 identified tobacco users in 2 participating LIAs. This article highlights specific CQI tools to achieve the project aim. On the basis of CQI interventions, Alabama reached its goal; 12 of 20 primary caregivers in 2 home visiting programs made quit attempts. Alabama utilized multiple CQI tools to reach an ambitious, behavior-based aim; these same concepts could be broadly applied to quality improvement initiatives in any federal or state public health program to guide process- and outcomes-based improvement efforts. (author abstract)

Data Collection Methods

  • Program administrative record reviews
  • Surveys or questionnaires



For More Information

Fifolt, M., Preskitt, J., Johnson, H. H., Johns, E., Zeribi, K. A., & Arbour, M. (2018). Using continuous quality improvement tools to promote tobacco cessation among primary caregivers in a home visiting program in Alabama. Journal of Public Health Management and Practice, 00(00), 1-4.
doi: 10.1097/PHH.0000000000000833
Author Contact Information:
Matthew Fifolt


  • Program Quality, Continuous Quality Improvement, and Fidelity