Advertisement

Influencing Taft–Hartley Funds to Provide Tobacco Cessation Benefits

      Background

      Taft–Hartley Health and Welfare Funds (“funds”) administer health insurance plans that cover approximately nine million U.S. adults. Unionized workers covered by funds work primarily in blue- and pink-collar occupations and smoke at a rate almost twice that of workers in other occupations. Most funds do not provide comprehensive coverage for tobacco cessation treatment for fund participants (workers, family members, and retirees).

      Purpose

      This study tested a pilot intervention to increase the provision and promotion of cessation benefits among Minnesota-based funds by educating the funds' advisors.

      Methods

      Tailored educational outreach was conducted to advisors (administrators, consultants, attorneys) of 10 Minnesota-based funds (2009–2011). Pre- and post-intervention advisor interviews measured perceptions/knowledge/attitudes about tobacco use, cessation, coverage, and promotion of benefits. Pre- and post-intervention data on benefit provision were collected from Summary Plan Descriptions (SPDs) and Summary Material Modifications (SMMs) of 10 Minnesota-based funds and 19 comparison funds in Massachusetts and Washington, and compared in 2011. SPDs/SMMs were scored on benefit adequacy, comparing services covered and the extent to which they met DHHS recommendations.

      Results

      Minnesota-based funds provided significantly higher coverage (except for copays and pre-conditions) pre-intervention. However, there were no significant differences between Minnesota and comparison funds in rate of improvement in benefits over time. At follow-up, advisors reported a significant increase in confidence in their knowledge to address smoking issues in funds. Advisors also reported sharing intervention information with fund trustees.

      Conclusions

      Educational strategies to influence advisors who provide guidance to fund trustees may help to increase advisors' confidence to address cessation benefit improvement.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Ringen K.
        • Anderson N.
        • McAfee T.
        • Zbikowski S.M.
        • Fales D.
        Smoking cessation in a blue-collar population: results from an evidence-based pilot program.
        Am J Ind Med. 2002; 42: 367-377
        • Shi L.
        • Singh D.A.
        Delivering health care in America: a systems approach.
        4th ed. Jones and Bartlett, Boston2008
        • AFSCME Collective Bargaining Reporter
        All for one and one for all: Taft–Hartley health insurance plans. 3. American Federation of State, County and Municipal Employees (AFSCME), 2000
        • National Labor College
        Open learning course: Taft–Hartley funds.
        (undated)
        • Au-Yeung C.M.
        • Weisman S.R.
        • Hennrikus D.J.
        • et al.
        An evaluation of health benefit modification in Taft–Hartley health and welfare funds: implications for encouraging tobacco cessation coverage.
        Am J Prev Med. 2010; 39: S30-S36
        • CDC
        Current cigarette smoking prevalence among working adults—U.S., 2004 2010.
        MMWR Morb Mortal Wkly Rep. 2011; 60: 1305-1309
        • Reda A.A.
        • Kaper J.
        • Fikretler H.
        • Severens J.L.
        • van Schayck C.P.
        Healthcare financing systems for increasing the use of tobacco dependence treatment.
        Cochrane Database Syst Rev. 2009; 2 (CD004305)
        • Fiore M.C.
        • Roberto Jaen C.
        • Baker T.B.
        • et al.
        Treating tobacco use and dependence: 2008 update.
        DHHS, Public Health Service, Rockville MD2008
        • Public Health Law Center
        WorkSHIFTS Tobacco Cessation News Archive .
        • Foulds J.
        • Hughes J.
        • Hyland A.
        • et al.
        Barriers to use of FDA-approved smoking cessation medications: implications for policy action.
        Society for Research on Nicotine and Tobacco, 2009