The challenges of translating an efficacious smoking cessation program, Commit to Quit, to the community setting of YMCAs.

Commit to Quit (CTQ), a program that utilized vigorous intensity exercise as an adjunct to a cognitive-behavioral smoking cessation program, was shown to be effective for female smokers (Marcus et al., Prev Med 26(4):586-597, 1997; Marcus et al., Arch Intern Med 159(11):1229-1234, 1999). Adapting effective programs, such as CTQ, to community settings could lead to a large public health impact as the program could substantially increase its reach. This case study chronicles the steps taken by researchers to translate CTQ from the medical to the community setting of YMCAs (CTQY). Use of aspects of Diffusion Theory [3] such as identifying a champion of the program and attending to the characteristics of an innovation to enhance program adoption are discussed. Details regarding attending to the tensions between internal and external validity as the program was adapted to the community setting are also outlined. The challenges of conducting community trials are discussed.