Developing a smoking cessation intervention for young adult workers: A practitioner, decisionmaker and researcher collaboration

Transcription

1 Developing a smoking cessation intervention for young adult workers: A practitioner, decisionmaker and researcher collaboration Stich, C., McCammon-Tripp, L., Clarke, C., Davis, K., Kane, C., Lang, J., MacSween, B., McDonald, P., Minian, N., Pandya, G., Schwartz, R., Selby, P., Steibelt, E., Roberts, M., & Garcia, J.

2 Project Partners Community-based partners Durham Region Public Health Elgin St. Thomas Public Health Ottawa Public Health Toronto Public Health Researchers Dr. John M. Garcia, University of Waterloo (Co-PI) Dr. Paul McDonald, University of Waterloo Dr. Nadia Minian, OTRU Dr. Robert Schwartz, OTRU Dr. Peter Selby, CAMH Public Health Ontario (formerly OAHPP) Melody Roberts

3 Objectives To develop, implement and evaluate an evidenceinformed and theory-based workplace smoking cessation intervention tailored to young adult (aged 18-34) retail trade workers To use an engaged scholarship approach that involves researchers, public health professionals and others bringing together research knowledge about public health interventions and practical knowledge and experiences from public health practice

4 Program Planning Intervention Mapping Approach (Bartholomew et al., 2006) Step 1: Needs Assessment Step 2: Preparing Matrices of Change Objectives Step 3: Selecting Theory-Informed Intervention Methods and Practical Strategies Step 4: Producing Program Components and Materials Step 5: Planning Program Adoption, Implementation, and Sustainability Step 6: Planning for Evaluation

5 Step 1: Needs Assessment Smoking rates in Canada: Young adults continue to report some of the highest smoking rates (Health Canada, 2008) Occupational disparities Smoking prevalence rates higher in blue-collar and service occupations than in white-collar occupations (Bang & Kim, 2001) Declines in smoking rates are smaller among blue-collar workers, compared to other occupations (Giovino, Pederson, & Trosclair, 2000) Analysis of the Young Adult Ontario Workforce (Stich & Garcia, 2011) suggests: Targeting young adults in the retail trade industry working as retail salespersons, sales clerks and cashiers and in sales, service and travel occupations

6 Step 2: Matrices of Change Objectives Specify who and what will change as a result of the intervention: State expected program outcomes for health-related behaviour and environmental conditions Divide behaviour and environmental conditions into performance objectives Select important and changeable personal and external determinants of behaviour and environmental conditions Create a matrix of change objectives by crossing performance objectives with determinants

7 Step 2: Matrix of Change Objectives Performance Objectives Know health risks of smoking & benefits of quitting Personal Determinants Knowledge & Skills K1a. Identify and discuss health risks of smoking and benefits of quitting K1b. Access information about tobacco products and tobacco-use K1c. Understand tobacco-use as an addiction Outcome expectations OE1a. Provide persuasive arguments for the health (and other) consequences of tobacco use cessation OE1b. Understand how behaviour changes are in selfinterest

8 Step 3: Theory-Informed Methods and Practical Strategies Literature review of 30 publications on workplace smoking cessation (Allison & Dwyer, 2010) suggested using: Social-Ecological model Social Cognitive Theory Theories of organizational change Principles of organizational, policy, and community-level approaches, and empowerment Group / individual counselling as core component Nicotine Replacement Therapy Incentives (for recruitment and retention) Provided methods and examples of strategies to change personal and environmental determinants

9 Step 4: Producing Program Components

10 Step 4: and Materials

11 Step 5: Planning Program Adoption, Implementation, and Sustainability Management commits to: Forming a WHC Providing time and space for committee members and program participants Promoting the program Supporting development of tobacco-free policy Considering co-paid or subsidized NRT Supporting evaluation WHC works together with PH practitioner to adopt and implement the intervention using the provided tools and guidelines Workplace champion will be trained to continue implementing the program

12 Step 6: Planning for Evaluation Expected behavioural and environmental outcomes: Program participants quit smoking and stay quit Increased social support for quitting at the workplace Social norm change : Co-workers supportive of quitting Increase of organizational support for quitting Creating a tobacco-free workplace Focus is on formative evaluation allowing us to improve the program by learning from adoption and implementation in 4 workplaces.

13 Engagement Process Meetings throughout the process of program planning: Researchers, practitioners and advisory committee meet every 3-4 months in person Researchers and practitioners meet bi-weekly through teleconferences Theory-based program structure was adapted based on practitioners experiences of what works in practice Practitioners Selected program materials for focus group testing and adaptation Developed materials supporting implementation (e.g., recruitment package, policy development guide, guide to developing a workplace health committee) Conducted community-based focus groups

14 Conclusion The IM approach has been a great planning tool that has helped us develop an evidence-informed and theory-based intervention program Engaging public health professionals, decision-makers and researchers in the process of developing an evidenceinformed workplace smoking cessation intervention: Enhances knowledge exchange among stakeholders Ensures that both research and practice knowledge are taken into account Results in an intervention program that is both based on theory and research evidence and informed by practice-based knowledge and experiences

15 Acknowledgement Contact information: This research is supported by a Seed Grant from the CAN- ADAPTT (Canadian Action Network for the Advancement, Dissemination and Adoption of Practiceinformed Tobacco Treatment) Project funded by the Tobacco Control Program, Health Canada

16 References Allison. K. R. & Dwyer, J. M. (2010). Workplace smoking cessation and fruit and vegetable consumption: Synthesis and recommendations for theory- and researchbased intervention planning. KR Allison Research Consulting. Bang, K.M. & Kim, J.H. (2001). Prevalence of cigarette smoking by occupation and industry in the United States. American Journal of Industrial Medicine, 40, Bartholomew, L.K., Parcel, G. S., Kok, G., & Gottlieb, N.H. (2006). Planning health promotion programs: An intervention mapping approach (2 nd ed.). San Francisco: Wiley & Sons, Inc. Health Canada. CTUMS (Canadian Tobacco Use Monitoring Survey): Summary of Annual Results for Available at Accessed April 29, Giovino G. A., Pederson L.L., Trosclair A. (2000). The Prevalence of Selected Cigarette Smoking Behaviors by Occupational Class in the United States. Work, smoking, and health: A NIOSH Scientific Workshop. Washington, DC, June 15 16, Stich, C. & Garcia, J. (2011) Analysis of the Young Adult Ontario Workforce: Identifying Points of Intervention for Smoking Cessation Within the Young Adult (Age 20-34) Workforce. A Special Report by the Ontario Tobacco Research Unit. Toronto, Canada: Ontario Tobacco Research Unit