WORKING WITH THE TRADES TO QUIT THE SMOKE BREAK. Heidi McKean,R.N.,B.Sc.N.,CCHN(C) John Atkinson, B.A. M.SW.

Transcription

1 WORKING WITH THE TRADES TO QUIT THE SMOKE BREAK Heidi McKean,R.N.,B.Sc.N.,CCHN(C) John Atkinson, B.A. M.SW.

2 CONSTRUCTION CESSATION PROJECT An innovative public / private partnership Launched in 2012 funded by the MOHLTC Goals: Support construction workers in quitting smoking Create a smoke-free culture with construction workers on site

3 Partnership MOHLTC provided funding Ontario Tobacco Research Unit (OTRU) Evaluation Smokers Helpline access to multi-modal intervention and continued support Centre for Addiction and Mental Health (CAMH) NRT eligibility and distribution Private partnership

4 WHY CONSTRUCTION? 16% of Canadians smoke 9% of Ottawa's population smoke 34% of people working in the construction industry smoke Nearly DOUBLE the national average! 3X Ottawa s average No other on site interventions in Canada

5 A DUAL HAZARD Construction workers are exposed to daily safety hazards on the job-site Tobacco users increase their risk of injury on the jobsite by up to 40% Asbestos workers 50X higher risk of developing cancer than non-smokers

6 How we got there Successful Public-Private Partnership

7 Developing a Partnership Stage 1: Stage 2: Stage 3: Stage 4: Formation Implementation Maintenance Institutionalization

8 STAGE 1: Formation The impetus: Window of opportunity Key principle of partnership: All partners have to believe they have something to gain Overcoming the mistrust: role for a champion

9 : WHAT S IN IT FOR ME? (OPH) Increased reach for OPH cessation services Expanded smoke-free outdoor bylaw OPH management identified construction workers as target population Hard to reach target group Advantages of workplace setting for health promotion Opportunity to build sustainable relationships for the future

10 WHAT S IN IT FOR ME? (Private Sector) Long-term: financial gain due to healthier workforce and fewer injuries Short-term: Show that the company cares Publicity Corporate image Improved morale and trust of the workers

11 WHAT S IN IT FOR ME? (Smokers Helpline) Increase reach of SHL services Target high risk hard to reach demographic Integrated solution-system capacity building

12 STAGE 2: Implementation Management support To steward the partners Support and trust the project team To streamline/fast-track the approval process To overcome the bureaucratic and legal obstacles

13 STAGE 2: Implementation Smokers Helpline Facilitating Data Sharing Between Providers Clear, concise consent documentation Secure electronic data transfer Standard Minimal Data Set at Intake and Evaluation Standard Quitline Intervention Adjunct to OPH (onsite engagement) and CAMH (NRT distribution) Scheduling End of Treatment Calls Define required questions and data collection process Point of re-engagement in service (relapse prevention)

14 STAGE 2: Implementation cont. Have the right team Knowledgeable and enthusiastic staff Capable of establishing trusting relationship with workers and company management Good salesmen Great networking abilities Be flexible The team was approved to start working on the partnership before they got the funding this was unique!

15 OVERCOMING THE MISTRUST Construction champion Well-connected and influential within the construction industry Who has influence at all company levels

16 STAGE 2: Implementation «Equality of Participation» Participatory Approach Each company is involved in the design and delivery of the program Workers are involved All participants feel heard and understood, and that they are contributing Tailor intervention to each company/site Each company present a unique set of challenges (culture, rules, organizational structure, etc)

17 WHAT IS OFFERED TO WORKERS? Lunch-and-Learn sessions General Cessation supports POSTER participate in FRESH AIR contest weekly on site visits - Brief Cessation counselling Follow-up counselling services through Smokers Helpline Nicotine Replacement Therapy through CAMH STOP Study

18 WHAT IS OFFERED TO WORKERS by Smokers Helpline Non-judgemental service that fits workers schedule (extended hours of operation) Increased chance of quitting Quit Coaches help callers with: Personalized quit plan Coping with cravings, withdrawal and stress Finding available services and resources Bilingual and Interpreter Services Available

19 WHAT IS OFFERED TO WORKERS by Smokers Helpline Self-Directed Materials

20 STAGE 3: Maintenance The partnership works well as long as individual relationships work well Mutual responsibility Accountability Transparency

21 STAGE 3: Maintenance Smokers Helpline role SHL Regional Coordinators support on-site outreach Continual enhancement of evidence-based service Provision of activity reporting

22 STAGE 4: Institutionalization Continue to promote a smoke-free environment Great networking abilities Capacity building work in progress

23 Evaluation Baseline assessment survey for workers Questions for administrators is focused on how best to disseminate health information and provide consistent support Seek motivational and promotional activities to increase chances for cessation

24 EVALUATION OPH debrief telephone contact with participants quitting smoking - 1 month Smokers Helpline follow-up at 5 weeks Ontario Tobacco Research Unit follow-up at 6 and 12 months In person focus group with employees on site workers pre/post implementation, Interview Employer (s)pre/post implementation

25 What appears to work? - SHL/counseling - NRT (different types) - Wellness support (weight & stress man.) - Contests/Challenges - Workplace Champions Intervention Sector - Job security/control - Permanence of Place? - Smoking culture - Regular working hours - Smoking policy (people smoking around me) - Boredom - Wellness culture - Commitment - Break/lunch activities - Larger organizations - Positive climate - Precariousness low - Smoking policy Organization Individual - Ready to quit - Supportive network - Mental health (reduce depression, stress) - Low nicotine addiction - Not using other tobacco

26 Predictors of Quitting increased the likelihood (odds) of cessation 7-day & 30-day point prevalence abstinence Used Smokers Helpline to quit Used contests/competitions to quit (30-day abstinence only) Considered weight gain as a challenge to quitting Reported no challenges/barriers to quitting Lower level of nicotine addiction Smoked because of boredom

27 Predictors of Quitting decreased the likelihood (odds) of cessation 7-day & 30-day point prevalence abstinence Depression Stress Used other tobacco products (follow-up)

28 Predictors of Quitting increase the likelihood (odds) of cessation 6-month continuous abstinence Reported no challenges/barriers to quitting

29 98% of respondents would recommend this program to others! (6-month follow-up)

30 WORKING WITH THE TRADES TO QUIT THE SMOKE BREAK Q & A

31 Construction Comment Magazine by Ottawa Construction Association February 2014 edition

32 GENERIC SITE POSTER

33 FRESH AIR CONTEST

34 INCENTIVES

35 INCENTIVES cont.

36 Here is what they have to say MXU&feature=youtu.be