WORKING WITH THE TRADES TO QUIT THE SMOKE BREAK Heidi McKean,R.N.,B.Sc.N.,CCHN(C) John Atkinson, B.A. M.SW.
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
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
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
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
How we got there Successful Public-Private Partnership
Developing a Partnership Stage 1: Stage 2: Stage 3: Stage 4: Formation Implementation Maintenance Institutionalization
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
: 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
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
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
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
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)
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!
OVERCOMING THE MISTRUST Construction champion Well-connected and influential within the construction industry Who has influence at all company levels
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)
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
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
WHAT IS OFFERED TO WORKERS by Smokers Helpline Self-Directed Materials www.cancer.ca/onestepatatime
STAGE 3: Maintenance The partnership works well as long as individual relationships work well Mutual responsibility Accountability Transparency
STAGE 3: Maintenance Smokers Helpline role SHL Regional Coordinators support on-site outreach Continual enhancement of evidence-based service Provision of activity reporting
STAGE 4: Institutionalization Continue to promote a smoke-free environment Great networking abilities Capacity building work in progress
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
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
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
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
Predictors of Quitting decreased the likelihood (odds) of cessation 7-day & 30-day point prevalence abstinence Depression Stress Used other tobacco products (follow-up)
Predictors of Quitting increase the likelihood (odds) of cessation 6-month continuous abstinence Reported no challenges/barriers to quitting
98% of respondents would recommend this program to others! (6-month follow-up)
WORKING WITH THE TRADES TO QUIT THE SMOKE BREAK Q & A
Construction Comment Magazine by Ottawa Construction Association February 2014 edition
GENERIC SITE POSTER
FRESH AIR CONTEST
INCENTIVES
INCENTIVES cont.
Here is what they have to say http://www.youtube.com/watch?v=gundxgzl MXU&feature=youtu.be