Assessing and Validating an Educational Resource Package for Health Professionals to Improve Smoking Cessation Care in Aboriginal and Torres Strait Islander Pregnant Women

Abstract

Australian Aboriginal pregnant women have a high smoking prevalence (45%). Health professionals lack adequate educational resources to manage smoking. Resources need to be tailored to ensure saliency, cultural-sensitivity and account for diversity of Indigenous populations. As part of an intervention to improve health professionals’ smoking cessation care in Aboriginal pregnant women, a resource package was developed collaboratively with two Aboriginal Medical Services. The purpose of this study was to assess and validate this resource package. A multi-centred community-based participatory 4-step process (with three Aboriginal Medical Services from three Australian states), included: (1) Scientific review by an expert panel (2) ‘Suitability of Materials’ scoring by two Aboriginal Health Workers (3) Readability scores (4) Focus groups with health professionals. Content was analysed using six pre-determined themes (attraction, comprehension, self-efficacy, graphics and layout, cultural acceptability, and persuasion), with further inductive analysis for emerging themes. Suitability of Material scoring was adequate or superior. Average readability was grade 6.4 for patient resources (range 5.1–7.2), and 9.8 for health provider resources (range 8.5–10.6). Emergent themes included ‘Getting the message right’; ‘Engaging with family’; ‘Needing visual aids’; and ‘Requiring practicality under a tight timeframe’. Results were presented back to a Stakeholder and Consumer Aboriginal Advisory Panel and resources were adjusted accordingly. This process ensured materials used for the intervention were culturally responsive, evidence-based and useful. This novel formative evaluation protocol could be adapted for other Indigenous and culturally diverse interventions. The added value of this time-consuming and costly process is yet to be justified in research, and might impact the potential adaption by other projects.

Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting

“…Barriers include social environments that encourage smoking, stressors, mental health issues, interpersonal violence, substance use and lack of access to suitable antenatal and smoking cessation services. Health providers face their own challenges to provide evidence-based smoking cessation care such as low knowledge and confidence about effective smoking cessation treatments, fear that their advice may adversely influence their relationship with a pregnant woman, and lack of optimism for successful treatment outcomes [7][8][9].…”

“Building strength in coming together”: A mixed methods study using the arts to explore smoking with staff working in Indigenous tobacco control

“…Indigenous peoples generally prefer culturally targeted tobacco control messages . Although it is likely that the arts and media are being used to deliver tobacco control and smoking cessation messages to Indigenous Australians, few studies that incorporate arts and media messages have reported details on how these have been developed, or evaluated outcomes …”

“…15 Although it is likely that the arts and media are being used to deliver tobacco control and smoking cessation messages to Indigenous Australians, few studies that incorporate arts and media messages have reported details on how these have been developed, or evaluated outcomes. 11,[16][17][18][19][20][21][22] The World Health Organization's Framework Convention for Tobacco Control (FCTC) is an international treaty developed in response to the globalisation of the tobacco epidemic, which expressed in its preamble, a deep concern "about the high levels of smoking and other forms of tobacco consumption by Indigenous peoples". 23 In article 12d, the FCTC recommended "effective and appropriate training or sensitisation and awareness programs on tobacco control addressed to persons such as health workers, community workers, social workers, media professionals, educators, decision-makers, administrators and other concerned persons."…”

“…significant increase in the median pre (median of 17; IQR = 6, range[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] to post-test (median 21; IQR=4, range[15][16][17][18][19][20][21][22][23][24][25][26][27] ranks of "understanding" the use of experiential arts (z = À3.537, P < 0.00001, exact 2-tailed). There was also a significant increase in pre (median 13; IQR= 4, range 4-18,) to post (median 16; IQR= 7, range 4-20) workshop scale scores for "likelihood" of using the arts for tobacco control (z = À2.76, P = 0.006, exact 2-tailed).…”

“…There was also a significant increase in pre (median 13; IQR= 4, range 4-18,) to post (median 16; IQR= 7, range 4-20) workshop scale scores for "likelihood" of using the arts for tobacco control (z = À2.76, P = 0.006, exact 2-tailed). The post-test satisfaction scale had a median of 17 (IQR =15, 19.75; range[11][12][13][14][15][16][17][18][19][20].…”