BREATHE (Building Research Evidence to Address Aboriginal Tobacco Habits)
- Increase the capacity of ACCHSs to implement local tobacco control activities and programs, and provide high quality evidence to inform future Aboriginal tobacco control program and policy development.
- Increase readiness to quit, number of quit attempts, and successful quit attempts.
- to contribute to the evidence base surrounding smoking issues and interventions in an Aboriginal comunity context.
- Deveop a smoking cessation and tobacco control program that is sustainable and transferable to other ACCHSs
Study Design
The design of the BREATHE Project is a community-randomised controlled trial, where six of the 12 participating communities have been randomly selected to receive the intervention. This will allow the impacts of having a specialist Tobacco Control Worker in an ACCHS to be compared with an ACCHS that continues with usual care.
The intervention
Each intervention site ACCHS will receive:
- Substantial funding towards the employment of a specialist Tobacco Control Worker (TCW).
- Access to training and support for the TCW Support to develop and implement a site-specific Tobacco Control Work Plan of evidence-based tobacco control activities.
The Tobacco Control Worker will be supported by the Project Team, the Project Management Group and partner organisations, with support including:
- Information about evidence-based practice and models of best practice in tobacco control and smoking cessation relevant to an Aboriginal community context.
- Access to formal training about tobacco control and to build skills to undertake advocacy work. A training module is being developed and will be piloted, based on existing smoking cessation and tobacco control training packages. It is planned to explore options to ensure the developed training package will be useable for future Aboriginal Health Worker training and up-skilling in smoking cessation tobacco control.
- Specific support to improve the inclusion of smoking cessation and tobacco control activities into policies of the ACCHS and other community organisations;
- The development of a network between Tobacco Control Workers in intervention sites, with regular quarterly face-to-face meetings and other contacts.
The intervention period ends in March 2010. Data collection activities will be conducted in April/May, with analysis and reporting finishing be the end of 2010.
- Cancer Council of NSW
- National Heart Foundation
- Sax Institute
- NSW Health; and
- 12 Aboriginal Community Controlled Health Services.
- Also Technical support provided by individuals with expertise in Aboriginal Tobacco Control (Dr Rowena Ivers) and through the National Centres for HIV Social Research and HIV Epidemiology and Clinical Research
This project is funded by the Australian Respiratory Council
The BREATHE project has submitted its research processes and methodologies to the AH&MRC Ethics Committee for review and received all the necessary approvals.
Baseline data collection was conducted at all 12 participating ACCHSs between October and December 2008. Local research assistants were employed and trained to conduct surveys with community members as they left the ACCHS after receiving care. Other baseline data collection activities included staff surveys, staff focus groups, interviews with key staff to assess the ACCHSs tobacco control capacity, and a scan of the local environment at the ACCHS to gauge the tobacco control message that the service was sending to the community. Analysis of the baseline data is continuing.
Recruitment of the Tobacco Control (BREATHE) Workers at intervention sites occurred between mid December 2008 and Mid March 2009. The BREATHE Workers come from a variety of backgrounds. Training is being provided to the BREATHE Workers to develop their skills to implement tobacco control and smoking cessation strategies at their ACCHSs. To date two training blocks have been delivered to the BREATHE Workers providing information on:
- The background, history, impacts of tobacco smoking in the Aboriginal community
- Nicotine dependence and NRT/pharmacology, and quitting
- Support for quitting – quit groups; quit plans
- Health promotion and social marketing
- Project specific practices – implementing their workplans; research and reporting requirements
- Tobacco control capacity building – staff training; developing ACCHS systems
A further two training blocks are planned for 2009, as well as regular support and information being given to the BREATHE Workers by AH&MRC project staff. The strategies the BREATHE Workers are implementing include:
1. Increasing the focus and profile of ACCHS tobacco control and smoking cessation activities
2. Improving ACCHS workplace tobacco control and smoking cessation policies
3. Increasing delivery of brief interventions to ACCHS clients
4. Increasing support for ACCHS clients interested in quitting smoking
5. Acting and advocating for increased tobacco control and smoking cessation in the community
6. Building evidence about tobacco control and smoking cessation in Aboriginal community settings
The evaluation will include:
- documentation and measures of the Project’s implementation and reach
- assessment of the impacts of the intervention through baseline and post-intervention assessment of:
- ACCHS staff knowledge and practices
- ACCHS systems and capacity relating to assessing smoking status and delivering smoking cessation interventions including NRT
- Content and implementation of tobacco control policies and procedures at ACCHSs and other Aboriginal community organisations
- Smoking-related knowledge and behaviours amongst Aboriginal community members. - Comparison of the nature and magnitude of changes at intervention sites with those at control sites.
- Analysis of possible contributing factors to sites of relatively high levels of impact.
Separate evaluation methods will be developed for ACCHS Quit groups and for site specific health promotion projects and other smoking cessation and tobacco control activities.
Sean Appoo
Aboriginal Health and Medical Research Council
Level 3, 66 Wentworth Ave, Surrey Hills, NSW 2010
PO Box 1565, Strawberry Hills, NSW 2012
Ph: 02 9212 4777
Email: SAppoo@ahmrc.org.au
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