Abstract
BackgroundDespite having high smoking rates, there have been few tailored cessation programmes for male Bangladeshi and Pakistani smokers in the UK. We report on a qualitative evaluation of a community-based, outreach worker delivered, intervention that aimed to increase uptake of NHS smoking cessation services and tailor services to meet the needs of Bangladeshi and Pakistani men.MethodsThis was a longitudinal, qualitative study, nested within a phase II cluster randomised controlled trial of a complex intervention. We explored the perspectives and experiences of five outreach workers, two stop smoking service managers and a specialist stop smoking advisor. Data were collected through focus group discussions, weekly diaries, observations of management meetings, shadowing of outreach workers, and one-to-one interviews with outreach workers and their managers. Analysis was undertaken using a modified Framework approach.ResultsOutreach workers promoted cessation services by word of mouth on the streets, in health service premises, in local businesses and at a wide range of community events. They emphasised the reasons for cessation, especially health effects, financial implications, and the impact of smoking on the family. Many smokers agreed to be referred to cessation services, but few attended, this in part being explained by concerns about the relative inflexibility of existing service provision. Although outreach workers successfully expanded service reach, they faced the challenges of perceived lack of awareness of the health risks associated with smoking in older smokers and apathy in younger smokers. These were compounded by perceptions of "lip service" being given to their role by community organisations and tensions both amongst the outreach workers and with the wider management team.ConclusionsOutreach workers expanded reach of the service through taking it to diverse locations of relevance to Pakistani and Bangladeshi communities. The optimum method of outreach to retain and treat Bangladeshi and Pakistani smokers effectively in cessation programmes needs further development.
Highlights
Despite having high smoking rates, there have been few tailored cessation programmes for male Bangladeshi and Pakistani smokers in the UK
Design Focus group discussions with the five community outreach workers were conducted at regular intervals during this 12 month trial, which was conducted in Heart of Birmingham Primary Care Trust (PCT) and Birmingham East and North Primary Care Trusts (PCTs) (HoB and Birmingham East and North Primary Care Trust (BEN) PCTs), Birmingham, UK
We present their views on working with fellow members of the outreach team and the views of their local stop smoking service management team on their overall performance
Summary
Despite having high smoking rates, there have been few tailored cessation programmes for male Bangladeshi and Pakistani smokers in the UK. Stopping smoking is important in Bangladeshi and Pakistani groups because their rates of heart disease, about and perceptions of such services, beliefs about the benefits of support and pharmacotherapy such as nicotine replacement therapy (NRT) in helping smokers quit, as well as the practicalities of service access [7,8,9]. Despite these concerns, no evaluated service models have been shown to overcome these barriers [10]. In the UK, NHS cessation services have developed community outreach interventions with lay workers, but these have not been formally evaluated
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