Advancing the Understanding of Barriers and Facilitators for Tobacco Prevention, Cessation Treatments, Doctor Visits for Related Illnesses and Health Research for Aboriginal Australians

Brief Summary

Detailed Description

We will identify barriers and facilitators for the implementation of smoking cessation pharmacotherapies, tobacco prevention, doctor visits, youth and smoking, community held health priorities and barriers to research through: 1. Multiple focus groups held within 2 communities with Aboriginal smokers and ex/non-smokers, and 2. Focus groups with healthcare workers serving these communities, and 3. Qualitative one-on-one interviews with key stakeholders in Aboriginal communities 4. Qualitative one-on-one interviews with specialists/doctors working with Aboriginal patients 5. Surveys with all participants mentioned above 6. Surveys with specialist groups including members of tobacco related special interest groups of the Thoracic Society of Australia and New Zealand (TSANZ) Smoking cessation is one of the most important ways to improve the prognosis of patients with respiratory diseases. Despite being over represented in the burden of smoking related morbidity and mortality, very little methodologically rigorous research has been conducted to evaluate and/or enhance the uptake of smoking cessation pharmacotherapies and smoking prevention for Aboriginal Australians, as evident in our two recent (2012) Cochrane meta-analyses and through extensive consultation over the past two years with Aboriginal Elders, key stakeholders, researchers and experts throughout Australia. Moreover, many of the healthcare workers and some doctors on the frontline are reporting that they do not believe they have the skills or ability to offer smoking cessation/prevention initiatives to these patients, and perhaps more importantly, admit to the attitude of 'even if I did, it's not going to work, so why bother'. In light of this gap in knowledge, our project relates specifically to understanding and improving the lung health of Aboriginal Australians, the cohort with the greatest burden of disease and lowest life expectancy, through qualitative analyses. A total of 10 focus groups, 30 one-on-one interviews and approximately 120 surveys (unless data saturation is reached sooner) will be carried out in collaboration with Aboriginal community involvement. The information obtained from these will provide an overall picture of the barriers and enablers from the perspectives of the various individuals involved, being: * Aboriginal participants from urban, regional and rural cohorts (8 focus groups plus surveys) * Aboriginal healthcare workers from urban, regional and rural cohorts (2 focus groups plus surveys) * Respiratory consultants who see Aboriginal patients (10 one-on-one interviews plus surveys) * Key stakeholders in Aboriginal health including Aboriginal liaison officers, Aboriginal health councils, Elders \& influential figures in communities (10 one-on-one interviews plus surveys) * Medical Consultants who see Aboriginal patients (2 one-on-one interviews plus surveys from each of the following disciplines: General Practitioners, cardiology, neurology, oncology and vascular; total of 10, or until data saturation) Triangulation will occur at multiple levels to improve credibility and dependability including: data collection (focus groups, interviews and surveys), investigators (minimum five investigators involved throughout various aspects of the study), data sources (multiple locations, communities and venues), analysis methods (Grounded theory and Triandis model of behavioural change). In addition a detailed audit trail will be kept and all focus groups and interviews will undergo feedback (confirmation of accuracy and interpretation) by participants. Quasi-statistics will also be employed as part of the analysis methods.

Primary Outcomes

Secondary Outcomes

• Identify barriers and facilitators to research initiatives in Aboriginal people and identify self-reported health priorities(18 months)
• Determine the barriers and facilitators for tobacco prevention initiatives, particularly related to Aboriginal youth(18 months)
• Identify the barriers and facilitators for doctor visits by Aboriginal people(18 months)