Advancing the Understanding of Barriers and Facilitators for Tobacco Prevention, Cessation Treatments, Doctor Visits for Related Illnesses and Health Research for Aboriginal Australians
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 16
- 试验地点
- 3
- 主要终点
- Determine the barriers and facilitators to pharmacological initiatives for tobacco cessation in Aboriginal populations
研究概览
简要总结
Aim: To identify barriers and facilitators in the uptake of smoking cessation pharmacotherapies, tobacco prevention, doctor visits, smoking amongst youth, community held health priorities and barriers to research in Aboriginal Australians from the perspectives of:
- Aboriginal smokers and ex/non-smokers
- Aboriginal Healthcare workers
- Consultants/general practitioners, and
- Key stakeholders in Aboriginal health
Focus groups, one-on-one interviews and surveys will be conducted to provide information at the 'grass-roots' level including examinations into perceived differences in locally held beliefs, attitudes, knowledge, traditional practices and the cultural and social constructs, to assist implementation of future tobacco cessation/prevention interventions and treatment of smoking related illnesses. This information can be used to improve the health of Aboriginal people by identifying inadequacies in current practices and highlighting what these are through the eyes of community members, healthcare workers, consultants/general practitioners and key stakeholders. We also intend on examining any facilitators that are identified as positive and working aspects of current initiatives e.g. community infrastructure, in an effort to not 'reinvent the wheel' and acknowledge what is working.
详细描述
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:
- Multiple focus groups held within 2 communities with Aboriginal smokers and ex/non-smokers, and
- Focus groups with healthcare workers serving these communities, and
- Qualitative one-on-one interviews with key stakeholders in Aboriginal communities
- Qualitative one-on-one interviews with specialists/doctors working with Aboriginal patients
- Surveys with all participants mentioned above
- 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)
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Male Smokers
- •Willing to participate
- •Identifies as an Aboriginal person
- •Uses more than 10 cigarettes or cigarette equivalent per week
- •Has lived in the relevant community for >12 months
- •Female Smokers
- •Willing to participate
- •Identifies as an Aboriginal person
- •Uses more than 10 cigarettes or cigarette equivalent per week
- •Has lived in the relevant community for >12 months
- •Male Non/Ex Smokers
- •Willing to participate
- •Identifies as an Aboriginal person
- •Has not used tobacco for >3 months
- •Has lived in the relevant community for >12 months
- •Female Non/Ex Smokers
- •Willing to participate
- •Identifies as an Aboriginal person
- •Has not used tobacco for >3 months
- •Has lived in the relevant community for >12 months
- •Healthcare worker
- •Willing to participate
- •Has provided healthcare to people from Aboriginal people for at least 25% of employment hours over the past 12 months, or
- •Has provided healthcare to people from Aboriginal people for at least 5 years of their working career
- •Is a qualified healthcare worker
- •GP's / Specialists
- •Willing to participate
- •Has provided clinical care to people from Aboriginal people over a 12 month period (at least one consult per week or equivalent)
- •Is a qualified General Practitioner or,
- •Is a qualified doctor specialising in one of the following disciplines: respiratory, vascular, neurology, oncology, cardiology
- •Key Stakeholders
- •Willing to participate
- •Currently working/has worked in Aboriginal health as a primary focus of the position, or
- •Is a community Elder, or
- •Is influential in Aboriginal health/communities
排除标准
- •Cannot speak English
- •Cannot sign a consent
- •Does not have the intellectual capacity required to respond to questions
结局指标
主要结局
Determine the barriers and facilitators to pharmacological initiatives for tobacco cessation in Aboriginal populations
时间窗: 18 months
Qualitative analysis (focus groups, one-on-one interviews and surveys). The use of pharmacotherapies for smoking cessation significantly improves the probability of successful abstinence. Identification of the barriers and facilitators for tobacco cessation pharmacotherapies will be determined through these qualitative discussions and mixed method approaches
次要结局
- 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)
研究者
Kristin Carson
Senior Scientist
The Queen Elizabeth Hospital