Experiences of outreach workers in promoting smoking cessation to Bangladeshi and Pakistani men: Longitudinal qualitative evaluation

Rachna A. Begh, Paul Aveyard, Penney Upton, Raj S. Bhopal, Martin White, Amanda Amos, Robin J. Prescott, Raman Bedi, Pelham M. Barton, Monica Fletcher, Paramjit Gill, Qaim Zaidi, Aziz Sheikh

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Despite 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. Methods. This 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. Results: Outreach 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. Conclusions: Outreach 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.

Original languageEnglish
Article number452
Pages (from-to)1-11
Number of pages11
JournalBMC Public Health
Volume11
DOIs
Publication statusPublished - 2011
Externally publishedYes

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Smoking Cessation
Smoking
Community-Institutional Relations
Apathy
Health
Focus Groups
Health Services
Longitudinal Studies
Randomized Controlled Trials
Organizations
Interviews

Cite this

Begh, Rachna A. ; Aveyard, Paul ; Upton, Penney ; Bhopal, Raj S. ; White, Martin ; Amos, Amanda ; Prescott, Robin J. ; Bedi, Raman ; Barton, Pelham M. ; Fletcher, Monica ; Gill, Paramjit ; Zaidi, Qaim ; Sheikh, Aziz. / Experiences of outreach workers in promoting smoking cessation to Bangladeshi and Pakistani men: Longitudinal qualitative evaluation. In: BMC Public Health. 2011 ; Vol. 11. pp. 1-11.
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abstract = "Background: Despite 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. Methods. This 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. Results: Outreach 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. Conclusions: Outreach 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.",
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Begh, RA, Aveyard, P, Upton, P, Bhopal, RS, White, M, Amos, A, Prescott, RJ, Bedi, R, Barton, PM, Fletcher, M, Gill, P, Zaidi, Q & Sheikh, A 2011, 'Experiences of outreach workers in promoting smoking cessation to Bangladeshi and Pakistani men: Longitudinal qualitative evaluation', BMC Public Health, vol. 11, 452, pp. 1-11. https://doi.org/10.1186/1471-2458-11-452

Experiences of outreach workers in promoting smoking cessation to Bangladeshi and Pakistani men: Longitudinal qualitative evaluation. / Begh, Rachna A.; Aveyard, Paul; Upton, Penney; Bhopal, Raj S.; White, Martin; Amos, Amanda; Prescott, Robin J.; Bedi, Raman; Barton, Pelham M.; Fletcher, Monica; Gill, Paramjit; Zaidi, Qaim; Sheikh, Aziz.

In: BMC Public Health, Vol. 11, 452, 2011, p. 1-11.

Research output: Contribution to journalArticle

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AU - Begh, Rachna A.

AU - Aveyard, Paul

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AU - Bhopal, Raj S.

AU - White, Martin

AU - Amos, Amanda

AU - Prescott, Robin J.

AU - Bedi, Raman

AU - Barton, Pelham M.

AU - Fletcher, Monica

AU - Gill, Paramjit

AU - Zaidi, Qaim

AU - Sheikh, Aziz

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N2 - Background: Despite 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. Methods. This 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. Results: Outreach 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. Conclusions: Outreach 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.

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