Promoting smoking cessation in Pakistani and Bangladeshi men in the UK

Pilot cluster randomised controlled trial of trained community outreach workers

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

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Abstract

Background: Smoking prevalence is high among Pakistani and Bangladeshi men in the UK, but there are few tailored smoking cessation programmes for Pakistani and Bangladeshi communities. The aim of this study was to pilot a cluster randomised controlled trial comparing the effectiveness of Pakistani and Bangladeshi smoking cessation outreach workers with standard care to improve access to and the success of English smoking cessation services.Methods: A pilot cluster randomised controlled trial was conducted in Birmingham, UK. Geographical lower layer super output areas were used to identify natural communities where more than 10% of the population were of Pakistani and Bangladeshi origin. 16 agglomerations of super output areas were randomised to normal care controls vs. outreach intervention. The number of people setting quit dates using NHS services, validated abstinence from smoking at four weeks, and stated abstinence at three and six months were assessed. The impact of the intervention on choice and adherence to treatments, attendance at clinic appointments and patient satisfaction were also assessed.Results: We were able to randomise geographical areas and deliver the outreach worker-based services. More Pakistani and Bangladeshi men made quit attempts with NHS services in intervention areas compared with control areas, rate ratio (RR) 1.32 (95%CI: 1.03-1.69). There was a small increase in the number of 4-week abstinent smokers in intervention areas (RR 1.30, 95%CI: 0.82-2.06). The proportion of service users attending weekly appointments was lower in intervention areas than control areas. No difference was found between intervention and control areas in choice and adherence to treatments or patient satisfaction with the service. The total cost of the intervention was £124,000; an estimated cost per quality-adjusted life year (QALY) gained of £8,500.Conclusions: The intervention proved feasible and acceptable. Outreach workers expanded reach of smoking cessation services in diverse locations of relevance to Pakistani and Bangladeshi communities. The outreach worker model has the potential to increase community cessation rates and could prove cost-effective, but needs evaluating definitively in a larger, appropriately powered, randomised controlled trial. These future trials of outreach interventions need to be of sufficient duration to allow embedding of new models of service delivery.Trial registration: Current Controlled Trials ISRCTN82127540.

Original languageEnglish
Article number197
Pages (from-to)1-14
Number of pages14
JournalTrials
Volume12
DOIs
Publication statusPublished - 19 Aug 2011
Externally publishedYes

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Community-Institutional Relations
Smoking Cessation
Randomized Controlled Trials
Patient Satisfaction
Costs and Cost Analysis
Appointments and Schedules
Smoking
Quality-Adjusted Life Years
Therapeutics
Population

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Begh, Rachna A. ; Aveyard, Paul ; Upton, Penney ; Bhopal, Raj S. ; White, Martin ; Amos, Amanda ; Prescott, Robin J. ; Bedi, Raman ; Barton, Pelham ; Fletcher, Monica ; Gill, Paramjit ; Zaidi, Qaim ; Sheikh, Aziz. / Promoting smoking cessation in Pakistani and Bangladeshi men in the UK : Pilot cluster randomised controlled trial of trained community outreach workers. In: Trials. 2011 ; Vol. 12. pp. 1-14.
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title = "Promoting smoking cessation in Pakistani and Bangladeshi men in the UK: Pilot cluster randomised controlled trial of trained community outreach workers",
abstract = "Background: Smoking prevalence is high among Pakistani and Bangladeshi men in the UK, but there are few tailored smoking cessation programmes for Pakistani and Bangladeshi communities. The aim of this study was to pilot a cluster randomised controlled trial comparing the effectiveness of Pakistani and Bangladeshi smoking cessation outreach workers with standard care to improve access to and the success of English smoking cessation services.Methods: A pilot cluster randomised controlled trial was conducted in Birmingham, UK. Geographical lower layer super output areas were used to identify natural communities where more than 10{\%} of the population were of Pakistani and Bangladeshi origin. 16 agglomerations of super output areas were randomised to normal care controls vs. outreach intervention. The number of people setting quit dates using NHS services, validated abstinence from smoking at four weeks, and stated abstinence at three and six months were assessed. The impact of the intervention on choice and adherence to treatments, attendance at clinic appointments and patient satisfaction were also assessed.Results: We were able to randomise geographical areas and deliver the outreach worker-based services. More Pakistani and Bangladeshi men made quit attempts with NHS services in intervention areas compared with control areas, rate ratio (RR) 1.32 (95{\%}CI: 1.03-1.69). There was a small increase in the number of 4-week abstinent smokers in intervention areas (RR 1.30, 95{\%}CI: 0.82-2.06). The proportion of service users attending weekly appointments was lower in intervention areas than control areas. No difference was found between intervention and control areas in choice and adherence to treatments or patient satisfaction with the service. The total cost of the intervention was £124,000; an estimated cost per quality-adjusted life year (QALY) gained of £8,500.Conclusions: The intervention proved feasible and acceptable. Outreach workers expanded reach of smoking cessation services in diverse locations of relevance to Pakistani and Bangladeshi communities. The outreach worker model has the potential to increase community cessation rates and could prove cost-effective, but needs evaluating definitively in a larger, appropriately powered, randomised controlled trial. These future trials of outreach interventions need to be of sufficient duration to allow embedding of new models of service delivery.Trial registration: Current Controlled Trials ISRCTN82127540.",
author = "Begh, {Rachna A.} and Paul Aveyard and Penney Upton and Bhopal, {Raj S.} and Martin White and Amanda Amos and Prescott, {Robin J.} and Raman Bedi and Pelham Barton and Monica Fletcher and Paramjit Gill and Qaim Zaidi and Aziz Sheikh",
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Begh, RA, Aveyard, P, Upton, P, Bhopal, RS, White, M, Amos, A, Prescott, RJ, Bedi, R, Barton, P, Fletcher, M, Gill, P, Zaidi, Q & Sheikh, A 2011, 'Promoting smoking cessation in Pakistani and Bangladeshi men in the UK: Pilot cluster randomised controlled trial of trained community outreach workers', Trials, vol. 12, 197, pp. 1-14. https://doi.org/10.1186/1745-6215-12-197

Promoting smoking cessation in Pakistani and Bangladeshi men in the UK : Pilot cluster randomised controlled trial of trained community outreach workers. / Begh, Rachna A.; Aveyard, Paul; Upton, Penney; Bhopal, Raj S.; White, Martin; Amos, Amanda; Prescott, Robin J.; Bedi, Raman; Barton, Pelham; Fletcher, Monica; Gill, Paramjit; Zaidi, Qaim; Sheikh, Aziz.

In: Trials, Vol. 12, 197, 19.08.2011, p. 1-14.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Promoting smoking cessation in Pakistani and Bangladeshi men in the UK

T2 - Pilot cluster randomised controlled trial of trained community outreach workers

AU - Begh, Rachna A.

AU - Aveyard, Paul

AU - Upton, Penney

AU - Bhopal, Raj S.

AU - White, Martin

AU - Amos, Amanda

AU - Prescott, Robin J.

AU - Bedi, Raman

AU - Barton, Pelham

AU - Fletcher, Monica

AU - Gill, Paramjit

AU - Zaidi, Qaim

AU - Sheikh, Aziz

PY - 2011/8/19

Y1 - 2011/8/19

N2 - Background: Smoking prevalence is high among Pakistani and Bangladeshi men in the UK, but there are few tailored smoking cessation programmes for Pakistani and Bangladeshi communities. The aim of this study was to pilot a cluster randomised controlled trial comparing the effectiveness of Pakistani and Bangladeshi smoking cessation outreach workers with standard care to improve access to and the success of English smoking cessation services.Methods: A pilot cluster randomised controlled trial was conducted in Birmingham, UK. Geographical lower layer super output areas were used to identify natural communities where more than 10% of the population were of Pakistani and Bangladeshi origin. 16 agglomerations of super output areas were randomised to normal care controls vs. outreach intervention. The number of people setting quit dates using NHS services, validated abstinence from smoking at four weeks, and stated abstinence at three and six months were assessed. The impact of the intervention on choice and adherence to treatments, attendance at clinic appointments and patient satisfaction were also assessed.Results: We were able to randomise geographical areas and deliver the outreach worker-based services. More Pakistani and Bangladeshi men made quit attempts with NHS services in intervention areas compared with control areas, rate ratio (RR) 1.32 (95%CI: 1.03-1.69). There was a small increase in the number of 4-week abstinent smokers in intervention areas (RR 1.30, 95%CI: 0.82-2.06). The proportion of service users attending weekly appointments was lower in intervention areas than control areas. No difference was found between intervention and control areas in choice and adherence to treatments or patient satisfaction with the service. The total cost of the intervention was £124,000; an estimated cost per quality-adjusted life year (QALY) gained of £8,500.Conclusions: The intervention proved feasible and acceptable. Outreach workers expanded reach of smoking cessation services in diverse locations of relevance to Pakistani and Bangladeshi communities. The outreach worker model has the potential to increase community cessation rates and could prove cost-effective, but needs evaluating definitively in a larger, appropriately powered, randomised controlled trial. These future trials of outreach interventions need to be of sufficient duration to allow embedding of new models of service delivery.Trial registration: Current Controlled Trials ISRCTN82127540.

AB - Background: Smoking prevalence is high among Pakistani and Bangladeshi men in the UK, but there are few tailored smoking cessation programmes for Pakistani and Bangladeshi communities. The aim of this study was to pilot a cluster randomised controlled trial comparing the effectiveness of Pakistani and Bangladeshi smoking cessation outreach workers with standard care to improve access to and the success of English smoking cessation services.Methods: A pilot cluster randomised controlled trial was conducted in Birmingham, UK. Geographical lower layer super output areas were used to identify natural communities where more than 10% of the population were of Pakistani and Bangladeshi origin. 16 agglomerations of super output areas were randomised to normal care controls vs. outreach intervention. The number of people setting quit dates using NHS services, validated abstinence from smoking at four weeks, and stated abstinence at three and six months were assessed. The impact of the intervention on choice and adherence to treatments, attendance at clinic appointments and patient satisfaction were also assessed.Results: We were able to randomise geographical areas and deliver the outreach worker-based services. More Pakistani and Bangladeshi men made quit attempts with NHS services in intervention areas compared with control areas, rate ratio (RR) 1.32 (95%CI: 1.03-1.69). There was a small increase in the number of 4-week abstinent smokers in intervention areas (RR 1.30, 95%CI: 0.82-2.06). The proportion of service users attending weekly appointments was lower in intervention areas than control areas. No difference was found between intervention and control areas in choice and adherence to treatments or patient satisfaction with the service. The total cost of the intervention was £124,000; an estimated cost per quality-adjusted life year (QALY) gained of £8,500.Conclusions: The intervention proved feasible and acceptable. Outreach workers expanded reach of smoking cessation services in diverse locations of relevance to Pakistani and Bangladeshi communities. The outreach worker model has the potential to increase community cessation rates and could prove cost-effective, but needs evaluating definitively in a larger, appropriately powered, randomised controlled trial. These future trials of outreach interventions need to be of sufficient duration to allow embedding of new models of service delivery.Trial registration: Current Controlled Trials ISRCTN82127540.

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U2 - 10.1186/1745-6215-12-197

DO - 10.1186/1745-6215-12-197

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JO - Current Controlled Trials in Cardiovascular Medicine

JF - Current Controlled Trials in Cardiovascular Medicine

SN - 1745-6215

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ER -