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

Begh, Rachna A and Aveyard, Paul and Upton, Penney and Bhopal, Raj S and White, Martin and Amos, Amanda and Prescott, Robin J and Bedi, Raman and Barton, Pelham M and Fletcher, Monica and Gill, Paramjit and Zaidi, Qaim and Sheikh, Aziz (2011) Experiences of outreach workers in promoting smoking cessation to Bangladeshi and Pakistani men: longitudinal qualitative evaluation. BMC Public Health, 11 (1). p. 452. ISSN 1471-2458

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URL of Published Version: http://dx.doi.org/10.1186/1471-2458-11-452

Identification Number/DOI: doi:10.1186/1471-2458-11-452

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.

Type of Work:Article
Date:09 June 2011 (Publication)
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:UK Centre for Tobacco Control Studies, Primary Care Clinical Sciences
Subjects:R Medicine (General)
Institution:University of Birmingham
Copyright Holders:Biomed Central
ID Code:955
Refereed:YES
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