236248 Designing a proactive smoking cessation treatment program: Focus group findings from low-income users

Tuesday, November 1, 2011

Christina Robert, PhD, LAMFT , Division of General Internal Medicine, University of Minnesota, Minneapolis, MN
Mandy Stahre, MPH , School of Public Health, Division of Epidemiology, University of Minnesota, Minneapolis, MN
Anne Joseph, MD, MPH , Department of Medicine, University of Minnesota, Minneapolis, MN
Michelle Van Ryn, PhD , School of Medicine, University of Minnesota, Minneapolis, MN
Diana Burgess, PhD , Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN
Donna McAlpine, PhD , Division of Health Policy and Management, School of Public Health, University of Minnesota, Mineapolis, MN
Janet Thomas, PhD , Division General Internal Medicine, University of Minnesota, Minneapolis, MN
Steve Fu, MD, MSCE , Veterans Administation HSR&D CCDOR, Minneapolis, MN
Tobacco use rates are significantly higher among low-income populations compared to the general population. Low-income smokers are less likely to use evidence-based smoking cessation treatments to help quit. Data suggest that proactive outreach, including systematically contacting everyone in a population of known smokers can increase the use of treatment programs. For proactive outreach programs to be successful, materials and interventions must be targeted to the population of interest. To target our materials to a low-income population receiving state-subsidized health care insurance, we conducted eight focus groups with low-income smokers residing in a major metropolitan area. Focus group participants (N= 59) reacted to outreach letters, brochures and the design of the program in a semi-structured conversation led by a professional moderator. Program design elements included outreach mailings and phone calls, phone counseling and free nicotine replacement products. Results indicate that participants were enthusiastic about a personalized, nonjudgmental, “innovative” program which gave them permission about ambivalence towards quitting and which included language and images representative of low-income smokers. Participants also expressed mistrust of outsiders and were concerned about potential intrusiveness by the phone coaches. Participants were positive about receiving outreach materials from a trusted organization such as the University (the program sponsor) and responded positively to free counseling and free NRT. Overall, results indicate that proactive smoking cessation programs targeting low-income smokers should provide free, nonjudgmental and flexible services; a participant-driven call schedule; the backing of a trusted organization in the community; and images and language representative of the community.

Learning Areas:
Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe a proactive smoking cessation outreach program designed for use in a low-income community Discuss the findings from focus groups about reactions to the proactive outreach program Demonstrate how to target low-income communities using adapted proactive outreach materials

Keywords: Tobacco Control, Low-Income

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am a current study coordinator for a project examining the effect of proactive outreach methods to help low income populations quit smoking.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.