262212 Translating population-based smoke-free policy concerns into a pair-based tobacco cessation intervention: A multi-staged formative approach for developing a novel intervention

Monday, October 29, 2012

Elisa Tong, MD , Division of General Internal Medicine, Department of Medicine, University of California, Davis, Sacramento, CA
Debora A. Paterniti, PhD , Center for Health Services Research in Primary Care, University of California, Davis Medical Center, Sacramento, CA
Lei-Chun Fung, MPH, MSW , Health Education Department, Chinatown Public Health Center, San Francisco, CA
Moon S. Chen Jr., PhD, MPH , Asian American Network for Cancer Awareness Research and Training (AANCART), University of California, Davis Cancer Center, Sacramento, CA
Leonard Tam , Health Education Department, Chinatown Public Health Center, San Francisco, CA
Carrie Tang , Health Education Department, Chinatown Public Health Center, San Francisco, CA
Chin-Shang Li, PhD , Department of Public Health Sciences, University of California, Davis, Davis, CA
Janice Tsoh, PhD , Department of Psychiatry, UCSF, San Francisco, CA
INTRODUCTION: Tobacco control has been most successful with population-based approaches such as smoke-free policies. Targeting individual behaviors is still necessary, but most adult cessation interventions do not address secondhand smoke concerns. We used a multi-staged, formative research to design, adapt and refine a novel household “pair-based” intervention with a smoker and nonsmoker for the clinical health education setting. METHOD: Our approach used three phases of focus groups which first interviewed a diverse general population and then targeted a high-risk population. Grounded theory was used after each focus group phase to refine and target interview questions. Focus groups were designed to assess feasibility of intervention strategies within a clinical health education setting and acceptability of specific intervention components. All groups were audio-recorded and iteratively analyzed. RESULTS: A total of 110 people participated in one of three phases of focus groups (n=13). 54% were smokers; 52% were female; 21% African American; 59% were Chinese-speaking immigrants. Phase 1 revealed preferences for intervention content, particularly communication strategies related to quitting and eliminating tobacco smoke exposure, and acceptability of biomarker feedback about smoke exposure. Phase 2 demonstrated preferences for intervention context, including acceptability of biomarker sampling methods, the pair-based intervention design, and refinement of messages about becoming smoke-free together and positive social support. Phase 3 focused the intervention design and messages for the target population, Chinese immigrants, who were selected to optimize an evaluation of the intervention's efficacy. CONCLUSION: A multi-stage formative process is useful in helping to develop a novel intervention with multiple components.

Learning Areas:
Assessment of individual and community needs for health education
Clinical medicine applied in public health
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Identify gaps between tobacco control policy and clinical practice 2. Describe how multi-staged formative research using grounded theory can help develop a novel clinical intervention

Keywords: Tobacco Control, Community-Based Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a tobacco control researcher and the principal investigator of this research.
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.