Key elements for enrollment and participation in tailored commercial tobacco cessation programs: A process evaluation of the wiidookowishin program

While mainstream tobacco cessation programs have contributed to reducing smoking prevalence in mainstream populations, rates among American Indians remain disproportionately high (CDC, 2011). A limited literature suggests that tailored commercial tobacco cessation programs can achieve successful outcomes at reducing commercial tobacco use among American Indians (D'Silva, Schillo, Sandman, Leonard, & Boyle, 2011). The Wiidookowishin (Help Me) commercial tobacco cessation program implemented by the Fond du Lac Nation achieved quit rates similar to mainstream programs and is successfully recruiting and enrolling participants. While tailoring programs for tribal communities is important, it is also essential to understand characteristics that facilitate successful outreach, enrollment, and participation in cessation programs. Fond du Lac and their funding partner, ClearWay MinnesotaSM, collaborated to design a qualitative process evaluation to examine elements that contributed to member participation. Fond du Lac staff reviewed questions and assisted with identification of key stakeholder partners to interview. Key informant interviews were conducted with participants (n=20), stakeholders/partners (n=13), and the cessation counselors. Atlas ti software was used to code transcripts, and data were analyzed for common and emerging themes. This presentation will present findings from the process evaluation and highlight factors that contributed to successful recruitment and enrollment. One factor contributing to successful recruitment is the integration of services and systemic commitment among staff throughout the clinic and partner providers to reduce commercial tobacco use among tribal members, providing repeated opportunities to connect smokers to cessation services. Other factors include individualization, flexibility, accessibility, ongoing outreach, and inclusion of traditional tobacco teachings.