Using concept mapping to explore strategies for smoking cessation for women with experiences of homelessness and serious mental illness

People with experiences of homelessness and serious mental illness (SMI) have significantly higher rates of smoking and smoking related illness compared to the general public. Concept mapping methodology was used to explore smoking cessation strategies in women with experiences of homelessness and SMI. Women residents of two supportive housing sites in Philadelphia (24) and their support staff (9) participated in the study.  Participants were first asked to brainstorm answers to a focus question; “We want to develop a program to help people quit smoking.  What kinds of things should this program include?” Next participant were asked to sort brainstormed statements into categories however they saw fit, and rate each statement in terms of importance and feasibility using a 5-point likert scale. Staff completed sorting and rating exercises on-line.  Data was entered into the Concept Systems Global Software, which used multidimensional scaling and hierarchical cluster modeling to create a series of visual cluster maps. Maps and clusters were reviewed and refined with woman participants. Brainstormed ideas clustered into 5 categories: Provide rewards to help with smoking cessation, Take action to reduce triggers, Alternatives to smoking, Provide education and support, and Personal steps to reduce smoking. All participants rated the cluster ”Provide education and support” as the most important and most feasible area to address.  Interventions designed support smoking cessation in this population should target personal steps to quit smoking and education and support as important topic areas.  This study was supported by Grant #IRG 08-060-04 from the American Cancer Society.