Asian Smokefree Communities: Evaluation of a Community-Focused Smoking Cessation and Smokefree Environments Intervention In New Zealand

Abstract

Language, culture and not knowing how to access services are barriers to the use of health services for Asian migrants. Asian Smokefree Communities (ASC) pilot-tested a novel Asian-specific service model to address these issues for Asian smokers. Korean- and Chinese-speaking coordinators delivered home-, workplace- or clinic-based interventions to support smokers with cessation and create smoke-free environments with families. A prior planned evaluation investigated the acceptability of the service, quit rates and exposure to second-hand smoke. The methods included analysis of ASC service records, a client satisfaction survey and key informant interviews. Clients were satisfied with factors associated with culture, such as being comfortable when talking to coordinators (88.9%) and family involvement in treatment (79.4%). Appointment attendance was high (97%). The self-reported quit rate for the 93 cessation clients was 72% at 1 month, 53.8 % at 3 months and 40.9 % at 6 months. All homes (100%) were smoke-free after the intervention, an increase of 18% from preintervention levels. The ASC model was acceptable to Asian clients. It helped them stop smoking and increased household protection from second-hand smoke. The model could make an effective contribution to smoke-free services for Asian populations in western countries.

Chewing tobacco use among South‐East Asian men in Auckland

“…Even if they were aware of chewing tobacco practice and knew how to support cessation from chewing there are other barriers to access to be addressed. Language and cultural differences and not knowing how to access health and community services have been identified as barriers to accessing healthcare for South East Asian migrants in New Zealand (Wong et al, 2010). Even for stopping tobacco smoking, Asian people's use of the national free phone smoking cessation service, Quitline, is low.…”

The Implementation and Evaluation of Health Promotion Services and Programs to Improve Cultural Competency: A Systematic Scoping Review

“…The most common community-oriented strategy, utilized in 18 (18/22, 82%) of the interventions, was the participation of community members in the development and implementation of service-level interventions. Members of the community health workforce were the most frequently represented in studies ( 16 – 20 ), followed by general community members ( 18 , 21 – 23 ) and community or church leaders ( 24 , 25 ). Other community members involved in these interventions were cancer survivors and family members of survivors ( 25 , 26 ), heart attack and stroke survivors ( 23 ), community volunteers ( 24 ), seniors/elders ( 17 ) and representatives ( 27 ), and clinicians from the target population ( 28 ).…”

“…Another commonly reported community-oriented strategy was the creation of community partnerships through the research process. Two studies identified taking a community-based participatory research (CBPR) approach ( 16 , 25 ); another identified using a community participation framework to guide the research ( 21 ); and a further two discussed the involvement of a community steering committee ( 29 ) or advisory board ( 30 ). Other studies discussed community involvement such as being initiated by community leaders and maintaining a strong community engagement focus ( 24 ), thereby establishing partnerships with key community groups and stakeholders ( 30 ) and collaborating with community health departments ( 23 ).…”

“…Finally, there were three studies which utilized community networks and local media in the promotion and recruitment aspects of programs. This included the use of local, language appropriate radio and television, and print media ( 21 , 23 , 24 , 32 ), announcements at local religious facilities ( 24 , 32 ), and community meetings and events ( 21 , 32 ).…”

“…Various culturally oriented adaptations and strategies were implemented across the evaluated interventions, with the majority of studies including several different cultural aspects. The cultural adaptation most commonly reported was the inclusion of some aspect of the target group’s cultural values, beliefs, and practices/traditions ( 17 , 20 – 22 , 25 , 27 , 28 , 30 – 32 , 34 ), including things such as recognizing the role of extended family ( 25 , 27 ), the involvement of family ( 21 , 32 ), and the use of culturally relevant metaphors ( 25 , 30 ). Several studies also integrated aspects of the target community’s religion/spirituality and culture ( 17 , 24 , 25 , 28 , 32 , 34 ) and included culturally relevant activities congruent with the unique lifestyle preference of the targeted culture ( 28 , 29 , 31 , 32 ).…”