Keeping Each Other Accountable

Abstract

Vietnamese American males have high smoking rates. This study explored social support mechanisms provided by lay health workers (LHWs) and family members through a smoking cessation intervention. Eight focus groups (N = 54) were conducted in Vietnamese stratified by intervention arms (Tobacco [experimental] and healthy living [control]) with 18 smokers, 18 family members, and 18 LHWs. Smokers reported feeling more accountable for their health behaviors, and smoking changes were reinforced by family members, peers, and LHWs through conversations facilitated during and outside the program. Culturally appropriate interventions with multiple social support mechanisms may reduce smoking in minority populations.

Family Involvement in Asian American Health Interventions: A Scoping Review and Conceptual Model

“…Of the 7175 articles screened, 181 received full-text assessments, resulting in a final study sample of 48 (Figure 1). Studies included data from randomized controlled trials, 25-38 quasi-experimental studies, 39-56 protocols or trial registries, 57-63 program evaluations, 64-67 and developmental or usability studies. 68-72…”

“…In most studies (n = 41; 85%), family members were involved in some aspect related to the processes or implementation of intervention activities. Family members were commonly the recipients of an intervention together with participants, such as dyadic interventions aimed at smoking cessation 25,26,28,29,57 or breast cancer screening. 34,56,62,63 In such interventions, family dyads attended intervention sessions together, set shared goals, or completed discussion and homework activities to foster mutual support in achieving shared intervention goals.…”

“…Of the 7175 articles screened, 181 received full-text assessments, resulting in a final study sample of 48 (Figure 1). Studies included data from randomized controlled trials, [25][26][27][28][29][30][31][32][33][34][35][36][37][38] quasi-experimental studies, [39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56] protocols or trial registries, [57][58][59][60][61][62][63] program evaluations, [64][65][66][67] and developmental or usability studies. [68][69][70][71][72] Studies spanned a 26-year time frame (1995-2021) and were conducted...…”

“…Intervention materials focused on family member stories or experiences 66 • Recruitment: Referring participants to join study 48,56,64,66 or being recruited together with other family members 29,34,40,45 • Receiving intervention together: Attending joint sessions with participants or having interdependent goals 25,26,28,29,31,34,39,40,44,45,56,57,59,60,62,63,65,68,71 • Receiving parallel intervention: Attending separate sessions with separate intervention goals 26,38,68 • Enlisting support to achieve goals: Requesting assistance in participant communication, retention, and material/behavioral support 27,47,48,51,58,61 • Voluntary intervention support: Assisting implementation by attending some sessions, providing material/behavioral/moral support, and engaging with study staff 30,43,49,[51][52][53] • Agent of family-wide change: Intervention focusing on one family member with the implication of improving health or care for a different family member,…”

“…• Source of encouragement: Improved impact or experience of intervention attributed to family member encouragement and moral support 29,40,42,45,49,53,56,68 • Source of support: Improved impact attributed to family member material or behavioral support throughout intervention 27,28,30,42,51,53 • Source of insight: Ability to appropriately develop and evaluate intervention attributed to insights from family members of participant 45,68 • Source of accountability: Improved intervention fidelity attributed to family member role in monitoring intervention progress 27,64 • Source of comfort: Recruitment into study attributed to family members making participants feel safe, comfortable with study 40 • Source of passion: Adaptations to enhance engagement attributed to participant interests in sharing resources with family members 72 • Source of hindrance: Attrition, recruitment, and implementation barriers attributed to lack of proactive, positive family support or interest in intervention participant's intervention aims 27,50,64 • Source of backlash: Recruitment and implementation barriers attributed to family members conflicting with intervention goals 35,40,51 • Source of stigma: Recruitment and implementation barriers attributed to family member hesitancy in relation to intervention elements involving stigmatized topics 27,32,37,44,69 • Source of obligation: Attrition connected with family member obligations or crises 41,49 • Source of negative influence: Implementation and impact barriers attributed to family members acting as a negative environmental influence on participant's health 26,27 across intervention developm...…”