An observational study in Tobacco Dependence, sponsored by The Queen Elizabeth Hospital. Completed at 3 sites in Australia. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2017-04-10.
Sponsored by The Queen Elizabeth Hospital · Observational
Aim: To identify barriers and facilitators in the uptake of smoking cessation pharmacotherapies, tobacco prevention, doctor visits, smoking amongst youth, community held health priorities and barriers to research in Aboriginal Australians from the perspectives of:
Focus groups, one-on-one interviews and surveys will be conducted to provide information at the 'grass-roots' level including examinations into perceived differences in locally held beliefs, attitudes, knowledge, traditional practices and the cultural and social constructs, to assist implementation of future tobacco cessation/prevention interventions and treatment of smoking related illnesses. This information can be used to improve the health of Aboriginal people by identifying inadequacies in current practices and highlighting what these are through the eyes of community members, healthcare workers, consultants/general practitioners and key stakeholders. We also intend on examining any facilitators that are identified as positive and working aspects of current initiatives e.g. community infrastructure, in an effort to not 'reinvent the wheel' and acknowledge what is working.
We will identify barriers and facilitators for the implementation of smoking cessation pharmacotherapies, tobacco prevention, doctor visits, youth and smoking, community held health priorities and barriers to research through:
Smoking cessation is one of the most important ways to improve the prognosis of patients with respiratory diseases. Despite being over represented in the burden of smoking related morbidity and mortality, very little methodologically rigorous research has been conducted to evaluate and/or enhance the uptake of smoking cessation pharmacotherapies and smoking prevention for Aboriginal Australians, as evident in our two recent (2012) Cochrane meta-analyses and through extensive consultation over the past two years with Aboriginal Elders, key stakeholders, researchers and experts throughout Australia. Moreover, many of the healthcare workers and some doctors on the frontline are reporting that they do not believe they have the skills or ability to offer smoking cessation/prevention initiatives to these patients, and perhaps more importantly, admit to the attitude of 'even if I did, it's not going to work, so why bother'.
In light of this gap in knowledge, our project relates specifically to understanding and improving the lung health of Aboriginal Australians, the cohort with the greatest burden of disease and lowest life expectancy, through qualitative analyses. A total of 10 focus groups, 30 one-on-one interviews and approximately 120 surveys (unless data saturation is reached sooner) will be carried out in collaboration with Aboriginal community involvement. The information obtained from these will provide an overall picture of the barriers and enablers from the perspectives of the various individuals involved, being:
Triangulation will occur at multiple levels to improve credibility and dependability including: data collection (focus groups, interviews and surveys), investigators (minimum five investigators involved throughout various aspects of the study), data sources (multiple locations, communities and venues), analysis methods (Grounded theory and Triandis model of behavioural change).
In addition a detailed audit trail will be kept and all focus groups and interviews will undergo feedback (confirmation of accuracy and interpretation) by participants. Quasi-statistics will also be employed as part of the analysis methods.
968 studies on the registry are indexed under Tobacco Use Disorder; 128 are open to participants now.
This study's enrollment of 16 is below the median of 128 across 74 observational studies indexed under Tobacco Use Disorder.
Browse Tobacco Use Disorder studies →The Queen Elizabeth Hospital is the lead sponsor of 14 studies on the registry; none are open to participants now.
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Participants who agree to be involved in the focus groups will be recruited via existing community contacts (e.g., Aboriginal elders, leaders of community groups and doctors who support the planned research) in urban Adelaide and regional Murray Bridge. We also intend on actively recruiting through clinic visits made by our visiting respiratory clinicians. Copies of the participant information sheet and consent form will be disseminated via local healthcare workers to seek focus group volunteers and via existing contacts in health and by word of mouth for one-on-one interview participants. Survey participants will be recruited as per above methods in addition to use of delegate lists and mail outs.
Male Smokers
Female Smokers
Male Non/Ex Smokers
Female Non/Ex Smokers
Healthcare worker
GP's / Specialists
Key Stakeholders
Exclusion Criteria:
Focus group: Aboriginal smoker, male from Adelaide
Other: Focus group · Other: Survey
Focus group: Aboriginal smoker, female, from Adelaide
Other: Focus group · Other: Survey
Focus group: Aboriginal ex/non-smoker, male, from Adelaide
Other: Focus group · Other: Survey
Focus group: Aboriginal ex/non-smoker, female, from Adelaide
Other: Focus group · Other: Survey
Focus group: Healthcare workers who are based in Adelaide and work with Aboriginal patients
Other: Focus group · Other: Survey
Focus group: Healthcare workers who are based in Murray Bridge and work with Aboriginal patients
Other: Focus group · Other: Survey
Focus group: Aboriginal smoker, male, from Murray Bridge
Other: Focus group · Other: Survey
Focus group: Aboriginal smoker, female, from Murray Bridge
Other: Focus group · Other: Survey
Focus group: Aboriginal ex/non-smoker, male, from Murray Bridge
Other: Focus group · Other: Survey
Focus group: Aboriginal ex/non-smoker, female, from Murray Bridge
Other: Focus group · Other: Survey
One-on-one interviews with 10 key Aboriginal community stakeholders
Other: One-on-one interviews · Other: Survey
One-on-one interviews with 10 Respiratory physicians
Other: One-on-one interviews · Other: Survey
One-on-one interviews with 10 consultants and/or GP's
Other: One-on-one interviews · Other: Survey
Initially, ten focus groups with an average sample size of 5-7 participants each will be performed in two communities within South Australia, one being Adelaide and the other Murray Bridge, this includes focus groups held with healthcare workers. The proposed focus groups will be conducted by experienced mediators who have undertaken Aboriginal cultural awareness training and have experience in qualitative research methods. Both mediators have also been involved in all aspects of project development and consultation with Aboriginal Elders and key stakeholders since its conception. We will be using topic guides (reviewed by Aboriginal Elders and researchers) that will be semi-structured with open-ended questions designed to encourage group discussion around smoking cessation and the use of pharmacotherapies in particular, in addition to other objectives identified during the consultation phase of this research.
One-on- one interviews will be held with both medical clinicians and key stakeholders and will be conducted by existing TQEH (The Queen Elizabeth Hospital), Clinical Practice Unit employees, experienced in qualitative research. Informed consent will be required and the interview will be audio taped to allow analysis of the qualitative data. All interviews will remain anonymous, unless the interviewee prefers to be named. In this case, they will be named in the acknowledgement section of all publications and presentations. Moderator guides have been developed and reviewed in the same process undergone by the focus group moderator guides
A four page survey will be administered to all focus group and interview participants in addition to select cohorts including tobacco related special interest groups of the Thoracic Society of Australia and New Zealand (TSANZ). The survey will include demographic data, smoking history and current smoking status (questions related to smoking for current tobacco users include the Fagerstrom test for nicotine dependence, multiple Likert scales for cravings, motivation to quit, confidence etc.) and Likert scales examining perceptions, attitudes and knowledge about tobacco use, cessation, prevention, health and research in the Aboriginal setting.
Determine the barriers and facilitators to pharmacological initiatives for tobacco cessation in Aboriginal populations
Qualitative analysis (focus groups, one-on-one interviews and surveys). The use of pharmacotherapies for smoking cessation significantly improves the probability of successful abstinence. Identification of the barriers and facilitators for tobacco cessation pharmacotherapies will be determined through these qualitative discussions and mixed method approaches
Time frame: 18 months
Determine the barriers and facilitators for tobacco prevention initiatives, particularly related to Aboriginal youth
Qualitative analysis (focus groups, one-on-one interviews and surveys). The use of tobacco prevention initiatives significantly improves the probability of lower tobacco prevalence long-term. Identification of the barriers and facilitators for tobacco prevention initiatives will be determined through these qualitative discussions and mixed method approaches
Time frame: 18 months
Identify the barriers and facilitators for doctor visits by Aboriginal people
Qualitative analysis (focus groups, one-on-one interviews and surveys). Regular doctor visits by Aboriginal people can significantly reduce the progression of chronic illnesses, improve quality of life and reduce health care costs. Identification of the barriers and facilitators for these doctor visits, particularly with Respiratory physicians, will be determined through these qualitative discussions and mixed method approaches
Time frame: 18 months
Identify barriers and facilitators to research initiatives in Aboriginal people and identify self-reported health priorities
Qualitative analysis (focus groups, one-on-one interviews and surveys). Research in Aboriginal populations are often lengthy and in many cases fail to achieve their objectives, often due to inappropriate methodology or a lack of consultation with Aboriginal Elders or key stakeholders research initiatives particularly related to tobacco and chronic illnesses will be determined through these qualitative discussions and mixed method approaches. In addition, we aim to identify health priorities identified by participants within the focus groups, one-on-one interviews and surveys that can be targeted for future research initiatives.
Time frame: 18 months
Plan to share: Yes — Available on request
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