Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco control personnel. Smoking cessation strategies (n = 74) were brainstormed using 34 interviews, 3 focus groups and a stakeholder workshop. Stakeholders sorted strategies into meaningful groups and rated them on perceived importance and feasibility. A concept map was developed using multi-dimensional scaling and hierarchical cluster analyses. Ten unique clusters of smoking cessation strategies were depicted that targeted individuals, family and peers, community, workplace and public policy. Smoking cessation resources and services were represented in addition to broader strategies addressing social and environmental stressors that perpetuate smoking and make quitting difficult. The perceived importance and feasibility of clusters were rated differently by participants working in health services that were government-coordinated compared with community-controlled. For health service workers within vulnerable populations, these findings clearly implicate a need for contextualized strategies that mitigate social and environmental stressors in addition to conventional strategies for tobacco control. The concept map is being applied in knowledge translation to guide development of smoking cessation programs for AHWs.

译文

澳大利亚原住民,包括土著卫生工作者 (ahw),吸烟率是非土著人口的两倍。这项研究利用概念映射方法来确定和确定与文化相关的策略以促进ahw戒烟。利益相关者参与者包括AHWs,其他卫生服务员工和烟草控制人员。通过34次访谈,3个焦点小组和利益相关者研讨会,对戒烟策略 (n = 74) 进行了头脑风暴。利益相关者将策略分为有意义的组,并根据感知的重要性和可行性对其进行评分。使用多维缩放和分层聚类分析开发了概念图。描述了十种独特的戒烟策略,这些策略针对个人,家庭和同龄人,社区,工作场所和公共政策。除更广泛的策略外,还提供了戒烟资源和服务,以解决使吸烟永久化并使戒烟困难的社会和环境压力源。与社区控制相比,在政府协调的卫生服务中工作的参与者对集群的重要性和可行性的评价有所不同。对于弱势人群中的卫生服务工作者,这些发现显然暗示了除了传统的烟草控制策略之外,还需要有针对性的策略来减轻社会和环境压力。概念图已应用于知识翻译中,以指导ahw戒烟计划的开发。

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