“I know it’s bad for me and yet I do it- exploring the factors that perpetuate smoking in Aboriginal Health Workers - a qualitative study
详细信息 查看全文
- 作者：Anna P Dawson (1)
Margaret Cargo (1)
Harold Stewart (2)
Alwin Chong (2)
Mark Daniel (1) - 刊名：BMC Health Services Research
- 出版年：2012
- 出版时间：December 2012
- 年：2012
- 卷：12
- 期：1
- 全文大小：241KB
- 参考文献：1. Ratsch A, Steadman K, Bogossian F: The pituri story: a review of the historical literature surrounding traditional Australian Aboriginal use of nicotine in Central Australia. / Journal of Ethnobiology Ethnomedicine 2010, 6:26. CrossRef
2. Brady M: Historical and cultural roots of tobacco use among Aboriginal and Torres Strait Islander people. / Australian and New Zealand Journal of Public Health 2002,26(2):120-24. CrossRef
3. Australian Bureau of Statistics: / National Aboriginal and Torres Strait Islander Social Survey, 2008. Cat. No. 4714.0. Australian Bureau of Statistics, Canberra, Australia; 2009.
4. Australian Bureau of Statistics: / The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, 2010. Cat. No. 4704.0. Australian Bureau of Statistics, Canberra, Australia; 2010.
5. Vos T, Barker B, Begg S, Stanley L, Lopez A: Burden of disease and injury in Aboriginal and Torres Strait Islander Peoples: the Indigenous health gap. / International Journal of Epidemiology 2009,38(2):470-77. CrossRef
6. Council of Australian Governments: / National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes. Accessed on April 17th. 2012. http://www.coag.gov.au/intergov_agreements/federal_financial_relations/docs/national_partnership/NP_closing_the_Gap_indigenous_health_outcomes.pdf
7. Australian Institute of Health and Welfare: / Aboriginal and Torres Strait Islander health labour force statistics and data quality assessment. Cat. no. IHW 27. AIHW, Canberra, Australia; 2009.
8. Mitchell M, Hussey L: The Aboriginal health worker. / Medical Journal of Australia 2006,184(10):529-30.
9. Winstanley M: Tobacco use among Aboriginal peoples and Torres Strait Islanders. In / In Tobacco in Australia: Facts and Issues. 3rd edition. Edited by: Scollo M, Winstanley M. Cancer Council Victoria, Melbourne, Australia; 2008.
10. Andrews B, Oates F, Naden P: Smoking among Aboriginal health workers: findings of a 1995 survey in western New South Wales. / Australian and New Zealand Journal of Public Health 1997,21(7):789-91. CrossRef
11. Mark A, McLeod I, Booker J, Ardler C: Aboriginal health worker smoking: a barrier to lower community smoking rates? / Aboriginal and Islander Health Worker Journal 2005,29(5):22-6.
12. Harvey D, Tsey K, Cadet-James Y, Minniecon D, Ivers R, McCalman J, Lloyd J, Young D: An evaluation of tobacco brief intervention training in three indigenous health care settings in north Queensland. / Australian and New Zealand Journal of Public Health 2002,26(5):426-31. CrossRef
13. Kerdel K, Brice G: / Exploring the smokescreen - reducing the stress: Action research on tobacco with Aboriginal primary health care workers in Adelaide. Aboriginal Health Council of South Australia, Inc, Adelaide, Australia; 2001.
14. Maksimovic L: / Characterising the smoking status and quit attempts of Aboriginal Health Workers in South Australia: A quantitative study with smoking cessation implications. University of South Australia, Adelaide, Australia; 2009.
15. Thompson M, Robertson J, Clough A: A review of the barriers preventing Indigenous health workers delivering tobacco interventions to their communities. / Australian and New Zealand Journal of Public Health 2011,35(1):47-3. CrossRef
16. Pilkington A, Carter O, Cameron A, Thompson S: Tobacco control practices among Aboriginal health professionals in Western Australia. / Australian Journal of Primary Health 2009,15(2):152-58. CrossRef
17. Thompson M: What Are Indigenous Health Workers Saying about Their Smoking Status: Does It Prevent Them Providing Tobacco Information and/or Quit Support to the Community? / Aboriginal and Islander Health Worker Journal 2010,34(2):3-.
18. Cargo M, Mercer S: The value and challenges of participatory research: strengthening its practice. / Annual Review of Public Health 2008, 29:325-50. CrossRef
19. Sandelowski M: Whatever happened to qualitative description? / Res Nurs Heal 2000,23(4):334-40. CrossRef
20. Bronfenbrenner U: / The ecology of human development: experiments by nature and design. Harvard University Press, Cambridge, Massachusetts; 1979.
21. Stokols D: Translating social ecological theory into guidelines for community health promotion. / Am J Heal Promot 1996,10(4):282-98. CrossRef
22. Carson B, Dunbar T, Chenhall R, Bailie R: Introduction. In / In Social Determinants of Indigenous Health. Edited by: Carson B, Dunbar T, Chenhall R, Bailie R. Allen & Unwin, Crows Nest, Australia; 2007.
23. Emmons K: Health behaviours in a social context. In / In Social Epidemiology. Edited by: Berkman L, Kawachi I. Oxford University Press, New York; 2000.
24. Berndt R, Berndt C: / The World of the First Australians: Aboriginal Traditional Life - Past and Present. Aboriginal Studies Press, Canberra, Australia; 1999.
25. Morse J: Using shadowed data. / Qual Heal Res 2001,11(3):291-92. CrossRef
26. Legard R, Keegan J, Ward K: In-depth Interviews. In / In Qualitative research practice: a guide for social science students and researchers. Edited by: Ritchie J, Lewis J. Sage Publications, London, United Kingdom; 2003:138-70.
27. Graneheim U, Lundman B: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. / Nurse Education Today 2004,24(2):105-12. CrossRef
28. Patton Q: / How to use qualitative methods in evaluation. Sage Publications Inc., London; 1987.
29. Kitzinger J: Focus groups. In / n Qualitative research in health care. 3rd edition. Edited by: Pope C, Mays N. Blackwell Publishing, Malden, Massachusetts; 2006.
30. Lindorff K: / Tobacco: Time for Action. National Aboriginal and Torres Strait Islander Tobacco Control Project - Final Report. National Aboriginal Community Controlled Health Organisation, Canberra; 2002.
31. McEwen A, West R, McRobbie H: Motives for smoking and their correlates in clients attending Stop Smoking treatment services. / Nicotine & Tobacco Research 2008,10(5):843-50. CrossRef
32. Johnston V, Thomas D: Smoking behaviours in a remote Australian Indigenous community: the influence of family and other factors. / Social Science and Medicine 2008,67(11):1708-716. CrossRef
33. South Australian Aboriginal Health Partnership: / Aboriginal health - everybody's business: social & emotional wellbeing: a South Australian strategy for Aboriginal & Torres Strait Islander People 2005 -2010. South Australian Aboriginal Health Partnership, Adelaide, South Australia; 2004.
34. Human Rights and Equal Opportunity Commission: / Bringing them Home: Report of the National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families. Human Rights and Equal Opportunity Commission, Canberra, Australia; 1997.
35. Thomas D, Briggs V, Anderson I, Cunningham J: The social determinants of being an Indigenous non-smoker. / Australian and New Zealand Journal of Public Health 2008,32(2):110-16. CrossRef
36. Poland B, Frohlich K, Haines R, Mykhalovskiy E, Rock M, Sparks R: The social context of smoking: the next frontier in tobacco control? / Tob Control 2006,15(1):59-3. CrossRef
37. McKie L, Laurier E, Taylor RJ, Lennox AS: Eliciting the smoker's agenda: implications for policy and practice. / Social Science & Medicine 2003,56(1):83-4. CrossRef
38. Vink JM, Willemsen G, Engels RCME, Boomsma DI: Smoking Status of Parents, Siblings and Friends: Predictors of Regular Smoking? Findings from a Longitudinal Twin-family Study. / Twin Research 2003, 6:209-17.
39. Sibthorpe B, Becking F, Humes G: Positions and training of the indigenous health workforce. / Australian and New Zealand Journal of Public Health 1998,22(6):648-52. CrossRef
40. Krieg A: The experience of collective trauma in Australian Indigenous communities. / Australasian Psychiatry 2009,17(Suppl 1):S28-2. CrossRef
41. Paradies Y: A systematic review of empirical research on self-reported racism and health. / International Journal of Epidemiology 2006,35(4):888-01. CrossRef
42. Daniel M, Lekkas P, Cargo M, Stankov I, Brown A: Environmental risk conditions and pathways to cardiometabolic diseases in indigenous populations. / Annu Rev Public Health 2011, 32:327-47. CrossRef
43. Roche A, Ober C: Rethinking smoking among Aboriginal Australians: the harm minimisation-abstinence conundrum. / Health Promotion Journal of Australia 1997,7(2):128-33.
44. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6963/12/102/prepub - 作者单位：Anna P Dawson (1)
Margaret Cargo (1)
Harold Stewart (2)
Alwin Chong (2)
Mark Daniel (1)
1. Social Epidemiology and Evaluation Research Group, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
2. Aboriginal Health Council of South Australia, Adelaide, South Australia, Australia
文摘
Background Aboriginal Health Workers (AHWs) have a mandate to deliver smoking cessation support to Aboriginal people. However, a high proportion of AHWs are smokers and this undermines their delivery of smoking cessation programs. Smoking tobacco is the leading contributor to the burden of disease in Aboriginal Australians and must be prevented. Little is known about how to enable AHWs to quit smoking. An understanding of the factors that perpetuate smoking in AHWs is needed to inform the development of culturally relevant programs that enable AHWs to quit smoking. A reduction of smoking in AHWs is important to promote their health and also optimise the delivery of smoking cessation support to Aboriginal clients. Methods We conducted a fundamental qualitative description study that was nested within a larger mixed method participatory research project. The individual and contextual factors that directly or indirectly promote (i.e. perpetuate) smoking behaviours in AHWs were explored in 34 interviews and 3 focus groups. AHWs, other health service staff and tobacco control personnel shared their perspectives. Data analysis was performed using a qualitative content analysis approach with collective member checking by AHW representatives. Results AHWs were highly stressed, burdened by their responsibilities, felt powerless and undervalued, and used smoking to cope with and support a sense of social connectedness in their lives. Factors directly and indirectly associated with smoking were reported at six levels of behavioural influence: personal factors (e.g. stress, nicotine addiction), family (e.g. breakdown of family dynamics, grief and loss), interpersonal processes (e.g. socialisation and connection, domestic disputes), the health service (e.g. job insecurity and financial insecurity, demanding work), the community (e.g. racism, social disadvantage) and policy (e.g. short term and insecure funding). Conclusions An extensive array of factors perpetuated smoking in AHWs. The multitude of personal, social and environmental stressors faced by AHWs and the accepted use of communal smoking to facilitate socialisation and connection were primary drivers of smoking in AHWs in addition to nicotine dependence. Culturally sensitive multidimensional smoking cessation programs that address these factors and can be tailored to local needs are indicated.