ces presentation-complex evaluation · title: ces presentation-complex evaluation.ppt author: susan...
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A complex evaluation of a complexsystem: Evaluating the smoking
cessation system of a Public HealthUnit to guide policy change
Nadia Minian; Robert Schwartz; John Garcia;Roshan Guna.
Ontario Tobacco Research Unit
Background
Reducing the burden of tobacco diseaserequires a comprehensive smokingcessation system with multi-levelinterventions (policies and programs) thataddress environmental, institutional, andsocial systems.
Ontario Tobacco Research Unit
Need for protocols
An overall vision for smoking cessation inOntario has been developed and provides abasis for evaluating the adequacy of theexisting system.
Those responsible for tobacco control needprotocols for assessing and planning localsystems consistent with this vision.
Ontario Tobacco Research Unit
Determining the gaps
An essential step in planning of cessationsystems is determine the gaps betweenexisting services and needs as determinedby an expert panel and by self-reports ofsmokers from various sub-populationgroups.
Ontario Tobacco Research Unit
AIM
A pilot study, aimed at determining themethodology needed to reveal the needs fora comprehensive smoking cessation service,was conducted in a Public Health Unit inOntario.
Ontario Tobacco Research Unit
Reaching different populations
Important that the methodology can measurethe gaps for the general population as wellas for sub-groups that suffer from relativelyhigh prevalence of tobacco use.
Two groups were chosen for this pilot study,blue collar workers and young adults.
The methodology used for reaching thesegroups is different than the generalpopulation.
Ontario Tobacco Research Unit
Methodology
The gaps assessment synthesizes informationcollected from six sources:
An environmental scan Interviews with key informants, A random phone survey with smokers and recent
smokers, A street intercept survey with blue collar and young
adult smokers and recent smokers. Semi structured interviews with smokers who want to
quit, Semi structured interviews with community leaders
and workplace managers.
Ontario Tobacco Research Unit
The Environmental Scan
The environmental scan provided a quickway of understanding what services andpolicies are available, as well as their reach.
There were no other documents thatcontained all this information.
Ontario Tobacco Research Unit
Interviews with key informants and withcommunity leaders
Interviews with key informants enhanced ourunderstanding of what services wereavailable, their advantages anddisadvantages, as well as what serviceswere most needed in order to have acomprehensive smoking cessation strategy.
Highlighted sub-populations that were athigher need of smoking cessation services.
Ontario Tobacco Research Unit
Phone Survey
We used was random digit dialing method, sowere able to weight the data by age and gender toget estimates for all PHU residents.
The phone survey showed importantcharacteristics of how people in the PHU smoke,their quit intentions, their awareness, use andsatisfaction with smoking cessation services.
The results showed that participants smokingbehaviors as well as awareness and use ofservices are very different than those from Ontarioin general.
Ontario Tobacco Research Unit
Street-intercept survey
Provided: A way to reach populations usually not
reached by phone survey. Critical data on important characteristics of
how blue collar workers and young adultssmoke, their quit intentions, their awareness,use and satisfaction with smoking cessationservices.
Ontario Tobacco Research Unit
Street Intercept
However the fact that it is not a randomsample, and that the number of participantssurveyed wasn’t large enough, this methoddoes not allow for generalizing to all peoplein the sub-population.
In spite of this drawback, the value of thismethod is shown in the insight it providesinto a community of smokers not reachedthrough other methods.
Ontario Tobacco Research Unit
Interviews with smokers
Provided : Important understanding of how smokers are
making choices when it comes to cessationservices and products.
Rich information on the success and failuresof existing cessation services from smokersthemselves as well as on the programs,products and services that smokers want tosee available in the region to assist them intheir quit attempts.
Ontario Tobacco Research Unit
Conclusion
Each component has merit in itself and,therefore, makes a contribution on its own.
Together they provide useful guidelinesabout where to invest in order to have acomprehensive smoking cessation system.
Ontario Tobacco Research Unit
Acknowledgements
This project was financially supported by theMinistry of Health Promotion.
Thank you to the Research AdvisoryCommittee, and all the participants who sogenerously participated in this study.
