title: Developing anti-tobacco messages for Australian Aboriginal and Torres Strait Islander peoples: evidence from a national cross-sectional survey.
abstract: BACKGROUND
  Smoking rates in Australian Aboriginal and Torres Strait Islander peoples remain high, with limited impact of government measures for many subgroups. The aim of this cross-sectional study was to investigate differences in organisational practice for developing anti-tobacco messages for these target populations.
  
  
  METHODS
  Telephone interviews were conducted with 47 organisation representatives using a structured questionnaire based on health communication and health promotion frameworks. Responses were coded into phases of message development, message types (educational, threat, positive or advocacy), target groups, message recommendations, and evaluations undertaken. Cultural sensitivity for message development was divided into surface structure (use of images, language, demographics) and deep structure (use of socio-cultural values). A categorical principal component analysis explored the key dimensions of the findings and their component relationships.
  
  
  RESULTS
  Among organisations interviewed, a community-orientated, bottom-up approach for developing anti-tobacco messages was reported by 47% (n=24); 55% based message development on a theoretical framework; 87% used a positive benefit appeal; 38% used threat messages. More Aboriginal Medical Services (AMSs) targeted youth (p<0.005) and advised smokers to quit (p<0.05) than other types of organisations. AMSs were significantly more likely to report using deep structure in tailoring messages compared with non-government (p<0.05) and government organisations (p<0.05). Organisations that were oriented to the general population were more likely to evaluate their programs (p<0.05). A two-dimensional non-linear principal component analysis extracted components interpreted as "cultural understanding" (bottom-up, community-based approaches, deep structures) and "rigour" (theoretical frameworks, and planned/completed evaluations), and accounted for 53% of the variability in the data.
  
  
  CONCLUSIONS
  Message features, associated with successful campaigns in other populations, are starting to be used for Aboriginal and Torres Strait Islander peoples. A model is proposed to facilitate the development of targeted anti-tobacco messages for Aboriginal and Torres Strait Islander peoples. Organisations could consider incorporating both components of cultural understanding-rigour to enable the growth of evidence-based practice.
authors.affiliation: School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, PO Box 6811, Cairns, Queensland 4870, Australia. gillian.gould1@my.jcu.edu.au.
authors.forename: Gillian S
authors.initials: GS
authors.lastname: Gould
authors.forename: Kerrianne
authors.initials: K
authors.lastname: Watt
authors.forename: Leah
authors.initials: L
authors.lastname: Stevenson
authors.forename: Andy
authors.initials: A
authors.lastname: McEwen
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Cadet-James
authors.forename: Alan R
authors.initials: AR
authors.lastname: Clough
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D058015:Health Communication; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D016730:Program Development / Q000379:methods*; D012907:Smoking / Q000208:ethnology; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000208:ethnology / Q000517:prevention & control; D055815:Young Adult