title: Could 'Aunties' Recruit Pregnant Indigenous Women Who Smoke Into a Trial and Deliver a Cessation Intervention? A Feasibility Study.
abstract: Objective Māori (indigenous New Zealand) women have the highest smoking prevalence rates in New Zealand and whilst pregnant. We hypothesized that community health workers ('Aunties') could find pregnant Māori women who smoke, recruit them into a study and deliver an acceptable cessation intervention. The aim of the study was to test the feasibility of such an intervention. Method A community health organization was engaged to, using a participatory approach, conduct a feasibility study. Participants were ten Aunties and the pregnant women the Aunties recruited. The Aunties advised their participants to abstain from smoking, offered a Quitcard (for subsidized nicotine replacement) or referral to local cessation providers. A booklet on healthy eating for pregnancy was given and discussed and the Aunties offered help if needed to register with a lead maternity carer (LMC). All women completed a baseline questionnaire. Semi-structured follow up face-to-face interviews were conducted with a subsample of women and hospital birth records were examined. Descriptive statistics were produced using quantitative data. Qualitative data was deductively analysed. Results During 4 months eight Aunties recruited 67 pregnant women who smoked, 88 % were Māori, 84 % were of low socio economic status and 73 % had up to high school education. Only 36 % of the recruited women had registered with an LMC. The participants described the Aunties as supportive, nice and non-judgmental. The only criticism was a lack of follow up. Aspects of the intervention that the Aunties thought worked well were knowing and being involved with their community, and being able to give a gift pack to the participating women. Insufficient follow up was one aspect that didn't work well. The infant's birth record was found for 54 % of the participants. Conclusion Aunties were able to identify and recruit pregnant Māori women who smoked. The study method and intervention were acceptable to Aunties and participants and it was feasible to collect data from the participants' hospital birth records. Based on this study, with a similar number of Aunties recruiting, it would take 2 years to recruit over 300 participants, which would be sufficient for a stronger controlled trial.
authors.affiliation: School of Public Health, Massey University, Private Bag 102904, North Shore, Auckland, 0745, New Zealand. m.glover@massey.ac.nz.
authors.forename: Marewa
authors.initials: M
authors.lastname: Glover
authors.affiliation: School of Public Health, Massey University, Private Bag 102904, North Shore, Auckland, 0745, New Zealand.
authors.forename: Anette
authors.initials: A
authors.lastname: Kira
authors.affiliation: Te Poutokomanawa, Maori Health Directorate, Northland District Health Board, Maunu Road, Private Bag 9742, Whangarei, 0148, New Zealand.
authors.forename: Tracey
authors.initials: T
authors.lastname: Cornell
authors.affiliation: Ringa Atawhai, 59 Settlers Way, Okaihau, New Zealand.
authors.forename: Ces
authors.initials: C
authors.lastname: Smith
mesh_terms: D000328:Adult; D003150:Community Health Workers; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009520:New Zealand; D011247:Pregnancy; D037841:Pregnant People; D011295:Prenatal Care / Q000458:organization & administration*; D012907:Smoking / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology; D016540:Smoking Cessation / Q000208:ethnology* / Q000379:methods; D011795:Surveys and Questionnaires; D064424:Tobacco Use; D055815:Young Adult
keywords: Cessation; Indigenous; Pregnancy; Smoking; Tobacco