SISTAQUIT (Supporting Indigenous Smokers To Assist Quitting) – a cluster randomised trial to implement culturally competent evidence-based smoking cessation for pregnant Aboriginal and Torres Strait Islander smokers

Background

Smoking prevalence among Indigenous pregnant women is four times the rate in non-Indigenous women (45% vs.12%). An evidence-practice gap exists in evidence-based primary care approaches for Indigenous pregnant smokers.

Aims

To determine whether a comprehensive culturally-competent multi-component intervention can increase quit rates in pregnant Indigenous smokers.

Project plan

To achieve the following objectives:

1. Assess the efficacy of SISTAQUIT intervention to increase cessation among Indigenous pregnant smokers at 4 weeks post-baseline (end of treatment) measured by carbon moxoxide validation of self-reported smoking cessation.

2. Increase the proportion of health providers offering assistance in quitting to Indigenous pregnant smokers early in their pregnancy (self-report, audit of charts, and patient report).

3. Reduce episodes of respiratory illness and adverse perinatal outcomes among Indigenous babies, followed to 6 months of age (baby health diary and survey).

4. Conduct an economic evaluation the SISTAQUIT intervention that incorporates a cost-effectiveness analysis.

We developed a culturally competent evidence-based guide for smoking cessation care specific to Indigenous maternal smokers, with a multi-component intervention called ICAN QUIT in Pregnancy. The approach aims to empower women and involve them in shared decision making, using ABCD (Ask, Brief intervention, Cessation, and Discuss the psychosocial context), and recommends the expedited use of nicotine replacement therapy. The resources for provider training and clients were collaboratively developed with ACCHS in Hunter New England. The intervention, including provider training, will be pilot tested, and then a cluster randomised controlled trial will determine the efficacy of the ICAN QUIT approach. Primary outcomes will be provider practices relating to an offer of NRT to Indigenous pregnant women (measured by audit of NRT prescription). Secondary outcomes will be mean scores on client checklists of care they received, and items of smoking cessation care recorded on client notes. Results The outcomes of the collaborative development of the intervention will be discussed.

Impact

The project team worked closely with the community to develop this culturally appropriate intervention. Although the project itself did not show impact, the intervention was further developed and scaled up, leading to the development of the online iSISTAQUIT training for health professionals, which was implemented in health services across Australia. iSISTAQUIT was supported by the Australian Government Department of Health and a further study was funded through the GACD Scale Up Research Programme.

Publications and output

This project has a related case study Co-developing a smoking cessation intervention with Indigenous mothers in Australia.

Funding organisations

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