Education for Changewww.efc.co.nz
2
Context
Our intervention challenge Pregnancy Low self-efficacy “Quit” approach the norm
Design Inclusive Response to dose effects Change approach
Education for Changewww.efc.co.nz
3
Smokechange
Health funded Home visits Personalised Change focus Family, too Dual goals
More people smokefree More people ready to consider it
Education for Changewww.efc.co.nz
4
Measurement
Principle We value what we measure, so,
let’s measure what we value Value
Readiness Intervention steps Personal change steps
Assessment Tools
Education for Changewww.efc.co.nz
5
Assessing readiness
Ask: What do you feel ready to do about smoking… Hold? Reduce? Stop?
Smokechange Test 8 factors, points assigned, score
calculated, feedback given
Education for Changewww.efc.co.nz
6
Study group
Included in the analysis were: 1320 women All smoking at enrolment All participated to 6 month assessment All completed programme Period: 1/1/2005 to 30/6/2007
Education for Changewww.efc.co.nz
7
24
76
0
10
20
30
40
50
60
70
80
readiness at enrolment
%
ready
not ready
Ready vs notmost women (76%) did not feel ready to stop smoking at enrolment (n=1001)
Education for Changewww.efc.co.nz
8
Personal factorsReady
N=319
Not ready
N=1001Significance
Teenaged 11 13 ns
Pregnant 72 79 ns
Maori 30 36 ns
Pacific 14 14 ns
NZ European 59 56 ns
Other 8 6 ns
Low income (CSC holder) 55 60 ns
No partner 14 14 ns
Personal comparisonsbetween ready and not ready people (n=1320)
Education for Changewww.efc.co.nz
9
Readiness factorsReady
N=319
Not
N=1001Significance
Light smoking (<10/day) 56 39 p<0.0001
First smoke after 60 mins 43 31 p<0.0001
Recent smokefree attempt 38 21 p<0.0001
No others smoking at home 31 27 ns
High importance 94 74 p<0.0001
High confidence 70 28 p<0.0001
High knowledge 68 65 ns
Low personal stress 30 22 ns
Readiness comparisonsbetween ready and not ready people
Education for Changewww.efc.co.nz
10
Purpose Build capacity and confidence to:
Consider and plan Achieve and maintain change
Strategy Build smokefree:
Thinking Habits Talk
Interventionfor working with “not ready” people
Education for Changewww.efc.co.nz
12
Readiness factors At the start At 6 months
Light smoking (<10/day) 39 77
First smoke after 60 mins 31 74
Recent smokefree attempt 21 65
No others smoking at home 27 38
High importance 74 80
High confidence 28 58
High knowledge 65 94
Low personal stress 22 27
Smokefree 0 31
Changes madeby the 1001 people in the “not ready” group
Education for Changewww.efc.co.nz
13
48
31
52
69
0
20
40
60
80
ready not
readiness at enrolment
% smokefree
not
Programme outcomesdistribution of women smokefree or not at 6 months by ready or not at enrolment (n=1320)
Education for Changewww.efc.co.nz
14
33
67
0
20
40
60
80
smokefree at 6 months
% ready
not
Smokefree outcomes onlydistribution of women smokefree at 6 months (35%) by ready or not at enrolment (n=458)
Education for Changewww.efc.co.nz
15
Most people were “not ready” (76%) Compared to “ready” people, they had:
significantly more barriers to change social and ethnic similarities
I in 3 succeeded in being smokefree at 6 months (31%)
“Not ready” people made up two thirds of those eventually smokefree at 6 months
What we have learntabout the “not ready” group (n=1001)
Education for Changewww.efc.co.nz
16
Ready group smaller group (24%) higher smokefree rates (48%) fewer people smokefree(152)
Not ready group larger group (76%) lower smokefree rates (31%) more people smokefree (306)
Summary