changing, ready or not stephanie cowan education for change september 2007

Changing, ready or notStephanie Cowan

Education for Change

September 2007

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


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Smokechange

Health funded Home visits Personalised Change focus Family, too Dual goals

More people smokefree More people ready to consider it


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Measurement

Principle We value what we measure, so,

let’s measure what we value Value

Readiness Intervention steps Personal change steps

Assessment Tools


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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


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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


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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)


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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)


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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


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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


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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


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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)


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)


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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)


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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


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To have an impact on the public health, programmes need to achieve smokefree change in the larger, “not ready” group, too.

Conclusion

Thank you.

changing, ready or not stephanie cowan education for change september 2007

Documents

smokefree change

people ready

ready people n

ready group n

ready vs

ready group larger group

readiness factors ready

summary slide