Promoting smoking cessation in Bangladeshi and Pakistani male adults: design of a pilot cluster randomised controlled trial of trained community smoking cessation workers

BACKGROUND: The prevalence of smoking is higher among Pakistani and Bangladeshi males than among the general population. Smokers who receive behavioural support and medication quadruple their chances of stopping smoking, but evidence suggests that these populations do not use National Health Service run stop smoking clinics as frequently as would be expected given their high prevalence of smoking. This study aims to tackle some of the main barriers to use of stop smoking services and adherence to treatment programmes by redesigning service delivery to be more acceptable to these adult male populations. The study compares the effectiveness of trained Pakistani and Bangladeshi smoking cessation workers operating in an outreach capacity ('clinic + outreach') with standard care ('clinic only') to improve access to and success of National Health Service smoking cessation services. METHODS/DESIGN: This is a pilot cluster randomised controlled trial based in Birmingham, UK. Super output areas of Birmingham will be identified in which more than 10% of the population are of Pakistani and/or Bangladeshi origin. From these areas, 'natural geographical communities' will be identified. Sixteen aggregated agglomerations of super output areas will be identified, separating areas from each other using buffer regions in order to reduce potential contamination. These natural communities will be randomised to 'clinic + outreach' (intervention) or 'clinic only' (control) arms. The use of stop smoking services and the numbers of people quitting smoking (defined as prolonged self-reported abstinence at four weeks, three months and six months) will be assessed in each area. In addition, we will assess the impact of the intervention on adherence to smoking cessation treatments and patient satisfaction

Promoting smoking cessation in Pakistani and Bangladeshi men in the UK: pilot cluster randomised controlled trial of trained community outreach workers

<p>Abstract</p> <p>Background</p> <p>Smoking prevalence is high among Pakistani and Bangladeshi men in the UK, but there are few tailored smoking cessation programmes for Pakistani and Bangladeshi communities. The aim of this study was to pilot a cluster randomised controlled trial comparing the effectiveness of Pakistani and Bangladeshi smoking cessation outreach workers with standard care to improve access to and the success of English smoking cessation services.</p> <p>Methods</p> <p>A pilot cluster randomised controlled trial was conducted in Birmingham, UK. Geographical lower layer super output areas were used to identify natural communities where more than 10% of the population were of Pakistani and Bangladeshi origin. 16 agglomerations of super output areas were randomised to normal care controls vs. outreach intervention. The number of people setting quit dates using NHS services, validated abstinence from smoking at four weeks, and stated abstinence at three and six months were assessed. The impact of the intervention on choice and adherence to treatments, attendance at clinic appointments and patient satisfaction were also assessed.</p> <p>Results</p> <p>We were able to randomise geographical areas and deliver the outreach worker-based services. More Pakistani and Bangladeshi men made quit attempts with NHS services in intervention areas compared with control areas, rate ratio (RR) 1.32 (95%CI: 1.03-1.69). There was a small increase in the number of 4-week abstinent smokers in intervention areas (RR 1.30, 95%CI: 0.82-2.06). The proportion of service users attending weekly appointments was lower in intervention areas than control areas. No difference was found between intervention and control areas in choice and adherence to treatments or patient satisfaction with the service. The total cost of the intervention was £124,000; an estimated cost per quality-adjusted life year (QALY) gained of £8,500.</p> <p>Conclusions</p> <p>The intervention proved feasible and acceptable. Outreach workers expanded reach of smoking cessation services in diverse locations of relevance to Pakistani and Bangladeshi communities. The outreach worker model has the potential to increase community cessation rates and could prove cost-effective, but needs evaluating definitively in a larger, appropriately powered, randomised controlled trial. These future trials of outreach interventions need to be of sufficient duration to allow embedding of new models of service delivery.</p> <p>Trial registration</p> <p>Current Controlled Trials <a href="http://www.controlled-trials.com/ISRCTN82127540">ISRCTN82127540</a></p

Social Cooking Project

The overall aim of the Social Cooking Project was to reduce the salt consumption of South Asian families of Indian descent in certain cities in the UK, in order to reduce levels of cardiovascular disease in these populations.The specific aims were: • to reduce the level of salt used in social cooking at Hindu temples and Sikh gurdwaras. (During the course of the project, it was decided to set a target of a 5% reduction in salt in social cooking.) • to raise awareness of the link between salt consumption and cardiovascular disease among the local communities served by these places of worship • to put salt reduction in the context of other healthy eating habits, eg, reducing fat consumption, reading food labels, etc.• to demonstrate to volunteer cooks and congregations how the salt content of the meals that they are receiving has been reduced without compromising on taste • to educate and improve the confidence of the volunteers who undertake social cooking so that they can cook with low levels of salt – even after the dietitians have left • to empower congregation members to reduce the quantities of salt that they are using at home • to help volunteers and congregation members to identify high-/low-salt foods from nutrition label information on packaged food, and to choose lower salt options • to augment the evidence base for salt reduction in Indian communities in the UK.The project had six objectives: • to provide training for a small number of dietitians to enable them to work with religious leaders, volunteers and congregations in temples and gurdwaras • to provide training and support for volunteer cooks at temples and gurdwaras to demonstrate how salt levels can be reduced and other healthy eating habits incorporated into social cooking without impairing the attractiveness and palatability of the food • to manage the reduction of salt usage over a six-month period at each place of worship • to provide information sessions and distribute leaflets to volunteers and congregations • to generate publicity about the project and the impact of salt consumption on health in ethnic minority media • to produce and disseminate an evaluation report

New plant breeding technologies for food security

[No abstract available