Mills T, Dawkins L, Dean R, Lewis E G, Jenkins C L, Wills J, Sykes S
PHIRST South Bank, London South Bank University, 103 Borough Road, London SE1 0AA, UK.
PHIRST South Bank, London South Bank University, London, UK.
Perspect Public Health. 2025 Mar;145(2):97-104. doi: 10.1177/17579139251322314. Epub 2025 Mar 31.
This co-inquiry project aimed to develop a qualitatively informed model of professionally led stop smoking outreach. It involved 13 staff from a Stop Smoking Service (SSS) which operates across three Local Authorities in England (Central Bedfordshire, Bedford Borough and Milton Keynes). Staff's outreach sought to engage people from the most deprived areas who smoked but were not engaging with the service.
The co-inquiry comprised six reflection sessions and ethnographic research which aimed to explicate and examine staff's assumptions about how outreach works, conducted over 12 months. Data included 32 diary entries, eight observations of staff's outreach events, 10 interviews with staff and eight interviews with members of the communities being targeted. Data were reflected on to develop a 'real-world' logic model and summarised using thematic analysis.
Professionally led outreach can raise awareness of service offers, remove access barriers and generate referrals. A non-judgemental, person-centred approach is vital through which staff carefully initiate conversations with community members about smoking, and tailor information to community members' needs and preferences. Such an approach, in combination with an e-cigarette support option, can generate interest in SSS and challenge negative perceptions. However, outreach is time-consuming for busy frontline staff, unpredictable and best implemented via effective community partnerships.
Our findings suggest that stop smoking advisors' outreach can contribute substantially to national ambition to create a 'smoke free generation' provided that sufficient investment is provided. Professionally led outreach, delivered in partnership with community organisations, can generate referrals among people who are disconnected from health services. Such non-traditional referral routes are likely to become more significant as smoking prevalence further declines in the general population.
本共同探究项目旨在开发一个基于定性研究的专业主导戒烟外展服务模式。该项目涉及来自一家戒烟服务机构（SSS）的13名工作人员，该机构在英格兰的三个地方政府辖区（贝德福德郡中部、贝德福德自治市和米尔顿凯恩斯）开展业务。工作人员的外展工作旨在接触那些来自最贫困地区、吸烟但未使用该服务的人群。
共同探究包括六次反思会议和人种志研究，旨在阐释和检验工作人员对外展工作如何开展的假设，研究持续了12个月。数据包括32篇日记条目、对工作人员外展活动的8次观察、对工作人员的10次访谈以及对目标社区成员的8次访谈。对数据进行反思以开发一个“现实世界”的逻辑模型，并采用主题分析法进行总结。
专业主导的外展工作可以提高对服务提供的认识，消除获取障碍并产生转介。一种非评判性的、以人为本的方法至关重要，通过这种方法，工作人员谨慎地与社区成员就吸烟问题展开对话，并根据社区成员的需求和偏好定制信息。这种方法与电子烟支持选项相结合，可以激发对戒烟服务机构的兴趣并挑战负面看法。然而，外展工作对于忙碌的一线工作人员来说耗时较长，不可预测，并且最好通过有效的社区伙伴关系来实施。
我们的研究结果表明，只要有足够的投入，戒烟顾问的外展工作可以为实现“无烟一代”的国家目标做出重大贡献。与社区组织合作开展的专业主导外展工作，可以在与医疗服务脱节的人群中产生转介。随着一般人群吸烟率的进一步下降，这种非传统的转介途径可能会变得更加重要。
