Could 'Aunties' Recruit Pregnant Indigenous Women Who Smoke Into a Trial and Deliver a Cessation Intervention? A Feasibility Study.

Objective Maori (indigenous New Zealand) women have the highest smoking prevalence rates in New Zealand and whilst pregnant. We hypothesized that community health workers ('Aunties') could find pregnant Maori women who smoke, recruit them into a study and deliver an acceptable cessation intervention. The aim of the study was to test the feasibility of such an intervention. Method A community health organization was engaged to, using a participatory approach, conduct a feasibility study. Participants were ten Aunties and the pregnant women the Aunties recruited. The Aunties advised their participants to abstain from smoking, offered a Quitcard (for subsidized nicotine replacement) or referral to local cessation providers. A booklet on healthy eating for pregnancy was given and discussed and the Aunties offered help if needed to register with a lead maternity carer (LMC). All women completed a baseline questionnaire. Semi-structured follow up face-to-face interviews were conducted with a subsample of women and hospital birth records were examined. Descriptive statistics were produced using quantitative data. Qualitative data was deductively analysed. Results During 4 months eight Aunties recruited 67 pregnant women who smoked, 88 % were Maori, 84 % were of low socio economic status and 73 % had up to high school education. Only 36 % of the recruited women had registered with an LMC. The participants described the Aunties as supportive, nice and non-judgmental. The only criticism was a lack of follow up. Aspects of the intervention that the Aunties thought worked well were knowing and being involved with their community, and being able to give a gift pack to the participating women. Insufficient follow up was one aspect that didn't work well. The infant's birth record was found for 54 % of the participants. Conclusion Aunties were able to identify and recruit pregnant Maori women who smoked. The study method and intervention were acceptable to Aunties and participants and it was feasible to collect data from the participants' hospital birth records. Based on this study, with a similar number of Aunties recruiting, it would take 2 years to recruit over 300 participants, which would be sufficient for a stronger controlled trial.

Enlisting "Aunties" to Support Indigenous Pregnant Women to Stop Smoking: Feasibility Study Results.

INTRODUCTION: Smoking during pregnancy increases the risk of many pregnancy and birth complications. New Zealand's smoking cessation programmes rely on the smoker to take action and are embedded within New Zealand's health care. This article describes the smoking behavior outcomes of a feasibility project testing a proactive approach, utilizing Maori voluntary community health workers to identify and reach Maori pregnant women who smoke and provide cessation support. METHODS: Women, who smoked while pregnant, were identified and recruited by "Aunties" and cessation support was provided. Baseline and follow-up interviews were conducted. Outcome measures included smoking status, cigarettes smoked per day, time until first cigarette, cessation attempts during pregnancy, household smoking, and smoking inside the home or car. Simple descriptive statistics were produced and simple proportions reported. RESULTS: The majority of women were Maori, 20-30 years old, had their first cigarette within 30 minutes of waking and 58% had not tried to quit during the current pregnancy. Of the participants who completed a follow-up interview 33% had stopped smoking while they were pregnant and 57% had cut down. There was an increase at follow-up of people who had used cessation support or products. CONCLUSIONS: Aunties are well-placed to find pregnant women and provide cessation support and referral in a way consistent with traditional Maori knowledge and practices. This study suggests such an intervention could increase quit attempts and increase use of effective cessation methods. A more robust study is warranted to develop an enhanced Aunties intervention.