A qualitative study assessing how reach and participation can be improved in workplace smoking cessation programs.

INTRODUCTION: Randomized controlled trials have demonstrated the effectiveness of workplace smoking cessation programs. However, with low participation rates reported, it is important to understand the barriers and facilitators for the reach and participation of employees in workplace smoking cessation programs. The objective of the present study is to uncover the needs of employees regarding reach and participation when implementing a workplace program to address smoking cessation. METHODS: We carried out 19 semi-structured qualitative interviews in 2019 based on the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) Framework with current and former smoking employees of organizations with ≥100 employees in the Netherlands. Some of the interviewees had experience with a cessation program. Data were analyzed using the Framework method. RESULTS: The main barriers according to employees were insufficient promotion of the cessation program, completing the program in the employee's own time and working night shifts and peak hours. Facilitators included being actively approached to participate by a colleague, positive reactions from colleagues about employee's participation in the program, providing the program on location and integrating the program as part of the organization's vitality policy. CONCLUSIONS: Effective workplace programs for smoking cessation can stimulate cessation but implementers often experience low participation rates. Our study presents recommendations to improve the recruitment and participation of employees in a workplace smoking cessation program, such as using active communication strategies, training managers to stimulate smoking employees to participate and making the program as accessible as possible by reimbursing time spent and offering the program at the workplace or nearby. Integrating the smoking cessation program into wider company vitality policy will also aid continued provision of the program.

Implementation of Financial Incentives for Successful Smoking Cessation in Real-Life Company Settings: A Qualitative Needs Assessment among Employers.

Randomized studies have shown that financial incentives can significantly increase the effect of smoking cessation treatment in company settings. Evidence of effectiveness alone is, however, not enough to ensure that companies will offer this intervention. Knowledge about the barriers and facilitators for implementation in the workplace is needed, in order to develop an implementation strategy. We performed a qualitative needs assessment among 18 employers working in companies with relatively many employees with a low educational level, and our study revealed priority actions that aim to improve the implementation process in these types of workplaces. First, employers need training and support in how to reach their employees and convince them to take part in the group training. Second, employers need to be convinced that their non-smoking employees will not consider the incentives unfair, or they should be enabled to offer alternative incentives that are considered less unfair. Third, the cost-effectiveness of smoking cessation group trainings including financial incentives should be explained to employers. Finally, smoking cessation should become a standard part of workplace-based health policies.

Drug users' participation in addiction care: different groups do different things.

This study allocated 201 (nearly) daily users of heroin and/or crack into four groups, depending on their addiction care participation. Earlier studies have compared treatment groups and nontreatment groups. In this study the treatment group is divided into three categories: (1) drug users in contact with only treatment agencies--i.e., methadone maintenance, clinical and ambulant drug treatment; (2) drugs users in contact with only care agencies--i.e., day and night shelters and drug consumption rooms, which have no explicit aims to change patterns of drug use; and (3) drug users in contact with both treatment and care agencies. This allocation intro three different groups fits the notion of harm reduction, one of the policy aims in The Netherlands. The fourth group consists of drug users in contact with neither treatment nor care agencies. The results show that it is useful to distinguish these four categories, instead of two. The four groups are different from each other with respect to some of their characteristics (e.g. debt situation, prostitution, homelessness) and their drug use (e.g. drug use in public, use of crack, and use of other drugs). A much clearer distinction can be made between the "care" group and the "treatment and care" group. Treatment and care agencies can thus better match their services to their clients or patients.

The rise of the mobile phone in the hard drug scene of Rotterdam.

The rise of mobile phone dealing in the retail market of heroin and cocaine in the city of Rotterdam is described. Multiple methods were used for the study, including analysis of street survey data (1998, 2000, 2003), qualitative and quantitative analysis of fieldwork data, and semi-open interviews with drug users and key informants. In 2000, 70% of the respondents to a street survey bought drugs from a mobile dealer. Qualitative data showed that the majority of mobile dealers have an ethnic Moroccan background; the reasons for this may include the ambiguous attitude of the Moroccan community towards drug crime, and repressive legislation causing the market to find alternatives for basic street dealing. The rise of mobile dealing is discussed as a form of reshaping of the drug market under prohibition.

Tracing selection effects in three non-probability samples.

Snowball sampling and targeted sampling are widely applied techniques to recruit samples from hidden populations, such as problematic drug users. The disadvantage is that they yield non-probability samples which cannot be generalised to the population. Despite thorough preparatory mapping procedures, selection effects continue to occur. This paper proposes an interpretation frame that allows estimating the direction of selection bias after data collection. Critical examination of the recruitment procedure and comparison with statistical and non-statistical external data sources are the core features of the interpretation frame. Applying the interpretation frame increases insight into the reliability of the results and allows to estimate where selection bias may have occurred.

Homeless drug users in Rotterdam, the Netherlands: profile, way of life, and the need for assistance.

Decreasing the number of homeless drug users is one of the main characteristics of inner city drugs policy. The present study selected an urban-ethnographic perspective (the subculture theory) in order to explore why one drug user is homeless and another 7 not, and to attempt to describe and define the homeless and their immediate social environment. These issues were formulated into the following research questions: 1. What are the sociodemographic characteristics of homeless drug users in Rotterdam, and do they differ from domiciled drug users? 2. What are their living conditions? 3. What are the reasons for being homeless? 4. Does the period of homelessness play a role in the need to change one's lifestyle? Five research methods were employed for this study: a literature search, interviews with key persons, field notes from community fieldworkers, a survey among drug users (n = 204), and photographic reports from six homeless users. Data were collected in 1998/1999. The results document that in our study population there were more women, more illegal persons, and more foreigners than among domiciled drug users, and that the homeless group used heroin and cocaine on more days. A large proportion of the homeless users had no identity papers and no health insurance. This did not, however, lead to more self-reported sickness or a higher prevalence of infectious diseases compared with nonhomeless drug users. Easily accessible (low threshold) social care centers and assistance are very important. Few of the homeless had voluntarily chosen a homeless life-most describe an event that was a trigger for their homelessness. The average duration of being homeless was 17 months, and the longer someone had been homeless the less inclined they were to change their situation. This paper also discusses policymaking implications.

Drug consumption rooms in rotterdam: an explorative description.

The Rotterdam Drug Monitoring System used survey data, fieldnotes and interviews with staff to investigate the functioning of four (out of six) consumption rooms in Rotterdam. The results show that for most drug users, access to the drug consumption room results in less frequent drug use in public places and more time and rest. Pass holders value being able to use drugs safely inside, and make use of the additional services provided, such as refreshments, washing/showering facilities and talking with others about their personal problems. Two 'weak points' reported by the drug users are discussed in relation to their personal health situation and public nuisance reduction.