Evaluation of Aboriginal and Torres Strait Islander smoking cessation interventions with pregnant women in Australia: utilising a culturally appropriate tool.

The purpose of this article was to review and evaluate three Australian projects with a focus on smoking cessation and Aboriginal and Torres Strait Islander pregnant women, funded under the Tackling Indigenous Smoking Innovation Grants Scheme, Australian Department of Health. The aim was to determine the impacts of culturally appropriate smoking cessation support for pregnant Aboriginal and Torres Strait Islander women. To provide an equity-focused lens to the review, our team of Indigenous and non-Indigenous researchers utilised an Australian-developed assessment tool: the 'Cultural Identity Interventions Systematic Review Proforma'. The tool was used to measure cultural approaches across a range of domains, and these were independently assessed by two reviewers, along with an assessment of the projects' smoking cessation outcomes. The results were compared to the evidence base in relation to aims, methods, results and conclusions, and consensus for scoring was reached. The review found that these Tackling Indigenous Smoking projects about pregnancy intentionally and effectively incorporated culturally based approaches that sought to work with the participants in culturally informed ways. Each project utilised existing social networks and partnerships to provide their participants with access to a range of community resources, adding value to existing programs.

Perspectives about smoking cessation during pregnancy and beyond of Aboriginal women in Australia: A qualitative analysis using the COM-B model.

OBJECTIVE: Aboriginal and Torres Strait Islander women (hereafter Aboriginal) and their babies experience poor health outcomes for which smoking is a major risk factor. This paper explores Aboriginal women's perspectives on and experiences of smoking cessation, within and outside pregnancy, and their use of smoking cessation services using the COM-B (Capability, Opportunity, Motivation as determinants of Behaviour) model to understand Aboriginal women's capabilities, opportunities, and motivation for smoking cessation. METHODS: Data came from 11 focus groups conducted in regional New South Wales, Australia, with 80 women aged between 16 and 68 years. Thematic analysis was performed following the COM-B model. RESULTS: Seven themes related to capability, opportunity, motivation, and smoking cessation behaviors were identified. The themes highlighted that agency, knowledge, and self-efficacy (as capability), a supportive social environment, and access to culturally appropriate services and resources (as opportunities), together with automatic and reflective motivations for quitting, may enable short- or long-term smoking cessation. CONCLUSION: Smoking cessation interventions may be more effective if the dynamics of the COM-B factors are considered. Policy and practice changes for further enhancing regional Aboriginal women's psychological capability and supportive social environments, and making smoking cessation services culturally appropriate are warranted.