RESUMO
INTRODUCTION: Innovative smoking cessation approaches that overcome barriers such as traveling to program site or that require the staff and infrastructure for sustaining are likely needed to improve smoking quit rates among American Indian (AI) peoples in the United States. In this study, qualitative methods identified recommendations from AI peoples to guide alignment of an evidence-based smoking cessation smartphone app (i.e., QuitGuide) to the culture and needs of AI persons. METHODS: Semi-structured interviews were conducted with AI adults who smoke (n = 40) and with public health professionals (n = 6). Questions included: "The app asks if something triggered you to slip and lists several options. What options were you expecting to see on this list?" as well as how to make the app more engaging such as "What would make the app more helpful for AI peoples, like you, who want to quit smoking?." Constant comparative techniques were used to develop codes and themes. RESULTS: Loss, grief, and not accessing traditional tobacco were put forward as smoking triggers to be addressed in the app. Features that help users connect with and learn about AI cultures and promote healing, such as encouraging traditional tobacco use, being in community, embracing Native spirituality, and participating in cultural crafting were recommended. Some noted the need to motivate AI peoples to think about legacy and ability to care for younger generations and Indigenizing the app with Native imagery. CONCLUSIONS: Themes pointed towards promotion of strengths-based factors, such as healing, cultural connectedness and traditional tobacco use, in the app. IMPLICATIONS: Results will be used to culturally align a smartphone app for smoking cessation among AI peoples and may be insightful for other tribal, federal, and state public health efforts aimed at advancing health equity for AI peoples.
Assuntos
Indígenas Norte-Americanos , Aplicativos Móveis , Abandono do Hábito de Fumar , Adulto , Humanos , Abandono do Hábito de Fumar/métodos , Uso de TabacoRESUMO
People in prison are disproportionately affected by health problems, some of which lead to imprisonment and some of which are caused by imprisonment. Mental illness and substance use disorders fall into both of these categories, but they are not the only ailments affiliated with incarceration. Prior to their incarceration, many people in prison did not have safe housing or stable employment and job security, and institutional policies and/or budgetary concerns prevent many inmates from receiving adequate health care while in prison. Prison inmates in the United States are both victims and perpetrators of violence while incarcerated. In all cases, acts of violence have negative psychological consequences for the victim, including depression and shame. Mindfulness meditation training for prison inmates might be among the most effective of interventions, helping to prevent violence, improve quality of life, and reduce recidivism. Research and evaluation of data suggest that mindfulness-based nonviolence programs are transferable to other inmate populations, and the author recommends that both the private and public prison systems implement such programs nationwide, with the support of state and federal governments.