How can engagement with underserved communities be enhanced? A co-inquiry informed model of stop smoking outreach.

Abstract

Aims: 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.

Methods: 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.

Results: 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.

Conclusions: 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.