Tailored intervention for smoking cessation among migrant smokers in health centers for precarious people in Paris: A co-design approach

Abstract

Objective

Certain groups of migrants in Europe exhibit higher smoking prevalence compared to non-migrants, with social inequalities significantly impacting their health outcomes. Culturally adapted smoking cessation interventions are more effective for migrants. Co-design a smoking cessation intervention tailored to migrant smokers attending in health centers for precarious people in Paris.

Methods

Following an adapted experience-based co-design iterative process to gradually refine our crafted intervention, the study brought together migrants, health professionals, representatives from associations, and a research team between January and July 2024. Pre-workshop enabled to adapt ideation working tools to better suit the public. In the initial phase, migrants helped shape intervention design based on their tobacco use habits and preferences. Subsequent workshops benefitted medical and tobacco-expertise from healthcare workers in co-design workshops, refining our prototypes and ensuring they adhere to evidence-based practices. Data collection included questionnaires, audio-recordings, and field notes analyzed through thematic analysis.

Results

Fourteen migrants (mostly undocumented, from African countries, and current smokers) and fourteen healthcare workers (mostly medical practitioners or nurses) were involved in the co-design sessions. The co-designed intervention consisted in a monthly face-to-face participant-led group discussion supervised by health professionals with flexible attendance combined with WhatsApp group support with facilitated access to nicotine replacement therapy or existing interventions, and adapted health literacy materials.

Conclusion

Co-designing intervention with migrants enabled the development of an intervention addressing their barriers to smoking cessation. Combining peer-support, digital engagement, and facilitated access to existing resources may improve uptake and effectiveness of cessation programs among this vulnerable population.