NACCHO Smoke Free news: Stickin’ It Up The Smokes – has there been a catchier campaign name?

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The recent NACCHO Summit had a number of presentations about different tobacco control projects that are underway across the country.

While their goals differ, they all are harnessing new technologies and online communications channels, reports journalist John Thompson-Mills.


Tobacco control projects in the spotlight 

John Thompson-Mills writes:

Tablets are being used to survey Aboriginal and Torres Strait Islander people and the staff and clients of community controlled services about smoking-related issues.

The Talking About the Smokes project aims to better understand the pathways to smoking and quitting for Aboriginal and Torres Strait Islander people, and to evaluate what works in helping them to quit smoking. (Many organisations are involved in the project, as outlined here).

So far, more than 2400 Aboriginal and Torres Strait Islander people have completed the first wave of the survey, which has seen health workers and even community Elders involved in collecting the data, using tablet technology.

Vouchers to supermarket and other major shopping chains are also used as inducements to encourage participation. A second wave of the survey is about to begin.

Jamahl, a Townsville health-worker, has been smoking since he was sixteen. He’s been convinced quitting is a good idea since recently losing a dearly loved Aunty to cancer.

Jamahl has taken the survey, and was surprised about what he learnt.

He says it’s made him think differently about his community and is convinced other respondents will feel the same way.


Making it Work

In NSW, more than 1000 “Tobacco Resistance Toolkits” have been downloaded since the Australian Health & Medical Research Council launched “Making It Work” in October last year.

Aimed at new Aboriginal service providers who lack training or culturally appropriate resources, the Tobacco Resistance and Control team (ATRAC) toolkit is a series of three modules.

These offer a practical template for data collection, creating a smoke-free workplace policy and how to source current facts and figures, called “Let’s Get Started.” A fourth module, Social Marketing, is about to be launched.

The three-year program has placed no limit as to how many modules will be available to its service providers. The more the community needs, the more consultation-based modules will be developed.

Once again, the community will shape and drive the program.

Jasmine Sarin who presented the seminar at the NACCHO Summit said defining success won’t be about the Toolkit’s effect on smoking prevalence.

“It’s more about measuring how people move through stages of change,” she says. “So, not smoking in the home anymore, or no longer smoking around children, any improvements in those areas would represent a success for us.”


Stickin’ It Up The Smokes

In South Australia, a unique program IS looking to reduce smoking prevalence – among young pregnant Aboriginal women.

In SA, the smoking rate for pregnant women is three times higher for Indigenous women than non-Indigenous women, totalling nearly 53%.

South Australia also has the highest number of low birth-weight babies.

The answer is Stickin’ It Up The Smokes, put together by the Aboriginal Health Council of South Australia (AHCSA).

Using social media, a series of flyers, posters and regional radio ads, a multi-faceted campaign has been pulled together in very quick fashion and for very little cost.

Mary Anne Williams, the Maternal Health Tackling Smoking Program Officer at AHCSA, says her initial campaign costs were heading towards $20,000.

But by bringing in a number of Aboriginal media students and finding a young social marketing expert, the final outlay was a fraction of that, at $2,000.

Speaking at the NACCHO Summit, Williams said the campaign only took four months to go from concept to delivery; a massive eight months quicker than a Government-led process would have taken.

She even managed to get some help from X-Factor finalist Ellie Lovegrove who wrote a rap for the campaign.

There were some challenges though. Convincing some community Elders about the merits of the strategy took time. And it was a struggle to find the nine non-smoking ambassadors until a Facebook campaign was launched. Then the quota was filled within two days.

The target audience is primarily pregnant SA Aboriginal women aged in their early 20s.

The secondary targets include: Aboriginal mothers with young babies, especially those who are breastfeeding; families, and particularly partners, of pregnant Aboriginal women; young Aboriginal women who have not yet taken up smoking or had children (especially those aged 10-14 years); and Aboriginal communities throughout South Australia.

The aim of the Stickin It Up The Smokes campaign is modest:  a 2.1% per year reduction in smoking during pregnancy for Aboriginal women by June 2016.

The Summit also heard yesterday about anti-smoking efforts by the Kimberley Aboriginal Medical Services Council, in WA. Some tweet reports follow.

Remote Aboriginal people have more to gain from electronic-health than most.

120818 Glance

Picture: Richard Polden Source: The Australian

By: Stephen Pincock The Australian August 18, 2012

Glance and his colleagues developed the system, known as Medical Message Exchange, with the Kimberley Aboriginal Medical Services Council, an umbrella group for Aboriginal Community Controlled Health Services in towns and remote communities in the region.

BY the time David Glance joined the University of WA’s Centre for Software Practice in 2001, life had already handed him a number of rewarding experiences.

After finishing a doctorate in physiology in the mid 1980s, Glance shifted his focus to the intersection of high finance and high technology and started designing the digital innards of trading room technology for London firms.

A few years later, with the dotcom bubble deflating, he found himself in the US headquarters of Microsoft in Redmond, Washington.

But he considers working with health workers in remote northwestern Australia for the past five years “the single most significant project I’ve worked on”.

Put simply, the project enables doctors, nurses and other health workers to co-ordinate the care of about 26,000 mostly indigenous patients across the vast distances of the Kimberley, by accessing medical records online.

Glance and his colleagues developed the system, known as Medical Message Exchange, with the Kimberley Aboriginal Medical Services Council, an umbrella group for Aboriginal Community Controlled Health Services in towns and remote communities in the region.With a patient’s consent, GPs, hospitals, visiting specialists and allied and mental health professionals can share their record, which includes all care plans, medications and communications.

There may appear to be something incongruous about developing a digital solution to the health needs of people living the least urban, least technologically connected lives in the country.

But remote Aboriginal people have more to gain from electronic-health than most, says Tamati Shepherd,, chair of the National Indigenous Informatics Special Interest Group in the Health Informatics Society of Australia.

The very remoteness of many indigenous communities, and the nomadic lifestyles of many Aboriginal people in places such as the Kimberley, make it difficult for healthcare workers to keep the detailed medical records considered vital for good healthcare.

“Keeping track of their health can be really hard,” says Shepherd. An e-health record can serve as a kind of digital glue, he says, keeping the healthcare system together.

This is critical as indigenous people are at high risk for chronic conditions such as diabetes that require careful, long-term monitoring, and have an unconscionably low average life expectancy. These are problems that have defied many well-intentioned initiatives, but Shepherd believes IT can make a difference: “Technology can have a huge impact in the health of indigenous communities.”

Trevor Lord, a GP who has worked in the Kimberley for the past two years, can testify to the difference MMEx makes. “One of the really nice things about this record is if I’m on call in Broome and a nurse calls from Beagle Bay about a patient, I can look up their record and check the details.”

And when Lord prescribes a drug, the nurse on the other end of the line doesn’t need to scribble down the information on the back of her hand. Lord enters the details on to the e-record. “It doesn’t matter where you are or where the patient is. We can all keep in contact with each other and do the best for the patient.”

According to Lord, an antenatal record added to the MMEx system about a year ago is invaluable. Previously, hospitals often had to ring three or four clinics to piece together a woman’s pregnancy record. “Now it doesn’t matter where the lady has her antenatal care done, because its all in the record.”

The project garnered global attention in 2010 when the Organisation for Economic Co-operation and Development produced an e-health report and chose an early version of MMEx as a case study. Regionally, health organisations in other states and in New Zealand adopted it. “We have around 250,000 patients in MMEx and about 10,000 health providers,” Glance says.

One key to the project’s success was the input from clinicians from the start.

“That’s what’s exciting about this project. It’s not just us as a software supplier sitting in Melbourne or Sydney … dreaming up what a disconnected group of GPs want. I’ve held meetings with customers in the emergency department. It’s that level of engagement that really triumphs what we’re doing.”

At a health informatics conference in Sydney last month, University of Tasmania IT expert Terry Hannan described an international example of the difference e-health records can make.

The story begins with a group of academics, including Hannan, brought to Kenya by Indiana University in the US and sitting in the dirt outside a remote village clinic. It ends with a web-based e-health record system, now used to treat 140,000 HIV-positive people, that reaches more than half a million people through home-based counselling and testing and has reduced mother-to-child transmission rates of HIV to below 2 per cent.

Known as the Academic Model Providing Access to Healthcare, the philanthropically funded service expanded its scope to include delivery of essential primary care services, and control of communicable diseases and chronic illnesses. Clinicians can use a smartphone to instantly access patient-specific data and also receive alerts when a scheduled test is overdue, or when a needed medication has not been started.

They can respond to reminders by wirelessly printing requisitions for laboratory tests, with all patient information pre-filled.

It now extends to social and economic benefits, Hannan claims: “The social effects of information management just exploded through society.”

Out of the Kenyan experience grew a wider project called OpenMRS. This free, open-source medical record software supports the delivery of healthcare elsewhere in Africa, North and South America, Asia and Europe.

Back in WA, Glance says hearing stories of how access to information has helped save lives is enormously satisfying. But he acknowledges it’s the doctors, nurses and health workers who make the biggest difference.

“I pale into insignificance compared to the efforts they’re putting in.”