Perween Riaz
New Leaf Advisor
Nottingham City PCT
Tel: 07900 003338
Email: perween.riaz@nottinghamcity-pct.nhs.uk
Summary
This project was developed to improve access to the New Leaf smoking cessation service for the diverse black and minority ethnic groups. This was achieved through the recruitment of local people who were trained to become peer educators. The peer educators had the relevant skills required to effectively deliver New Leaf health campaign messages, which were culturally, religiously and linguistically sensitive. As a result of this intervention some of the most disadvantaged groups have been able to make informed health choices and adopt a healthier lifestyle, which has been demonstrated in an increase in referrals from the diverse population.
Aims: To raise awareness of the health risks of smoking and tobacco use amongst the diverse black and minority ethnic groups, and promote the New Leaf smoking cessation service through appropriate and acceptable channels by recruiting local community members.
Objectives: To increase awareness of the ill effects of smoking/ tobacco use amongst the diverse black and minority ethnic groups. To increase awareness of the local New Leaf smoking cessation service. To improve New Leaf service uptake from the diverse black and minority ethnic population, reflecting smoking prevalence locally. To increase access to appropriate resources for the diverse black and minority ethnic groups. These objectives fit with national and local policy developments in terms of improving health and preventing disease through supporting individuals to make healthy choices within the communities in which they live.
The project was secured through the local neighbourhood renewal fund and supported by the Director of Public Health. The change will be sustained through access to trained peer educators, who will be an ongoing resource to the New Leaf service on a sessional basis. The project was delivered through joint partnerships with the health promotion service and local community organisations. The success and learning from this project will be used to develop the Health Trainer Model for our Primary Care Trust.
The New Leaf service held a community consultation event to establish how it could improve its provision for the local diverse black and minority ethnic smoking population. The feedback has been compiled into a working document, which is used to address the identified gaps, and improve future service development and delivery. The development of the peer educators project was one of the outcomes of the action points, and has been taken forward by direct input and guidance from the community. Community consultation and feedback was an ongoing feature during the delivery of the project, and was used to adapt the interventions accordingly. For example, it was identified that it may not always be appropriate to have a health campaign session in all religious settings.
The project has introduced the development of a new skilled and knowledge-based workforce within the PCT. Peer educators have the additional skills and expertise required to engage and empower local communities to help them make informed health choices, which are appropriate and acceptable to their lifestyles. The peer educators are a very effective interface between the communities and the health professionals and are able to build bridges to enable a two way meaningful interaction, hereby developing and enhancing existing roles.
The project has been monitored by the neighbourhood renewal fund, and has recruited ten peer educators who have individually delivered six health campaign sessions within their identified communities. Each session was evaluated through questionnaires to establish the number of people reached and the effectiveness of the campaign messages. In order to get a demographic profile of the local diverse population based on a needs assessment, the interpreting agency was approached for data on the most frequently requested languages. This, along with the local 2001 census information and the Index multiple deprivation 2004 were used as the tools to identify the relevant communities for intervention. Although other services and organisations are attempting to meet the needs of their diverse minority ethnic groups, this approach has been innovative in addressing the needs of existing and newly migrated communities using current data.
The Peer Educators project was packaged and contextualised appropriately and sensitively, taking account of the cultural, religious and linguistic needs of the local population. The communities were able to identify with the messages and use them effectively, which resulted in informed decision makers, able to make healthier lifestyle changes. This has been demonstrated through positive feedback during the intervention, and an increase in service uptake from the target groups.
Evidence suggests that the diverse black and minority ethnic groups face higher levels of health and social deprivation. They have higher rates of unemployment, poorer housing and education levels. The incidence of certain illness and diseases are higher amongst certain diverse minority ethnic groups. However, when attempting to access health care they are further disadvantaged due to cultural, religious and linguistic barriers. This data guided our rationale for the Peer Educators project ensuring access to the New Leaf service was appropriate and sensitive to its diverse smoking population. This model of working has also introduced a new skills mix, which will not only improve job prospects for the local diverse population but also reflect a diverse staff group within the NHS.
The project has shared the learning through the Directorate presentation, at team meetings and training sessions within the Primary Care Trust. The Health Promotion Service will use the learning from this project on which to base their Health Trainer Model. The learning has also been shared with local Sure Start and voluntary community organisations looking to adapt a similar model within their organisations.
The main feature of this work, which demonstrates imagination and innovation, is that it has developed inroads to working with communities who face multiple disadvantages, and who have previously had little or no input. It has been ahead of its time in using an evidence based model as highlighted in the NHS Choosing Health and adapting it to suit local need. The project has supported the development potential for a new workforce, which needed additional skills and knowledge to support a diverse population.
