Concept and Practice in Community Mobilization for Health: A Qualitative Evaluation of the Brantford COMMIT Smoking Cessation Intervention Trial

Abstract

<p>The Community Intervention Trial for Smoking Cessation (COMMIT) was one of the largest health promotion interventions in North America. Using 11 pairs of matched intervention and control communities, the U.S. National Cancer Institute sought to establish the viability of a community-based approach to smoking cessation, with the expectation of significant impacts on cessation rates amongst heavy smokers during the four years of intervention.</p> <p>The evaluation components of the COMMIT trial relied primarily on the use of surveys to document quantitative changes in attitudes, beliefs and behaviours. A complementary ancillary qualitative evaluation was conducted by the author in the only Canadian intervention site in the trial in Brantford, Ontario. Depth interviews and focus groups were conducted with 45 members of a Smokers' Network established by COMMIT. Subsequently, 35 intervention staff, researchers and community influential were interviewed. Transcripts were coded and analyzed using qualitative analysis software.</p> <p>Several objectives guided the qualitative evaluation study in Brantford: 1) establish the degree to which the COMMIT met the needs of smokers for assistance in quitting; 2) identify the factors that inhibited or facilitated program success; and 3) consider the implications for community mobilization for smoking cessation. Findings in each of these areas are discussed.</p> <p>This work seeks to contribute to knowledge development in health promotion at the level of theory and method, as well as substantively in terms of the design and implementation of community health promotion interventions. A critical-interpretive methodology is advanced as being consistent with the 'new' health promotion, based on a review of the literature on social theory which also argues for an explicit critical and emancipatory orientation to theory and practice in health promotion. These approaches are applied to the examination of a community-level smoking cessation intervention. Chapter 9 contains a critical sociological examination of the nature of tobacco control, drawing upon the work of Goffman.</p>