Funded by the Health Education Board for Scotland (HEBS) the Women, Low Income and Smoking Project aimed to explore new ways of working to address smoking reduction among women living on low income by funding and supporting community based initiatives and to gain new insights into appropriate methods of evaluation. This project was developed in response to the findings of the Under a Cloud Project which was initiated to address concerns highlighted in research that identified smoking rates, both prevalence and consumption, were increasingly associated with those living on low income and in materially disadvantaged circumstances, and that women were over-represented in this low income group (Crossan and Amos, 1994). The Under a Cloud Project showed that there was a great willingness, enthusiasm and motivation from those who work with women to develop initiatives to support smoking reduction among women living on low income. However, lack of funding, training, appropriate support and resources was hindering the development of initiatives at community and local level.
The Women, Low Income and Smoking Project operated between April 1996 and March 1999. The project adopted a community development approach, which sought to work with those at community level to identify support structures and initiatives that would address smoking reduction among women living on low income. The project had four objectives. These included the funding and support of community based initiatives, the exploration of different approaches and methods of evaluation, the development of a communication and network facility to support work at local level and the dissemination of the work throughout Scotland.
Distributing a total of £37,000, twenty initiatives were awarded grants of between £500 and £3000 to undertake work that would operate for a maximum of a year. A variety of methods were used by the initiatives to provide an opportunity for participants to address their smoking behaviour while developing new skills and interests and raising their confidence and self esteem. Some initiatives tackled smoking using direct methods and focused on cessation. However, the majority used a variety of indirect methods e.g. poetry and video work, drama, exercise and diversionary activities.
The project staff provided support to those groups and organisations that applied for small grant funding and the funded initiatives. The support was intentionally flexible to take account of the diversity of groups and the level of support they were able to access from within their own organisations. Two Information Days and a Seminar Day were organised to bring initiatives together at different stages of the small grant funding process and to provide participants with an opportunity for initiatives to share their work plans, methods and learning.
A database detailing information from all the small grant applications was set up to provide evaluation data. Four project bulletins were produced to disseminate information about the funded initiatives to groups and organisations throughout Scotland.
A pluralist approach to evaluation was adopted to collect material from the different elements of the project. Process and outcome data from the work of the initiatives was collected and collated from the final reports of the initiatives, in-depth case studies of five initiatives and from feedback obtained during project manager visits and contact, the Information Days, Seminar Day and National Conference. To gather data on the project as a whole, focus group sessions and interviews were carried out with members of the staff team, management group and evaluation advisory group. This supplemented information that had been gathered through contact with the initiatives and from the Information Days, Seminar Day and National Conference.
A similar pluralist approach was taken with dissemination, which included presentations at regional, national and international conferences and the publication of four papers in the Health Education Journal. In addition a round table meeting was organised by ASH Scotland involving members of the management group, evaluation advisory group and staff team and senior staff within HEBS to update them on the progress of the project and share some of the preliminary findings. The chief executive of ASH Scotland maintained an ongoing dialogue with those involved in the development of health and tobacco policy at the Scottish Office.
At the national conference in February 1999, `Women, Low Income and Smoking`, the project findings were disseminated to an audience of policy makers and practitioners working within health, social work and community work in the UK. Eight initiatives gave a fifteen-minute presentation of their work, followed by a brainstorming session to identify recommendations for policy. These recommendations were then presented to a panel of policy makers for discussion in the final session of the day.
In achieving its` objectives the project has stimulated significant interest among groups and organisations wishing to work within a community development approach to developing services which support smoking reduction among women. Many of the funded groups and organisations had no previous experience of developing such work and had to overcome significant internal and external barriers to undertake the initiative. Only one initiative failed to start and a minority have been able to continue work on health and smoking after funding had come to an end. However, further work is required to develop work that is sustainable over the longer term. The project has provided some invaluable lessons about evaluation and the support and training required to assist community workers to develop community based services. Many groups and organisations had limited experience of collecting and recording evaluation material and felt it was crucial that support and training be available to those developing tobacco related work at community level. It is important the funding and development of future work in this area must reflect the findings of this project with the aim of meeting the needs of those living on low income.
1. Project Manager, Women, Low Income and Smoking Project, ASH Scotland
2. Senior Lecturer in Health Promotion, Public Health Sciences, Edinburgh University
3. Voluntary Sector Programme Manger, Health Education Board for Scotland
4. Research Professor in Sociology, Glasgow Caledonian University
5. Chief Executive, ASH Scotland
Executive Summary
Conclusions
Recommendations
Introduction
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Last updated: 15 July 2009