Mickie Tubman can still recall her excitement last April. Having quit smoking only one week before, she was trekking up a small incline when she suddenly realized something: She could breathe.
“I felt like I had just climbed Mount Rushmore,” Ms. Tubman said.
On a recent afternoon in January, Ms. Tubman gathered with five women who also quit smoking last spring with the help of Sister to Sister, a community-based Medical College of Georgia program to help women in public housing kick the habit.
They were there for many reasons—to provide suggestions on improving the program, to update each other on their progress, but most of all, to thank MCG faculty for helping them regain control of their lives.
“I am just so grateful,” Ms. Tubman said.
The program was initiated six years ago by Dr. Jeanette Andrews, assistant professor of nursing, when a Richmond County school counselor asked her to help school staff and parents quit smoking. Community focus groups helped researchers glean how prevalent smoking was in public housing, how much interest its residents had in quitting and what types of strategies they thought would best help them.
“African-American women in public housing communities reported a smoking prevalence of 40 percent, with at least two-thirds of households having at least one smoker in the residence,” Dr. Andrews says.
The focus groups had very clear ideas about how to tackle the problem.
“They preferred community-based group meetings with preferences for family kinships and networks that were nonjudgmental, included spiritual themes and were personalized to meet individual needs,” Dr. Andrews said. “The initial advisory group named the approach Sister to Sister not only because women were encouraged to quit along with other female relatives, but the support among women quickly becomes a sisterhood as they collectively strive for the goal of quitting smoking.”
The hope was that by involving friends and family members, success rates would skyrocket.
With predoctoral fellowship funding from the National Institutes of Health and additional funding from the American Cancer Society and the American Legacy Foundation, Dr. Andrews began her first trial in 2002 in two public housing neighborhoods – one treatment and one comparison– with 103 African-American women smokers.
In the treatment community, a neighborhood advisory board distributed anti-smoking brochures and placed a message board with monthly anti-smoking messages near the entrance to the community. Women smokers in the treatment neighborhood received nicotine patches in conjunction with nurse-led behavioral treatment, support from African-American neighbors who were former smokers and neighborhood anti-tobacco initiatives.
Small-group
sessions were held weekly for six weeks with cessation materials, empowerment
counseling and group prayer. Two community health workers attended each meeting
and contacted the women weekly to provide additional support.
In the comparison community, women smokers attended weekly nurse-led educational meetings about health topics including hypertension, nutrition, exercise and self-esteem.
In results Dr. Andrews characterized as astonishing, 27.5 percent of women in the treatment neighborhood were smoke-free six months after the program ended. Only 5.7 percent of the comparison group had quit.
“Having the community members involved not only in the planning and implementation of the project, but also in the evaluation, was instrumental to empowering them to strengthen and promote behavioral changes in their communities,” Dr. Andrews says.
Today, four years after those first group meetings, 150 women from four public housing neighborhoods are enrolled in Sister to Sister. Stacey Crawford, a lay member of the community and a former smoker, leads group meetings in treatment neighborhoods. Nicotine patches continue to be provided for both the treatment and comparison neighborhoods.
Sister to Sister participants consider the program nothing less than a lifesaver.
“I recently found out that I have to have an operation,” Ms. Tubman says. “My doctor told me that if I still smoked, I couldn’t have it unless I quit. I’m thankful that’s not an issue for me anymore. After being a smoker for 40-plus years and the constant buying of cigarettes, I just don’t want to do it anymore. I just know that I’m too good to smoke now, and that was a real group effort.”
Jennifer Hilliard