Improving Participants’ Retention in a Smoking Cessation Intervention Using a Community‑based Participatory Research Approach

Abstract

Background: This study compares participants’ retention in three phases of smoking cessation interventions, one provided in a health clinic and the subsequent two in community‑based settings.

Methods: Smoking cessation interventions were conducted in three phases from 2008 to 2015 in two underserved urban communities with low socioeconomic profles and high rates of smoking (n = 951). Phase I was conducted in a clinic; Phases II and III were conducted in community venues. In Phases II and III, incremental changes were made based on lessons learned from the previous phases. Retention (attending six or more sessions) was the primary predictor of cessation and was analyzed while controlling for associated factors including age, gender, race, employment, education, and nicotine dependence.

Results: Retention increased substantially over the three phases, with rates for attending six or more sessions of 13.8%, 51.9%, and 67.9% in Phases I, II, and III, respectively. Retention was signifcantly higher in community settings than in the clinic setting (adjusted odds ratio [OR] = 6.7; 95% confdence intervals [CI] = 4.6, 9.8). In addition to the
intervention in community venues, predictors of retention included age and unemployment. Higher retention was signifcantly associated with higher quit rates (adjusted OR = 2.4; 95% CI = 1.5, 3.8).

Conclusions: Conducting the intervention in community settings using trained peer motivators rather than health‑care providers resulted in signifcantly higher retention and smoking cessation rates. This was due in part to the ability to tailor cessation classes in the community for specifc populations and improving the quality of the intervention based on feedback from participants and community partners.

Keywords: Community‑based participatory research, retention, smoking cessation, underserved populations