Effective engagement of stakeholders, partner organisations and the local media will pay dividends.
In 2009 NHS Leicester City STOP! smoking service collaborated with Pfizer to implement an intensive three-month community-level intervention targeted at smokers in New Parks, Leicester. ‘Lose the Smoker in You’ successfully raised awareness and uptake of local services in an area with a smoking prevalence of 40.5%, but it also taught us a great deal about securing the support and time of local community members, including volunteers, to enable a truly community-run campaign. We were of course fortunate to have support from Pfizer, but many much of of the learning from the project is t learnings relevant to smaller-scale initiatives targeting “hard to reach” smokers.
In this article I have used examples taken from the highs and lows of working with a huge range of local stakeholders and developed a series of pointers for any services thinking of travelling a similar path and implementing their own community-run campaign.
Be upfront about time commitments – and offer tiered levels of support
Begin any campaign with a wide group of stakeholders as a steering group – but then whittle down to a local implementation group consisting of people with the time and commitment to take action. Keep the steering group informed through emails.
When asking people to contribute, be really upfront about the time involved: “This is what we are asking you to do, and this is what we as the campaign team will do to minimise the impact on your time.”
Find a means of consistent communication for the implementation group – either face-to-face, telephone or electronic – to ensure everyone feels really involved, but also essential in ensuring everyone feels accountable for their part.
Anticipate any concerns and address them head-on
New Parks has a very close-knit identity. This proved both an advantage and a disadvantage.
When we first held meetings with local stakeholders it was clear that as NHS workers we were perceived, with some mistrust, as outsiders by some members of the community.
The most successful antidote to mistrust of the NHS was to establish strong relationships with key community members, and to consistently demonstrate that you are not out to make people feel guilty about smoking, nor to claim all of the ‘glory’ for the campaign results. We stressed that we just wanted to raise awareness of the benefits of stopping smoking and of the services available in a community where smoking is a family activity, and a noteworthy cause of lives being cut short.
Demonstrate how the campaign will live on
One challenge from stakeholders was that when the project finished we would pack our bags and move on, leaving the community with nothing in its place.
It is essential to emphasise that the campaign is not a “one off” – it is part and parcel of the presence your service already has in the area, and you will always be there to offer free quit support to anyone who needs it after the campaign.
Both the manager and one of the bar staff at the local pub used the service to stop smoking during the campaign, and were kind enough to allow us to host our end-of-campaign celebration. Right in the heart of the community, and the place where many families went for social activities, such as karaoke after picking up the kids from school. The pub was also ideal for a new drop-in after the end of the project.
The pub is an example of a new “space” the campaign enabled us to access – and made us visible to a whole new audience, and giving us an opportunity to demonstrate our continued commitment.
Recognise the input of volunteers
The roles played by paid workers and those who volunteered were at times a source of conflict. What could at face value appear to be quite trivial incidents could become magnified, such as who was inside the campaign bus and who was outside drumming up trade.
Potential flash-points can be anticipated and handled with diplomacy. A frank and open conversation with volunteers at the beginning can help. Ask volunteer leaders how to recognise the time given by their volunteers, and what you can offer. It could be important to give volunteers cash to cover travel expenses, rather than leaving them out of pocket while waiting to be reimbursed. Providing lunch is a great way to show gratitude.
We were fortunate to have the team of Let’s Talk volunteers, all themselves local people already working on a community-level project to help people spot the early signs of cancer. Prevention being a natural link, they encouraged people in New Parks to take a really important step to improve overall health and specifically to reduce the risk of cancer in later life.
Make local voices heard
We launched the campaign with a “stunt” photo opportunity and street consultations by Dr Jonty Heaversedge – one of the BBC “Street Doctors”. This high-profile launch was important to grab the attention of local residents and the media – but after overhearing some “nanny state” scepticism, it became important to step back and allow local voices to be heard.
During the lifetime of the project, some real stars emerged, and we are enormously grateful for their commitment. Local residents who stopped smoking with our help, especially those who did it for their children, were more than willing to be featured in our local newspaper the Leicester Mercury – making a strong and passionate appeal for others to use the stop smoking service. I believe that it is these local advocates who have the strongest influence on their peers – and they will continue to drive their friends and family to take action and quit with help.
Build relationships with the local media
The media have an important role in any health awareness campaign, reaching a wide audience with your message. Involve them early.
We visited key local journalists before the campaign began – including the Leicester Mercury and local BBC team – asking them what types of stories and photo opportunities would best work for them. We were able to use this information to hone our campaign activities – making sure that our events were held at the best time of day and had all the elements the media had asked for – including spokespeople, photo opportunities and local quitters to be interviewed.
The health correspondent of the Leicester Mercury was very enthusiastic about covering stories from the project, especially the more picturesque moments like the tug-of-war that included the local police force and the fire service.
Throw the net wide for partner organisations
Look widely for groups who might have time to offer. We were able to tap into a local social enterprise organisation called Community Arts who incorporated quitting smoking into their local filming project. The manager of the New Parks Boxing Club, herself a smoker, was filmed as part of a video-diary series on her quit attempt. The film was put on YouTube and has influenced many young club members – and their parents – to think about quitting.
Heroes who worked to make the campaign a success included the local pharmacists, GP practices, the Salvation Army, the Leisure Centre staff, schools in the area, the Sure Start Centres, and the local councillors, who could always be relied upon to support us. One of the councillors has now been appointed Lord Mayor of Leicester, and we know we can count on him for support for further tobacco control work.
We wish the best for any future community-focused campaigns aimed at helping people access local stop smoking services – and we would be very happy to provide further advice if you would like to get in touch.
Louise Ross of NHS Leicester City STOP! smoking service.