Which Way? Gulibaa Project: a state-wide, co-designed model of care to support Aboriginal and Torres Strait Islander women to be smoke and vape free

The Gulibaa Project aims to reduce the prevalence of smoking and vaping among Aboriginal and Torres Strait Islander women by implementing and evaluating an Indigenous led, co-designed group-based smoking and vaping cessation program for healthcare workers within NSW. Aboriginal and Torres Strait Islander researchers, health workers, and communities were collectively involved in the co-design process to develop the group-based program. This included Yarns between Aboriginal researchers and Aboriginal and Torres Strait Islander women to understand what a group-based cessation program should look like, and how it could best support them to quit. Further non-formal Yarns were conducted with maternal teams to uncover what would be needed to implement cessation support groups within their model of care. A half-day workshop was then held with key community partners including Aboriginal Health Workers, nurses, midwives, and the management team of a maternal health service held at the local Aboriginal Land Council, where they were presented with two key questions: ‘What could a group-based programme to empower Aboriginal and Torres Strait Islander women look like and include?’ and ‘What behaviour change techniques do you think are most important to include in a smoking and vaping programme for Aboriginal and Torres Strait Islander women?’. These were used to inform the program development, with ongoing feedback and oversight by health workers at the maternal service. Training has been developed specifically for this study to assist health workers to implement the co-designed program. The group-based program: The Which Way? women’s program is a group-based smoking and vaping cessation program. It covers key content including the harms of smoking and vaping, benefits of quitting, overcoming challenges to quitting, and education on nicotine dependence and available cessation supports. The program guides participants on how make a quit plan, explore motivations for quitting and build social supports to help them on their quitting journey. Each session embeds cultural practices and covers practical such as setting a quit date, identifying triggers, using behavioural tools to resist cravings, the importance of healthy lifestyle, relapse prevention, and celebrating successes. The program has been designed to be flexible so that services can deliver the six sessions in a way that is responsive and appropriate to their community and service (i.e., across 6 weeks, condensed across two days, half-day event etc.). The program uses a range of resources to deliver content in an engaging and supportive way, including activities, worksheets, facilitator manuals, and women’s journals. Sessions are structured as follows: Session 1: Benefits of quitting the smokes and vapes Session 2: Overcoming the challenges to quitting Session 3: Support to quit Session 4: Changing behaviours and developing a quit plan Session 5: Celebrating success and staying on track Session 6: Graduation The acceptability of the program content and implementation was piloted through Yarns and feedback. The program has now been finalised based, and will be implemented and evaluated using the re-aim framework as part of the Gulibaa project.