iSISTAQUIT Ngurrajili (implementing Supporting Indigenous Smokers to Assist Quitting) Scale-Up in Indigenous populations of Australia

We are scaling up iSISTAQUIT which was the implementation phase of SISTAQUIT research implemented in around 40 health services. The full iSISTAQUIT intervention for scale up consists of 15 eLearning modules that take approximately four hours to complete. The training is internet-enabled, self-paced and includes videos, text, and interactive elements, The iSISTAQUIT online modules are 1. Getting started, 2. Acknowledgement of country, 3. About SISTAQUIT, 4. Supporting Indigenous smokers to assist quitting, 5. ABCD approach, 6. A: Ask and assess, 7. B: Brief, 8. C: Cessation aids, 9. BCT, 10. Nicotine Replacement Therapy (NRT), 11. D: Discuss family, social and cultural contexts, 12. Vaping in pregnancy, 13. Practice Session: making a quit plan, 14. Follow up, 15. Telling a new story. There are also resources to aid smoking cessation care including a Treatment Manual, a Patient Flipchart for use during consultations, a patient (My Journey) booklet that includes augmented reality videos, and strategies for quitting smoking and vaping, Nicotine Replacement Therapy posters, Vaping posters, and an ABCD (A—ask; B—brief advice; C—cessation; D—discuss the psychosocial context of smoking) mousepad for use within the health service, These resources were developed for SISTAQUIT and updated with vaping content for this scale-up study. We have also developed medical practice software templates based on the ABCD (A—ask; B—brief advice; C—cessation; D—discuss the psychosocial context of smoking) approach. The ABCD digital decision-making tool guides consultations and collects data. It can be implemented into health services and medical practices that have PenCS compatible clinical/medical practice software such as Medical Director, Best Practice or ZedMed OR Communicare clinical/medical practice software. The project also supplies CO breath monitors (smokerlyzers), After attaching a new breath sampling piece to the smokerlyzer, the patient inhales deeply and holds their breath for 15 seconds while the device counts down. Then the patient blows slowly into the mouthpiece, aiming to empty lungs completely. The smokerlyzer provides a CO ppm score, and the woman's %COHb and the baby's corresponding %FCOHb will show. A CO level over 6ppm is indicative of smoking. Services are given the option to choose from four implementation packages which vary in the amount of health service participation. This approach was adopted to maximise the reach of iSISTAQUIT training to time-poor health services. iSISTAQUIT scale-up aims at doing a comprehensive scalability assessment of the iSISTAQUIT intervention with the intention of scale up in around 50-100 health services Australia-wide. Package 1 is the standard package which includes online training with CDP points, and hardcopy resources, Package 2 is the standard package which includes online training with CDP points, hardcopy resources, iSISTAQUIT mobile phone app, smokerlyzer, access to Social Media, Community of Practice membership, and the ABCD medical software template. Package 3 is the standard package plus a Boost of Adaption of Posters & Social Media tiles to local context - ie the Health Service is able to provide local pictures to go in their posters and social media tiles. Package 4 is the Standard Package plus a Boost of Hybrid Training model. This may be, for example: online train the trainer or online group-training allowing small group discussion and role play facilitated by iSISTAQUIT. Thus, the iSISTAQUIT training is online only unless the health services picks the option 4 package in which case iSISTAQUIT will facilitate the training either online or in person - depending on the location of the health service. Adherence to the intervention will be assessed through completion of the on-line post-training survey, the 1,3 and 6 month implementation surveys and qualitative end of study interviews.