Summary of evidence regarding impact of media-based anti-tobacco messages for Indigenous populations
| Reference (lead author, year) | Study and specificity | Population | Type of study | SIGN rankings | Qualitative rankings (Daly et al) | Summary of evidence relevant to review |
| Wilson, 200530 | TV media campaign, Maori specific | New Zealand Maori | Quantitative database | 2− | N/A | More calls to Quitline after generic graphic advert compared to holistic Maori advert |
| Grigg, 200833 | TV media campaign, Maori specific | New Zealand Maori | Quantitative BAS | 2− | N/A | Increased recall of adverts and calls by Maori to Quitline |
| Fernandez, 200839 | TV media campaign, Maori specific | New Zealand Maori | Qualitative focus groups | N/A | II | Positive feedback to IAW campaign, compared with generic graphic TV adverts |
| Ivers, 200535 | TV campaign and community interventions, Mostly generic | Aboriginal and/or Torres Strait Islanders | Mixed methods BAS pre/post-intervention surveys | 2− | Insufficient information to assess | High recall of adverts. Exposure to any of the various interventions did not influence cessation. |
| Boyle, 201031 | TV and radio media campaign, generic | Aboriginal and/or Torres Strait Islanders | Quantitative survey interviews | 2– | N/A | High recall of adverts. In all, 25% attempted to quit, 1.5% successful. |
| Johnston, 201040 | TV campaign and other interventions, generic | Aboriginal and/or Torres Strait Islanders | Qualitative study semistructured interviews | N/A | III | Best recall of graphic imagery in TV adverts. Health staff believe adverts need to be culturally targeted. |
| Stewart, 201146 | TV advertisements, mostly generic | Aboriginal and/or Torres Strait Islanders | Mixed methodology questionnaire and discussion | 2+ | III | Strong graphic adverts and first person narratives rated highly by Indigenous smokers |
| Vogeltanz-Holm, 200932 | TV and radio media campaign, generic | American Indian (youth) | Quantitative study structured interviews | 2− | N/A | Confirmed recall and perceived effectiveness highest to ‘Artery’ advert |
| Daley, 200640 and Choi, 200644 | Program curriculum and printed resources, American Indian specific | American Indian/Alaska Native | Qualitative focus groups | N/A | II Daley, III Choi | Modifications provided for the ‘Second Wind’ smoking cessation program to improve pan-tribal cultural suitability |
| Daley, 200943 | Health promotional pamphlets, American Indian specific | American Indian/Alaska Native | Mixed methodology: expert opinion, readability scores and focus group | 4 | III | Scientific and cultural content, and readability scores appropriate: minor changes advocated |
| Doorenbos, 201128 | Native calendar, American Indian/Alaska Native specific | American Indian/Alaska Native | Single-blind randomised controlled trial | 1+ | N/A | Calendar with health messages did not increase smoking cessation related outcomes compared to calendar without messages |
| Wilson, 201030 | Pack health warnings, generic | New Zealand Maori | Quantitative BAS pre/post telephone surveys | 2− | N/A | Significant increase in Quitline number recognition from improved PHWs |
| Swartz, 200626 | Internet website, targeted content | American Indian subset | Non-blinded randomised controlled trial | 1+ | N/A | No significant difference in cessation rates between ethnic groups |
| Taualii, 201041 | Internet website, American Indian specific | American Indian/Alaska Native (youth) | Qualitative focus groups | N/A | III | Favourable response to targeted website |
| Bramley, 200525 | Mobile phone text messages, targeted for Maori, generic for others | New Zealand Maori and non-Maori (youth) | Single-blind randomised controlled trial | 1++ | N/A | No significant difference in response between Maori and non-Maori |
| Whittaker, 200842 | Mobile phone video messages, targeted choice | New Zealand Maori subset (youth) | Mixed methodology questionnaire | 2− | III | Favourable attitudes to content. High self-reported quit rate; not stratified to population group |
| Whittaker, 201129 | Mobile phone video messages, targeted choice | New Zealand Maori subset (youth) | Single-blind randomised controlled trial | 1+ | N/A | No significant difference in cessation rates between intervention and control; results not reported by ethnic group |
| Johnston, 199837 | CD-ROM and other community interventions, Indigenous specific | Aboriginal and/or Torres Strait Islanders (youth) | Mixed methodology BAS questionnaires and informal feedback | 2− | Insufficient information to assess | No change in smoking behaviour, increased knowledge, CD favourably viewed |
| Mitschke, 201036 | Education-entertainment drama, Pacific Islander/Native specific | Pacific Islander and native Hawaiian subset (youth) | Mixed methodology, BAS pre/post-intervention | 2− | III | Evidence of high-level engagement of viewers. Participants' knowledge increased and intentions to smoke decreased. |
| Patten, 201038 | Video and educational materials, Alaska Native specific | Alaska Native pregnant women | Mixed methodology, BAS pre/post-intervention randomised control | 2− | Insufficient information to assess | Intervention deemed not acceptable or feasible as low interest and recruitment. No significant difference between intervention and control groups. |
Scottish Intercollegiate Guidelines Network (SIGN) levels of evidence rankings (descriptors taken from SIGN 50)22: 1++, high quality meta-analyses or systematic reviews of RCTs, or RCTs with very low risk of bias; 1+, well conducted meta-analyses, systematic reviews, or RCTs with a low risk of bias; 1−, meta-analyses, systematic reviews, or RCTs with a high risk of bias; 2++, high quality systematic reviews of case-control/cohort studies or high quality case-control/cohort studies: very low risk of confounding/bias and a high probability of causal relationship; 2+, well conducted case-control/cohort studies: low risk of confounding/bias and moderate probability of causal relationship; 2−, case-control/cohort studies with a high risk of confounding/bias and significant risk relationship is not causal; 3, non-analytic studies, for example case reports, case series; 4, expert opinion.
Daly et al rankings for Qualitative Studies24: level I, generalisable studies: high quality, well reported analytical studies based on comprehensive literature review and conceptual framework with diverse sample; level II, conceptual studies: comprehensive study based on conceptual framework, sample may not be diversified but selected on theoretical basis; level III, descriptive studies: atheoretical, no diversification, descriptive only, sample selected to illustrate practical rather than theoretical issues; level IV, single case study: single or small number interviews, may provide rich data or insights.
BAS, before and after study; IAW, ‘it's about whanau’ (campaign title); N/A, not applicable; PHW, pack health warnings.