Description of tobacco use and cessation among Bhutanese refugees participating in a tobacco cessation program

Conceptualizing Mental Health Through Bhutanese Refugee Lens: Findings from a Mixed Methods Study

Despite the rapidly growing need to understand mental health challenges faced by refugee subpopulations, there is a dearth of literature exploring mental health conceptualization through the unique refugee lens. Guided by historical trauma theory, we gathered data using a two-phase explanatory sequential mixed-methods study (quantitative: n = 40; qualitative: n = 6) in a Midwestern U.S. region to understand mental health conceptualization from the Bhutanese refugee perspective by examining the cultural meaning and perception of mental health, describing experiences of mental health problems, and examining cultural protective factors and coping strategies. We argue that recognition of refugees' conceptualization of mental health and identification of cultural protective factors is paramount to healing. Findings emphasize the need to understand historical and cultural perspectives in cross-cultural contexts for the development and implementation of culturally responsive services. Our study also contributes to emerging knowledge on methodological rigor in research among understudied, hard-to-reach, small populations.

Community-based health promotion about alcohol and other drugs in a multicultural Australia-what works? A review of evidence

Refugee and migrant communities from culturally and linguistically diverse backgrounds in Australia experience dependency, stigma, isolation, mental health issues, family issues and other problems associated with alcohol and other drugs. Yet, refugee and migrant communities also face major linguistic, cultural and technological barriers to health promotion about drug-related problems. The aim of this review is to identify effective techniques and approaches for health promotion that reduces the risk of problems with drugs in culturally and linguistically inclusive ways. To identify what is effective, the Medline/PubMed database was systematically searched for health promotion literature published between 2008 and 2018. Grey literature from relevant agencies was also searched. The review considered both quantitative and qualitative outcome measures, and assessed studies using the Critical Appraisal Skills Programme quality assessment tool. Three studies met inclusion criteria, with weak evaluations. The studies demonstrated effective community engagement, but do not provide conclusive evidence of what is effective drug-related health promotion. The review's findings point to an important knowledge gap. More rigorous research and evaluation are required to identify effective health promotion for reducing drug-related issues with a larger, more diverse range of refugee and migrant communities.

Models for pharmacist-delivered tobacco cessation services: a systematic review

OBJECTIVES

To summarize delivery models of pharmacist-led tobacco cessation services.

DATA SOURCES

Studies published from July 1, 2003, to April 1, 2019, describing pharmacist-led tobacco cessation services in the United States were identified via PubMed/MEDLINE and EBSCO searches.

STUDY SELECTION

Studies were considered for inclusion if they met the following criteria: population, patients 18 years of age and older using tobacco products; intervention, pharmacist-led tobacco cessation services; comparator, not required; and outcome, tobacco cessation. We used a web-based tool, Rayyan QCRI, to assist with study selection.

DATA EXTRACTION

We used a data extraction tool to collect article reference, study design, primary and secondary objectives, brief description of intervention, pharmacologic interventions, service model, business model, method to measure tobacco cessation, tobacco cessation rates, and other comments.

RESULTS

A total of 16 articles were incorporated into this review. Most studies included were observational (87.5%). The pharmacy settings included ambulatory care (68.8%), community (25%), and managed care (6.3%). Service models described most frequently followed an appointment-based, individual, face-to-face session between the patient and pharmacist. Business models included grant funding (12.5%), fee-for-service (6.3%), value-based (6.3%), and free services (6.3%), but most studies (56.3%) did not address reimbursement. Cessation rates ranged from 3.98% to 77.14% and were predominantly measured through self-report (62.5%). The timing of follow-up varied from 1 to 6 months after program completion, but in some articles was not reported (37.5%).

CONCLUSION

Pharmacists currently manage tobacco cessation services via an assortment of methods and can successfully assist patients in achieving abstinence. Gaps in the literature necessitate further guidance on consistent outcomes reporting, impact of service model on tobacco cessation, and economic data of business models. The profession will benefit from such information to further expand the pharmacists' role within tobacco cessation services.