Table 4 Example 4, Waterpipe smoking

Shaping interventions to address waterpipe smoking in Arabic-speaking communities in Sydney, Australia: a qualitative study [43, 44]

This study explored the perceptions and cultural meaning of waterpipe smoking in Arabic-speaking communities. Focus groups were chosen as the preferred method to understand the range of experiences and diversity of perceptions held about waterpipe smoking within a diverse community

Focus groups were offered in Arabic and/or English, acknowledging the language preferences of first and second/third generation migrants

Funding source:

South Eastern Sydney Local Health District

Recruitment and consent: Four BRAs, recruited through existing networks, were trained in conducting and recording focus groups. Using a convenience sampling approach, focus group participants were recruited by BRAs from Arabic-speaking community groups and networks. All participants who expressed interest in participating in the focus groups were included. Participant information sheets and consent forms were translated by a nationally accredited translator into Arabic

Data collection and analysis: Ten focus groups were conducted, 8 by the BRAs (Arabic and/or English) and 2 by the research team (English), and included a total of 88 participants. Two facilitators were present at each focus group. Notes were taken during the focus groups and provided to the research team. Focus groups were audio recorded where all participants agreed; participants in some groups were uncomfortable with this so only written notes were taken. The themes and subthemes from the focus groups were presented at a meeting with BRAs to validate and contextualize the key findings

Findings: Waterpipe smoking was reported to be widely practiced within the community and was related to feelings of cultural identity and belonging. The study highlighted the misconceptions that exist within communities about the health impacts of waterpipe smoking. Eleven themes were identified from the data relating to the perceptions of waterpipe smoking and possible health promotion interventions

Significance and impact: This was one of the first Australian studies that explored the perceptions and cultural meaning of waterpipe smoking in Arabic-speaking communities. The findings informed a culturally responsive health promotion campaign to raise awareness of the harms of waterpipe smoking in young people from Arabic-speaking communities. The Shisha No Thanks project employed co-design and co-production of social media messages to address myths about the perceived relative safety of waterpipe smoking compared with cigarettes, and encouraged community conversations to challenge prevailing perceptions