A Process Evaluation of ‘We Can Quit’: a Community-Based Smoking Cessation Intervention Targeting Women From Areas of Socio-Disadvantage in Ireland

Abstract

Background: Smoking poses a serious risk of early preventable death and disease especially for women living with socio-economic disadvantage (SED). A smoking cessation programme ‘We Can Quit’ was developed in Ireland tailored to SED women. The programme includes group-based support delivered by trained lay local women and free nicotine replacement therapy (NRT). The intervention was pilot tested in a cluster randomised controlled trial, ‘We Can Quit 2’. A process evaluation assessed feasibility and acceptability of the programme and trial processes.Methods: Embedded qualitative design using the Medical Research Council’s (MRC) process evaluation framework. Semi-structured interviews with trial participants (N=18) and programme deliverers, the community facilitators (CFs; N=8). Thematic analysis was used for interview transcripts.Results: Results focused on programme and trial operational factors. Peer-modelling, a non-judgemental environment, and CFs supportive role of group support were viewed as facilitative. Potential for broader message diffusion into the social networks of participating women was observed. Free NRT was helpful for cessation. Some participants expressed concerns about NRT side effects. Community pharmacists provided guidance relating to NRT and additional support between programme meetings. Provision of saliva samples proved challenging. Low literacy was a barrier for engagement with programme and trial-related materials. Hypothetical scenarios of direct or indirect observational fidelity assessment for a future definitive trial (DT) were acceptable. Conclusions: The We Can Quit intervention and trial-related processes were feasible and acceptable to participants and Community Facilitators. Any future DT will need to address low literacy.Trial registration: Controlled trials ISRCTN74721694.

The We Can Quit2 Smoking Cessation Trial: Knowledge Exchange and Dissemination Following a Community-Based Participatory Research Approach

“…The overall aim of WCQ2 was to determine the feasibility and acceptability of trial-related processes and of the WCQ intervention. A description of the trial protocol [ 18 ] and trial findings can be found elsewhere [ 19 , 34 ]. In brief, the pilot trial was conducted in four consecutive phases (waves), each one taking place in a randomly allocated matched pair of SED districts in Ireland [ 18 ].…”

Health Behavior Interventions Among People With Lower Socio-Economic Status: A Scoping Review of Behavior Change Techniques and Effectiveness

“…The type, duration and intensity of interventions varied greatly between studies. Interventions consisted, for example, (both solely or combined) of classes or workshops (e.g., Dickin et al, 2014;Hand et al, 2014;Nieves et al, 2022), policy implementations (e.g., tobacco price increases or sugar-content-based taxes; Essman et al, 2021;Kim & Cho, 2022;Tabuchi et al, 2017), cognitive or behavioral counselling (e.g., Jenum et al, 2009;Steptoe et al, 2004), therapy (e.g., pharmacotherapy, cognitive behavioral therapy or nicotine replacement therapy; Darker et al, 2022;Landais et al, 2021;Webb Hooper et al, 2017) or environmental changes (e.g., nudges or neighborhood walking route; Huitink et al, 2020;Prins et al, 2019). Most interventions had a relatively short duration of one occasion up to two months and interventions differed in the number of contact moments provided (e.g., 6week interventions consisting of weekly one-hour education classes versus sessions of 15 hours in total; Backman et al, 2011;West et al, 2020).…”