Accessing National Health Service Stop Smoking Services in the UK: a COM-B analysis of barriers and facilitators perceived by smokers, ex-smokers and stop smoking advisors

Kwah, Kayleigh; Fulton, Emily; Brown, Katherine

doi:10.1016/j.puhe.2019.03.012

Cited by 10 publications

(12 citation statements)

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“…[20][21][22][23] Concerns from smokers about a lack of information and perceived availability of services have been highlighted, alongside work commitments and time constraints, which can impede attendance. 25 The authors conducted studies to explore these perceived barriers and facilitators in depth, 26 and discovered similar findings, including beliefs that needing support to quit smoking is a sign of weakness 27 and that smokers should not need help. Therefore, an understanding of the potential barriers to access, particularly in lower SES groups, is paramount, and should be addressed within the development and evaluation of interventions designed to increase SSS access.…”

Section: Chapter 1 Introductionmentioning

confidence: 88%

“…The process involved in the development of the StopApp, in terms of its theory and evidence base, and patient and public involvement (PPI) in content and functionality design, has been described elsewhere. 26,27,37 Figure 2 illustrates the participant flow and message tailoring content that StopApp recipients experienced. Initially, StopApp users are given persuasive messages applying BCTs tailored to past experiences of quit attempts and SSS use.…”

Section: Interventionmentioning

confidence: 99%

“…. I've got to make sure they have a good experience with us.Pharmacy32, lines 114-116Negative experiences of taking partNegative experiences were described in terms of a lack of communication between the CRN and the study team, which resulted in sending out letters on a set day the contact reported being unaware of (GPA, lines[19][20][21][22][23][24][25][26][27][28][29]; and a lack of funding available to send letters as expected. Pharmacy staff described feeling disappointed about the lack of bookings received (pharmacy14, lines 113-115):…”

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confidence: 99%

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A digital behaviour change intervention to increase booking and attendance at Stop Smoking Services: the MyWay feasibility RCT

et al. 2021

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Background Smoking remains a leading cause of illness and preventable death. NHS Stop Smoking Services increase quitting, but, as access is in decline, cost-effective interventions are needed that promote these services. StopApp™ (Coventry University, Coventry, UK) is designed to increase booking and attendance at Stop Smoking Services. Design A two-arm feasibility randomised controlled trial of StopApp (intervention) compared with standard promotion and referral to Stop Smoking Services (control) was conducted to assess recruitment, attrition and health equity of the design, alongside health economic and qualitative process evaluations. Setting Smokers recruited via general practitioners, community settings and social media. Participants Smokers aged ≥ 16 years were recruited in one local authority. Participants had to live or work within the local authority area, and there was a recruitment target of 120 participants. Interventions StopApp to increase booking and attendance at Stop Smoking Services. Main outcome measures Participants completed baseline measures and follow-up at 2 months post randomisation entirely online. Objective data on the use of Stop Smoking Services were collected from participating Stop Smoking Services, and age groups, sex, ethnicity and socioeconomic status in baseline recruits and follow-up completers/non-completers were assessed for equity. Results Eligible participants (n = 123) were recruited over 116 days, with good representation of lower socioeconomic status groups; black, Asian and minority ethnic groups; and all age groups. Demographic profiles of follow-up completers and non-completers were broadly similar. The attrition rate was 51.2%, with loss to follow-up lowest in the social media setting (n = 24/61; 39.3%) and highest in the general practitioner setting (n = 21/26; 80.8%). Most measures had < 5% missing data. Social media represented the most effective and cost-efficient recruitment method. In a future, definitive, multisite trial with recruitment driven by social media, our data suggest that recruiting ≥ 1500 smokers over 12 months is feasible. Service data showed that five bookings for the Stop Smoking Services were scheduled using StopApp, of which two did not attend. Challenges with data access were identified. A further five participants in the intervention arm self-reported booking and accessing Stop Smoking Services outside StopApp compared with two control arm participants. Event rate calculations for the intervention were 8% (Stop Smoking Services data), 17% (including self-reports) and 3.5% from control arm self-reports. A conservative effect size of 6% is estimated for a definitive full trial. A sample size of 840 participants would be required to detect an effect for the primary outcome measure of booking a Stop Smoking Services appointment in a full randomised controlled trial. The process evaluation found that participants were satisfied with the research team contact, study methods and provision of e-vouchers. Staff interviews revealed positive and negative experiences of the trial and suggestions for improvements, including encouraging smokers to take part. Conclusion This feasibility randomised controlled trial found that, with recruitment driven wholly or mainly by social media, it is possible to recruit and retain sufficient smokers to assess the effectiveness and cost-effectiveness of StopApp. The study methods and measures were found to be acceptable and equitable, but accessing Stop Smoking Services data about booking, attendance and quit dates was a challenge. A full trial may be feasible if service data are accessible. This will require careful planning with data controllers and a targeted social media campaign for recruitment. Changes to some study measures are needed to avoid missing data, including implementation of a more intensive follow-up data collection process. Future work We plan a full, definitive randomised controlled trial if the concerns around data access can be resolved, with adaptations to the recruitment and retention strategy. Limitations Our trial had high attrition and problems with collecting Stop Smoking Services data, which resulted in a reliance on self-reporting. Trial registration Research Registry: 3995. The trial was registered on 18 April 2018. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 5. See the NIHR Journals Library website for further project information.

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Section: Chapter 1 Introductionmentioning

confidence: 88%

Section: Interventionmentioning

confidence: 99%

mentioning

confidence: 99%

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A digital behaviour change intervention to increase booking and attendance at Stop Smoking Services: the MyWay feasibility RCT

et al. 2021

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“…14 18 33 Analytical frameworks and conceptual models such as the Risks, Attitudes, Norms, Abilities, and Self-regulation, 34 Capability, Opportunity, Motivation-Behaviour (COM-B) and Behaviour Change Wheel (BCW) can guide the development and implementation of behavioural interventions, [35][36][37] but have not been widely used to promote sustained, exclusive use of cleaner cookstoves and fuels. [38][39][40][41] We sought to overcome these barriers within the Household Air Pollution Intervention Network (HAPIN) trial. 42 The HAPIN trial aims to measure the effect of an LPG cooking intervention on HAP and health among study populations in Guatemala, India, Peru and Rwanda.…”

Section: Introductionmentioning

confidence: 99%

“… 14 18 33 Analytical frameworks and conceptual models such as the Risks, Attitudes, Norms, Abilities, and Self-regulation, 34 Capability, Opportunity, Motivation–Behaviour (COM–B) and Behaviour Change Wheel (BCW) can guide the development and implementation of behavioural interventions, 35–37 but have not been widely used to promote sustained, exclusive use of cleaner cookstoves and fuels. 38–41 …”

Section: Introductionmentioning

confidence: 99%

Designing a comprehensive behaviour change intervention to promote and monitor exclusive use of liquefied petroleum gas stoves for the Household Air Pollution Intervention Network (HAPIN) trial

Williams¹,

Thompson

Sakas

et al. 2020

BMJ Open

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IntroductionIncreasing use of cleaner fuels, such as liquefied petroleum gas (LPG), and abandonment of solid fuels is key to reducing household air pollution and realising potential health improvements in low-income countries. However, achieving exclusive LPG use in households unaccustomed to this type of fuel, used in combination with a new stove technology, requires substantial behaviour change. We conducted theory-grounded formative research to identify contextual factors influencing cooking fuel choice to guide the development of behavioural strategies for the Household Air Pollution Intervention Network (HAPIN) trial. The HAPIN trial will assess the impact of exclusive LPG use on air pollution exposure and health of pregnant women, older adult women, and infants under 1 year of age in Guatemala, India, Peru, and Rwanda.MethodsUsing the Capability, Opportunity, Motivation–Behaviour (COM–B) framework and Behaviour Change Wheel (BCW) to guide formative research, we conducted in-depth interviews, focus group discussions, observations, key informant interviews and pilot studies to identify key influencers of cooking behaviours in the four countries. We used these findings to develop behavioural strategies likely to achieve exclusive LPG use in the HAPIN trial.ResultsWe identified nine potential influencers of exclusive LPG use, including perceived disadvantages of solid fuels, family preferences, cookware, traditional foods, non-food-related cooking, heating needs, LPG awareness, safety and cost and availability of fuel. Mapping formative findings onto the theoretical frameworks, behavioural strategies for achieving exclusive LPG use in each research site included free fuel deliveries, locally acceptable stoves and equipment, hands-on training and printed materials and videos emphasising relevant messages. In the HAPIN trial, we will monitor and reinforce exclusive LPG use through temperature data loggers, LPG fuel delivery tracking, in-home observations and behavioural reinforcement visits.ConclusionOur formative research and behavioural strategies can inform the development, implementation, monitoring and evaluation of theory-informed strategies to promote exclusive LPG use in future stove programmes and research studies.Trial registration numberNCT02944682, Pre-results.

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The Latrobe Smoking Support Service: A quantitative study of participants in a regional area

Porter,

Soldatenko,

Borgelt

et al. 2024

Health Science Reports

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Background and AimsMore than 70% of current smokers in Australia have a definite plan to stop smoking and around half of them try to quit every year. Latrobe Community Health Service (LCHS) was commissioned by Gippsland Primary Health Network to establish Latrobe Smoking Support Service (LSSS) to break down barriers to accessing services and increase support for smoking cessation. This research aims to assess the feasibility of an ongoing smoking cessation support service and determine the effect the LSSS has on client smoking behavior.MethodsQuantitative data were collected for the LSSS situated at LCHS during the period from September 2021 to March 2022. A new client survey, a returning client survey, and a 6‐week follow‐up survey were conducted by Clinic staff. The consent forms were obtained from the clients. A total of 117 clients attended the LSSS at least once, and a further 315 returning client sessions were conducted. The data analysis was undertaken by means of various descriptive and inferential statistical techniques, such as multiple linear regression analysis.ResultsThe research findings demonstrate the strong positive effect of the LSSS in helping clients to change their smoking behavior. Results of multiple regression analysis highlight the significant role of behavioral intervention strategies in the LSSS's success. A combination of both nicotine replacement therapy (NRT) and counseling was a key contributor to the project's success.ConclusionThis research proposed and tested the model of a smoking cessation support service that combines a comprehensive mix of services for smokers including free NRT, free counseling, and ongoing support of counselors or/and nurse practitioners.

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Accessing National Health Service Stop Smoking Services in the UK: a COM-B analysis of barriers and facilitators perceived by smokers, ex-smokers and stop smoking advisors

Cited by 10 publications

References 22 publications

A digital behaviour change intervention to increase booking and attendance at Stop Smoking Services: the MyWay feasibility RCT

A digital behaviour change intervention to increase booking and attendance at Stop Smoking Services: the MyWay feasibility RCT

Designing a comprehensive behaviour change intervention to promote and monitor exclusive use of liquefied petroleum gas stoves for the Household Air Pollution Intervention Network (HAPIN) trial

The Latrobe Smoking Support Service: A quantitative study of participants in a regional area

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