Feasibility of audio-recording consultations with pregnant Australian Indigenous women to assess use of smoking cessation behaviour change techniques

Abstract

Background Behavioural counselling is an effective method to improve smoking cessation rates during pregnancy. It is not always clear whether counselling is delivered as per guidelines. Audio-recordings of consultations have been used previously to assess fidelity of the intervention delivered. This has been performed mainly in specialized smoking cessation services for the general population. This study aimed to assess the feasibility of audio-recording smoking cessation counselling between health providers and pregnant women as part of an intervention in Aboriginal primary care settings. A secondary aim was to explore the number and type of behaviour change techniques delivered. Methods A nested feasibility study within a larger intervention trial in six Aboriginal Medical Services. Recruited health providers and pregnant women were asked to agree or decline audio-recording their smoking cessation related consultations, pre and post intervention. Data collected included percentage providing consent to audio-recording; number of recordings performed, type of health provider performing the consultation, and date (pre/post intervention). Transcribed recordings were coded by two researchers. At the end of the trial, interviews were conducted to assess the acceptability of the study. Data relevant to the audio-recordings was extracted. Results Two services provided seven recordings, all pre-intervention. Of 22 recruited women, 14 consented to being audio-recorded (64%) and five provided recordings; of 23 recruited health providers, 16 agreed (69%), and two provided recordings. Qualitative data suggest health providers found audio-recording difficult to remember. Health providers spend two minutes discussing smoking (range 00:47-03:47 minutes), and used few behaviour change techniques for each consultation (average 4 behaviour change techniques, range 2-8). Conclusions Audio-recordings of smoking related counselling were not feasible as planned. Future research will need to explore acceptable methods to assess behaviour change techniques use in primary care, and specifically in Aboriginal health services. Trial registration: ACTRN 12616001603404

SISTAQUIT: training health care providers to help pregnant Aboriginal and Torres Strait Islander women quit smoking. A cluster randomised controlled trial

“…We will assess the number and type of behaviour change techniques used by health care providers, using professionally transcribed recorded interviews. Two behaviour change technique coders will independently code up to 72 consultations with participating women, applying the taxonomy of smoking cessation behaviour change techniques 24 and the coding framework developed for our pilot study 25 …”