Feasibility of Audio-Recording Consultations with Pregnant Australian Indigenous Women to Assess Use of Smoking Cessation Behaviour Change Techniques

Introduction. Behavioural counselling is an effective method to improve smoking cessation during pregnancy. Audio recordings of consultations have been used previously to assess fidelity in specialized smoking cessation services, but not in primary care. Aims. The study is aimed at assessing the feasibility of audio-recording smoking cessation counselling as part of an intervention in primary care settings and exploring the number and type of behaviour change techniques (BCTs) delivered. Methods. This study was a nested feasibility study within a larger trial. Health providers (HPs) and pregnant women were asked to agree or decline audio recording their smoking-related consultations. Data collected included percentage providing consent, number of recordings performed, HP type, and date (pre/post intervention). Interviews were conducted to assess the trial procedures’ acceptability. Results. Two services provided seven recordings, all pre-intervention. Of the 22 recruited women, 14 consented to being audio recorded (64%) and five provided recordings; of the 23 recruited HPs, 16 agreed (69%), and two provided recordings. Qualitative data suggest that HPs found audio recording difficult to remember. HPs spent on average two minutes discussing smoking and used few BCTs. Conclusions. Audio recordings of smoking-related counselling were not feasible as planned. Future research will need to explore acceptable methods to assess BCT use in primary care.

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

10.21203/rs.2.14124/v1 ◽

2019 ◽

Author(s):

Yael Bar-Zeev ◽

Eliza Skelton ◽

Michelle Bovill ◽

Maree Gruppetta ◽

Billie Bonevski ◽

...

Keyword(s):

Primary Care ◽

Smoking Cessation ◽

Pregnant Women ◽

Behaviour Change ◽

Future Research ◽

Behaviour Change Techniques ◽

Health Providers ◽

Post Intervention ◽

Audio Recording ◽

Audio Recordings

Abstract 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

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Characterising smoking cessation smartphone applications in terms of behaviour change techniques, engagement and ease-of-use features

Translational Behavioral Medicine ◽

10.1007/s13142-015-0352-x ◽

2015 ◽

Vol 6 (3) ◽

pp. 410-417 ◽

Cited By ~ 27

Author(s):

Harveen Kaur Ubhi ◽

Susan Michie ◽

Daniel Kotz ◽

Onno C. P. van Schayck ◽

Abiram Selladurai ◽

...

Keyword(s):

Smoking Cessation ◽

Behaviour Change ◽

Ease Of Use ◽

Behaviour Change Techniques ◽

Smartphone Applications

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Proactive Telephone Smoking Cessation Counseling Tailored to Parents: Results of a Randomized Controlled Effectiveness Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16152730 ◽

2019 ◽

Vol 16 (15) ◽

pp. 2730

Author(s):

Tessa Scheffers-van Schayck ◽

Roy Otten ◽

Rutger C.M.E. Engels ◽

Marloes Kleinjan

Keyword(s):

Smoking Cessation ◽

Large Scale ◽

Telephone Counseling ◽

Future Research ◽

Effectiveness Trial ◽

Smoking Cessation Counseling ◽

Post Intervention ◽

Counseling Intervention ◽

Randomized Controlled ◽

Quit Smoking

A recent Dutch efficacy trial showed the efficacy of a telephone smoking cessation counseling tailored to smoking parents. Currently, it is unknown whether such telephone counseling would be effective under more real-world conditions. This study aimed to examine the effectiveness of parent-tailored telephone smoking cessation counseling in a two-arm randomized controlled effectiveness trial and whether the effectiveness depended on the recruitment approaches that were used to recruit parents (mass media vs. health care). In total, 87 parents received either telephone counseling (intervention) or a self-help brochure (control). Parents were asked to complete questionnaires at baseline and three months post-intervention. Results showed that the odds of reporting 7-day point-prevalence abstinence at three months post-intervention was 7.54 higher for parents who received telephone counseling than for parents in the control condition (53.3% vs. 13.2%, 95% CI = 2.49–22.84). Because inclusion was lower than anticipated, interaction-effects of condition and recruitment approach could not be interpreted. The present study demonstrates that the parent-tailored smoking cessation telephone counseling is effective in helping parents to quit smoking. Yet, before large-scale implementation, future research should focus on how recruitment of parents via the recruitment approaches could be improved.

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Perceived Barriers and Facilitators to Breaking Up Sitting Time among Desk-Based Office Workers: A Qualitative Investigation Using the TDF and COM-B

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16162903 ◽

2019 ◽

Vol 16 (16) ◽

pp. 2903 ◽

Cited By ~ 6

Author(s):

Samson O. Ojo ◽

Daniel P. Bailey ◽

David J. Hewson ◽

Angel M. Chater

Keyword(s):

Behaviour Change ◽

Theoretical Domains Framework ◽

Perceived Barriers ◽

Barriers And Facilitators ◽

Office Workers ◽

Sitting Time ◽

Future Research ◽

Behaviour Change Techniques ◽

Organisational Support ◽

Sitting Behaviour

High amounts of sedentary behaviour, such as sitting, can lead to adverse health consequences. Interventions to break up prolonged sitting in the workplace have used active workstations, although few studies have used behaviour change theory. This study aimed to combine the Theoretical Domains Framework (TDF) and the Capability, Opportunity, and Motivation to Behaviour system (COM-B) to investigate perceived barriers and facilitators to breaking up sitting in desk-based office workers. Semi-structured interviews with 25 desk-based employees investigated barriers and facilitators to breaking up sitting in the workplace. Seven core inductive themes were identified: ‘Knowledge-deficit sitting behaviour’, ‘Willingness to change’, ‘Tied to the desk’, ‘Organisational support and interpersonal influences’, ‘Competing motivations’, ‘Emotional influences’, and ‘Inadequate cognitive resources for action’. These themes were then deductively mapped to 11 of the 14 TDF domains and five of the six COM-B constructs. Participants believed that high amounts of sitting had adverse consequences but lacked knowledge regarding recommendations and were at times unmotivated to change. Physical and social opportunities were identified as key influences, including organisational support and height-adjustable desks. Future research should identify intervention functions, policy categories and behaviour change techniques to inform tailored interventions to change sitting behaviour of office workers.

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Using a group medical visit model to promote healthy behaviour change with an underserved population

Family Practice ◽

10.1093/fampra/cmaa028 ◽

2020 ◽

Vol 37 (4) ◽

pp. 507-512

Author(s):

Holly Ann Russell ◽

Mechelle Sanders ◽

Lynn Moll ◽

Melanie Murphy ◽

Angela M Lanigan ◽

...

Keyword(s):

Physical Activity ◽

Primary Care ◽

Weight Loss ◽

Behaviour Change ◽

Underserved Populations ◽

Preliminary Evidence ◽

Models Of Care ◽

Underserved Population ◽

Medical Visit ◽

Post Intervention

Abstract Background Models of care are needed to address physical activity, nutrition promotion and weight loss in primary care settings, especially with underserved populations who are disproportionately affected by chronic illness. Group medical visits (GMVs) are one approach that can help overcome some of the barriers to behaviour change in underserved populations, including the amount of time required to care for these patients due to socio-economic stressors and psychosocial complexities (1). GMVs have been shown to improve care in coronary artery disease and diabetes, but more evidence is needed in underserved settings. Objective This project sought to evaluate a GMV incorporating a physical activity component in an underserved patient population, measuring biometric and motivation outcome measures. Methods This project used a pre–post intervention study design through patient surveys at baseline and 12 weeks. We included validated motivational measures along with self-reported demographic information. A GMV intervention promoting physical activity and nutrition to promote weight loss was delivered by an interdisciplinary primary care team and community partners in a Federally Qualified Health Center in Rochester, NY. The intervention consisted of six, 2-hour sessions that occurred every other week at the clinic site. Results Participants lost a significant amount of weight and maintained the weight loss at 6 months. In addition, there was a significant improvement in motivation measures. Conclusion This study provides preliminary evidence that our GMV model can improve weight loss and autonomous motivation in an underserved population. This project has potential for scalability and sustainability.

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Improving Implementation of Smoking Cessation Guidelines in Pregnancy Care: Development of an Intervention to Address System, Maternity Service Leader and Clinician Factors

10.21203/rs.3.rs-136223/v1 ◽

2020 ◽

Author(s):

Megan Passey ◽

Catherine Adams ◽

Christine Paul ◽

Lou Atkins ◽

Jo M. Longman

Keyword(s):

Smoking Cessation ◽

Behaviour Change ◽

Feasibility Study ◽

Complex Interventions ◽

Primary Data ◽

Advisory Group ◽

Behaviour Change Techniques ◽

Smoking During Pregnancy ◽

Maternity Services ◽

Stakeholder Input

Abstract BackgroundSmoking during pregnancy increases the risk of multiple serious adverse infant, child and maternal outcomes, yet nearly 10% of Australian women still smoke during pregnancy. Despite evidence-based guidelines that recommend routine and repeated smoking cessation support (SCS) for all pregnant women, the provision of recommended SCS remains poor. Guidance on developing complex interventions to improve health care recommends drawing on existing theories, reviewing evidence, undertaking primary data collection, attending to future real-world implementation, and designing and refining interventions using iterative cycles with stakeholder input throughout. Here we describe using the Behaviour Change Wheel (BCW) to apply these principles in developing an intervention to improve provision of SCS in Australian maternity services.MethodsWorking closely with key stakeholders in the New South Wales (NSW) health system, we applied the steps of the BCW method then undertook a small feasibility study in one service to further refine the intervention. Stakeholders were engaged in multiple ways – as a core research team member, through a project Advisory Group, targeted meetings with policy makers, a large workshop to review potential components and the feasibility study. ResultsBarriers to and enablers of providing SCS were identified in five of six components described in the BCW method (psychological capability, physical opportunity, social opportunity, and in reflective and automatic motivation). These were mapped to intervention types and we selected education, training, enablement, environmental restructuring, persuasion, incentivisation and modelling as suitable in our context. Through application of the APEASE criteria (Affordability, Practicability, Effectiveness, Acceptability, Side effects, and Equity) in the stakeholder workshop, behaviour change techniques were selected and applied in developing the intervention which includes systems, clinician and leadership elements. The feasibility study confirmed feasibility and acceptability of the midwifery component and the need to further strengthen the leadership component. ConclusionsUsing the BCW method combined with strong stakeholder engagement from inception resulted in transparent development of the MOHMQuit intervention, which targets identified barriers to and enablers of the provision of SCS and is developed specifically for the context in which it will be implemented. The intervention is being trialed in eight public maternity services in NSW.

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Primary Care implementation of Germ Defence, a digital behaviour change intervention to improve household infection control during the COVID-19 pandemic: A structured summary of a study protocol for a randomised controlled trial

Trials ◽

10.1186/s13063-021-05188-7 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jeremy Horwood ◽

Melanie Chalder ◽

Ben Ainsworth ◽

James Denison-Day ◽

Frank de Vocht ◽

...

Keyword(s):

Primary Care ◽

Usual Care ◽

Behaviour Change ◽

Controlled Trial ◽

Behaviour Change Techniques ◽

Current Standard ◽

Link Type ◽

Implementation Period ◽

Full Protocol ◽

Randomised Controlled

Abstract Objectives To examine the effectiveness of randomising dissemination of the Germ Defence behaviour change website via GP practices across England UK. Trial design A two-arm (1:1 ratio) cluster randomised controlled trial implementing Germ Defence via GP practices compared with usual care. Participants Setting: All Primary care GP practices in England. Participants: All patients aged 16 years and over who were granted access by participating GP practices. Intervention and comparator Intervention: We will ask staff at GP practices randomised to the intervention arm to share the weblink to Germ Defence with all adult patients registered at their practice during the 4-month trial implementation period and care will otherwise follow current standard management. Germ Defence is an interactive website (http://GermDefence.org/) employing behaviour change techniques and practical advice on how to reduce the spread of infection in the home. The coronavirus version of Germ Defence helps people understand what measures to take and when to take them to avoid infection. This includes hand washing, avoiding sharing rooms and surfaces, dealing with deliveries and ventilating rooms. Using behaviour change techniques, it helps users think through and adopt better home hygiene habits and find ways to solve any barriers, providing personalised goal setting and tailored advice that fits users’ personal circumstances and problem solving to overcome barriers. Comparator: Patients at GP practices randomised to the usual care arm will receive current standard management for the 4-month trial period after which we will ask staff to share the link to Germ Defence with all adult patients registered at their practice. Main outcomes The primary outcome is the effects of implementing Germ Defence on prevalence of all respiratory tract infection diagnoses during the 4-month trial implementation period. The secondary outcomes are: 1) incidence of COVID-19 diagnoses 2) incidence of COVID-19 symptom presentation 3) incidence of gastrointestinal infections 4) number of primary care consultations 5) antibiotic usage 6) hospital admissions 7) uptake of GP practices disseminating Germ Defence to their patients 8) usage of the Germ Defence website by individuals who were granted access by their GP practice Randomisation GP practices will be randomised on a 1:1 basis by the independent Bristol Randomised Trials Collaboration (BRTC). Clinical Commission Groups (CCGs) in England will be divided into blocks according to region, and equal numbers in each block will be randomly allocated to intervention or usual care. The randomisation schedule will be generated in Stata statistical software by a statistician not otherwise involved in the enrolment of general practices into the study. Blinding (masking) The principal investigators, the statistician and study collaborators will remain blinded from the identity of randomised practices until the end of the study. Numbers to be randomised (sample size) To detect planned effect size (based on PRIMIT trial, Little et al, 2015): 11.1 million respondents from 6822 active GP practices. Assuming 25% of these GP practices will engage, we will contact all GP practices in England spread across 135 Clinical Commissioning Groups. Trial status Protocol version 2.0, dated 13 January 2021. Implementation is ongoing. The implementation period started on 10 November 2020 and will end on 10 March 2021. Trial registration This trial was registered in the ISRCTN registry (isrctn.com/ISRCTN14602359) on 12 August 2020. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

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Applying the Behaviour Change Wheel: insights into the development of the breastfeeding component of the Baby Buddy smartphone app

10.21203/rs.3.rs-33159/v1 ◽

2020 ◽

Author(s):

Loretta Musgrave ◽

Alison Baum ◽

Nilushka Perera ◽

Caroline SE Homer ◽

Adrienne Gordon

Keyword(s):

Behaviour Change ◽

Self Efficacy ◽

World Health Organisation ◽

World Health ◽

Future Research ◽

Behaviour Change Techniques ◽

Clear Understanding ◽

Younger Women ◽

Breastfeeding Knowledge ◽

Behaviour Change Wheel

Abstract BackgroundBreastfeeding plays a major role in the health of mothers and babies and has the potential to positively shape an individual’s life both in the short and long-term. In the United Kingdom (UK), despite around 81% of women initiating breastfeeding, only 1% of women breastfeed exclusively to 6 months as recommended by the World Health Organisation (WHO). Women who are socially disadvantaged and younger, are less likely to breastfeed at 6-8 weeks postpartum. One strategy that aims to improve these statistics is the Baby Buddy app which has been designed, developed and implemented by the UK charity Best Beginnings to be a universal intervention to help reduce health inequalities, including breastfeeding. The aim was this study was to retrospectively examine the development of Baby Buddy as a Digital Behaviour Change Intervention (DBCI) that may increase breastfeeding self-efficacy, knowledge and confidence to positively impact breastfeeding rates and duration.MethodsThe study used a three-stage process evaluation, triangulation methods and formalised tools. A retrospective evaluation was done after the app was developed and embedded. The app development process and content were reviewed by applying the Behaviour Change Wheel (BCW), Capability, Opportunity and Motivation-Behaviour (COM-B) system and Behaviour Change Techniques Taxonomy (BCTTv1). A clear understanding of behaviours that need to change in pregnancy to improve breastfeeding knowledge, self-efficacy and confidence was sought. ResultsRetrospective application of the BCW, COM-B and BCTTv1 confirmed that the Baby Buddy app is a well-designed DBCI, appealing particularly to younger women and women for whom English is not their first language. The Best Beginnings charity used several frameworks and guidelines and the use of these instruments contributed to the good design and development of Baby Buddy. Content analysis verified that the resources developed could affect attitudes and assist women to make decisions, and perceptions of self-efficacy in relation to breastfeeding. ConclusionsBaby Buddy has the potential to improve breastfeeding knowledge, confidence and self-efficacy. Future research should assess which components of the app are most effective on breastfeeding and whether it has an impact on clinical health outcomes for mothers and babies.

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Improving implementation of smoking cessation guidelines in pregnancy care: development of an intervention to address system, maternity service leader and clinician factors

Implementation Science Communications ◽

10.1186/s43058-021-00235-5 ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Megan E. Passey ◽

Catherine Adams ◽

Christine Paul ◽

Lou Atkins ◽

Jo M. Longman

Keyword(s):

Smoking Cessation ◽

Behaviour Change ◽

Feasibility Study ◽

Complex Interventions ◽

Theoretical Domains Framework ◽

Primary Data ◽

Advisory Group ◽

Behaviour Change Techniques ◽

Smoking During Pregnancy ◽

Maternity Services

Abstract Background Smoking during pregnancy increases the risk of multiple serious adverse infant, child and maternal outcomes, yet nearly 10% of Australian women still smoke during pregnancy. Despite evidence-based guidelines that recommend routine and repeated smoking cessation support (SCS) for all pregnant women, the provision of recommended SCS remains poor. Guidance on developing complex interventions to improve health care recommends drawing on existing theories, reviewing evidence, undertaking primary data collection, attending to future real-world implementation and designing and refining interventions using iterative cycles with stakeholder input throughout. Here, we describe using the Behaviour Change Wheel (BCW) and the Theoretical Domains Framework to apply these principles in developing an intervention to improve the provision of SCS in Australian maternity services. Methods Working closely with key stakeholders in the New South Wales (NSW) health system, we applied the steps of the BCW method then undertook a small feasibility study in one service to further refine the intervention. Stakeholders were engaged in multiple ways—as a core research team member, through a project Advisory Group, targeted meetings with policymakers, a large workshop to review potential components and the feasibility study. Results Barriers to and enablers of providing SCS were identified in five of six components described in the BCW method (psychological capability, physical opportunity, social opportunity and reflective and automatic motivation). These were mapped to intervention types and we selected education, training, enablement, environmental restructuring, persuasion, incentivisation and modelling as suitable in our context. Through application of the APEASE criteria (Affordability, Practicability, Effectiveness, Acceptability, Side effects and Equity) in the stakeholder workshop, behaviour change techniques were selected and applied in developing the intervention which includes systems, clinician and leadership elements. The feasibility study confirmed the feasibility and acceptability of the midwifery component and the need to further strengthen the leadership component. Conclusions Using the BCW method combined with strong stakeholder engagement from inception resulted in transparent development of the MOHMQuit intervention, which targets identified barriers to and enablers of the provision of SCS and is developed specifically for the context in which it will be implemented. The intervention is being trialled in eight public maternity services in NSW.

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Experts’ Views on Behaviour Change Techniques for Smoking Cessation in Pregnancy: A Qualitative Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17217729 ◽

2020 ◽

Vol 17 (21) ◽

pp. 7729

Author(s):

Fizzah B. Abidi ◽

Libby Laing ◽

Sue Cooper ◽

Tim Coleman ◽

Katarzyna A. Campbell

Keyword(s):

Smoking Cessation ◽

Behaviour Change ◽

Group Discussion ◽

Behaviour Change Techniques ◽

Visual Aids ◽

Smoking During Pregnancy ◽

Behavioural Support ◽

Quit Attempts ◽

The Family ◽

In Pregnancy

Smoking during pregnancy is a global health problem which has devastating health implications. Behavioural support is an important part of smoking cessation support for pregnant women. Research has identified barriers and facilitators (B&Fs) and effective behaviour change techniques (BCTs) to aid women’s quit attempts. However, the extent to which and how these BCTs are used in practice is unclear. The research aimed to establish experts’ views on how behavioural support can be optimised and techniques operationalised in clinical practice, by identifying ways to address known B&Fs for smoking cessation in pregnancy. A focus group discussion took place with six experts, which highlighted how BCTs can be used in practice to support women in their quit attempts. A thematic analysis was conducted to elicit overarching themes. Five themes were found: involving the family, empowering women, using incentives to boost motivation, using practical techniques to help women with their quit attempts and managing expectations about nicotine replacement therapy. Empowering women to make their own decisions and encouraging small positive changes in smoking habits, using visual aids (e.g., growth charts) to inform women of the harms of smoking to the baby and treating families holistically were deemed important.

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