Benson Fiona E, Stronks Karien, Willemsen Marc C, Bogaerts Nina M M, Nierkens Vera
Department Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
BMC Public Health. 2014 Jul 7;14:695. doi: 10.1186/1471-2458-14-695.
Attendance of a behavioural support programme facilitates smoking cessation. Disadvantaged smokers have been shown to attend less than their more affluent peers. We need to gain in-depth insight into underlying reasons for differing attendance behaviour in disadvantaged smokers, to better address this issue. This study aims to explore the underlying motivations, barriers and social support of smokers exhibiting different patterns of attendance at a free smoking cessation behavioural support programme in a disadvantaged neighbourhood of The Netherlands.
In 29 smokers undertaking smoking cessation group therapy or telephone counselling in a disadvantaged neighbourhood, qualitative interviews were completed, coded and analysed. Major themes were motivations, barriers to attend and social support. Motivations and social support were analysed with reference to the self-determination theory.
Two distinct patterns of attendance emerged: those who missed up to two sessions ("frequent attenders"), and those who missed more than two sessions ("infrequent attenders"). The groups differed in their motivations to attend, barriers to attendance, and in the level of social support they received. In comparison with the infrequent attenders, frequent attenders more often had intrinsic motivation to attend (e.g. enjoyed attending), and named more self-determined extrinsic motivations to attend, such as commitment to attendance and wanting to quit. Most of those mentioning intrinsic motivation did not mention a desire to quit as a motivation for attendance. No organizational barriers to attendance were mentioned by frequent attenders, such as misunderstandings around details of appointments. Frequent attenders experienced more social support within and outside the course.
Motivation to attend behavioural support, as distinct from motivation to quit smoking, is an important factor in attendance of smoking cessation courses in disadvantaged areas. Some focus on increasing motivation to attend may help to prevent participants missing sessions.
参加行为支持项目有助于戒烟。事实表明，处于社会劣势的吸烟者比经济条件较好的同龄人参加此类项目的比例更低。我们需要深入了解社会劣势吸烟者参加项目行为存在差异的根本原因，以便更好地解决这一问题。本研究旨在探讨在荷兰一个社会条件不利社区参加免费戒烟行为支持项目时，呈现不同出勤模式的吸烟者的潜在动机、障碍和社会支持因素和社会支持情况。
对在一个社会条件不利社区参加戒烟团体治疗或电话咨询的29名吸烟者进行了定性访谈，并对访谈内容进行编码和分析。主要主题包括动机、参加障碍和社会支持。依据自我决定理论对动机和社会支持进行了分析。
出现了两种不同的出勤模式：错过课程不超过两节的吸烟者（“频繁参加者”）和错过课程超过两节的吸烟者（“不频繁参加者”）。两组在参加动机、出勤障碍以及获得的社会支持水平方面存在差异。与不频繁参加者相比，频繁参加者更常有内在参加动机（例如喜欢参加），并且提到更多自主的外在参加动机，如坚持参加的承诺和想要戒烟。大多数提及内在动机的人没有将想要戒烟作为参加的动机。频繁参加者未提及任何组织方面的出勤障碍，如对预约细节的误解。频繁参加者在课程内外都获得了更多的社会支持。
参加行为支持的动机，与戒烟动机不同，是社会条件不利地区参加戒烟课程的一个重要因素。一些关注提高参加动机的措施可能有助于防止参与者错过课程。
