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将社区药房工作人员培养成为健康行为改变的推动者:开发并测试一种基于理论的戒烟干预措施。

Equipping community pharmacy workers as agents for health behaviour change: developing and testing a theory-based smoking cessation intervention.

作者信息

Steed Liz, Sohanpal Ratna, James Wai-Yee, Rivas Carol, Jumbe Sandra, Chater Angel, Todd Adam, Edwards Elizabeth, Macneil Virginia, Macfarlane Fraser, Greenhalgh Trisha, Griffiths Chris, Eldridge Sandra, Taylor Stephanie, Walton Robert

机构信息

Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Faculty of Health Sciences, University of Southampton, UK.

出版信息

BMJ Open. 2017 Aug 11;7(8):e015637. doi: 10.1136/bmjopen-2016-015637.

Abstract

OBJECTIVE

To develop a complex intervention for community pharmacy staff to promote uptake of smoking cessation services and to increase quit rates.

DESIGN

Following the Medical Research Council framework, we used a mixed-methods approach to develop, pilot and then refine the intervention.

METHODS

: We used information from qualitative studies in pharmacies, systematic literature reviews and the Capability, Opportunity, Motivation-Behaviour framework to inform design of the initial version of the intervention. : We then tested the acceptability of this intervention with smoking cessation advisers and assessed fidelity using actors who visited pharmacies posing as smokers, in a pilot study. : We reviewed the content and associated theory underpinning our intervention, taking account of the results of the earlier studies and a realist analysis of published literature. We then confirmed a logic model describing the intended operation of the intervention and used this model to refine the intervention and associated materials.

SETTING

Eight community pharmacies in three inner east London boroughs.

PARTICIPANTS

12 Stop Smoking Advisers.

INTERVENTION

Two, 150 min, skills-based training sessions focused on communication and behaviour change skills with between session practice.

RESULTS

The pilot study confirmed acceptability of the intervention and showed preliminary evidence of benefit; however, organisational barriers tended to limit effective operation. The pilot data and realist review pointed to additional use of Diffusion of Innovations Theory to seat the intervention in the wider organisational context.

CONCLUSIONS

We have developed and refined an intervention to promote smoking cessation services in community pharmacies, which we now plan to evaluate in a randomised controlled trial.

TRIAL REGISTRATION NUMBER

UKCRN ID 18446, Pilot.

摘要

目的

为社区药房工作人员开发一种综合干预措施,以促进戒烟服务的采用并提高戒烟率。

设计

遵循医学研究理事会的框架,我们采用混合方法来开发、试点并完善该干预措施。

方法

我们利用药房定性研究的信息、系统的文献综述以及能力、机会、动机 - 行为框架来为干预措施的初始版本设计提供依据。然后,在一项试点研究中,我们与戒烟顾问测试了该干预措施的可接受性,并使用假扮吸烟者前往药房的演员来评估干预的保真度。我们回顾了干预措施的内容及相关理论基础,同时考虑了早期研究的结果以及对已发表文献的实证分析。然后,我们确定了一个描述干预措施预期运作的逻辑模型,并使用该模型来完善干预措施及相关材料。

地点

伦敦东部三个行政区的八家社区药房。

参与者

12名戒烟顾问。

干预措施

两次时长150分钟、基于技能的培训课程,重点是沟通和行为改变技能,并在课程间隙进行实践。

结果

试点研究证实了该干预措施的可接受性,并显示出初步的益处证据;然而,组织障碍往往会限制其有效运作。试点数据和实证综述指出,需额外运用创新扩散理论将干预措施置于更广泛的组织背景中。

结论

我们已经开发并完善了一种在社区药房促进戒烟服务的干预措施,我们现在计划在一项随机对照试验中对其进行评估。

试验注册号

英国临床试验注册号18446,试点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/377b/5724215/9b4c0efca926/bmjopen-2016-015637f01.jpg

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