UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
Public Health Wales, Health Improvement Division, Cardiff, Wales, UK.
Public Health. 2021 May;194:216-222. doi: 10.1016/j.puhe.2021.03.003. Epub 2021 May 5.
NHS Stop Smoking Services (NHS-SSS) have been available in the United Kingdom (UK) since 2000. The service has proven to be effective, however uptake remains below aspirations. Understanding people's willingness and reasons for accessing and engaging with NHS-SSS is, therefore, important. The aim of this systematic review is to summarise the findings from qualitative research to understand people's views, perceptions and willingness to access NHS-SSS.
Qualitative systematic review with meta-aggregation synthesis.
Four electronic databases were searched for published qualitative studies, from Jan 2000 to Jan 2020. Following the screening, data extraction and quality assessment, data synthesis was conducted using meta-aggregation based on a patient-centred theoretical framework. We explored five 'demand-side' dimensions of service accessibility: the ability to perceive, seek, reach, pay and engage. Confidence in the synthesised findings relating to dependability and credibility was established using CONQual.
Seventeen studies were included in the review. Twelve categories emerged, contributing to five synthesised statements, all with a CONQual rating of moderate confidence. Access and willingness to use NHS-SSS were found to be related to an individual's readiness to perceive that smoking is a problem for which a solution should be sought, their ability to seek a perceived effective treatment, to conveniently reach NHS-SSS, their perceptions around associated costs and tailoring care to improve engagement with individuals.
By using a theoretical framework incorporating healthcare access, this study provides policymakers valuable insights into people's willingness to access these services. Willingness to access NHS-SSS is multifaceted, nuanced and complex. Strategies to promote NHS-SSS uptake should include making services more attractive, relevant and responsive to individual perceptions around smoking and health. Given the higher prevalence of smoking in less affluent socioeconomic groups and in some ethnic minority groups, the importance of having a comprehensive and inclusive tobacco control policy, one that is linguistically and culturally sensitive, cannot be overstated.
英国国民健康服务戒烟服务（NHS-SSS）自 2000 年以来一直在英国提供。该服务已被证明是有效的，然而使用率仍低于预期。因此，了解人们愿意并愿意使用 NHS-SSS 的原因非常重要。本系统评价的目的是总结定性研究的结果，以了解人们对 NHS-SSS 的看法、看法和意愿。
基于患者为中心的理论框架进行定性系统评价和元聚合综合。
从 2000 年 1 月至 2020 年 1 月，对四个电子数据库进行了已发表的定性研究搜索。经过筛选、数据提取和质量评估，使用基于患者为中心的理论框架的元聚合进行了数据综合。我们探索了服务可及性的五个“需求方”维度：感知、寻求、到达、支付和参与的能力。使用 CONQual 建立了对与可靠性和可信度相关的综合研究结果的信心。
共纳入 17 项研究。出现了 12 个类别，对 5 个综合陈述做出了贡献，所有陈述的 CONQual 评分均为中等置信度。使用 NHS-SSS 的意愿与个人是否准备好认识到吸烟是一个需要寻求解决方案的问题、他们是否有能力寻求被认为有效的治疗方法、是否方便地获得 NHS-SSS、他们对相关成本的看法以及是否定制护理以提高个人参与度有关。
通过使用包含医疗保健可及性的理论框架，本研究为政策制定者提供了有价值的见解，了解人们使用这些服务的意愿。使用 NHS-SSS 的意愿是多方面的、细微的和复杂的。促进 NHS-SSS 使用的策略应包括使服务更具吸引力、更符合个人对吸烟和健康的看法，并更具针对性。鉴于较贫困社会经济群体和某些少数族裔群体中吸烟的比例较高，制定全面和包容性的烟草控制政策，即语言和文化上敏感的政策，至关重要。
