Kellar Ian, Al Azdi Zunayed, Jackson Cath, Huque Rumana, Mdege Noreen Dadirai, Siddiqi Kamran
School of Psychology, Faculty of Medicine & Health, University of Leeds, Leeds, LS2 9JT, UK.
ARK Foundation, Suite C-3, C-4, House number 06, Road 109, Dhaka, 1212, Bangladesh.
Pilot Feasibility Stud. 2022 Jul 2;8(1):136. doi: 10.1186/s40814-022-01100-5.
Deaths from second-hand smoke (SHS) exposure are increasing, but there is not sufficient evidence to recommend a particular SHS intervention or intervention development approach. Despite the available guidance on intervention reporting, and on the role and nature of pilot and feasibility studies, partial reporting of SHS interventions is common. The decision-making whilst developing such interventions is often under-reported. This paper describes the processes and decisions employed during transitioning from the aim of adapting an existing mosque-based intervention focused on public health messages, to the development of the content of novel community-based Smoke-Free Home (SFH) intervention. The intervention aims to promote smoke-free homes to reduce non-smokers' exposure to SHS in the home via faith-based messages.
The development of the SFH intervention had four sequential phases: in-depth interviews with adults in households in Dhaka, identification of an intervention programme theory and content with Islamic scholars from the Bangladesh Islamic Foundation (BIF), user testing of candidate intervention content with adults, and iterative intervention development workshops with Imams and khatibs who trained at the BIF.
It was judged inappropriately to take an intervention adaptation approach. Following the identification of an intervention programme theory and collaborating with stakeholders in an iterative and collaborative process to identify barriers, six potentially modifiable constructs were identified. These were targeted with a series of behaviour change techniques operationalised as Quranic verses with associated health messages to be used as the basis for Khutbahs. Following iterative user testing, acceptable intervention content was generated.
The potential of this community-based intervention to reduce SHS exposure at home and improve lung health among non-smokers in Bangladesh is the result of an iterative and collaborative process. It is the result of the integration of behaviour change evidence and theory and community stakeholder contributions to the production of the intervention content. This novel combination of intervention development frameworks demonstrates a flexible approach that could provide insights for intervention development in related contexts.
因接触二手烟（SHS）导致的死亡人数正在增加，但尚无足够证据推荐特定的二手烟干预措施或干预措施开发方法。尽管有关于干预措施报告以及试点和可行性研究的作用及性质的现有指南，但二手烟干预措施的部分报告很常见。在制定此类干预措施时的决策过程往往报告不足。本文描述了从调整现有的以清真寺为基础、侧重于公共卫生信息的干预措施的目标，过渡到开发基于社区的新型无烟家庭（SFH）干预措施内容的过程和决策。该干预措施旨在通过基于信仰的信息推广无烟家庭，以减少非吸烟者在家中接触二手烟。
无烟家庭干预措施的开发有四个连续阶段：对达卡家庭中的成年人进行深入访谈；与孟加拉国伊斯兰基金会（BIF）的伊斯兰学者确定干预计划理论和内容；对成年人进行候选干预内容的用户测试；以及与在BIF接受培训的伊玛目和讲经人举办迭代式干预措施开发研讨会。
采用干预措施改编方法被认为不合适。在确定干预计划理论并与利益相关者进行迭代协作过程以识别障碍后，确定了六个可能可修改的要素。针对这些要素采用了一系列行为改变技术，将其转化为带有相关健康信息的古兰经经文，用作讲道的基础。经过迭代用户测试，生成了可接受的干预措施内容。
这种基于社区的干预措施在减少孟加拉国非吸烟者在家中接触二手烟和改善肺部健康方面的潜力，是一个迭代协作过程的结果。它是行为改变证据和理论与社区利益相关者对干预措施内容制作的贡献相结合的结果。这种干预措施开发框架的新颖组合展示了一种灵活的方法，可为相关背景下的干预措施开发提供见解。
