Promoting and maintaining changes in smoking behaviour for patients following discharge from a smokefree mental health inpatient stay: Development of a complex intervention using the Behaviour Change Wheel.

Shoesmith, Emily; Huddlestone, Lisa; Pervin, Jodi; Shahab, Lion; Coventry, Peter; Coleman, Tim; Lorencatto, Fabiana; Gilbody, Simon; Leahy, Moira; Horspool, Michelle; Paul, Claire; Colley, Lesley; Hough, Simon; Hough, Phil; Ratschen, Elena

Abstract

Evidence suggests that smokers can successfully quit, remain abstinent or reduce smoking during a smokefree mental health inpatient stay, provided behavioural/pharmacological support are offered. However, few evidence-based strategies to prevent the return to pre-hospital smoking behaviours post-discharge exist. We report the development of an intervention designed to support smoking-related behaviour change following discharge from a smokefree mental health stay. We followed the Behaviour Change Wheel (BCW) intervention development process. The target behaviour was supporting patients to change their smoking behaviours following discharge from a smokefree mental health stay. Using systematic reviews, we identified the barriers/enablers, classified according to the Theoretical Domains Framework (TDF). Potential intervention functions to address key influences were identified by consulting the BCW and Behaviour Change Technique (BCT) taxonomy. Another systematic review identified effectiveness of BCTs in this context. Stakeholder consultations were conducted to prioritise/refine intervention content. Barriers/enablers to supporting smoking cessation were identified within the domains of environmental context and resources (lack of staff time); knowledge (ill-informed interactions about smoking); social influences, and intentions (lack of intention to deliver support). Potential strategies to address these influences included goal setting, problem solving, feedback, social support, and information on health consequences. A strategy for operationalising these techniques into intervention components was agreed: pre-discharge evaluation sessions, personalised resource folder, tailored behavioural and text message support post-discharge, and a peer interaction group, delivered by a trained mental health worker. The intervention includes targeted resources to support smoking-related behaviour change in patients following discharge from a smokefree mental health setting. Using the BCW and TDF supported a theoretically and empirically informed process to define and develop a tailored intervention that acknowledges barriers and enablers to supporting smoking cessation in mental health settings. The result is a novel complex theory- and evidence-based intervention that will be formally tested in a randomised controlled feasibility study.

Citation

Shoesmith, E., Huddlestone, L., Pervin, J., Shahab, L., Coventry, P., Coleman, T., …Ratschen, E. (2023). Promoting and maintaining changes in smoking behaviour for patients following discharge from a smokefree mental health inpatient stay: Development of a complex intervention using the Behaviour Change Wheel. Nicotine & Tobacco Research, 25(4), 729-737. https://doi.org/10.1093/ntr/ntac242

• Journal Article Type: Article
• Acceptance Date: Oct 12, 2022
• Online Publication Date: Oct 17, 2022
• Publication Date: 2023-04
• Deposit Date: Nov 3, 2022
• Publicly Available Date: Nov 3, 2022
• Journal: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
• Print ISSN: 1462-2203
• Electronic ISSN: 1469-994X
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 25
• Issue: 4
• Pages: 729-737
• DOI: https://doi.org/10.1093/ntr/ntac242
• Keywords: Public Health, Environmental and Occupational Health
• Public URL: https://nottingham-repository.worktribe.com/output/12624825
• Publisher URL: https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac242/6761978?login=false