Development of “Baby, Me, & NRT”: A Behavioral Intervention to Improve the Effectiveness of Nicotine Replacement Therapy in Pregnancy

McDaid, Lisa; Emery, Joanne; Thomson, Ross; Coleman, Tim; Cooper, Sue; Dickinson, Anne; Kinahan-Goodwin, Darren; Phillips, Lucy; Naughton, Felix

Abstract

Background
The effectiveness of Nicotine Replacement Therapy (NRT) for smoking cessation in pregnancy is limited by inconsistent and incorrect use. This paper describes the development process for “Baby, Me, & NRT”, a novel pregnancy-specific intervention aimed at enhancing adherence to NRT.

Methods
An integrated approach to intervention development was used, combining evidence, theory, stakeholders’ feedback, and tailoring principles. The process involved six iterative steps: (1) synthesizing relevant published evidence and guidance, (2) collecting primary qualitative data on barriers and facilitators to NRT adherence along with potential intervention design features, (3) identifying relevant behavioral theories and mapping the evidence against these, (4) prioritizing behavioral determinants identified in steps 1 and 2, generating intervention objectives, and identifying behavior change techniques which target the prioritized determinants, (5) consulting with stakeholders on intervention components, key content and tailoring features, and (6) producing a prototype intervention along with implementation guidance.

Results
The prototype intervention comprises of a multi-component, 1-month cessation programme, which includes six enhanced behavioral support sessions delivered by a trained advisor, tailored text messages, a website, and an illustrated booklet. It promotes the uptake of high-dose and combination NRT, emphasizes the importance of adherence, addresses motivation to use NRT, proactively helps problem solve NRT use issues, and provides guidance on preventing and managing smoking lapses.

Conclusion
The development process generated an evidence- and theory-guided intervention, designed with stakeholder input, aimed at improving NRT effectiveness for smoking cessation in pregnancy. The prototype intervention has since been optimized and is being evaluated in a randomized controlled trial.

Citation

McDaid, L., Emery, J., Thomson, R., Coleman, T., Cooper, S., Dickinson, A., …Naughton, F. (2023). Development of “Baby, Me, & NRT”: A Behavioral Intervention to Improve the Effectiveness of Nicotine Replacement Therapy in Pregnancy. Nicotine and Tobacco Research, 25(11), 1770-1780. https://doi.org/10.1093/ntr/ntad102

• Journal Article Type: Article
• Acceptance Date: Jun 21, 2023
• Online Publication Date: Jun 22, 2023
• Publication Date: 2023-11
• Deposit Date: Aug 3, 2023
• Publicly Available Date: Aug 3, 2023
• Journal: Nicotine and Tobacco Research
• Print ISSN: 1462-2203
• Electronic ISSN: 1469-994X
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 25
• Issue: 11
• Article Number: ntad102
• Pages: 1770-1780
• DOI: https://doi.org/10.1093/ntr/ntad102
• Keywords: Public Health, Environmental and Occupational Health
• Public URL: https://nottingham-repository.worktribe.com/output/22186696
• Publisher URL: https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntad102/7205459