Understanding the implementation strategy of a secondary care tobacco addiction treatment pathway (the CURE project) in England: a strategic behavioural analysis
Objectives The Conversation, Understand, Replace, Experts and evidence-based treatment (CURE) project implemented an evidence-based intervention that offers a combination of pharmacotherapy and behavioural support to tobacco-dependent inpatients. Understanding key characteristics of CURE’s implement...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022-06-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e054739.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832584093261365248 |
|---|---|
| author | Matthew Evison Anna Haste Catherine Haighton Freya Howle Angela M Rodrigues Angela Wearn Verity Mallion |
| author_facet | Matthew Evison Anna Haste Catherine Haighton Freya Howle Angela M Rodrigues Angela Wearn Verity Mallion |
| author_sort | Matthew Evison |
| collection | DOAJ |
| description | Objectives The Conversation, Understand, Replace, Experts and evidence-based treatment (CURE) project implemented an evidence-based intervention that offers a combination of pharmacotherapy and behavioural support to tobacco-dependent inpatients. Understanding key characteristics of CURE’s implementation strategy, and identifying areas for improvement, is important to support the roll-out of nationwide tobacco dependence services. This study aimed to (1) specify key characteristics of CURE’s exiting implementation strategy and (2) develop theoretical-informed and stakeholder-informed recommendations to optimise wider roll-out.Design and methods Data were collected via document review and secondary analysis of interviews with 10 healthcare professionals of a UK hospital. Intervention content was specified through behaviour change techniques (BCTs) and intervention functions within the Behaviour Change Wheel. A logic model was developed to specify CURE’s implementation strategy and its mechanisms of impact. We explored the extent to which BCTs and intervention functions addressed the key theoretical domains influencing implementation using prespecified matrices. The development of recommendations was conducted over a two-round Delphi exercise.Results We identified six key theoretical domains of influences: ‘environmental context and resources’, ‘goals’, ‘social professional role and identity’, ‘social influences’, ‘reinforcement’ and ‘skills’. The behavioural analysis identified 26 BCTs, 4 intervention functions and 4 policy categories present within the implementation strategy. The implementation strategy included half the relevant intervention functions and BCTs to target theoretical domains influencing CURE implementation, with many BCTs focusing on shaping knowledge. Recommendations to optimise content were developed following stakeholder engagement.Conclusions CURE offers a strong foundation from which a tobacco dependence treatment model can be developed in England. The exiting strategy could be strengthened via the inclusion of more theoretically congruent BCTs, particularly relating to ‘environmental context and resources’. The recommendations provide routes to optimisation that are both theoretically grounded and stakeholder informed. Future research should assess the feasibility/acceptability of these recommendations in the wider secondary-care context. |
| format | Article |
| id | doaj-art-c5ea29e469884b94afaa70b1fb62fddf |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-c5ea29e469884b94afaa70b1fb62fddf2025-01-27T17:05:10ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-054739Understanding the implementation strategy of a secondary care tobacco addiction treatment pathway (the CURE project) in England: a strategic behavioural analysisMatthew Evison0Anna Haste1Catherine Haighton2Freya Howle3Angela M Rodrigues4Angela Wearn5Verity Mallion6Lung Cancer and Thoracic Surgery Directorate, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UKCentre for Applied Psychological Science, Department of Psychology, School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UKDepartment of Social Work, Education and Community Wellbeing, Northumbria University Newcastle, Newcastle Upon Tyne, UKThe CURE Project Team, Greater Manchester Cancer Alliance, Greater Manchester Strategic Health Authority, Manchester, UKDepartment of Psychology, Northumbria University, Newcastle upon Tyne, UKPopulation Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UKBehavioural Insights Team, Public Health England, London, UKObjectives The Conversation, Understand, Replace, Experts and evidence-based treatment (CURE) project implemented an evidence-based intervention that offers a combination of pharmacotherapy and behavioural support to tobacco-dependent inpatients. Understanding key characteristics of CURE’s implementation strategy, and identifying areas for improvement, is important to support the roll-out of nationwide tobacco dependence services. This study aimed to (1) specify key characteristics of CURE’s exiting implementation strategy and (2) develop theoretical-informed and stakeholder-informed recommendations to optimise wider roll-out.Design and methods Data were collected via document review and secondary analysis of interviews with 10 healthcare professionals of a UK hospital. Intervention content was specified through behaviour change techniques (BCTs) and intervention functions within the Behaviour Change Wheel. A logic model was developed to specify CURE’s implementation strategy and its mechanisms of impact. We explored the extent to which BCTs and intervention functions addressed the key theoretical domains influencing implementation using prespecified matrices. The development of recommendations was conducted over a two-round Delphi exercise.Results We identified six key theoretical domains of influences: ‘environmental context and resources’, ‘goals’, ‘social professional role and identity’, ‘social influences’, ‘reinforcement’ and ‘skills’. The behavioural analysis identified 26 BCTs, 4 intervention functions and 4 policy categories present within the implementation strategy. The implementation strategy included half the relevant intervention functions and BCTs to target theoretical domains influencing CURE implementation, with many BCTs focusing on shaping knowledge. Recommendations to optimise content were developed following stakeholder engagement.Conclusions CURE offers a strong foundation from which a tobacco dependence treatment model can be developed in England. The exiting strategy could be strengthened via the inclusion of more theoretically congruent BCTs, particularly relating to ‘environmental context and resources’. The recommendations provide routes to optimisation that are both theoretically grounded and stakeholder informed. Future research should assess the feasibility/acceptability of these recommendations in the wider secondary-care context.https://bmjopen.bmj.com/content/12/6/e054739.full |
| spellingShingle | Matthew Evison Anna Haste Catherine Haighton Freya Howle Angela M Rodrigues Angela Wearn Verity Mallion Understanding the implementation strategy of a secondary care tobacco addiction treatment pathway (the CURE project) in England: a strategic behavioural analysis BMJ Open |
| title | Understanding the implementation strategy of a secondary care tobacco addiction treatment pathway (the CURE project) in England: a strategic behavioural analysis |
| title_full | Understanding the implementation strategy of a secondary care tobacco addiction treatment pathway (the CURE project) in England: a strategic behavioural analysis |
| title_fullStr | Understanding the implementation strategy of a secondary care tobacco addiction treatment pathway (the CURE project) in England: a strategic behavioural analysis |
| title_full_unstemmed | Understanding the implementation strategy of a secondary care tobacco addiction treatment pathway (the CURE project) in England: a strategic behavioural analysis |
| title_short | Understanding the implementation strategy of a secondary care tobacco addiction treatment pathway (the CURE project) in England: a strategic behavioural analysis |
| title_sort | understanding the implementation strategy of a secondary care tobacco addiction treatment pathway the cure project in england a strategic behavioural analysis |
| url | https://bmjopen.bmj.com/content/12/6/e054739.full |
| work_keys_str_mv | AT matthewevison understandingtheimplementationstrategyofasecondarycaretobaccoaddictiontreatmentpathwaythecureprojectinenglandastrategicbehaviouralanalysis AT annahaste understandingtheimplementationstrategyofasecondarycaretobaccoaddictiontreatmentpathwaythecureprojectinenglandastrategicbehaviouralanalysis AT catherinehaighton understandingtheimplementationstrategyofasecondarycaretobaccoaddictiontreatmentpathwaythecureprojectinenglandastrategicbehaviouralanalysis AT freyahowle understandingtheimplementationstrategyofasecondarycaretobaccoaddictiontreatmentpathwaythecureprojectinenglandastrategicbehaviouralanalysis AT angelamrodrigues understandingtheimplementationstrategyofasecondarycaretobaccoaddictiontreatmentpathwaythecureprojectinenglandastrategicbehaviouralanalysis AT angelawearn understandingtheimplementationstrategyofasecondarycaretobaccoaddictiontreatmentpathwaythecureprojectinenglandastrategicbehaviouralanalysis AT veritymallion understandingtheimplementationstrategyofasecondarycaretobaccoaddictiontreatmentpathwaythecureprojectinenglandastrategicbehaviouralanalysis |