Factors associated with provision of smoking cessation support to pregnant women - a cross-sectional survey of midwives in New South Wales, Australia.
Antenatal care
Health professional behaviour
Smoking cessation
Theoretical domains framework
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
15 Apr 2020
15 Apr 2020
Historique:
received:
12
01
2020
accepted:
30
03
2020
entrez:
17
4
2020
pubmed:
17
4
2020
medline:
13
1
2021
Statut:
epublish
Résumé
Smoking is the most important preventable cause of adverse pregnancy outcomes, but provision of smoking cessation support (SCS) to pregnant women is poor. We examined the association between midwives' implementation of SCS (5As - Ask, Advise, Assess, Assist, Arrange follow-up) and reported barriers/enablers to implementation. On-line anonymous survey of midwives providing antenatal care in New South Wales (NSW), Australia, assessing provision of the 5As and barriers/enablers to their implementation, using the Theoretical Domains Framework (TDF). Factor analyses identified constructs underlying the 5As; and barriers/enablers. Multivariate general linear models examined relationships between the barrier/enabler factors and the 5As factors. Of 750 midwives invited, 150 (20%) participated. Respondents more commonly reported Asking and Assessing than Advising, Assisting, or Arranging follow-up (e.g. 77% always Ask smoking status; 17% always Arrange follow-up). Three 5As factors were identified- 'Helping', 'Assessing quitting' and 'Assessing dependence'. Responses to barrier/enabler items showed greater knowledge, skills, intentions, and confidence with Assessment than Assisting; endorsement for SCS as a priority and part of midwives' professional role; and gaps in training and organisational support for SCS. Nine barrier/enabler factors were identified. Of these, the factors of 'Capability' (knowledge, skills, confidence); 'Work Environment' (service has resources, capacity, champions and values SCS) and 'Personal priority' (part of role and a priority) predicted 'Helping'. The TDF enabled systematic identification of barriers to providing SCS, and the multivariate models identified key contributors to poor implementation. Combined with qualitative data, these results have been mapped to intervention components to develop a comprehensive intervention to improve SCS.
Sections du résumé
BACKGROUND
BACKGROUND
Smoking is the most important preventable cause of adverse pregnancy outcomes, but provision of smoking cessation support (SCS) to pregnant women is poor. We examined the association between midwives' implementation of SCS (5As - Ask, Advise, Assess, Assist, Arrange follow-up) and reported barriers/enablers to implementation.
METHODS
METHODS
On-line anonymous survey of midwives providing antenatal care in New South Wales (NSW), Australia, assessing provision of the 5As and barriers/enablers to their implementation, using the Theoretical Domains Framework (TDF). Factor analyses identified constructs underlying the 5As; and barriers/enablers. Multivariate general linear models examined relationships between the barrier/enabler factors and the 5As factors.
RESULTS
RESULTS
Of 750 midwives invited, 150 (20%) participated. Respondents more commonly reported Asking and Assessing than Advising, Assisting, or Arranging follow-up (e.g. 77% always Ask smoking status; 17% always Arrange follow-up). Three 5As factors were identified- 'Helping', 'Assessing quitting' and 'Assessing dependence'. Responses to barrier/enabler items showed greater knowledge, skills, intentions, and confidence with Assessment than Assisting; endorsement for SCS as a priority and part of midwives' professional role; and gaps in training and organisational support for SCS. Nine barrier/enabler factors were identified. Of these, the factors of 'Capability' (knowledge, skills, confidence); 'Work Environment' (service has resources, capacity, champions and values SCS) and 'Personal priority' (part of role and a priority) predicted 'Helping'.
CONCLUSION
CONCLUSIONS
The TDF enabled systematic identification of barriers to providing SCS, and the multivariate models identified key contributors to poor implementation. Combined with qualitative data, these results have been mapped to intervention components to develop a comprehensive intervention to improve SCS.
Identifiants
pubmed: 32295541
doi: 10.1186/s12884-020-02912-0
pii: 10.1186/s12884-020-02912-0
pmc: PMC7161220
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
219Subventions
Organisme : National Health and Medical Research Council of Australia
ID : GNT1072213
Organisme : Cancer Institute NSW
ID : 13/ECF/1-11
Références
Eur J Epidemiol. 2011 Oct;26(10):763-70
pubmed: 21994150
J Obstet Gynecol Neonatal Nurs. 2010 Jan-Feb;39(1):64-77
pubmed: 20409104
Nicotine Tob Res. 2015 Jun;17(6):746-9
pubmed: 25634937
Cochrane Database Syst Rev. 2017 Feb 14;2:CD001055
pubmed: 28196405
Nicotine Tob Res. 2017 May 1;19(5):636-641
pubmed: 28403469
Implement Sci. 2012 Apr 24;7:36
pubmed: 22531641
J Gen Intern Med. 2009 Feb;24(2):149-54
pubmed: 19083066
Cochrane Database Syst Rev. 2009 Jul 08;(3):CD001096
pubmed: 19588323
J Adv Nurs. 2015 Jun;71(6):1210-26
pubmed: 25430626
Public Health Res Pract. 2018 Jun 14;28(2):
pubmed: 29925084
Cochrane Database Syst Rev. 2012 May 16;(5):CD000214
pubmed: 22592671
Prog Community Health Partnersh. 2008 Winter;2(4):279-89
pubmed: 20208308
J Eval Clin Pract. 2013 Oct;19(5):948-52
pubmed: 22845193
Cochrane Database Syst Rev. 2015 Apr 29;(4):CD005470
pubmed: 25923419
J Addict Med. 2014 Jan-Feb;8(1):14-24
pubmed: 24317354
Int J Epidemiol. 2008 Oct;37(5):941-7
pubmed: 17881411
Aust N Z J Public Health. 2003;27(3):300-9
pubmed: 14705286
J Womens Health (Larchmt). 2006 May;15(4):400-41
pubmed: 16724888
Nicotine Tob Res. 2017 May 1;19(5):642-646
pubmed: 28403464
JAMA Intern Med. 2015 Sep;175(9):1509-16
pubmed: 26076313
Midwifery. 2009 Oct;25(5):473-82
pubmed: 18280015
Eval Health Prof. 2013 Sep;36(3):382-407
pubmed: 23975761
BMC Public Health. 2019 Sep 11;19(1):1255
pubmed: 31510969
Tob Control. 2018 Jan;27(1):90-98
pubmed: 28202783
Int J Nurs Stud. 2016 Jan;53:228-37
pubmed: 26302658
Implement Sci. 2012 Apr 24;7:37
pubmed: 22530986
Birth. 2013 Jun;40(2):81-7
pubmed: 24635461
Midwifery. 2018 Mar;58:137-144
pubmed: 29367150
Implement Sci. 2014 Jan 15;9:11
pubmed: 24423394
Nature. 2007 Jan 18;445(7125):257-8
pubmed: 17230171
Tob Control. 2000;9 Suppl 3:III80-4
pubmed: 10982917
Am J Health Promot. 2013 Jan-Feb;27(3):170-6
pubmed: 23286593