Implementing babyClear© to support pregnant women to stop smoking: a process evaluation
PHE ePoster Library. E Jones S. Sep 12, 2017; 186658; 77
Susan E Jones
Susan E Jones
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Abstract Introduction: A package of measures based on NICE guidance, including routine carbon monoxide monitoring, opt-out referral to stop smoking services (SSS) and staff training, was introduced to reduce exceptionally high smoking rates in pregnancy across North East England. An effectiveness study showed referrals to SSS increased by 2.5 times and the proportion of women quitting by delivery by nearly twofold.Methods: Interviews with trainers, maternity and SSS staff and observations of training provided data to assess acceptability to staff of system changes, helps and hindrances to implementation, and impact on both services. Interview guides were framed using Normalisation Process Theory. Analysis was undertaken using Framework Analysis.Results: Interviews took place with staff from areas covered by eight NHS trusts at a time of widespread restructuring in SSS. Despite significant variation across organisations there was widespread take up and sustained use of simple routines, evidence of a changed culture and greater confidence amongst staff tackling this issue. Appointing a champion helped staff set up and maintain adjustments to their practice, promote integration of services and reflect on adapting themselves and the work context to face new challenges. Other key features for success included openness to change and available resources.Conclusion: The babyClear© package offers ways to reduce smoking in pregnancy that are acceptable to staff in multiple agencies. It is predicated on producing individual behaviour change in women but does this largely through reorganising and standardising service delivery systems and changing the culture in which pregnant smokers are approached and monitored. External funding details This work presents independent research funded by the NIHR School for Public Health Research (SPHR). NIHR SPHR is a partnership between the Universities of Sheffield, Bristol, Cambridge, Exeter, University College London; The London School for Hygiene and Tropical Medicine; the LiLaC collaboration between the Universities of Liverpool and Lancaster; and Fuse, the Centre for Translational Research in Public Health, a collaboration between Teesside, Newcastle, Durham, Northumbria and Sunderland Universities. Fuse is a UK Clinical Research Collaboration (UKCRC) Public Health Research Centres of Excellence, which receives funding from British Heart Foundation, Cancer Research UK, ESRC, Medical Research Council and the NIHR.
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