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Chadborn T, Williams S, Jorgensen T, Price C, Buckel A, Altieri E. An approach for embedding behavioural science in antimicrobial resistance One Health research. J Infect Public Health 2023; 16 Suppl 1:134-140. [PMID: 37973498 DOI: 10.1016/j.jiph.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023] Open
Abstract
Antimicrobial Resistance (AMR) is a global health emergency that threatens modern medicine and incurs great cost to human health. The World Health Organization as part of a quadripartite joint initiative with the Food and Agriculture Organization of the United Nations, World Organisation for Animal Health, and United Nations Environment Programme, has recently published a One Health Priority Research Agenda for AMR. In this article we present a multidisciplinary approach, proposed by behavioural science experts, One Health experts and AMR experts to support the implementation of the Priority Research Agenda. We review, using specific examples of complex interventions designed to tackle AMR in which behavioural science has been embedded, five main steps: Define - what behaviours are a priority in each context; Diagnose - What are the barriers and enablers to the behaviours prioritised? Design - what interventions exist and what new or enhanced interventions could work to tackle the barriers identified? and, Implement and Evaluate the intervention(s). The approach presented will be useful for funders and researchers who wish to incorporate methods, frameworks and insights from the behavioural sciences into research plans, proposals and protocols in relation to a multisectoral One Health agenda and produce findings that are more relevant to policymakers.
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Affiliation(s)
- Tim Chadborn
- Behavioural Insights Unit, World Health Organization (WHO), Switzerland.
| | - Simon Williams
- Behavioural Insights Unit, World Health Organization (WHO), Switzerland
| | - Tine Jorgensen
- AMR Unit, Communicable Diseases and Environment Division, World Health Organization (WHO EURO), Switzerland
| | - Cortney Price
- Office of Innovation (OIN), Food and Agriculture Organization of the United Nations (FAO), Kenya
| | - Anica Buckel
- Food and Agriculture Organization of the United Nations (FAO), Nairobi, Kenya
| | - Elena Altieri
- Behavioural Insights Unit, World Health Organization (WHO), Switzerland
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Hock ES, Franklin M, Baxter S, Clowes M, Chilcott J, Gillespie D. Covariates of success in quitting smoking: a systematic review of studies from 2008 to 2021 conducted to inform the statistical analyses of quitting outcomes of a hospital-based tobacco dependence treatment service in the United Kingdom. NIHR OPEN RESEARCH 2023; 3:28. [PMID: 37881466 PMCID: PMC10596416 DOI: 10.3310/nihropenres.13427.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 10/27/2023]
Abstract
Background Smoking cessation interventions are being introduced into routine secondary care in the United Kingdom (UK), but there are person and setting-related factors that could moderate their success in quitting smoking. This review was conducted as part of an evaluation of the QUIT hospital-based tobacco dependence treatment service ( https://sybics-quit.co.uk). The aim of the review was to identify a comprehensive set of variables associated with quitting success among tobacco smokers contacting secondary healthcare services in the UK who are offered support to quit smoking and subsequently set a quit date. The results would then be used to inform the development of a statistical analysis plan to investigate quitting outcomes. Methods Systematic literature review of five electronic databases. Studies eligible for inclusion investigated quitting success in one of three contexts: (a) the general population in the UK; (b) people with a mental health condition; (c) quit attempts initiated within a secondary care setting. The outcome measures were parameters from statistical analysis showing the effects of covariates on quitting success with a statistically significant (i.e., p-value <0.05) association. Results The review identified 29 relevant studies and 14 covariates of quitting success, which we grouped into four categories: demographics (age; sex; ethnicity; socio-economic conditions; relationship status, cohabitation and social network), individual health status and healthcare setting (physical health, mental health), tobacco smoking variables (current tobacco consumption, smoking history, nicotine dependence; motivation to quit; quitting history), and intervention characteristics (reduction in amount smoked prior to quitting, the nature of behavioural support, tobacco dependence treatment duration, pharmacological aids). Conclusions In total, 14 data fields were identified that should be considered for inclusion in datasets and statistical analysis plans for evaluating the quitting outcomes of smoking cessation interventions initiated in secondary care contexts in the UK. PROSPERO registration CRD42021254551 (13/05/2021).
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Affiliation(s)
- Emma S. Hock
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health School, The University of Sheffield, Sheffield, England, UK
| | - Matthew Franklin
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health School, The University of Sheffield, Sheffield, England, UK
| | - Susan Baxter
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health School, The University of Sheffield, Sheffield, England, UK
| | - Mark Clowes
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health School, The University of Sheffield, Sheffield, England, UK
| | - James Chilcott
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health School, The University of Sheffield, Sheffield, England, UK
| | - Duncan Gillespie
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health School, The University of Sheffield, Sheffield, England, UK
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Lussiez A, Zondlak A, Hsu PJ, Delaney L, Vitous CA, Telem D, Rubyan M. Surgeon behaviors related to engaging patients in smoking cessation at the time of elective surgery. Am J Surg 2023; 226:218-226. [PMID: 37105853 DOI: 10.1016/j.amjsurg.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/02/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Despite the abundance of evidence supporting smoking cessation before elective surgery, there is wide variation in surgeon adherence to these best practices. METHODS This qualitative study used convenience sampling to recruit General Surgery trained surgeons. Surgeons participated in semi-structured interviews based on domains from the Theoretical Domains Framework (TDF). Content analysis was guided by the TDF. RESULTS Of the 14 TDF domains, social or professional role/identity, memory, attention and decision processes, environmental context and resources, and beliefs about consequences emerged most frequently. Mapping these domains to the Behavior Change Wheel identified education, enablement, and incentivization as effective intervention functions. CONCLUSIONS Using the TDF, this study identified a widespread sense of responsibility among surgeons to engage patients in perioperative smoking cessation despite workplace barriers and lacking resources. These findings provide valuable insight to facilitate surgeon participation in health promotion through targeted, theory-based interventions informed by surgeon identified barriers to perioperative smoking cessation.
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Affiliation(s)
- Alisha Lussiez
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
| | - Allyse Zondlak
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Phillip J Hsu
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Lia Delaney
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - C Ann Vitous
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Dana Telem
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Michael Rubyan
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Groves S, McCutchan G, Quaife SL, Murray RL, Ostroff JS, Brain K, Crosbie PAJ, Yorke J, Baldwin D, Field JK, McWilliams L. Attitudes towards the integration of smoking cessation into lung cancer screening in the United Kingdom: A qualitative study of individuals eligible to attend. Health Expect 2022; 25:1703-1716. [PMID: 35514094 PMCID: PMC9327806 DOI: 10.1111/hex.13513] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION There is limited research exploring how smoking cessation treatment should be implemented into lung cancer screening in the United Kingdom. This study aimed to understand attitudes and preferences regarding the integration of smoking cessation support within lung cancer screening from the perspective of those eligible. METHODS Thirty-one lung cancer screening eligible individuals aged 55-80 years with current or former smoking histories were recruited using community outreach and social media. Two focus groups (three participants each) and 25 individual telephone interviews were conducted. Data were analysed using the framework approach to thematic analysis. RESULTS Three themes were generated: (1) bringing lung cancer closer to home, where screening was viewed as providing an opportunity to motivate smoking cessation, depending on perceived personal risk and screening result; (2) a sensitive approach to cessation with the uptake of cessation support considered to be largely dependent on screening practitioners' communication style and expectations of stigma and (3) creating an equitable service that focuses on ease of access as a key determinant of uptake, where integrating cessation within the screening appointment may sustain increased quit motivation and prevent loss to follow-up. CONCLUSIONS The integration of smoking cessation into lung cancer screening was viewed positively by those eligible to attend. Screening appointments providing personalized lung health information may increase cessation motivation. Services should proactively support participants with possible fatalistic views regarding risk and decreased cessation motivation upon receiving a good screening result. To increase engagement in cessation, services need to be person-centred. PATIENT OR PUBLIC CONTRIBUTION This study has included patient and public involvement throughout, including input regarding study design, research materials, recruitment strategies and research summaries.
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Affiliation(s)
- Samantha Groves
- School of Health Sciences, Manchester Centre for Health Psychology, Division of Psychology and Mental Health, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - Grace McCutchan
- Wales Cancer Research Centre, Division of Population Medicine, School of MedicineCardiff UniversityCardiffUK
| | - Samantha L. Quaife
- Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population HealthQueen Mary University of LondonLondonUK
| | - Rachael L. Murray
- Academic Unit of Lifespan and Population Health, Faculty of MedicineUniversity of NottinghamNottinghamUK
| | - Jamie S. Ostroff
- Memorial Sloan‐Kettering Cancer Center, Behavioral Sciences ServiceNew YorkNew YorkUSA
| | - Kate Brain
- Wales Cancer Research Centre, Division of Population Medicine, School of MedicineCardiff UniversityCardiffUK
| | - Philip A. J. Crosbie
- LydiaBecker Institute of Immunology and Inflammation, Division of Immunology, Immunity to Infection and Respiratory MedicineThe University of ManchesterWythenshaweUK
| | - Janelle Yorke
- School of Health Sciences, Manchester Centre for Health Psychology, Division of Psychology and Mental Health, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Christie Patient‐Centred Research, Division of Nursing, Midwifery and Social Work, The Christie NHS Foundation TrustThe University of ManchesterManchesterUK
| | - David Baldwin
- Department of Respiratory MedicineNottingham University Hospitals NHS TrustNottinghamUK
| | - John K. Field
- Institute of Systems, Molecular and Integrative Biology, Molecular and Clinical Cancer Medicine, Faculty of Health and Life SciencesUniversity of LiverpoolLiverpoolUK
| | - Lorna McWilliams
- School of Health Sciences, Manchester Centre for Health Psychology, Division of Psychology and Mental Health, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
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Rodrigues AM, Wearn A, Haste A, Mallion V, Evison M, Howle F, Haighton C. Understanding the implementation strategy of a secondary care tobacco addiction treatment pathway (the CURE project) in England: a strategic behavioural analysis. BMJ Open 2022; 12:e054739. [PMID: 35701059 PMCID: PMC9198791 DOI: 10.1136/bmjopen-2021-054739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 05/08/2022] [Indexed: 11/24/2022] Open
Abstract
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.
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Affiliation(s)
- Angela M Rodrigues
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Angela Wearn
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Anna Haste
- Centre for Applied Psychological Science, Department of Psychology, School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - Verity Mallion
- Behavioural Insights Team, Public Health England, London, UK
| | - Matthew Evison
- The CURE Project Team, The Christie NHS Foundation Trust, Manchester, UK
| | - Freya Howle
- The CURE Project Team, The Christie NHS Foundation Trust, Manchester, UK
| | - Catherine Haighton
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, Tyne and Wear, UK
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Riddell H, Haighton C. Staff perspectives on the impact of COVID 19 on the delivery of specialist domestic abuse services in the UK: A qualitative study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000310. [PMID: 36962238 PMCID: PMC10021249 DOI: 10.1371/journal.pgph.0000310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/25/2022] [Indexed: 11/20/2022]
Abstract
Domestic abuse is a significant public health issue effecting 2.4 million adults in England and Wales each year. In March 2020 the World Health Organisation declared a global pandemic following the outbreak of COVID-19. As a result, the UK moved to a period of lockdown. There is growing evidence that highlights the unintended negative consequences of lockdown, particularly in households where abuse is present. The aim of this study was to explore the experiences of frontline specialist domestic abuse staff who continued to support victims during the period of lockdown to understand the impact of COVID-19 on service delivery. Ten, one to one, semi structured qualitative interviews were carried out with staff from a specialist domestic abuse service that operates in regions across the north-east of England. All participants had been involved in service delivery for a minimum of 12 months prior to March 2020 and had continued to deliver services throughout the UK initial lockdown period between March and July 2020. Each interview was transcribed verbatim, anonymised, then subjected to thematic analysis. Six themes were developed from the data covering: emergency support for victims; wider service efficiencies; victim safety; group work versus one-to-one support; criminal and family courts; and workforce development. While lockdown resulted in increased levels and severity of referrals, the switch to remote working brought a range of service efficiencies including time and money saved by negating the need to travel. Remote working also enhanced support offered to male victims and those with mental health issues but not those in rural locations with poor connectivity and those effected by the digital divide. Services should not underestimate the long-term benefits of peer support both to clients and staffs.
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Affiliation(s)
- Helen Riddell
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
- Public Health, Adult and Health Services, Durham County Council, Durham, United Kingdom
| | - Catherine Haighton
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
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