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Addict Behav. 2019 Jan;88:163-168. doi: 10.1016/j.addbeh.2018.08.003. Epub 2018 Aug 6.

Exploring individual and contextual factors contributing to tobacco cessation intervention implementation.

Author information

1
Faculty of Psychology, Education and Sport Sciences, Ramon Llull University, Blanquerna. C/ Císter, 34, Barcelona 08022, Spain.
2
Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, Barcelona 08908, Spain.
3
Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, Barcelona 08908, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, Barcelona 08908, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, C/ Feixa llarga s/n, Barcelona 08907, Spain.
4
Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, Barcelona 08908, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, Barcelona 08908, Spain; Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona. C/ Villarroel 170, Barcelona 08036, Spain.
5
Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, Barcelona 08908, Spain; Health Sciences Studies Department, Universitat Oberta de Catalunya, Rambla de Poblenou, 156, Barcelona 08018, Spain.
6
Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, Barcelona 08908, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, Barcelona 08908, Spain; Medicine and Health Sciences School, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Barcelona 08915, Spain; School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, C/ Feixa llarga s/n, Barcelona 08907, Spain. Electronic address: cmartinez@iconcologia.net.

Abstract

BACKGROUND:

Previous research suggests that smoking cessation interventions are poorly implemented. This study reports the development and testing of a questionnaire including knowledge, attitude, behavioral, and organizational (KABO) factors affecting the implementation of smoking cessation practices in hospitals by health care providers and organizations.

METHODS:

An initial pool of 44 items was developed to assess the individual knowledge, attitudes, and beliefs of health professionals towards smoking cessation practices according to the 5 A's intervention model, as well as organizational barriers and opportunities for its implementation. Items were measured in a scale from 0="Not at all/Never" to 10 = "Completely/Always". Data were collected from health workers (n = 702) in Catalonia. The validity of the instrument was measured by: (a) analyzing the items, (b) assessing the internal structure, (c) estimating the internal consistency, and (d) analyzing the relationship between this tool and the 5 A's intervention model.

RESULTS:

Seven domains were extracted: individual skills, positive organizational support, attitudes and beliefs, individual commitment, organizational resources, beliefs about patient desire/readiness to quit, and organizational endorsement. These domains explained 69.7% of the variance, and allowed for the development of a refined 26-item version of the questionnaire. Both the seven domains and the total scale showed adequate internal consistency.

CONCLUSIONS:

Psychometric testing indicates that the KABO questionnaire is a reliable and valid instrument for assessing the main barriers and facilitators to smoking cessation intervention implementation. Individual factors better explained the implementation of smoking cessation interventions in hospitals, and the seven identified domains can be used for further investigations into how the implementation of evidence-based practices impacts smoking cessation performance.

KEYWORDS:

Health care services; Hospitals; Implementation; Instrument development, psychometrics; Smoking cessation

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