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Tailoring a smoking cessation intervention for persons with spinal cord injury: informing theory-based recommendations

University of British Columbia

Introduction: Compared to the general population, people with spinal cord injury (SCI) report higher smoking rates, a disproportionate burden of tobacco-related health disparities, and unique circumstances to treatment engagement. Despite these inequities, theory-informed behavioural interventions have not been developed or tailored to support people with SCI to stop smoking. Objective: Use an integrated knowledge translation (IKT) approach, the Behaviour Change Wheel (BCW), and the Theoretical Domains Framework (TDF) to (1) explore factors influencing smoking cessation behaviours among people with SCI, and (2) explore the preferred intervention and implementation options for a smoking cessation intervention for persons with SCI living in British Columbia. Methods: Aligned with an IKT approach, a provincial SCI organization was meaningfully engaged throughout the entire research process. Semi-structured interviews were conducted with people with SCI who have successfully or have tried to stop smoking. To understand the behaviour, barriers and facilitators to smoking cessation were extracted and deductively coded to the TDF and inductively analyzed. To identify preferred intervention options, a behavioural analysis was conducted using the BCW. To identify implementation options, modes of delivery and intervention messengers were extracted. Modes of delivery were deductively coded to the Mode of Delivery Taxonomy, and themes around intervention messengers were constructed. Results: Among the 12 individuals with SCI who were interviewed (7 males; mean age=55.9±9.9yrs), seven had successfully quit smoking, and five had tried to quit but had relapsed. Across the 12 interviews, 138 barriers and 223 facilitators to smoking cessation were extracted. The prominent TDF domains were beliefs about consequences, social influences, environmental context and resources, and behavioural regulation. These domains served as themes in the inductive analysis. Across the four themes, ten subthemes were constructed. All intervention options were identified as potentially relevant. Multiple modes of delivery and intervention messengers were considered important for the delivery of smoking cessation interventions. Conclusion: Our findings indicate that conventional smoking cessation interventions likely fail to address the unique circumstances encountered by persons with SCI, highlighting the need for tailored theory-informed smoking cessation interventions for persons with SCI. Future efforts should focus on tailoring, testing, and implementing real-world interventions.

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2020-08-31

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/75643

Health and Exercise Sciences

University of British Columbia

UBCO

http://creativecommons.org/licenses/by-nc-nd/4.0/