Using the Behaviour Change Wheel and modified Delphi method to identify behavioural change techniques for improving adherence to smoking cessation medications

Amanual Getnet Mersha; Michelle Kennedy; Parivash Eftekhari; K S Kylie Lee; Penney Upton; Catherine Segan; Melissa A Jackson; Kirsty Jennings; Gillian Sandra Gould

doi:10.1186/s12889-023-16278-3

Using the Behaviour Change Wheel and modified Delphi method to identify behavioural change techniques for improving adherence to smoking cessation medications

BMC Public Health. 2023 Jul 17;23(1):1362. doi: 10.1186/s12889-023-16278-3.

Authors

Amanual Getnet Mersha^{1

2}, Michelle Kennedy^{3

4}, Parivash Eftekhari^{3

4}, K S Kylie Lee^{5

6

7

8

9}, Penney Upton¹⁰, Catherine Segan^{11

12}, Melissa A Jackson^{3

13

14}, Kirsty Jennings³, Gillian Sandra Gould¹⁵

Affiliations

¹ School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle, NSW, 2308, Australia. AmanualGetnet.Mersha@uon.edu.au.
² Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW, 2305, Australia. AmanualGetnet.Mersha@uon.edu.au.
³ School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle, NSW, 2308, Australia.
⁴ Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW, 2305, Australia.
⁵ NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.
⁶ The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, Australia.
⁷ National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.
⁸ Burnet Institute, Melbourne, Australia.
⁹ Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia.
¹⁰ University of Canberra, Health Research Institute, 11 Kirianri Street, Bruce, Canberra, ACT, 2601, Australia.
¹¹ Cancer Council Victoria, Victoria, Australia.
¹² Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia.
¹³ Hunter New England Local Health District Drug & Alcohol Clinical Services, 670 Hunter Street, Newcastle, NSW, 2300, Australia.
¹⁴ Drug & Alcohol Clinical Research Improvement Network, 1 Reserve Road, St Leonards, NSW, 2065, Australia.
¹⁵ Faculty of Health, Southern Cross University, Hogbin Drive, Coffs Harbour, 2450, Australia.

Abstract

Background: Medication adherence is a crucial component of the pharmacological treatment of smoking. Previous interventions targeted to improve adherence to smoking cessation medications (SCMs) were designed using pragmatic approaches. This study aims to develop a comprehensive intervention strategy to improve adherence to SCMs using the Behaviour Change Wheel (BCW) and a modified Delphi method.

Methods: Recommendations for the design of intervention strategies were based on the BCW guide and six studies conducted by the research team. Factors related to healthcare providers and consumers (person making a quit attempt) that showed associations with adherence were mapped into the Capability, Opportunity, Motivation, Behaviour (COM-B) model, and corresponding intervention functions and policy categories. Interventions were then represented using the Behaviour Change Technique Taxonomy. Finally, a modified Delphi study using 17 experts was conducted to evaluate the nominated strategies using the Acceptability, Practicability, Effectiveness, Affordability, Side-effects, and Equity (APEASE) criteria.

Results: Following a stepped approach, an adherence support wheel was designed to guide implementation strategies and programmes. Thirteen intervention strategies were selected. The selected interventions include providing detailed instructions on how to use SCMs; establishing realistic expectations from SCMs; and providing training for healthcare providers regarding comprehensive smoking cessation care with specifics on the provision of adherence support.

Conclusion: The BCW guide and a modified Delphi were applied successfully to design interventions tailored to improve adherence to SCMs. Improving adherence to SCMs requires a comprehensive intervention approach involving various stakeholders. Future research is needed to assess the effectiveness of the nominated intervention strategies.

Keywords: Adherence; Behaviour change wheel; Nicotine replacement therapy; Pharmacotherapy; Smoking cessation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Behavior Therapy
Delphi Technique
Humans
Motivation
Smoking
Smoking Cessation* / methods