Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Dec 20, 2019
Date Accepted: Jun 16, 2020
Implementing facilitated access to a text messaging smoking cessation intervention among Swedish patients having elective surgery: patients’ and health care professionals’ perspectives
ABSTRACT
Background:
There is strong evidence that short-term smoking cessation before surgery can reduce postoperative morbidity. There are however several structural problems in health care systems concerning how to implement smoking cessation interventions in routine practice for patients with elective surgery.
Objective:
This study aimed to analyse the implementation of a text messaging smoking cessation intervention targeting patients with elective surgery. Implementation of facilitated access (referral from practitioners) and the perceived usefulness among patients were investigated.
Methods:
A qualitative study was carried out at two medium sized hospitals in the south of Sweden. The implementation process of a text messaging smoking cessation intervention was investigated during a 12-month period from April 2018 to April 2019. Smoking cessation specialists (focus groups; n=2) and patients (individual interviews; n=10) took part. Qualitative content analysis was used to analyse the data.
Results:
Two categories were identified in the focus group data: implementation approach and perceptions about the intervention. Implementation approach referred to how specialists adapted their efforts to situational factors and the needs and preferences of patients. Also, that they built rapport with patients to facilitate implementation. The category perceptions about the intervention showed that specialists thought the content and structure of the intervention felt familiar and a good complement to current practice. Two categories were identified in the patient interview data: Incorporating new means of support from health care and determinants of use. The first category referred to how patients adopted and incorporated the intervention in their smoking cessation journey. Patients were receptive, shared the text messages with friends and family, humanised the text messages and used messages as a complement to other strategies to quit smoking. The category determinants of use refer to aspects that influenced how and when patients used the intervention and included: timing of the intervention and text messages, motivation to change and perceptions of the mobile-phone medium.
Conclusions:
Smoking cessation specialists adopted an active role in implementing the intervention by adapting their approach and fitting the intervention into existing routines. Patients showed strong motivation to change and openness to incorporate the intervention in their behaviour change journey, however, the timing of the intervention and messages are important to optimise the support. Text messaging smoking cessation intervention can be a valuable and feasible way to reach smoking patients with elective surgery. Clinical Trial: Not applicable
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