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Int. J. Environ. Res. Public Health 2018, 15(2), 359; https://doi.org/10.3390/ijerph15020359

Improving Behavioral Support for Smoking Cessation in Pregnancy: What Are the Barriers to Stopping and Which Behavior Change Techniques Can Influence Them? Application of Theoretical Domains Framework

1
Division of Primary Care, University of Nottingham, Room 1406, Tower Building, University Park, Nottingham NG7 2RD, UK
2
Centre for Behaviour Change, University College London, London WC1E 7HB, UK
3
Division of Population Health Sciences and Education, St George’s University of London, London SW17 ORE, UK
4
Institute of Social Marketing, University of Stirling, Stirling, FK9 4LA Scotland, UK
*
Author to whom correspondence should be addressed.
Received: 18 January 2018 / Revised: 2 February 2018 / Accepted: 13 February 2018 / Published: 17 February 2018
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Abstract

Behavioral support interventions are used to help pregnant smokers stop; however, of those tested, few are proven effective. Systematic research developing effective pregnancy-specific behavior change techniques (BCTs) is ongoing. This paper reports contributory work identifying potentially-effective BCTs relative to known important barriers and facilitators (B&Fs) to smoking cessation in pregnancy; to detect priority areas for BCTs development. A Nominal Group Technique with cessation experts (n = 12) elicited an expert consensus on B&Fs most influencing women’s smoking cessation and those most modifiable through behavioral support. Effective cessation interventions in randomized trials from a recent Cochrane review were coded into component BCTs using existing taxonomies. B&Fs were categorized using Theoretical Domains Framework (TDF) domains. Matrices, mapping BCT taxonomies against TDF domains, were consulted to investigate the extent to which BCTs in existing interventions target key B&Fs. Experts ranked ‘smoking a social norm’ and ‘quitting not a priority’ as most important barriers and ‘desire to protect baby’ an important facilitator to quitting. From 14 trials, 23 potentially-effective BCTs were identified (e.g., ‘information about consequences). Most B&Fs fell into ‘Social Influences’, ‘Knowledge’, ‘Emotions’ and ‘Intentions’ TDF domains; few potentially-effective BCTs mapped onto every TDF domain. B&Fs identified by experts as important to cessation, are not sufficiently targeted by BCT’s currently within interventions for smoking cessation in pregnancy. View Full-Text
Keywords: smoking cessation; pregnancy; behavior change techniques; intervention development; Theoretical Domains Framework smoking cessation; pregnancy; behavior change techniques; intervention development; Theoretical Domains Framework
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Campbell, K.A.; Fergie, L.; Coleman-Haynes, T.; Cooper, S.; Lorencatto, F.; Ussher, M.; Dyas, J.; Coleman, T. Improving Behavioral Support for Smoking Cessation in Pregnancy: What Are the Barriers to Stopping and Which Behavior Change Techniques Can Influence Them? Application of Theoretical Domains Framework. Int. J. Environ. Res. Public Health 2018, 15, 359.

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