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

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

Health Research Institute

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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.

Original language	English
Article number	1362
Pages (from-to)	1-14
Number of pages	14
Journal	BMC Public Health
Volume	23
Issue number	1
DOIs	https://doi.org/10.1186/s12889-023-16278-3
Publication status	Published - 17 Jul 2023

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Mersha, A. G., Kennedy, M., Eftekhari, P., Lee, K. S. K., Upton, P., Segan, C., Jackson, M. A., Jennings, K., & Gould, G. S. (2023). Using the Behaviour Change Wheel and modified Delphi method to identify behavioural change techniques for improving adherence to smoking cessation medications. BMC Public Health, 23(1), 1-14. [1362]. https://doi.org/10.1186/s12889-023-16278-3

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

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 = "Humans, Smoking Cessation/methods, Delphi Technique, Smoking, Behavior Therapy, Motivation, Adherence, Smoking cessation, Nicotine replacement therapy, Pharmacotherapy, Behaviour change wheel",

author = "Mersha, {Amanual Getnet} and Michelle Kennedy and Parivash Eftekhari and Lee, {K S Kylie} and Penney Upton and Catherine Segan and Jackson, {Melissa A} and Kirsty Jennings and Gould, {Gillian Sandra}",

note = "Funding Information: A.G.M is supported by the University of Newcastle Vice-Chancellor{\textquoteright}s Higher Degree by Research Training Scholarship. G.S.G is supported by a National Health and Medical Research Council Translating Research into Practice Fellowship and an Australian Dept of Health consultancy. MK is supported by the National Health and Medical Research Council Early Career Research Fellowship. PE is supported by funding from the Australian Federal Government, department of health. Publisher Copyright: {\textcopyright} 2023, The Author(s).",

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doi = "10.1186/s12889-023-16278-3",

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T1 - Using the Behaviour Change Wheel and modified Delphi method to identify behavioural change techniques for improving adherence to smoking cessation medications

AU - Mersha, Amanual Getnet

AU - Kennedy, Michelle

AU - Eftekhari, Parivash

AU - Lee, K S Kylie

AU - Upton, Penney

AU - Segan, Catherine

AU - Jackson, Melissa A

AU - Jennings, Kirsty

AU - Gould, Gillian Sandra

N1 - Funding Information: A.G.M is supported by the University of Newcastle Vice-Chancellor’s Higher Degree by Research Training Scholarship. G.S.G is supported by a National Health and Medical Research Council Translating Research into Practice Fellowship and an Australian Dept of Health consultancy. MK is supported by the National Health and Medical Research Council Early Career Research Fellowship. PE is supported by funding from the Australian Federal Government, department of health. Publisher Copyright: © 2023, The Author(s).

PY - 2023/7/17

Y1 - 2023/7/17

N2 - 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.

AB - 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.

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KW - Nicotine replacement therapy

KW - Pharmacotherapy

KW - Behaviour change wheel

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DO - 10.1186/s12889-023-16278-3

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SN - 1471-2458

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JO - BMC Public Health

JF - BMC Public Health

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ER -

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

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