Development of a theory and evidence informed intervention to promote smoking cessation during pregnancy using narrative, text-messages and images as modes of delivery

Abstract

Background: Cigarette smoking is a leading preventable factor associated with complications in pregnancy including preterm birth and low birthweight. Past interventions have raised cessation rates by approximately 6% overall (Lumley et al. 2009). Methods: A three-part literature review, two qualitative studies with a total of 36 participants, and the development of an intervention to promote smoking cessation during pregnancy were completed. Central to the design of the research was the creation of the theoretical basis which was developed in line with recommendations from the MRC Framework for Complex Interventions (Craig et al. 2008, Campbell et al. 2000). For part one of the literature review, 24 qualitative and 44 quantitative studies were re-analysed to complete a mixed-methods secondary analysis of the active ingredients in interventions to promote smoking cessation during pregnancy. Part two consisted of an exploration of psychological models and constructs which are likely to predict or influence smoking behaviour during pregnancy. The final part was a discussion regarding the modes of delivery by which an intervention could feasibly be delivered. Qualitative interviews were carried out with participants from stakeholder groups to fill in gaps in literature and determine the acceptability and feasibility of the proposed intervention. The intervention was created using the theoretical basis developed from the findings. Further qualitative interviews, a focus group, and heuristic evaluation were used to determine the acceptability and usability of the intervention for the target group of pregnant smokers. Results and Conclusions: Findings from this work are potentially relevant for a wide range of behaviours and behavioural interventions. An intervention which has a strong grounding in theory and evidence, and is acceptable and feasible for the target group and in clinical practice was developed using evidence gathered in this thesis.