Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/25594
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dc.contributor.authorBauld, Lindaen_UK
dc.contributor.authorGraham, Hilaryen_UK
dc.contributor.authorSinclair, Lesleyen_UK
dc.contributor.authorFlemming, Kateen_UK
dc.contributor.authorNaughton, Felixen_UK
dc.contributor.authorFord, Allisonen_UK
dc.contributor.authorMcKell, Jenniferen_UK
dc.contributor.authorMcCaughan, Dorothyen_UK
dc.contributor.authorHopewell, Sarahen_UK
dc.contributor.authorAngus, Kathrynen_UK
dc.contributor.authorEadie, Douglasen_UK
dc.contributor.authorTappin, Daviden_UK
dc.date.accessioned2017-07-11T22:57:37Z-
dc.date.available2017-07-11T22:57:37Z-
dc.date.issued2017-06en_UK
dc.identifier.urihttp://hdl.handle.net/1893/25594-
dc.description.abstractBackground: Although many women stop smoking in pregnancy, others continue, causing harm to maternal and child health. Smoking behaviour is influenced by many factors, including the role of women's significant others (SOs) and support from health-care professionals (HPs).  Objectives: To enhance understanding of the barriers to, and facilitators of, smoking cessation and the feasibility and acceptability of interventions to reach and support pregnant women to stop smoking.  Design: Four parts: (1) a description of interventions in the UK for smoking cessation in pregnancy; (2) three systematic reviews (syntheses) of qualitative research of women's, SOs' and HPs' views of smoking in pregnancy using meta-ethnography (interpretative approach for combining findings); (3) semistructured interviews with pregnant women, SOs and HPs, guided by the social-ecological framework (conceptualises behaviour as an outcome of individuals' interactions with environment); and (4) identification of new/ improved interventions for future testing.  Setting: Studies in reviews conducted in high-income countries. Qualitative research was conducted from October 2013 to December 2014 in two mixed urban/rural study sites: area A (Scotland) and area B (England). Participants: Thirty-eight studies (1100 pregnant women) in 42 papers, nine studies (150 partners) in 14 papers and eight studies described in nine papers (190 HPs) included in reviews. Forty-one interviews with pregnant women, 32 interviews with pregnant women's SOs and 28 individual/group interviews with 48 HPs were conducted.  Main outcome measures: The perceived barriers to, and facilitators of, smoking cessation in pregnancy and the identification of potential new/modified interventions. Results: Syntheses identified smoking-related perceptions and experiences for pregnant women and SOs that were fluid and context dependent with the capacity to help or hinder smoking cessation. Themes were analysed in accordance with the social-ecological framework levels. From the analysis of the interviews, the themes that were central to cessation in pregnancy at an individual level, and that reflected the findings from the reviews, were perception of risk to baby, self-efficacy, influence of close relationships and smoking as a way of coping with stress. Overall, pregnant smokers were faced with more barriers than facilitators. At an interpersonal level, partners' emotional and practical support, willingness to change smoking behaviour and role of smoking within relationships were important. Across the review and interviews of HPs, education to enhance knowledge and confidence in delivering information about smoking in pregnancy and the centrality of the client relationship, protection of which could be a factor in downplaying risks, were important. HPs acknowledged that they could best assist by providing support and understanding, and access to effective interventions, including an opt-out referral pathway to Stop Smoking Services, routine carbon monoxide screening, behavioural support and access to pharmacotherapy. Additional themes at community, organisational and societal levels were also identified.  Limitations: Limitations include a design grounded in qualitative studies, difficulties recruiting SOs, and local service configurations and recruitment processes that potentially skewed the sample.  Conclusions: Perceptions and experiences of barriers to and facilitators of smoking cessation in pregnancy are fluid and context dependent. Effective interventions for smoking cessation in pregnancy should take account of the interplay between the individual, interpersonal and environmental aspects of women's lives.  Future work: Research focus: removing barriers to support, improving HPs' capacity to offer accurate advice, and exploration of weight concerns and relapse prevention. Interventions focus: financial incentives, self-help and social network interventions.  Study registration: This study is registered as PROSPERO CRD42013004170. Funding: The National Institute for Health Research Health Technology Assessment programme.en_UK
dc.language.isoenen_UK
dc.publisherNational Institute for Health Researchen_UK
dc.relationBauld L, Graham H, Sinclair L, Flemming K, Naughton F, Ford A, McKell J, McCaughan D, Hopewell S, Angus K, Eadie D & Tappin D (2017) Barriers to and facilitators of smoking cessation in pregnancy and following childbirth: literature review and qualitative study. Health Technology Assessment, 21 (36), pp. 1-158. https://doi.org/10.3310/hta21360en_UK
dc.rightsPermission to reproduce material from this published report is covered by the UK government’s non-commercial licence for public sector information: http://www.nationalarchives.gov.uk/doc/non-commercial-government-licence/version/2/en_UK
dc.rights.urihttp://www.nationalarchives.gov.uk/doc/non-commercial-government-licence/version/2/en_UK
dc.subjectQualitative Researchen_UK
dc.subjectSystematic Reviewen_UK
dc.subjectSmoking Cessationen_UK
dc.subjectNicotineen_UK
dc.subjectTobaccoen_UK
dc.subjectMaternal Healthen_UK
dc.subjectPregnant Womenen_UK
dc.subjectPostpartum Womenen_UK
dc.subjectPregnancyen_UK
dc.subjectPartnersen_UK
dc.subjectCouplesen_UK
dc.subjectExpectant Fathersen_UK
dc.subjectSignificant Othersen_UK
dc.subjectFriendsen_UK
dc.subjectFamilyen_UK
dc.subjectHealth-Care Professionalsen_UK
dc.subjectMidwivesen_UK
dc.subjectStop Smoking Servicesen_UK
dc.subjectProfessional–Patient Relationsen_UK
dc.titleBarriers to and facilitators of smoking cessation in pregnancy and following childbirth: literature review and qualitative studyen_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.3310/hta21360en_UK
dc.identifier.pmid28661375en_UK
dc.citation.jtitleHealth Technology Assessmenten_UK
dc.citation.issn1366-5278en_UK
dc.citation.volume21en_UK
dc.citation.issue36en_UK
dc.citation.spage1en_UK
dc.citation.epage158en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.contributor.funderNational Institute for Health Researchen_UK
dc.author.emaillinda.bauld@stir.ac.uken_UK
dc.contributor.affiliationInstitute for Social Marketingen_UK
dc.contributor.affiliationUniversity of Yorken_UK
dc.contributor.affiliationInstitute for Social Marketingen_UK
dc.contributor.affiliationUniversity of Yorken_UK
dc.contributor.affiliationUniversity of Cambridgeen_UK
dc.contributor.affiliationInstitute for Social Marketingen_UK
dc.contributor.affiliationInstitute for Social Marketingen_UK
dc.contributor.affiliationUniversity of Yorken_UK
dc.contributor.affiliationUniversity of Cambridgeen_UK
dc.contributor.affiliationInstitute for Social Marketingen_UK
dc.contributor.affiliationInstitute for Social Marketingen_UK
dc.contributor.affiliationUniversity of Glasgowen_UK
dc.identifier.isiWOS:000404293800001en_UK
dc.identifier.scopusid2-s2.0-85021909245en_UK
dc.identifier.wtid524742en_UK
dc.contributor.orcid0000-0002-2210-8181en_UK
dc.contributor.orcid0000-0002-2912-0837en_UK
dc.contributor.orcid0000-0002-5351-4422en_UK
dc.date.accepted2017-06-29en_UK
dcterms.dateAccepted2017-06-29en_UK
dc.date.filedepositdate2017-07-11en_UK
dc.relation.funderprojectBarriers and facilitators to smoking cessation in pregnancy and following childbirthen_UK
dc.relation.funderref11/93/01en_UK
rioxxterms.apcnot chargeden_UK
rioxxterms.typeJournal Article/Reviewen_UK
rioxxterms.versionVoRen_UK
local.rioxx.authorBauld, Linda|en_UK
local.rioxx.authorGraham, Hilary|en_UK
local.rioxx.authorSinclair, Lesley|0000-0002-2210-8181en_UK
local.rioxx.authorFlemming, Kate|en_UK
local.rioxx.authorNaughton, Felix|en_UK
local.rioxx.authorFord, Allison|en_UK
local.rioxx.authorMcKell, Jennifer|0000-0002-2912-0837en_UK
local.rioxx.authorMcCaughan, Dorothy|en_UK
local.rioxx.authorHopewell, Sarah|en_UK
local.rioxx.authorAngus, Kathryn|0000-0002-5351-4422en_UK
local.rioxx.authorEadie, Douglas|en_UK
local.rioxx.authorTappin, David|en_UK
local.rioxx.project11/93/01|National Institute for Health Research|http://dx.doi.org/10.13039/501100000272en_UK
local.rioxx.freetoreaddate2017-07-11en_UK
local.rioxx.licencehttp://www.nationalarchives.gov.uk/doc/non-commercial-government-licence/version/2/|2017-07-11|en_UK
local.rioxx.filenameBauld et al HealthTechnolAssess17.pdfen_UK
local.rioxx.filecount1en_UK
local.rioxx.source1366-5278en_UK
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