Implementation fidelity of a smoke-free workplace intervention in a private medical company: A mixed-methods process evaluation.

Autor:	Rasmussen SKB; Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, Frederiksberg, Denmark., Lidegaard LL; Department of Research, Danish Heart Foundation, Copenhagen, Denmark., Pisinger C; Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, Frederiksberg, Denmark.; Department of Research, Danish Heart Foundation, Copenhagen, Denmark.; Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Johnsen NF; Department of Research, Danish Heart Foundation, Copenhagen, Denmark., Kristiansen M; Department of Public Health and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Jazyk:	angličtina
Zdroj:	Tobacco prevention & cessation [Tob Prev Cessat] 2023 May 26; Vol. 9, pp. 17. Date of Electronic Publication: 2023 May 26 (Print Publication: 2023).
DOI:	10.18332/tpc/162878
Abstrakt:	Introduction: Smoke-free workplaces are considered an important part of tobacco control strategies. The purpose of this study was to evaluate implementation fidelity and explore the significance of social and contextual factors for the implementation of a strict smoke-free workplace intervention in a large Danish medical company. Methods: The UK Medical Research Council's guidance for process evaluation was used as a framework. Data were collected from approximately six months before the implementation until ten months after (2019-2020). A mixed method study design was used (a survey of 398 employees, a focus group of four employees and field visits on two days). Data were analyzed separately and later integrated through triangulation. We used the Fisher's exact test in the analysis of the questionnaire. Results: We assessed the implementation fidelity through four key factors: reach, dose and delivery, mechanisms of change, and context for the intervention components. Despite compliance issues, the policy component had high implementation fidelity. However, the implementation fidelity of the smoking cessation support component was low. We identified three social mechanisms influencing the employees' responsiveness towards the policy: expectation, the social aspect of the smoking facilities, and management leadership. COVID-19 was identified as the main contextual factor affecting the implementation. Conclusions: Although not all elements of the intervention components were implemented as planned, the strict smoke-free workplace intervention is considered implemented. Further strategies can be initiated to raise implementation fidelity through better communication concerning the cessation support component, compliance, and enforcement of the policy. Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported. (© 2023 Rasmussen S. K. B. et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu