Healthcare providers' perspectives on implementing a brief physical activity and diet intervention within a primary care smoking cessation program: a qualitative study.

Autor: Minian N; INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada.; Department of Family and Community Medicine, University of Toronto, Toronto, Canada.; Campbell Family Mental Health Research Institute, IMHPR, Centre for Addiction and Mental Health, Toronto, Canada.; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada.; Institute of Medical Sciences, University of Toronto, Toronto, Canada., Mehra K; INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada., Lingam M; INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada., Dragonetti R; INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada.; Department of Family and Community Medicine, University of Toronto, Toronto, Canada., Veldhuizen S; INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada.; Department of Family and Community Medicine, University of Toronto, Toronto, Canada., Zawertailo L; INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada.; Campbell Family Mental Health Research Institute, IMHPR, Centre for Addiction and Mental Health, Toronto, Canada.; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada., deRuiter WK; INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada., Melamed OC; INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada.; Department of Family and Community Medicine, University of Toronto, Toronto, Canada., Moineddin R; Department of Family and Community Medicine, University of Toronto, Toronto, Canada., Thorpe KE; Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Toronto, Canada.; Dalla Lana School of Public Health, University of Toronto, Toronto, Toronto, Canada., Taylor VH; Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada., Hahn M; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada.; Institute of Medical Sciences, University of Toronto, Toronto, Canada.; Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.; Department of Psychiatry, University of Toronto, Toronto, Canada.; Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada.; Banting and Best Diabetes Centre, University of Toronto, Toronto, Canada., Selby P; INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada. peter.selby@camh.ca.; Department of Family and Community Medicine, University of Toronto, Toronto, Canada. peter.selby@camh.ca.; Campbell Family Mental Health Research Institute, IMHPR, Centre for Addiction and Mental Health, Toronto, Canada. peter.selby@camh.ca.; Dalla Lana School of Public Health, University of Toronto, Toronto, Toronto, Canada. peter.selby@camh.ca.; Department of Psychiatry, University of Toronto, Toronto, Canada. peter.selby@camh.ca.
Jazyk: angličtina
Zdroj: BMC primary care [BMC Prim Care] 2024 Jan 06; Vol. 25 (1), pp. 16. Date of Electronic Publication: 2024 Jan 06.
DOI: 10.1186/s12875-023-02259-3
Abstrakt: Background: Post-smoking-cessation weight gain can be a major barrier to quitting smoking; however, adding behavior change interventions for physical activity (PA) and diet may adversely affect smoking cessation outcomes. The "Picking up the PACE (Promoting and Accelerating Change through Empowerment)" study assessed change in PA, fruit/vegetable consumption, and smoking cessation by providing a clinical decision support system for healthcare providers to utilize at the intake appointment, and found no significant change in PA, fruits/vegetable consumption, or smoking cessation. The objective of this qualitative study was to explore the factors affecting the implementation of the intervention and contextualize the quantitative results.
Methods: Twenty-five semi-structured interviews were conducted with healthcare providers, using questions based on the National Implementation Research Network's Hexagon Tool. The data were analyzed using the framework's standard analysis approach.
Results: Most healthcare providers reported a need to address PA and fruit/vegetable consumption in patients trying to quit smoking, and several acknowledged that the intervention was a good fit since exercise and diet could improve smoking cessation outcomes. However, many healthcare providers mentioned the need to explain the fit to the patients. Social determinants of health (e.g., low income, food insecurity) were brought up as barriers to the implementation of the intervention by a majority of healthcare providers. Most healthcare providers recognized training as a facilitator to the implementation, but time was mentioned as a barrier by many of healthcare providers. Majority of healthcare providers mentioned allied health professionals (e.g., dieticians, physiotherapists) supported the implementation of the PACE intervention. However, most healthcare providers reported a need for individualized approach and adaptation of the intervention based on the patients' needs when implementing the intervention. The COVID-19 pandemic was found to impact the implementation of the PACE intervention based on the Hexagon Tool indicators.
Conclusion: There appears to be a need to utilize a flexible approach when addressing PA and fruit/vegetable consumption within a smoking cessation program, based on the context of clinic, the patients' it is serving, and their life circumstances. Healthcare providers need support and external resources to implement this particular intervention.
Name of the Registry: Clinicaltrials.gov.
Trial Registration Number: NCT04223336.
Date of Registration: 7 January 2020 Retrospectively registered. URL OF TRIAL REGISTRY RECORD: https://classic.
Clinicaltrials: gov/ct2/show/NCT04223336 .
(© 2024. The Author(s).)
Databáze: MEDLINE
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