Implementation of ask-advise-connect for smoking cessation in Dutch general practice during the COVID-19 pandemic: a mixed-methods evaluation using the CFIR framework

Substance Abuse Treatment, Prevention, and Policy

Research

Niels H. Chavannes¹  Eline Meijer¹  Esther A. Croes²  Naomi A. van Westen-Lagerweij³  Marc C. Willemsen³ 

[1] Public Health and Primary Care, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands;National eHealth Living Lab, PO Box 9600, 2300 RC, Leiden, The Netherlands;The Netherlands Expertise Centre for Tobacco Control, Trimbos Institute, PO Box 725, 3500 AS, Utrecht, The Netherlands;The Netherlands Expertise Centre for Tobacco Control, Trimbos Institute, PO Box 725, 3500 AS, Utrecht, The Netherlands;Department of Health Promotion, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands;

关键词: Ask-Advise-Connect;    Implementation;    General practice;    COVID-19 pandemic;    Mixed-methods;   

DOI  :  10.1186/s13011-023-00535-0

 received in 2023-02-16, accepted in 2023-04-28,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe Ask-Advise-Connect (AAC) approach can help primary care providers to increase the number of people who attempt to quit smoking and enrol into cessation counselling. We implemented AAC in Dutch general practice during the COVID-19 pandemic. In this study we describe how AAC was received in Dutch general practice and assess which factors played a role in the implementation.MethodsA mixed-methods approach was used to evaluate the implementation of AAC. Implementation took place between late 2020 and early 2022 among 106 Dutch primary care providers (general practitioners (GPs), practice nurses and doctor’s assistants). Quantitative and qualitative data were collected through four online questionnaires. A descriptive analysis was conducted on the quantitative data. The qualitative data (consisting of answers to open-ended questions) were inductively analysed using axial codes. The Consolidated Framework for Implementation Research was used to structure and interpret findings.ResultsDuring the study, most participants felt motivated (84–92%) and able (80–94%) to apply AAC. At the end of the study, most participants reported that the AAC approach is easy to apply (89%) and provides advantages (74%). Routine implementation of the approach was, however, experienced to be difficult. More GPs (30–48%) experienced barriers in the implementation compared to practice nurses and doctor’s assistants (7–9%). The qualitative analysis showed that especially external factors, such as a lack of time or priority to discuss smoking due to the COVID-19 pandemic, negatively influenced implementation of AAC.ConclusionsAlthough AAC was mostly positively received in Dutch general practice, implementation turned out to be challenging, especially for GPs. Lack of time to discuss smoking was a major barrier in the implementation. Future efforts should focus on providing additional implementation support to GPs, for example with the use of e-health.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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Fig. 1