Self-help materials for smoking relapse prevention: a process evaluation of the SHARPISH randomized controlled trial

Area of Science:

• Public Health
• Behavioral Science
• Health Psychology

Background:

• UK Stop Smoking Services effectively aid smoking cessation but high relapse rates persist.
• There is a significant public health problem due to a lack of effective smoking relapse prevention interventions.
• This study evaluated patient perspectives on a self-help intervention to explain null trial findings.

Purpose of the Study:

• To understand patient perspectives on a self-help smoking relapse prevention intervention.
• To identify reasons for the intervention's null findings within a randomized controlled trial.
• To provide recommendations for developing more effective future interventions.

Main Methods:

• An embedded qualitative process evaluation was conducted alongside a randomized controlled trial.
• The study utilized a British version of the 'Forever Free' self-help booklets.
• Data were collected through 43 in-depth interviews and 10 focus groups (participants and health professionals), followed by thematic analysis.

Main Results:

• Significant variation was observed in how individuals engaged with self-help materials.
• Engagement differences were linked to 'motivation for cessation' and 'positioning on information provision'.
• The 'mechanisms for information provision' theme interacted with engagement variations.

Conclusions:

• Future interventions should target self-help information towards highly motivated individuals, considering their social and cultural contexts.
• Appraising individual preferences for information delivery mechanisms is crucial for intervention design.
• Personalized, long-term follow-up could be a simple yet effective strategy to reduce smoking relapse rates.