Barriers and facilitators to implementing the CURE stop smoking project: a qualitative study

Area of Science:

• Health Services Research
• Behavioral Science
• Public Health

Background:

• The Conversation, Understand, Replace, Experts (CURE) project offers pharmacotherapy and specialist support for hospitalised smokers.
• A pilot study in Greater Manchester indicated CURE's potential success in improving patient outcomes.
• Plans are underway to expand the CURE model to other English sites.

Purpose of the Study:

• To identify factors influencing healthcare professionals' implementation behaviour of the CURE project.
• To inform the wider implementation of CURE across England.

Main Methods:

• Qualitative study using semi-structured telephone interviews with 10 purposively sampled health professionals.
• Interviews guided by the Theoretical Domains Framework (TDF).
• Analysis using the framework method, coding data to TDF domains and mapping to the COM-B model.

Main Results:

• Eight TDF domains influenced CURE implementation: environmental context, social influence, goals, professional role, beliefs about consequences, reinforcement, skills, and knowledge.
• 'Environmental context and resources' emerged as the most significant factor, with integration challenges posing barriers.
• 'Beliefs about consequences' and 'knowledge' were identified as facilitators.

Conclusions:

• Multi-level barriers and facilitators to CURE implementation were identified.
• Theoretical frameworks (TDF, COM-B) aid in developing targeted interventions for behaviour change.
• Stakeholder engagement is crucial for developing feasible and practicable intervention strategies for widespread adoption in acute care settings.