Multiphase optimization implementation strategy for tobacco cessation interventions in primary care clinics: A...

Area of Science:

• Implementation Science
• Public Health
• Clinical Intervention Research

Background:

• Brief verbal intervention for smoking cessation (BISC) is effective but underutilized in China's primary healthcare (PHC).
• Multifaceted implementation strategies are needed to integrate evidence-based practices (EBPs) into routine care.
• The Multiphase Optimization Strategy (MOST) provides a framework for optimizing interventions.

Purpose of the Study:

• To identify and test effective implementation strategies for BISC in Chinese PHC settings.
• To customize and optimize BISC implementation using the MOST framework.
• To determine the most effective and efficient components of multi-component interventions for smoking cessation.

Main Methods:

• A two-phase study employing MOST, including a completed scoping review, stakeholder consultations, and Best-Worst Scaling (BWS).
• A cluster-randomized 2x2x2 factorial trial in Guangdong province, China (Jan-Dec 2026) with blinded outcome assessment.
• Data collection via unannounced standardized patient (USP) visits, questionnaires, interviews, and follow-ups, assessing outcomes at six months.

Main Results:

• Phase 1 successfully identified and defined four key implementation strategies for BISC.
• Phase 2 is ongoing, utilizing a factorial design to analyze implementation and effectiveness outcomes.
• The study aims to provide a methodological paradigm for implementation science in low- and middle-income countries.

Conclusions:

• The MOST framework and factorial design offer a rigorous approach to optimizing BISC implementation.
• This research is expected to enhance the integration of effective smoking cessation interventions into primary healthcare.
• Findings will inform strategies for advancing implementation science globally, particularly in resource-limited settings.