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ARTÍCULO
TITULO

Improving Behavioral Support for Smoking Cessation in Pregnancy: What Are the Barriers to Stopping and Which Behavior Change Techniques Can Influence Them? Application of Theoretical Domains Framework

Katarzyna A Campbell    
Libby Fergie    
Tom Coleman-Haynes    
Sue Cooper    
Fabiana Lorencatto    
Michael Ussher    
Jane Dyas and Tim Coleman    

Resumen

Behavioral support interventions are used to help pregnant smokers stop; however, of those tested, few are proven effective. Systematic research developing effective pregnancy-specific behavior change techniques (BCTs) is ongoing. This paper reports contributory work identifying potentially-effective BCTs relative to known important barriers and facilitators (B&Fs) to smoking cessation in pregnancy; to detect priority areas for BCTs development. A Nominal Group Technique with cessation experts (n = 12) elicited an expert consensus on B&Fs most influencing women?s smoking cessation and those most modifiable through behavioral support. Effective cessation interventions in randomized trials from a recent Cochrane review were coded into component BCTs using existing taxonomies. B&Fs were categorized using Theoretical Domains Framework (TDF) domains. Matrices, mapping BCT taxonomies against TDF domains, were consulted to investigate the extent to which BCTs in existing interventions target key B&Fs. Experts ranked ?smoking a social norm? and ?quitting not a priority? as most important barriers and ?desire to protect baby? an important facilitator to quitting. From 14 trials, 23 potentially-effective BCTs were identified (e.g., ?information about consequences). Most B&Fs fell into ?Social Influences?, ?Knowledge?, ?Emotions? and ?Intentions? TDF domains; few potentially-effective BCTs mapped onto every TDF domain. B&Fs identified by experts as important to cessation, are not sufficiently targeted by BCT?s currently within interventions for smoking cessation in pregnancy.

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