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Research article
Identifying contexts and mechanisms in multiple behavior change interventions affecting smoking cessation success: A rapid realist review
Peter Selby
Centre for Addiction and Mental Health
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5401-2996
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Smoking continues to be a leading cause of preventable chronic disease-related morbidity and mortality, excess healthcare expenditure, and lost work productivity. Tobacco users are disproportionately more likely to be engaging in other modifiable risk behaviours such as excess alcohol consumption, physical inactivity, and poor diet. While hundreds of interventions addressing the clustering of smoking and other modifiable risk behaviours have been conducted worldwide, there is insufficient information available about the context and mechanisms in these interventions that promote successful smoking cessation. The aim of this rapid realist review was to identify possible contexts and mechanisms used in multiple health behaviour change interventions (targeting tobacco and two or more additional risk behaviours) that are associated with improving smoking cessation outcome.
Methods: This realist review method incorporated the following steps: (1) clarifying the scope, (2) searching for relevant evidence, (3) relevance confirmation, data extraction, and quality assessment, (4) data analysis and synthesis.
Results: Of the 20,423 articles screened, 138 articles were included in this realist review. Following Michie et al.’s behavior change model (the COM-B model), capability, opportunity, and motivation were used to identify the mechanisms of behaviour change. Universally, increasing opportunities (i.e. factors that lie outside the individual that prompt the behaviour or make it possible) for participants to engage in healthy behaviours was associated with smoking cessation success. However, increasing participant’s capability or motivation to make a behaviour change was only successful within certain contexts.
Conclusion: In order to address multiple health behaviours and assist individuals in quitting smoking, public health promotion interventions need to shift away from ‘individualistic epidemiology’ and invest resources into modifying factors that are external from the individual (i.e. creating a supportive environment).
Study registration: PROSPERO registration number: CRD42017064430
Keywords
realist review, multiple health behaviour interventions, smoking cessation, COM-B
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CURRENT STATUS: Under Review
Version 3
Posted 01 Jun, 2020
No community comments so far
Submission checks complete
On 22 May, 2020
No comments provided
Editorial decision: Minor revision
On 20 May, 2020
Review #2 received
Received 11 May, 2020
Reviewer #1 agreed
On 01 Apr, 2020
Reviewer #2 agreed
On 01 Apr, 2020
Review #1 received
Received 01 Apr, 2020
Reviewers invited
Invitations sent on 27 Mar, 2020
Editor assigned
On 23 Mar, 2020
Submission checks complete
On 22 Mar, 2020
Editor invited
On 22 Mar, 2020
No comments provided
Editorial decision: Minor revision
On 12 Mar, 2020
Review #2 received
Received 11 Mar, 2020
Review #1 received
Received 02 Mar, 2020
Reviewer #2 agreed
On 17 Feb, 2020
Reviewer #1 agreed
On 14 Feb, 2020
Reviewers invited
Invitations sent on 12 Feb, 2020
Editor assigned
On 06 Feb, 2020
Submission checks complete
On 05 Feb, 2020
Editor invited
On 05 Feb, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Policy
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Identifying contexts and mechanisms in multiple behavior change interventions affecting smoking cessation success: A rapid realist review
Peter Selby
Centre for Addiction and Mental Health
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5401-2996
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 3
Posted 01 Jun, 2020
No community comments so far
Submission checks complete
On 22 May, 2020
No comments provided
Editorial decision: Minor revision
On 20 May, 2020
Review #2 received
Received 11 May, 2020
Reviewer #1 agreed
On 01 Apr, 2020
Reviewer #2 agreed
On 01 Apr, 2020
Review #1 received
Received 01 Apr, 2020
Reviewers invited
Invitations sent on 27 Mar, 2020
Editor assigned
On 23 Mar, 2020
Submission checks complete
On 22 Mar, 2020
Editor invited
On 22 Mar, 2020
No comments provided
Editorial decision: Minor revision
On 12 Mar, 2020
Review #2 received
Received 11 Mar, 2020
Review #1 received
Received 02 Mar, 2020
Reviewer #2 agreed
On 17 Feb, 2020
Reviewer #1 agreed
On 14 Feb, 2020
Reviewers invited
Invitations sent on 12 Feb, 2020
Editor assigned
On 06 Feb, 2020
Submission checks complete
On 05 Feb, 2020
Editor invited
On 05 Feb, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Policy
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Smoking continues to be a leading cause of preventable chronic disease-related morbidity and mortality, excess healthcare expenditure, and lost work productivity. Tobacco users are disproportionately more likely to be engaging in other modifiable risk behaviours such as excess alcohol consumption, physical inactivity, and poor diet. While hundreds of interventions addressing the clustering of smoking and other modifiable risk behaviours have been conducted worldwide, there is insufficient information available about the context and mechanisms in these interventions that promote successful smoking cessation. The aim of this rapid realist review was to identify possible contexts and mechanisms used in multiple health behaviour change interventions (targeting tobacco and two or more additional risk behaviours) that are associated with improving smoking cessation outcome.
Methods: This realist review method incorporated the following steps: (1) clarifying the scope, (2) searching for relevant evidence, (3) relevance confirmation, data extraction, and quality assessment, (4) data analysis and synthesis.
Results: Of the 20,423 articles screened, 138 articles were included in this realist review. Following Michie et al.’s behavior change model (the COM-B model), capability, opportunity, and motivation were used to identify the mechanisms of behaviour change. Universally, increasing opportunities (i.e. factors that lie outside the individual that prompt the behaviour or make it possible) for participants to engage in healthy behaviours was associated with smoking cessation success. However, increasing participant’s capability or motivation to make a behaviour change was only successful within certain contexts.
Conclusion: In order to address multiple health behaviours and assist individuals in quitting smoking, public health promotion interventions need to shift away from ‘individualistic epidemiology’ and invest resources into modifying factors that are external from the individual (i.e. creating a supportive environment).
Study registration: PROSPERO registration number: CRD42017064430
Figure 1
Due to technical limitations the Tables are available as a download in the Supplementary Files.