Summary: | Background
Previous
research has identified that smoking cessation interventions are poorly
implemented into the routine practice.
Both, provider and organizational factors could intervene as facilitators
or barriers. This study aimed to develop
and test a questionnaire that includes factors “Knowledge, Attitudes, Behaviours,
and Organizational (KABO)” that affect providers and organizations in
implementing smoking cessation practices in hospitals.
Methods
An
initial pool of 44 items was developed to assess individual knowledge,
attitudes and beliefs of health professionals towards smoking cessation
practices according to the 5As' intervention model, and organizational barriers
and opportunities for its implementation into daily practice. Specific items
were drawn mostly from the literature. All items were measured in a 11-point scale 0=“not at all/never” to 10=“completely/always”. The data were collected
form health workers (n= 702) in Catalonia (Spain) using a web-based survey. The validity of the instrument was measured in
the following ways: (a) analyzing the items; (b) assessing the internal
structure; (c) estimating the internal consistency; and (d) analyzing the
relationship between this tool and the 5As' intervention model.
Results
The
estimated Cronbach's α coefficient of 37 items for reliability was .909,
indicating good internal consistency.
Using exploratory factor analysis, seven factors were extracted
including: individual skills, attitudes and beliefs, positive organizational
support, beliefs about patient wish/readiness to quit, organizational resources,
individual commitment, and organizational endorsement. These
seven factors explained 61.58% of the variance, and a new refined 36-item
version of the questionnaire was obtained.
Conclusions
Psychometric
testing supports that the KABO questionnaire is reliable and valid for
assessing main barriers and facilitators of smoking cessation practices. Up to
know, individual factors explained better the implementation of smoking
cessation interventions in hospitals. The
seven dimensions identified can be used for investigating how changes on individual
and organizational dimensions have an impact on smoking cessation
implementation services.
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