Motivational Interviewing for Nurses' Smoking Cessation

Study Overview
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Brief Summary
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This study's objective was to test the efficacy, acceptability and feasibility of a motivational interviewing (MI) based smoking cessation intervention with nurses.

Detailed Description
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Despite the important role that health professionals have in reducing tobacco use, many have a smoking habit themselves. The prevalence of smoking is particularly high among nurses. A smoking cessation intervention for nurses who smoked, based on MI, was designed and evaluated following the UK Medical Research Council's (MRC) framework for complex interventions.

Official Title
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Motivational Interviewing as a Smoking Cessation Strategy With Nurses: an Exploratory Randomized Controlled Trial Following the MRC's Framework for Complex Interventions

Conditions
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Health Behavior, Smoking Cessation, Health Personnel Attitude

Intervention / Treatment
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* Behavioral: Motivational interviewing for smoking cessation in nurses
* Behavioral: Brief advice


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Nurses who were smokers Nurses willing to participate in the study Exclusion Criteria: Nurses who were pregnant
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention group<br>MI based four individual sessions | Behavioral: Motivational interviewing for smoking cessation in nurses<br>* Intervention, four one-to-one sessions on an approximately weekly basis, with 3 components: MI context, toolkit, and relapse prevention. The sessions were embedded in a MI context and followed two phases: exploratory and resolutive. The former explored the potential ambivalence that nurses experienced and constructed motivation for change; the latter reinforced the decision to quit and developed a change plan. Participants could choose over a range of tools: some more helpful in the exploratory phase (i.e. decisional balance sheet) and others in the resolutive phase (i.e. problem solving skills). The third component was directed at maintenance strategies. The therapy stayed with the nurses in terms of where they were in relation to they readiness for change.<br>|
| Active Comparator: Control group<br>Brief advice following 5As | Behavioral: Brief advice<br>* Brief advice based on 5As<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Biochemically verified smoking cessation | Urine sample collected in nurses who self-reported being abstinent for at least one week | Following nurses' self-report of quitting (end of intervention (1 month) to 3 month follow-up) | 
| Participant satisfaction | Client Satisfaction Questionnaire (CHQ-8) (Roberts et al 1984) | End of intervention (1 month) | 
| Duration of sessions | Following researcher's diary records | End of intervention (1 month) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Mean cigarettes smoked | Number of cigarettes smoked | Baseline, end of intervention (1 month) and 3 month follow-up | 
| Changes in Stages of change | Assessment of desire and readiness to quit smoking (Prochaska and Velicer, 1997) | Baseline, end of intervention (1 month) and 3 month follow-up | 
| Changes in Nicotine Dependence | Assessment of nicotine dependence using the Fagerström Test for Nicotine Dependence (FTND) (Becoña and Vazquez, 1998) | Baseline, end of intervention (1 month) and 3 month follow-up | 
| Changes in Self-efficacy | Assessment of general self-efficacy using GSE scale (Scholz et al, 2002) | Baseline, end of intervention (1 month) and 3 month follow-up | 
| Changes in Depression score | Depression screening using the Patient Health Questionnaire (PHQ-9) (Kroenke et al 2001) | Baseline, end of intervention (1 month) and 3 month follow-up | 
| Adherence to MI | Assessment of intervention fidelity and adherence to MI principles using Motivational Interviewing Treatment Integrity (MITI) Code (Moyers et al 2005) | End of intervention (1 month) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cognitive dissonance, Motivational interviewing, Health Professional role, Nurses, Health Promotion, Lifestyle, Smoking cessation