Using the theoretical domains framework and COM-B model in identifying barriers and facilitators to addressing smoking cessation in improving access to psychological therapies services: A qualitative study

Varnes, Laura

Abstract

Objectives: Tobacco smoking is the leading cause of preventable death worldwide, and the prevalence rates of smoking in individuals with mental health conditions remains high. Improving Access to Psychological Therapies’ (IAPT) services could be a platform to provide smoking cessation support alongside psychological interventions. This study aimed to explore mental health professionals (MHPs) experience in addressing smoking cessation with their patients in IAPT services to gain insight into the barriers and facilitators they face, by using the Theoretical Domains Framework and COM-B model.

Methods: A qualitative design using semi-structured interviews was used. Nineteen MHPs were recruited from 8 IAPT services. Interviews were analysed using an inductive approach to thematic analysis, followed by a deductive approach when generating themes.

Findings: MHPs capability, opportunity and motivation impacted their smoking cessation practice. Addressing smoking was undermined by MHPs 1) psychological capability, including poor knowledge on smoking and guidelines; 2) physical opportunity in terms of time constraints and lack of resources; 3) social opportunity in terms of permissive organisational culture towards smoking cessation; 4) reflective motivation, including decision making processes related to addressing behaviours viewed as more important; and 5) automatic motivation in terms of apprehension and anxiety. The main facilitators included MHPs belief that they had the skills to address smoking cessation, belief it was part of their job role, and opportunity to do so.

Conclusion: Barriers were identified across 5 domains of the COM-B model. The study highlighted several facilitators which should be considered in clinical practice and intervention development.

• Thesis Type: Thesis
• Deposit Date: Oct 18, 2022
• Publicly Available Date: May 9, 2023
• Public URL: https://uwe-repository.worktribe.com/output/10039226
• Award Date: May 9, 2023