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Implementation fidelity of a smoke-free workplace intervention in a private medical company: A mixed-methods process evaluation

INTRODUCTION: Smoke-free workplaces are considered an important part of tobacco control strategies. The purpose of this study was to evaluate implementation fidelity and explore the significance of social and contextual factors for the implementation of a strict smoke-free workplace intervention in...

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Autores principales: Rasmussen, Sofie K. B., Lidegaard, Lærke P., Pisinger, Charlotta, Johnsen, Nina F., Kristiansen, Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Publishing on behalf of the European Network for Smoking and Tobacco Prevention (ENSP) 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10214475/
https://www.ncbi.nlm.nih.gov/pubmed/37251694
http://dx.doi.org/10.18332/tpc/162878
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author Rasmussen, Sofie K. B.
Lidegaard, Lærke P.
Pisinger, Charlotta
Johnsen, Nina F.
Kristiansen, Maria
author_facet Rasmussen, Sofie K. B.
Lidegaard, Lærke P.
Pisinger, Charlotta
Johnsen, Nina F.
Kristiansen, Maria
author_sort Rasmussen, Sofie K. B.
collection PubMed
description INTRODUCTION: Smoke-free workplaces are considered an important part of tobacco control strategies. The purpose of this study was to evaluate implementation fidelity and explore the significance of social and contextual factors for the implementation of a strict smoke-free workplace intervention in a large Danish medical company. METHODS: The UK Medical Research Council’s guidance for process evaluation was used as a framework. Data were collected from approximately six months before the implementation until ten months after (2019–2020). A mixed method study design was used (a survey of 398 employees, a focus group of four employees and field visits on two days). Data were analyzed separately and later integrated through triangulation. We used the Fisher’s exact test in the analysis of the questionnaire. RESULTS: We assessed the implementation fidelity through four key factors: reach, dose and delivery, mechanisms of change, and context for the intervention components. Despite compliance issues, the policy component had high implementation fidelity. However, the implementation fidelity of the smoking cessation support component was low. We identified three social mechanisms influencing the employees’ responsiveness towards the policy: expectation, the social aspect of the smoking facilities, and management leadership. COVID-19 was identified as the main contextual factor affecting the implementation. CONCLUSIONS: Although not all elements of the intervention components were implemented as planned, the strict smoke-free workplace intervention is considered implemented. Further strategies can be initiated to raise implementation fidelity through better communication concerning the cessation support component, compliance, and enforcement of the policy.
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spelling pubmed-102144752023-05-27 Implementation fidelity of a smoke-free workplace intervention in a private medical company: A mixed-methods process evaluation Rasmussen, Sofie K. B. Lidegaard, Lærke P. Pisinger, Charlotta Johnsen, Nina F. Kristiansen, Maria Tob Prev Cessat Research Paper INTRODUCTION: Smoke-free workplaces are considered an important part of tobacco control strategies. The purpose of this study was to evaluate implementation fidelity and explore the significance of social and contextual factors for the implementation of a strict smoke-free workplace intervention in a large Danish medical company. METHODS: The UK Medical Research Council’s guidance for process evaluation was used as a framework. Data were collected from approximately six months before the implementation until ten months after (2019–2020). A mixed method study design was used (a survey of 398 employees, a focus group of four employees and field visits on two days). Data were analyzed separately and later integrated through triangulation. We used the Fisher’s exact test in the analysis of the questionnaire. RESULTS: We assessed the implementation fidelity through four key factors: reach, dose and delivery, mechanisms of change, and context for the intervention components. Despite compliance issues, the policy component had high implementation fidelity. However, the implementation fidelity of the smoking cessation support component was low. We identified three social mechanisms influencing the employees’ responsiveness towards the policy: expectation, the social aspect of the smoking facilities, and management leadership. COVID-19 was identified as the main contextual factor affecting the implementation. CONCLUSIONS: Although not all elements of the intervention components were implemented as planned, the strict smoke-free workplace intervention is considered implemented. Further strategies can be initiated to raise implementation fidelity through better communication concerning the cessation support component, compliance, and enforcement of the policy. European Publishing on behalf of the European Network for Smoking and Tobacco Prevention (ENSP) 2023-05-26 /pmc/articles/PMC10214475/ /pubmed/37251694 http://dx.doi.org/10.18332/tpc/162878 Text en © 2023 Rasmussen S. K. B. et al. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License.
spellingShingle Research Paper
Rasmussen, Sofie K. B.
Lidegaard, Lærke P.
Pisinger, Charlotta
Johnsen, Nina F.
Kristiansen, Maria
Implementation fidelity of a smoke-free workplace intervention in a private medical company: A mixed-methods process evaluation
title Implementation fidelity of a smoke-free workplace intervention in a private medical company: A mixed-methods process evaluation
title_full Implementation fidelity of a smoke-free workplace intervention in a private medical company: A mixed-methods process evaluation
title_fullStr Implementation fidelity of a smoke-free workplace intervention in a private medical company: A mixed-methods process evaluation
title_full_unstemmed Implementation fidelity of a smoke-free workplace intervention in a private medical company: A mixed-methods process evaluation
title_short Implementation fidelity of a smoke-free workplace intervention in a private medical company: A mixed-methods process evaluation
title_sort implementation fidelity of a smoke-free workplace intervention in a private medical company: a mixed-methods process evaluation
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10214475/
https://www.ncbi.nlm.nih.gov/pubmed/37251694
http://dx.doi.org/10.18332/tpc/162878
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