A Process Evaluation of ‘We Can Quit’: a Community-Based Smoking Cessation Intervention Targeting Women From Areas of Socio-Disadvantage in Ireland

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Abstract Background: Smoking poses a serious risk of early preventable death and disease especially for women living with socio-economic disadvantage (SED). A smoking cessation programme ‘We Can Quit’ was developed in Ireland tailored to SED women. The programme includes group-based support delivered by trained lay local women and free nicotine replacement therapy (NRT). The intervention was pilot tested in a cluster randomised controlled trial, ‘We Can Quit 2’. A process evaluation assessed feasibility and acceptability of the programme and trial processes.Methods: Embedded qualitative design using the Medical Research Council’s (MRC) process evaluation framework. Semi-structured interviews with trial participants (N=18) and programme deliverers, the community facilitators (CFs; N=8). Thematic analysis was used for interview transcripts.Results: Results focused on programme and trial operational factors. Peer-modelling, a non-judgemental environment, and CFs supportive role of group support were viewed as facilitative. Potential for broader message diffusion into the social networks of participating women was observed. Free NRT was helpful for cessation. Some participants expressed concerns about NRT side effects. Community pharmacists provided guidance relating to NRT and additional support between programme meetings. Provision of saliva samples proved challenging. Low literacy was a barrier for engagement with programme and trial-related materials. Hypothetical scenarios of direct or indirect observational fidelity assessment for a future definitive trial (DT) were acceptable. Conclusions: The We Can Quit intervention and trial-related processes were feasible and acceptable to participants and Community Facilitators. Any future DT will need to address low literacy.Trial registration: Controlled trials ISRCTN74721694.

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