A digital intervention to increase motivation and access to NHS Stop Smoking Services: Applying the Behaviour Change Wheel to develop the ‘Stop-app’

Background: Smokers are four times more likely to stop smoking with the help of an NHS Stop Smoking Service (SSS). However attendance is in decline, possibly due to the increase in popularity of e-cigarettes. SSS’s will support smokers who choose to use e-cigarettes as part of a quit attempt, therefore interventions are needed to encourage continued access and uptake of SSS.

Aim: To design an evidence based intervention (Stop-app) to increase referrals, 4 week quit rates and reduce ‘did not attend’ (DNA) rates within SSS.

Methods/Results: In Phase 1 we collected data to explore the barriers and facilitators to people using SSS. Smokers and ex-smokers identified a number of barriers, including a lack of knowledge about what happens at the service; the belief that there would be ’scare tactics’, ‘nagging’, that the service would be unfriendly and clinical; and a lack of perceived efficacy of the service. In Phase 2, data from extant literature and phase 1 were subject to behavioural analysis as outlined by the Behaviour Change Wheel framework. A range of factors were identified as needing to change. These aligned with capability (e.g. a lack of knowledge about the benefits of SSS), opportunity (e.g. beliefs that SSS are not easy to access) and to motivation to act (e.g. beliefs that they did not need and would not benefit from SSS). We describe the content development process, illustrating the choice of 19 ‘Behaviour Change Techniques’ included in our digital intervention. In Phase 3 we assessed the acceptability of the proposed intervention by interviewing stop smoking service advisors and non-NHS provider sites (e.g. library services and children’s centres). Findings from interviews are presented and have been used to consider the best path for implementation of the web-app within service provision.

Conclusion: The ‘Stop –app’ is in development and will be accessible online, linking with the SSS booking system used by Public Health Warwickshire, and other local authorities nationally for NHS and non-NHS providers. Stop-app incorporates a brief behaviour change intervention to increase motivation to attend SSS, along with an e-referral system for instant appointment booking. Examples of content and functionality of the app are outlined. Usability and feasibility testing are planned for Phase 4; and a pilot efficacy trial protocol is in development.