Table 3 Overview of factors which played a role in the implementation of AAC, based on participants’ answers to the open-ended questions in the questionnaires
CFIR domain | CFIR construct | Factor | Mentioned by |
|---|---|---|---|
Innovation | Evidence-base | ( +) AAC is scientifically provena | GP |
Relative advantage | ( +) AAC makes it easier to discuss smoking cessation and provide advice | GP and PN/DA | |
( +) AAC results in more active provision of smoking cessation care | GP | ||
( +) AAC results in improved communication towards patient | GP and PN/DA | ||
( +) AAC results in more patients who enrol into counselling | GP and PN/DA | ||
(-) Not better than other methodsa | GP | ||
Complexity | ( +) AAC is convenient and simple | GP and PN/DA | |
( +) AAC can be quickly applied | GP and PN/DA | ||
( +) AAC provides structure | GP and PN/DA | ||
(-) ‘Connect’ takes more time and can be more difficult to carry out | GP | ||
Outer setting | Critical incidents | ( +) More people motivated to quit smoking due to COVID-19 | GP and PN/DA |
( +) Easier to discuss smoking due to COVID-19 | GP | ||
(-) Lack of time/priority in practice to discuss smoking (due to COVID-19) | GP and PN/DA | ||
(-) Consultations more often by telephone due to COVID-19 | GP and PN/DA | ||
(-) Fewer patients seen due to COVID-19 | GP and PN/DA | ||
(-) Patients less motivated to quit or they delay quit attempt due to COVID-19 | GP and PN/DA | ||
(-) Problems with availability of smoking cessation medication | GP | ||
Local attitudes of innovation recipients | ( +) AAC offers patient advantages, such as not needing to make an appointment themselves | GP | |
(-) AAC is not always received well by patients | GP | ||
Partnerships & connections | (-) Lack of group counselling nearby | GP and PN/DA | |
Financing | (-) Lack of time during consultation to discuss smoking | GP and PN/DA | |
Inner setting | Compatibility | ( +) AAC already known and applied in practice | GP and PN/DA |
(-) Did not use the method or used a different method | PN/DA | ||
Available resources | ( +) A professional who offers counselling was employed in the practice during the study | GP and PN/DA | |
(-) No counselling offered within the practice | GP and PN/DA | ||
Characteristics of individuals | Motivation of innovation deliverers | (-) AAC sometimes feels inappropriate or pushy | GP |
Implementation process | Engaging innovation deliverers | ( +) More (knowledge of) possibilities for external smoking cessation counselling | GP and PN/DA |
Reflecting & Evaluating: Implementation | ( +) AAC carried out as planned, on individual level and/or practice level | GP and PN/DA | |
( ±) Attempts made to implement AAC but not completely successful yet | GP and PN/DA | ||
(-) AAC insufficiently implemented | GP and PN/DA |