Background
Methods
The pilot IBA intervention
Settings
Participants and sampling
Data collection
Data analysis
Results
Setting | Qualitative Interviews |
---|---|
Community pharmacy |
Face to face interviews
|
6 pharmacists | |
1 pharmacy technician | |
2 counter staff | |
2 health Champion/smoking cessation advisors | |
1 pharmacy supervisor | |
Supermarket |
Telephone interviews
|
12 supermarket delivery staff | |
Community Health Organisations Total | Face to face interviews* |
2 smoking cessation advisors | |
2 health and well-being advisors | |
3 volunteers/team members | |
31 Interviews
|
Perceived facilitators and barriers to intervention delivery and implementation
Sub-themes | Setting Specific | ||
---|---|---|---|
Supermarket | Community pharmacy | Community Health (range of site types) | |
Role legitimacy |
- Role legitimacy less clear
|
+ Fits well with changing responsibilities of pharmacy and contractual arrangements
| +Integration with other services (e.g. smoking cessation) |
+Strong role legitimacy | |||
+ Compatibility with raising awareness and marketing approaches
| -Variability of roles | ||
+Integrates with other services (e.g. MUR) | |||
+Trusted health professional status and strong role legitimacy for pharmacists and healthy living champions
| |||
-Role legitimacy for other pharmacy staff more variable
| |||
Audience reach and engagement |
+ Wide audience reach
|
+ Time available when waiting for prescriptions
|
+Flexibility of multiple sites and wide audience reach in targeted hard to reach areas
|
+ Information taken home for others
|
-High percentage of regular/repeat customers limits audience reach
| ||
-Variable reach of customer base and engagement
|
+Able to attend to wider range of social factors
| ||
+Some sites (e.g. café) more time for discussion | |||
Level of information and materials |
+ Appropriate training and materials for setting
|
+Materials encourage permission to ask for advice
|
+ Materials attract attention
|
+Displays, free giveaways and materials attract attention
|
-Additional “props” felt necessary
|
- Lack of flexibility to incorporate more creative local solutions
| |
- Perceived insufficient training and knowledge can result in lack of confidence
| |||
Dealing with a sensitive topic within public spaces |
- Not wanting to offend or embarrass
|
+Availability of private consultation room
|
+Support from wellbeing advisors available
|
-Public space - not engaging those most in need
|
+Availability of support from trained health professional for counter staff
|
+Trained in provision of healthy lifestyle advice
| |
-Public space - not appropriate for dealing with sensitive
|
-Not wanting to offend or embarrass
|
- Public space - not engaging those most in need
| |
topics or people upset
| |||
- Public space – not engaging those most in need
| |||
-Lack of privacy at counter
| |||
Familiarity with customer base |
+ Existing relationships know customers well
|
+ Existing relationships – know customers well
| +Know customers well (when integrated with other services) |
- Public expecting food testing/giveaways
|
-Familiarity affects engagement when “private” topic
| - Lack of time to develop trust | |
-Familiarity affects engagement when “private” topic
|
+Ability to follow progress of return customers
| ||
Dealing with a sensitive topic within public spaces |
- Not wanting to offend or embarrass
|
+Availability of private consultation room + Availability of support from trained health professional for counter staff
|
+Support from wellbeing advisors available
|
-Public space - not engaging those most in need
|
+Trained in provision of healthy lifestyle advice
| ||
- Public space not appropriate for dealing with sensitive topics or people upset
|
-Not wanting to offend or embarrass
|
- Public space - not engaging those most in need
| |
- Public space – not engaging those most in need
| |||
-Lack of privacy at counter
| |||
Physical spaces and environmental context |
+ Cue to action – proximity to alcohol sales
|
+ seen as health-related space
|
+Flexibility and variability of delivery “sites”
|
- Conflict of interest – proximity to alcohol sales
|
-“busyness” of pharmacy setting
| -External conditions in some sites (e.g. weather, noise) | |
Organisational context |
+Dedicated staff time
|
+Existing links to other referral networks and services
|
+Volunteer training
|
-Working on own with no support
|
-Lack of dedicated staff time
|
+Links to local knowledge and other referral networks
| |
-No existing links to or knowledge of other services
|
-Can conflict with other pharmacy priorities
|
+Dedicated staff time
| |
- Health professional status can limit honest responses
|
-Variable organisational support and priorities
|
“Healthy living its part of what we have to do as part of our contract anyway and as well as being a healthy living pharmacy, it’s an additional requirement now.” (Community Pharmacy 2, Pharmacist)
"One thing beneficial is that we go into places less corporate or clinical. Really positive and beneficial things for us, grab people who don’t necessarily go in to speak to people [health professionals]." (Community Health Team, UI-1, Supervisor)
“The information we were given was appropriate at the level of talking to people in supermarkets. I think if you were a health care professional talking to somebody in private obviously you would need far more detailed information.” (Supermarket 3, Brand Ambassador)
“I just always bring it up anyway in when we are doing the smoking [cessation] and I think they’re a bit more honest … but when you’re outside in the shop we just sort of, I think they get a bit more embarrassed about it.” (Community Pharmacy 5, Counter Assistant/Smoking Cessation Advisor)
Some pharmacists reported that their status as “trusted health professionals” helped to engage customers, however, most encounters within this setting were completed by busy pharmacy counter staff who often did not have time to facilitate participation. One pharmacist, however, acknowledged that their role as health professional might make it more difficult for customers to be honest about their drinking consumption.“It’s difficult to tell people they’re at risk and they should go and see a doctor you know, it’s like who are you to tell me?” (Supermarket 12, Brand ambassador)
“I think maybe because we are sort of in charge of their medicines and their health maybe they feel they didn’t want to be totally honest” (Community Pharmacy 4, Pharmacist)
“while you’re waiting for us to find your prescription would you be able to help us out and fill in one of these scratch cards and here’s a leaflet as well”, rather than: “What score did you get, let’s go through this”, when it can become a bit invasive … [There’s] also a time aspect, … we haven’t got the actual manpower [for the recommended intervention approach] … (Community Pharmacy-3, Pharmacist)
“…plus the fact that people purchase alcohol in the supermarket so I actually thought it was an appropriate place to have a discussion about alcohol.” (Supermarket 3, Brand Ambassador)“I thought it was a bit awkward because obviously I was set up by the beer, wines and spirit aisle so whether that was the right place ... because it’s a bit too close to home but I’m not too sure it made too much difference to customers” (Supermarket 1, Brand Ambassador)
“We’re giving them the information but I don’t think we’re giving them the tools to implement the information... If we had more training then perhaps we could take it further” (Community Pharmacy 1, Pharmacist)
“I said to her promise me you’ll go and see a doctor and then it was almost like I sort of ended the conversation because I’m not a counsellor, but I did what I was supposed to do” (Community Health 2, Smoking Cessation Advisor)