Background
Study 1: a qualitative study of GPs' beliefs
Methods
Design
Participants
The interview
Data analysis
FV reads interview transcripts and generates codes for beliefs reported by GPs about intervening with smokers and about smoking cessation medication and services. |
FV reads and compares the codes to identify themes within these: the principal beliefs GPs reported about intervening with smokers and about smoking cessation medication and services. |
Data relating to each theme are assembled. FV, SH, and TMM independently read these and discuss definitions of themes and the data within these. During this process some definitions are altered and some data re-coded. |
FV re-codes all transcripts for these themes. |
FV begins coding for sub-themes within themes: more detailed variations in GPs' thinking within themes. Sub-themes include GPs' explanations for reasons behind preferring local services to central services. |
The process of coding for sub-themes includes building a framework containing themes and sub-themes. This process includes shifting themes to sub-themes and vice versa. |
The framework is arranged in tables using text segments to represent the themes in order to facilitate understanding of the data |
FV, SH, and TMM study the tables to gain an understanding of themes and sub-themes and decide on main issues. Disagreements are discussed and amendments made where appropriate. |
Procedure
Results
Referring motivated smokers
Preference for in-house support over PCTs' central services
Results summary
Study 2: a quantitative study of GPs' beliefs
Methods
Design
Participants
Characteristic | Levels | N | % |
---|---|---|---|
Gender | Female | 60 | 16.3% |
Male | 307 | 83.7% | |
Decade of qualification | 1960s | 11 | 3% |
1970s | 122 | 33.2% | |
1980s | 146 | 39.8% | |
1990s | 86 | 23.4% | |
2000s | 2 | 0.5% | |
Commitment | Full time | 323 | 88% |
Pat time | 44 | 12% | |
Country of training | UK | 327 | 89.1% |
Other | 40 | 10.9% | |
Geographical location | London | 32 | 8.7% |
South East | 63 | 17.2% | |
South West | 40 | 10.9% | |
West Midlands | 41 | 11.2% | |
Eastern | 46 | 12.5% | |
Trent | 44 | 12% | |
North West | 56 | 15.3% | |
Northern and Yorkshire | 45 | 12.3% | |
Presence of trained practice nurse | No | 89 | 24.3% |
Yes | 277 | 75.5% | |
missing | 1 | 0.3% |
Procedure
Measures
Intention
Beliefs
Path analysis
Data preparation
Results
Prevalence of beliefs and intentions
Proportion | ||||
---|---|---|---|---|
Beliefs |
Agree (>4)
|
Neutral (4)
|
Disagree (<4)
|
Missing
|
Central services are effective. | 66.0% (241) | 22.5% (82) | 11.5% (42) | 0.5% (2) |
Central services are cost-effective. | 48.5% (177) | 29.9% (109) | 21.6% (79) | 0.5% (2) |
Local services are effective. | 81.6% (297) | 11.8% (43) | 6.5% (24) | 0.8% (3) |
Local services are cost-effective. | 47.7% (175) | 21.0% (77) | 31.4% (115) | - |
Intentions |
Intend (>4)
|
Neutral (4)
|
Do not intend (<4)
|
Missing
|
Intention to recommend central services. | 63.8% (234) | 7.1% (26) | 29.2% (107) | - |
Intention to recommend local services. | 51.2% (188) | 8.4% (31) | 40.3% (148) | - |
Path analysis for intentions to recommend central services
Dependent variable | Independent variable | Effectsa
| ||
---|---|---|---|---|
Direct | Indirect | Total | ||
Intentions to recommend central services SMC = 0.44, 95% CI: 0.36 to 0.54, p < 0.01, f
2 = 0.79. | Perceived effectiveness | .60*** | .20*** | .79*** |
Perceived cost-effectiveness | .29*** | - | .29*** | |
Sufficient personalisation | - | .36*** | .36*** | |
Low-attendance | -.15** | -.15*** | -.30*** | |
Perceived cost-effectiveness SMC = 0.37, 95% CI: 0.28 to 0.47, p < 0.01. | Perceived effectiveness | .68*** | - | .68*** |
Sufficient personalisation | - | .31*** | .31*** | |
Low-attendance | - | -.13*** | -.13*** | |
Perceived effectiveness SMC = 0.32, 95% CI: 0.24 to 0.41, p < 0.01. | Sufficient personalisation | .46*** | - | .46*** |
Low-attendance | -.18*** | - | -.18*** |
Path analysis for intentions to recommend local services
Dependent variable | Independent variable | Effectsa
| ||
---|---|---|---|---|
Direct | Indirect | Total | ||
Intentions to recommend local services SMC = 0.51, 95% CI: 0.43 to 0.58, p < 0.01, f
2 = 1.04. | Perceived cost-effectiveness | .73*** | - | .73*** |
Perceived effectiveness | .15** | .48*** | .63*** | |
Sufficient personalisation | - | .24*** | .24*** | |
Low-attendance | -.17** | -.09*** | -.26*** | |
Perceived cost-effectiveness SMC = 0.22, 95% CI: 0.14 to 0.31, p < 0.01. | Perceived effectiveness | .65*** | - | .65*** |
Sufficient personalisation | - | .25*** | .25*** | |
Low-attendance | - | -.10*** | -.10*** | |
Perceived effectiveness SMC = 0.26, 95% CI: 0.17 to 0.35, p < 0.01. | Sufficient personalisation | .38*** | - | .38*** |
Low-attendance | -.15*** | - | -.15*** |