Evaluating the reach of the Smoking Treatment Optimisation in Pharmacies (STOP) intervention using simulated smoker feedback

Problem

To assess the reach of the STOP intervention and effects on smoker engagement by staff. Community pharmacies offering NHS smoking cessation services are experiencing low smoker uptake. The Smoking Treatment Optimisation in Pharmacies (STOP) programme aims to address this by developing a training intervention for pharmacy staff, implemented in 30 pharmacies across five culturally diverse London boroughs, Wales and Coventry.

Approach

We sent actors posing as smokers to interact with pharmacy staff. Actors recorded presence or absence of elements of the intervention using a fidelity checklist and made contemporaneous notes on staff behaviour. After initial numeric examination we carried out thematic analysis of field notes from pharmacies with the highest and lowest proportion of STOP trained staff members to assess effects of intervention reach on smoker engagement. Reach defined by the proportion of the total number of staff at a pharmacy consented to STOP, and/or trained by STOP.

Findings

Pharmacies with a higher proportion of STOP trained staff members had higher fidelity scores. Actors found that counter staff in pharmacies with low intervention reach had low levels of confidence, according to actor's Likert scale ratings andthematic analysis of actor comments, in approaching them about smoking. This resulted in missed opportunities for smoker recruitment.

Consequences

The reach of the STOP intervention was related to smoker engagement behaviour of pharmacy staff which we assessed using simulated customers. Assessing the effects of intervention reach can provide detailed insight into how and why an intervention is effective, limited or ineffective.