Determinants of adoption of cognitive behavioral interventions in a hospital setting: example of a minimal-contact smoking cessation intervention for cardiology wards.

Abstract

OBJECTIVE: The aim of our study was to identify the psychological and organizational determinants of adopting a smoking cessation intervention in cardiology wards, using the Integrated Change Model (I-Change Model) as the theoretical basis. METHODS: A cross-sectional survey by means of questionnaires was conducted among the heads of all 121 cardiology wards in Dutch hospitals, of whom 77 (64%) responded. RESULTS: Adopters had a significantly lower level of formalization and more nurses working on the ward. Adopters also had a significantly more positive attitude towards working with the intervention, perceived more positive social influences from their direct environment and had higher self-efficacy. Psychological determinants explained adoption to a greater extent than organizational determinants did. CONCLUSION: It is very important to take psychological factors into account when studying the adoption of preventive innovations and developing diffusion strategies. PRACTICE IMPLICATIONS: Programs for dissemination of preventive innovations in a hospital setting should primarily focus on psychological characteristics like social influence and self-efficacy.