Effectiveness of Behavior Change interventions for smoking cessation among expectant and new fathers

Abstract Background The perinatal period is an optimal time to intervene for achieving smoking cessation in expectant parents and offers multiple health benefits for women and the newborn. While Behavior Change Technique (BCT) interventions are a promising approach to support pregnant smokers to quit smoking, effectiveness of these interventions among expectant and new fathers is not equally well documented. Better understanding of the potential utility of these BCT interventions for this group is important for the development of effective gender-sensitive programmes. Methods This systematic review examines the existing evidence on effectiveness of BCTs on smoking cessation outcomes when offered to expectant and new fathers (child < 1 year) both through individual and/or couple-based interventions. Eight databases were searched for peer-reviewed articles. Studies were subjected to systematic retrieval and quality-assessment by two independent reviewers. Results We identified 9 randomised control trial studies (including 4,681 men) that fulfilled the inclusion criteria. In terms of quit outcome data, 8 studies reported biochemically verified quit rates for men. While 5 BCT interventions targeted expectant/new fathers, 3 were directed to couples and 1 primarily focused on women with a component directed at men. Though most of the interventions were found to be effective, they showed small significant positive effects on cessation outcomes. Findings are suggestive of gender specific interventions being more likely to have positive outcomes. High heterogeneity across the studies made it difficult to determine the most effective BCT approach. Conclusions This review suggests that use of BCT interventions for smoking cessation among expectant and new fathers is effective in achieving positive quit rates; however, these studies are limited. Further research is needed to determine the most effective BCT approach associated with smoking cessation among this group. Key messages • BCT interventions for smoking cessation among expectant and new fathers are a promising approach to increase quit rates. • Future research needs to develop evidence based BCT interventions for smoking cessation specifically targeting expectant and new fathers to inform policy and practice.


Background:
The perinatal period is an optimal time to intervene for achieving smoking cessation in expectant parents and offers multiple health benefits for women and the newborn. While Behavior Change Technique (BCT) interventions are a promising approach to support pregnant smokers to quit smoking, effectiveness of these interventions among expectant and new fathers is not equally well documented. Better understanding of the potential utility of these BCT interventions for this group is important for the development of effective gender-sensitive programmes.

Methods:
This systematic review examines the existing evidence on effectiveness of BCTs on smoking cessation outcomes when offered to expectant and new fathers (child < 1 year) both through individual and/or couple-based interventions. Eight databases were searched for peer-reviewed articles. Studies were subjected to systematic retrieval and quality-assessment by two independent reviewers.

Results:
We identified 9 randomised control trial studies (including 4,681 men) that fulfilled the inclusion criteria. In terms of quit outcome data, 8 studies reported biochemically verified quit rates for men. While 5 BCT interventions targeted expectant/ new fathers, 3 were directed to couples and 1 primarily focused on women with a component directed at men. Though most of the interventions were found to be effective, they showed small significant positive effects on cessation outcomes. Findings are suggestive of gender specific interventions being more likely to have positive outcomes. High heterogeneity across the studies made it difficult to determine the most effective BCT approach.

Conclusions:
This review suggests that use of BCT interventions for smoking cessation among expectant and new fathers is effective in achieving positive quit rates; however, these studies are limited. Further research is needed to determine the most effective BCT approach associated with smoking cessation among this group. Key messages: BCT interventions for smoking cessation among expectant and new fathers are a promising approach to increase quit rates. Future research needs to develop evidence based BCT interventions for smoking cessation specifically targeting expectant and new fathers to inform policy and practice.

Background:
The COVID-19 pandemic added new challenges to health workforce resilience. High workload, increased risk of COVID infection and continuing stress threaten the health and wellbeing of healthcare workers (HCWs) and increase existing (gendered) inequalities, thus reinforcing health labour market problems. Investment in the health workforce and prioritisation of the health and wellbeing needs of healthcare workers in health policy and pandemic recovery plans is therefore called for by the WHO, the European Union and others. However, health systems and policymakers across countries have not sufficiently understood the importance of HCWs.

Objectives:
This workshop brings health workforce needs onto the health policy agenda. It seeks to build capacity for a resilient and healthy health workforce, setting the focus on protection and preparedness of HCWs and their individual wellbeing, and reduction of gendered inequalities. The following major questions will be addressed: What do we know about COVID-19 and the health and wellbeing of HCWs? What skills are needed to respond to new demands? What policy approaches are available to improve protection, preparedness and mental health support of HCWs? How to integrate gender equality and the situation of migrant/refugee HCWs in these approaches, and finally build capacity for effective health workforce governance and its implementation. The workshop introduces novel results drawn from European comparative research and country case studies. It connects policy and practice, as well as health system and individual HCW needs. A number of important policy recommendations are emerging from the research. (1) The health and wellbeing of the health workforce must be addressed systematically across all levels of health policy and governance, including the organisation settings.
(2) Health systems must take responsibility and leadership in responding to health workforce needs.
(3) Important lessons to be learned from HCWs' experiences should guide future health workforce policy and pandemic recovery plans. (4) Participatory governance and inclusion of HCWs must be strengthened, including gender equality and diversity. The workshop will stimulate critical debate and improve knowledge exchange across countries and between researchers. It will contribute to strengthen resilience of the health workforce and health systems, and to build back better after COVID-19 in a fair and equitable manner. Key messages: Health workforce needs and mental health support must become policy priorities and addressed as part of health system resilience. Action has to be taken to strengthen participatory health workforce governance sensitive to new needs.
iii20 European Journal of Public Health, Volume 32 Supplement 3, 2022