Table 6 Results of the focus groups after the SAFER pregnancy study
Subject | Results of the focus groups |
|---|---|
Referral to the study and perceived motivation to quit smoking | Pregnant women who smoke are difficult to motivate towards smoking cessation, and midwives fear them leaving their clinic when discussing smoking cessation too often (H) Posters and flyers in the waiting rooms did not help in recruitment, personal conversations between healthcare providers and patients/clients were important (H). Little explanation of the content of the study to patients/clients and easy referral to the researcher were important in the recruitment of participants (H) Participants often have difficulty to quit smoking and remain committed to the study due to psychosocial problems (M), not all healthcare providers agree this complicates smoking cessation (H) |
Contact with researcher (including home visit) | Kind, understanding, positive, and non-judgmental approach was important in motivating and supporting participants (P) Initiating contact with the researcher for support when smoking cessation was difficult, was experienced as easy but participants did not often do so (P) The home visit and making of a quit plan were appreciated, however, discussing prevention of complete relapse after lighting up one cigarette was missed (P) |
Group sessions | Group sessions were daunting for some pregnant women, demotivating participation (H) One group session per month was too infrequent, more group dialogue about smoking cessation should be an option (P). Two hours per group session was sometimes too long (M) Guiding one or two group sessions per participant was too little to fully help (M) Partners who smoke impede smoke cessation (A), however partners should only partly be involved in the women’s’ intervention (P) Online group sessions can be a good addition, but should not completely replace face-two-face group sessions (P) Collaboration between session moderators could enhance connection between sessions and increase effect and usability for participants (M) |
Online platform | Rarely used and if used too many messages were send (P) Platform was impersonal and information was too easy, unfitted for the situation and unrealistic (P) |
Incentives | Mixed feelings about motivational effect (P and H), feels like bribery (H) and some participants felt guilty for receiving incentives while others did not receive them despite also doing their best to quit smoking (P) The beginning of smoking cessation is hard, rewards should be highest then (P) Group incentive was not motivational, increases (negative) group pressure (P) Reward for attending group sessions might increase presence (M) |
Validation | Breath test was motivating to quit smoking because it very clearly showed the effect of smoking (P). Only one participant was aware that the breath test could already be negative after one day of not smoking (P). Unplanned ‘surprise’ validation would not be appreciated (P) |
Investment of time and money | Financial compensation was sufficient (M). Time investment was minimal (H) Participants received less standard care due to the SAFER pregnancy study, as it was felt that the study would replace standard care (H) |
Other | Nicotine replacement therapy should be added to the intervention (P) |