title: A description of the adoption of the 'Fresh start' smoking cessation program by antenatal clinic managers.
abstract: This paper reports the dissemination by the Cancer Education Research Program (CERP) of a previously tested smoking cessation program called 'Fresh start' to 23 antenatal clinics. The program was specifically designed for use by staff in antenatal clinics. The aim of the study was to investigate the factors that influenced midwifery managers' adoption of the program. Clinics were randomly assigned to groups that received the program by simple dissemination (mail-out), or intensive dissemination (a mail-out, plus personal contact with midwifery facilitators). A case history approach was used to investigate the variables which influenced a midwifery manager's decision to adopt the program. The results indicated that intensive dissemination improved program adoption and that program components were selected to fit the physical and social context within antenatal clinics. Managers believed the main barriers to the implementation of the program were: the negative reactions of clients; insufficient time available for smoking cessation interventions; lack of support from professional colleagues; inability to provide follow-up to clients; staff turnover; and poor access and storage of materials.
authors.affiliation: Family Health Research Unit, St George Hospital, Kogarah, New South Wales, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Cooke
authors.forename: R P
authors.initials: RP
authors.lastname: Mattick
authors.forename: E
authors.initials: E
authors.lastname: Campbell
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003659:Decision Making, Organizational; D004509:Education, Nursing, Continuing / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D007318:Inservice Training / Q000379:methods* / Q000592:standards; D007400:Interprofessional Relations; D009718:Nurse Administrators / Q000193:education* / Q000523:psychology*; D009721:Nurse Midwives / Q000193:education* / Q000523:psychology*; D015402:Nursing Education Research; D010044:Outpatient Clinics, Hospital; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods; D015397:Program Evaluation; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology; D012944:Social Support; D017748:Time Management; D016526:Workload