title: Recruiting family dyads facing thoracic cancer surgery: Challenges and lessons learned from a smoking cessation intervention.
abstract: OBJECTIVE
  Persistent smoking after a cancer diagnosis has adverse effects. Most smoking cessation interventions focus on individual behaviors; however, family members who smoke are major barriers to success. This article describes challenges and lessons learned related to recruitment and retention to a longitudinal, dyadic-centered smoking cessation intervention study for individuals confronting a new diagnosis of thoracic cancer and their family members who smoke.
  
  
  METHODS
  A prospective, one-group repeated measures, mixed-method feasibility study measured recruitment, retention, adherence, and acceptability over a 6-month period in a thoracic surgery clinic at a university cancer center. A multidisciplinary, multi-component decision aid-"Tobacco Free Family"-was used to intervene with the dyads. Study recruitment occurred preoperatively with a thoracic surgery team member assessing smoking status.
  
  
  RESULTS
  During the 6-month recruitment period, 50 patients who smoked were screened, and 18 eligible families were approached to participate. Sixteen participants (8 dyads) enrolled. Patients were all male, and participating family members were all female-either spouses or long-term girlfriends. Others types of family members declined participation.
  
  
  CONCLUSIONS
  Recruitment was lower than anticipated (44%), retention was high (100%), and maximizing convenience was the most important retention strategy. Oncology nurses can assess the smoking status of patients and family members, facilitate understanding about the benefits of cessation, refer those willing to stop to expert resources, and help motivate those unwilling to quit. Research is needed to continue developing strategies to help patients with thoracic cancer and their families facing surgery as an impetus for stopping smoking. Novel intervention delivery and communication need further exploration.
authors.affiliation: University of South Carolina College of Nursing, 1601 Greene Street, Columbia, SC 29208, USA. Electronic address: karenkm@mailbox.sc.edu.
authors.forename: Karen Kane
authors.initials: KK
authors.lastname: McDonnell
authors.affiliation: University of Virginia, School of Nursing, Charlottesville, VA 22908-0782, USA; Department Pediatrics, School of Medicine, Charlottesville, VA 22908-0782, USA. Electronic address: p.hollen@virginia.edu.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Hollen
authors.affiliation: University of Kentucky College of Nursing, 315 College of Nursing Building, Lexington, KY 40536-0232, USA. Electronic address: jheath@uky.edu.
authors.forename: Janie
authors.initials: J
authors.lastname: Heath
authors.affiliation: University of South Carolina College of Nursing, 1601 Greene Street, Columbia, SC 29208, USA. Electronic address: jandrews@mailbox.sc.edu.
authors.forename: Jeannette O
authors.initials: JO
authors.lastname: Andrews
mesh_terms: D000328:Adult; D005190:Family / Q000523:psychology*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011446:Prospective Studies; D016540:Smoking Cessation / Q000523:psychology*; D013899:Thoracic Neoplasms / Q000517:prevention & control* / Q000523:psychology* / Q000601:surgery; D014481:United States
keywords: Decision aid; Dyads; Family intervention; Recruitment and retention; Smoking cessation; Thoracic neoplasms