Developing and implementing a smoking

cessation intervention within the PAL programme in Nepal

Health Research and Social Development Forum (HERD), Nepal

Background to the Study Feasibility study

Supported by University of Leeds (UK) COMDIS-HSD programme

Funded by DfID

18 months: July 2012 to Dec 2013

Aims and ObjectivesAim: To develop and test the feasibility of a behavioural support

intervention to promote smoking cessation within primary care in Nepal.

Objectives: To review current evidence on behavioural support

interventions for smoking cessation in LMICs. To develop the intervention using qualitative methods to inform

the form, content and delivery mechanism of the intervention. To use action research to test and evaluate a behavioural

support intervention for smoking cessation. To work with WHO and NTP to scale up the adapted PAL across

NTPs PAL districts, primary care in Nepal and with WHO's PAL programme internationally.

Methods

Phase 3

Implementation and follow up Follow up: Fagerstrom and CO monitors

Phase 2Intervention development

workshopAction Research: baseline

Fagerstrom and CO monitor

Phase 1

Evidence ReviewQualitative Interviews with lung health patients and FGDs with

PHC staff

Phase 1: Qualitative Interviews and Focus Groups Qualitative interviews with lung health patients

Selected by health workers Conducted in health centres or place convenient to

patients Aimed for male and female and different lung health

conditionsAim to understand community perceptions of smoking,

smoking habits and interest/support for quitting.

Focus groups with health workers in the selected PHCCs to understand current practice, knowledge and ideas for the intervention.

The Action Research Cycle

PLAN

ACT

OBSERVE

REFLECT

Selection of Study SitesSelection of Primary Health Care Centres (PHCCs)1 in Kathmandu and 2 in Rupandehi, Terai (semi-urban and

rural)Main criteria for the selection of PHCCs: At least 2 staff trained in PAL High case load of lung health patients An urban/rural mix Enthusiasm of the PHCC team to participate in the study