1Form Approved

OMB No. 0920-0008

Exp. Date 07/31/2014

Interview Guide

WIC Clinic Not Currently Using FAIR Form (Inactive)

GUIDE:

Hello, my name is [interviewer’s name]. [If on the phone and someone else is in the room, introduce the other person by name]. I am working with the Ohio Department of Health to learn more about smoking cessation programs in WIC clinics in Ohio. The purpose of this interview is to gather information about your WIC clinic’s experiences with using the 5As for smoking cessation and other methods that you might be using to help your pregnant and postpartum clients stop smoking. The interview should not take more than 45 minutes. I will be using a digital recorder to record our conversation so that I will be able to refer to it later, and [other person] will be taking notes. The recording and all of the information gathered from this interview will be kept in a secure location and will remain confidential. The recording will only be used for the research staff to review what you have said and ensure that our notes are correct. Your decision whether to participate will remain confidential and your name will not be included in any notes or on the recording. Only summary and de-identified information will be published or released, and the results of this project will be used to improve the support that ODH provides to WIC clinics that provide smoking cessation services to their clients. Participation is voluntary, and your decision to participate is confidential. We truly appreciate your participation and your valuable contributions to this project.

Do you agree to participate in the interview?

___ Yes

___No (Thank them for their time and consideration and end the interview.)

Is it all right with you if I record our interview?

___ Yes

___ No (Ask if the interview can proceed but just with notes taken instead of the recording.)

[Begin recording if the participant has agreed to the audio recording.]

Thank you again for agreeing to participate.

  1. I’d like to start off by asking some questions that will help give us a better understanding of the behaviors and attitudes of those who live in the communities here. For the first few questions, I’d like to ask you to think about the communities your clients are from and the communities’ thoughts about smoking.
  1. In your opinion, how common is tobacco smoking in this community in general?
  1. Now, thinking still about the community, how common is smoking among pregnant women in the community?
  1. Can you tell me your opinion of what the community thinks about smoking during pregnancy?
  1. So, focusing a bit more on pregnant women who smoke, could you tell me a little bit about whether you think they experience any barriers to quitting smoking? (Prompt: if yes, can you tell me about what the barriers are?)
  1. OK, that was really helpful. Thanks. Now we’re going to switch gears a little bit and focus more on you and the work you do here at this WIC clinic.
  1. So, to start, can you tell me about your role here at the WIC clinic? (Prompt: What’s a typical day like for you?)
  1. Can you tell me a little about your educational background and professional training? (Prompt: Is your educational background in nutrition, public health, health care management, or something along those lines?)
  1. And can you tell me how long you’ve worked at this clinic?
  1. OK, now I’m going to ask you some questions about the 5As intervention for smoking cessation. I believe that your clinic received training in using the 5As in [year].
  1. Were you working at this clinic during the initial 5As training in [year]?

YES

  1. Can you tell me about the training and how it went?

(Prompt: Who participated in the training?)

  1. What do you think staff thought about the training? (Prompt: How did staff react to the training?)
  1. Was there anything about the training that you liked? (Prompt: can you tell me more about what you liked about the training?)
  1. And, on the other hand, was there anything about the training that you did not like?

NO

  1. Did youever receive training in using the 5As?
  2. Who provided the training?
  1. When did you do the training?
  1. What did you like and dislike about the training?
  1. I have just a few more questions about 5As training for you and your staff. Are there any parts of the 5 As that you feel your staff needs better training in?
  1. Thank you. Now, thinking about things your staff does to help clients stop smoking – other than the 5As – are there any topics you think would be helpful to have more training in? (Prompts: nicotine addiction, smoking effects during pregnancy, working with clients who might be resistant to change)
  1. If the Ohio Department of Health were to provide additional training on the 5As, what method of training do you think would best help improve staff’s knowledge and skills for use in helping clients quit smoking? (prompts: in-service, webinar, written materials, etc)
  1. So, thinking about the extra training that might be helpful for staff, how do you see additional training fitting into your clinic’s schedule (prompt: how much time could be devoted to an in-service? To a self-paced web training? To reviewing written materials?)
  1. Now I would like to talk about how your clinic uses the 5As.
  1. Is your clinic currently using the 5As to help pregnant and postpartum women quit smoking?

YESNO Q5

  1. I’d like to understand more about how the 5As is used in your clinic. For instance, to start, if a client were at her first prenatal visit, what would the staff do to use the 5As with that client? (Prompt: What is each staff member’s role?)
  1. OK, and what about after that - how would the staff use the 5As at subsequent prenatal visits?
  1. OK, thanks. Now I’d like to ask some more specific questions about three parts of the 5As: the assess, assist, and arrange steps. In your clinic, what would a staff member do if a client is assessed and she is not interested in quitting smoking?
  1. Does your staff have any resources available to assist women with quitting smoking? (Prompt: Can you tell me more about them…)
  1. What if a woman decides she wants to make a quit attempt, is there any follow up that happens? (Prompt: Can you tell me more about the follow up – how is it arranged?)
  1. Are you able to document or keep track of the follow up for patients that did attempt to quit? Prompt: If so, how is it documented? Is it always documented or are there times it might not be asked about or not documented?)
  1. What kinds of feedback have you gotten from staff about using the 5As? (Prompt: have the staff come to you with any complaints about the program? Success stories? Questions? Suggestions for modifying the program?)

*** If the clinic IS using the 5As at all, go to Q 7***

  1. Since you said that your clinic is not using the 5As right now, can you tell me about how the clinic used the 5As program in the past? (Prompts: did all health professional staff use the intervention? Did staff use the FAIR form to document client progress with smoking cessation?)

No or Don’t Know Q6b

  1. What was your role in providing the 5As intervention?
  1. When did the clinic stop using the 5As?
  1. Can you share with me why you think the clinic stopped using the 5As?
  1. It sounds like the clinic is using some parts of the 5As program, but not others; for example, using the 5As to counsel women, but not using the FAIR form to document the client’s progress. Can you tell me more about how the clinic same to stop using some parts of the 5As program?
  1. Why do you think the clinic stopped using the FAIR form?
  1. Is the clinic using another method to document client progress with smoking cessation? (Prompt: Can you tell me about what’s being done?)
  1. Is your clinic currently using a different tool or program for smoking cessation? (Prompt: Can you tell me more about it – what it is called, and how does it work?)
  1. In your opinion, are there specific supports or enhancements to the 5As intervention that you can think of that the Ohio Department of Health could have provided that might have helped your clinic continue using the5 As, including using the FAIR form? (Prompts: additional/more frequent training, incentives, technical assistance for quality improvement; tools or resources to help track clients or remind staff)
  1. Now I would like to ask some questions about your opinion of using the 5As program. If your clinic is no longer using the program, please try to recall how you felt about using the program when it was being used.

(If the clinicNEVER used the 5As Q9)

  1. Can you tell me whether you think there are strengths of the 5 As?
  1. Were there parts of the 5As that you think your clinic was doing well?
  1. Did you observe any benefits to using the 5As?
  1. Now, on the other hand, were there any challenges you encountered with using the 5 As in your clinic?
  1. Were there other things about using the 5 As that you did not like?
  1. Is there anything you can think of that would have made it possible to continue to use the5 As?

[Only use Q9 for clinics or respondents that NEVER used any part of the 5As program ]

  1. I understand that you personally did not experience using the 5As. The 5As is an evidence-based intervention for smoking cessation that can be delivered by health professionals.
  2. In your opinion, would there be any advantage to using a program like this one in your clinic? (prompt: what might be some of the advantages?)
  1. In[dd1] your opinion, do you see any potential barriers to using the 5As here in this clinic?
  1. Do you think that there might be any administrative barriers to using the 5As? (prompt: What administrative barriers could you foresee?)
  1. And what about staff – in your opinion, would staff foresee any barriers or challenges in using the 5As?
  1. And, finally, thinking about clients – do you think clients would be receptive to the 5As?
  1. Thinking back to everything that we talked about today, is there anything else that you feel we didn’t cover that you would like to share regarding efforts to help women in this clinic quit smoking?
  1. Is there anything else I didn’t ask about that you want to add, or anything you think we should be asking others about?

Thank you so much for your time today. Do you have any further questions for me?

Your participation will be helpful to ODH as we update and expand programs to help pregnant and postpartum women quit smoking. We expect to be able to share our results from this evaluation once it is completed, in a few months. If you have any questions, please feel free to contact Dr. Celia Quinn at ODH (614)-728-6941 or .

Public reporting burden of this collection of information is estimated to average 45 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS E-11 Atlanta, Georgia 30333; ATTN: PRA (0920-0008)

[dd1]Do you want to also include potential advantages of using the 5As? Not sure why we’re only asking about barriers.