Development and content validation of a questionnaire for measuring beliefs about using Nicotine Replacement Therapy for smoking cessation in pregnancy

Emery, Joanne ORCID: https://orcid.org/0000-0002-8915-7033, McDaid, Lisa ORCID: https://orcid.org/0000-0001-5032-2380, Coleman, Tim, Cooper, Sue, Thomson, Ross, Kinahan-Goodwin, Darren, Dickinson, Anne, Phillips, Lucy, Clark, Miranda, Bowker, Katherine, Brown, Emma and Naughton, Felix (2023) Development and content validation of a questionnaire for measuring beliefs about using Nicotine Replacement Therapy for smoking cessation in pregnancy. Nicotine and Tobacco Research, 25 (7). 1310–1318. ISSN 1462-2203

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Abstract

Introduction: Improving adherence to nicotine replacement therapy (NRT) in pregnancy may result in higher smoking cessation rates. Informed by the Necessities and Concerns Framework, we developed an intervention targeting pregnancy NRT adherence. To evaluate this, we derived the NRT in pregnancy necessities and concerns questionnaire (NiP-NCQ), which measures perceived need for NRT and concerns about potential consequences. Aims and Methods: Here we describe the development and content validation of NiP-NCQ. From qualitative work, we identified potentially modifiable determinants of pregnancy NRT adherence and classed these as necessity beliefs or concerns. We translated these into draft self-report items and piloted items on 39 pregnant women offered NRT and a prototype NRT adherence intervention, assessing distributions and sensitivity to change. After removing poorly performing items, smoking cessation experts (N = 16) completed an online discriminant content validation (DCV) task to determine whether retained items measure a necessity belief, concern, both, or neither construct. Results: Draft NRT concern items encompassed safety for the baby, side effects, too much or insufficient nicotine, and addictiveness. Draft necessity belief items included perceived need for NRT for short- and longer-term abstinence, and desire to minimize or cope without NRT. Of 22 out of 29 items retained after piloting, four were removed following the DCV task: three were judged to measure neither construct and one possibly both. The final NiP-NCQ comprised nine items per construct (18 total). Conclusions: The NiP-NCQ measures potentially modifiable determinants of pregnancy NRT adherence within two distinct constructs and may have research and clinical utility for evaluating interventions targeting these. Implications: Poor adherence to NRT in pregnancy may result from low perceived need and concerns about consequences; interventions challenging these beliefs may yield higher smoking cessation rates. To evaluate an NRT adherence intervention informed by the Necessities and Concerns Framework, we developed the NiP-NCQ. Through the content development and refinement processes described in this paper, we derived an evidence-based, 18-item questionnaire measuring two distinct constructs within two nine-item subscales. Higher concerns and lower necessity beliefs indicate more negative NRT beliefs; NiP-NCQ may have research and clinical utility for interventions targeting these.

Item Type: Article
Additional Information: Data Availability: Anonymised data for Phases 2 and 3 of this research are available upon reasonable request from the corresponding author. Funding information: This work was funded through a National Institute for Health Research (NIHR) Programme Grant for Applied Research (RP‐PG‐0615‐20003). T.C. is an NIHR Senior Investigator. The views expressed in this manuscript are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Uncontrolled Keywords: medicine(all) ,/dk/atira/pure/subjectarea/asjc/2700
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging
Faculty of Medicine and Health Sciences > Research Groups > Behavioural and Implementation Science
Faculty of Medicine and Health Sciences > Research Groups > Health Promotion
Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
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Depositing User: LivePure Connector
Date Deposited: 03 Mar 2023 10:30
Last Modified: 19 Oct 2023 03:33
URI: https://ueaeprints.uea.ac.uk/id/eprint/91327
DOI: 10.1093/ntr/ntad030

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