Web-based computer-tailoring to improve practice nurses’ adherence to smoking cessation guidelines: protocol for an RCT

Abstract

Background. Dutch practice nurses’ adherence to smoking cessation guidelines could be improved by providing them personal advice through a web-based computer-tailored program. We describe the development of such a program, the design of an effectiveness trial, and the results of usability tests. Methods. A web-based program was developed, consisting of e-learning modules with personal advice (i.e. tailored on psychosocial determinants), an online forum, project information, background information, frequently asked questions and a counselling checklist. Five experts (heuristic evaluation) and five practice nurses (think aloud method) tested the program’s usability. The effectiveness trial compares practice nurses in an intervention group to a control group (i.e. full versus limited access to the program) after six and twelve months and also assesses smoking behaviour of counselled patients. Findings. Experts and practice nurses reported similar usability issues: modules contained too much text; program navigation was complex; ‘print’ and ‘save’ functions did not work; and a visual analogue scale was unclear. Improvements were made by a) adding more images to modules with a lot of text; b) adding ‘return-to-home’ buttons; c) providing instructions for printing and saving; and d) changing the visual analogue scale to a numerical scale. Discussion. By adapting the content and design of the program based on feedback of experts and practice nurses, the program’s usability was optimized. The randomised effectiveness trial will prove whether a web-based computer-tailored program can enhance practice nurses’ adherence to smoking cessation guidelines adherence and hence improve the quality of smoking cessation care in Dutch general practices.