General practitioners' beliefs about effectiveness and intentions to prescribe smoking cessation medications: qualitative and quantitative studies

BACKGROUND: General practitioners' (GPs) negative beliefs about nicotine dependence medications may act as barriers to prescribing them. METHODS: Study1: Twenty-five GPs from 16 practices across London were interviewed in this qualitative study. Framework analysis was used to identify key themes. Study 2: A convenience sample of 367 GPs completed an internet-based survey. Path-analysis was used to examine the relations between beliefs and intentions to prescribe smoking cessation medications. RESULTS: Study 1: Whilst nicotine replacement therapy (NRT) and bupropion were generally perceived as effective and cost-effective, the effectiveness of NRT was seen as critically dependent on behavioural support for smoking cessation. This dependence appeared to be influenced by perceptions that without support smokers would neglect psychological aspects of smoking and use NRT incorrectly. GPs perceived bupropion as dangerous and were concerned about its side-effects. Study 2: GPs' beliefs had medium (NRT, f(2 )= .23) to large (bupropion, f(2)=.45; NRT without support, f(2)=.59) effects on their intentions to prescribe medications. Beliefs about effectiveness of NRT and bupropion and the perceived danger of bupropion were the key predictors of intentions to prescribe NRT and bupropion, respectively. Beliefs about neglecting psychological aspects of smoking and incorrect use had indirect effects on intentions to prescribe NRT without support, operating via beliefs about effectiveness. CONCLUSION: GPs vary in their beliefs about the effectiveness and safety of smoking cessation medications. Their intentions to prescribe these medications vary in line with these beliefs. Interventions aimed at increasing the likelihood with which GPs prescribe these medications may be more effective if they addressed these beliefs

Can public campaigns effectively change psychological determinants of safer sex? An evaluation of three Dutch campaigns

This study evaluated the 1994, 1995 and 1996 Dutch safer sex campaigns as to their effectiveness in terms of improved attitudes, perceived social norms, self-efficacy and intentions regarding safer sex. The hypotheses were tested that variables become more positive when campaigns are conducted and less positive when campaigns are discontinued, A comprehensive design, including a baseline-post-test/post-test-only group design and a longitudinal or multiple assessment group design, was employed to exclude testing effects, history effects, cultural changes and sample differences as alternative explanations. The results show that despite high baseline levels, the campaigns positively affected all variables. Importantly, levels of all variables decreased when no campaign was conducted. It is concluded that campaigns are needed to maintain high levels of determinants of safer sex and that future campaign goals should be formulated in terms of stabilization instead of growth

The effects of information about AIDS risk and self-efficacy on women's intentions to engage in AIDS preventive behavior

Female college students' perceived vulnerability to AIDS and their perceived self-efficacy regarding AIDS preventive behavior (APB), were manipulated in a 2 x 2 design. Consistent with protection motivation theory (e.g.. Rogers, 1983), the results showed that intention to engage in APE was highest among subjects who received information that their risk of getting infected with HIV was high, and who experienced relatively high feelings of self-efficacy. These subjects also seemed least likely to engage in denial of their AIDS risk. The implications of these findings for AIDS education programs are discussed