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Using a realist approach to evaluate smoking cessation interventions targeting pregnant women and young people.

Douglas, Flora C.G.; Gray, Denise A.; van Teijlingen, Edwin R.


Denise A. Gray

Edwin R. van Teijlingen


Background: This paper describes a study protocol designed to evaluate a programme of smoking cessation interventions targeting pregnant women and young people living in urban and rural locations in Northeast Scotland. The study design was developed on so-called 'realist' evaluation principles, which are concerned with the implementation of interventions as well as their outcomes. Methods/design: A two-phased study was designed based on the Theory of Change (TOC) using mixed methods to assess both process and outcome factors. The study was designed with input from the relevant stakeholders. The mixed-methods approach consists of semi-structured interviews with planners, service providers, service users and non-users. These qualitative interviews will be analysed using a thematic framework approach. The quantitative element of the study will include the analysis of routinely collected data and specific project monitoring data, such as data on service engagement, service use, quit rates and changes in smoking status. Discussion: The process of involving key stakeholders was conducted using logic modelling and TOC tools. Engaging stakeholders, including those responsible for funding, developing and delivering, and those intended to benefit from interventions aimed at them, in their evaluation design, are considered by many to increase the validity and rigour of the subsequent evidence generated. This study is intended to determine not only the components and processes, but also the possible effectiveness of this set of health interventions, and contribute to the evidence base about smoking cessation interventions aimed at priority groups in Scotland. It is also anticipated that this study will contribute to the ongoing debate about the role and challenges of 'realist' evaluation approaches in general, and the utility of logic modelling and TOC approaches in particular, for evaluation of complex health interventions.


DOUGLAS, F.C.G., GRAY, D.A. and VAN TEIJLINGEN, E.R. 2010. Using a realist approach to evaluate smoking cessation interventions targeting pregnant women and young people. BMC health services research [online], 10, article 49. Available from:

Journal Article Type Article
Acceptance Date Feb 23, 2010
Online Publication Date Feb 23, 2010
Publication Date Dec 31, 2010
Deposit Date Jul 9, 2021
Publicly Available Date Jul 9, 2021
Journal BMC Health Services Research
Electronic ISSN 1472-6963
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 10
Article Number 49
Keywords Smoking cessation; Service user; Smoking cessation intervention; Smoking cessation service; Smoking cessation advice
Public URL