The dissemination of a smoking cessation program: predictors of program awareness, adoption and maintenance

SUMMARY A self-report survey was used to collect data 18 months after the dissemination of a smoking cessation program to 23 antenatal clinics. Sixty-six percent of clinic staff (n = 187) completed and returned the survey. The study uses regres- sion modeling to examine the relationship between organ- izational characteristics, individual clinician characteristics and methods of dissemination on program awareness, adoption, implementation/maintenance and change in clinician smoking cessation intervention (SCI). The results indicated that participation in decision-making, working in a clinic at the time of the initial program dissemination, professional status and dissemination method were signifi- cant predictors of all stages of the dissemination process. Structural variables, e.g. policy, formalization of rules and organizational complexity, influenced early dissemination processes, e.g. awareness and adoption. Perceived hospital innovativeness and the degree to which smoking inter- vention was used in a clinic prior to dissemination were associated with program adoption. Clinician self-efficacy was associated with program maintenance and improved smoking cessation intervention.