Thesis Defence: A Systematic and Theory-Based Approach to Co-Developing a Tailored Smoking Cessation Intervention for Persons With Spinal Cord Injury

Kelsey Wuerstl, supervised by Dr. Heather L. Gainforth, will defend their dissertation titled “A Systematic and Theory-Based Approach to Co-Developing a Tailored Smoking Cessation Intervention for Persons With Spinal Cord Injury” in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Kinesiology.

An abstract for Kelsey Wuerstl’s dissertation is included below.

Examinations are open to all members of the campus community as well as the general public. Registration is not required for in-person defences.

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ABSTRACT

Persons with spinal cord injury (SCI) report high cigarette smoking rates and few relevant smoking cessation services, which may contribute to poor health outcomes and quality of life. Tailored smoking cessation interventions for persons with SCI are needed to address these tobacco use and health promotion inequities. Using an Integrated Knowledge Translation approach, this dissertation aimed to co-develop a theory-based smoking cessation intervention for persons with SCI that an SCI organization can deliver. The four studies of this dissertation are framed within Phase I (Design) of the ORBIT Model and follow a systematic process guided by the Behaviour Change Wheel and the Knowledge-to-Action cycle. The first study was a cross-sectional and secondary analysis of the Study of Health and Activity in People with SCI survey data to explore demographic, behavioural, and health differences between persons with SCI who smoke and do not smoke. Second, a scoping review guided by the Behaviour Change Intervention Ontology identified the theoretical and intervention components of smoking cessation interventions for persons with physical disabilities. The third study was a World Café conducted with staff of an SCI organization exploring strategies to improve the relevance and usefulness of a tailored smoking cessation intervention for persons with SCI. The fourth study convened a multidisciplinary panel of researchers and research users to co-develop a smoking cessation intervention for persons with SCI based on the findings from the first three studies. The resulting intervention outlines recommendations for how to have a conversation and what to say during a conversation about smoking cessation with individuals with SCI. The intervention was designed to be delivered by SCI peer health coaches in an SCI community organization. The findings of this dissertation suggest a theory-based smoking cessation intervention grounded in Motivational Interviewing and targets self-efficacy, social influences, and behavioural regulation may be a promising approach to support smoking cessation among this equity-seeking population. The partnered and systematic process presented in this dissertation may result in an intervention that is more likely to be effective, relevant, feasible to implement and lead to improvements in health and quality of life for persons with SCI.