Tobacco prevention & cessation
Adapting and implementing very brief advice+ (VBA+) in primary care to promote adolescent smoking cessation in Kyrgyzstan: A mixed-methods FRESHAIR4Life study
By van Koeveringe JM, Mirzalieva G, Taalaibekova A and 11 others.
Abstract
Introduction
Tobacco-related morbidity and mortality are increasingly shifting toward low- and middle-income countries (LMICs), with most smokers beginning during adolescence. In Kyrgyzstan, adolescent-specific cessation services are not yet systematically integrated into primary care. This study aimed to culturally and contextually adapt Very Brief Advice Plus (VBA+) to the local context, implement the intervention, and evaluate healthcare professionals' implementation behaviors and determinants following training.
Methods
This mixed-methods implementation study was conducted in six Family Medicine Centers in Kyrgyzstan as part of FRESHAIR4Life (2023-2026). VBA+ was adapted for adolescents (aged 14-21 years) through iterative stakeholder reviews to ensure contextual relevance. In total, 56 healthcare providers (HCPs) participated in the study and completed the Determinants of Implementation Behavior Questionnaire (DIBQ) to assess changes in implementation determinants following training on a five-point Likert scale. Qualitative data were collected through semi-structured interviews with 16 HCPs and analyzed using a framework approach, with deductive coding informed by the Theoretical Domains Framework and inductive coding to explore HCPs' experiences in delivering the intervention.