| Summary: | Introduction
Smoke-free workplaces are considered an important part of tobacco
control strategies. The purpose of this study was to evaluate implementation fidelity
and explore the significance of social and contextual factors for the implementation
of a strict smoke-free workplace intervention in a large Danish medical company.
Methods
The UK Medical Research Council’s guidance for process evaluation was
used as a framework. Data were collected from approximately six months before
the implementation until ten months after (2019–2020). A mixed method study
design was used (a survey of 398 employees, a focus group of four employees
and field visits on two days). Data were analyzed separately and later integrated
through triangulation. We used the Fisher’s exact test in the analysis of the
questionnaire.
Results
We assessed the implementation fidelity through four key factors: reach, dose
and delivery, mechanisms of change, and context for the intervention components.
Despite compliance issues, the policy component had high implementation fidelity.
However, the implementation fidelity of the smoking cessation support component
was low. We identified three social mechanisms influencing the employees’
responsiveness towards the policy: expectation, the social aspect of the smoking
facilities, and management leadership. COVID-19 was identified as the main
contextual factor affecting the implementation.
Conclusions
Although not all elements of the intervention components were
implemented as planned, the strict smoke-free workplace intervention is considered
implemented. Further strategies can be initiated to raise implementation fidelity
through better communication concerning the cessation support component,
compliance, and enforcement of the policy.
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