# Boosting self-efficacy and improving practices for smoking prevention and cessation among South American cancer care providers with a web-based algorithm

## TL;DR

A web-based algorithm improved cancer care providers' confidence and practices in smoking prevention and cessation in Peru and Colombia.

## Contribution

A web-based algorithm was developed and tested to enhance smoking prevention and cessation practices among South American cancer care providers.

## Key findings

- CCPs showed significant improvement in self-efficacy and practices after using the web-based algorithm.
- The algorithm received a high usability score (82.9 on the SUS) and was well-received by participants.
- Four key themes emerged from focus groups, including resource limitations and suggestions for improvement.

## Abstract

Digital technologies have positively impacted the availability and usability of clinical algorithms through the advancement in mobile health. Therefore, this study aimed to determine if a web-based algorithm designed to support the decision-making process of cancer care providers (CCPs) differentially impacted their self-reported self-efficacy and practices for providing smoking prevention and cessation services in Peru and Colombia.

A simple decision-making tree algorithm was built in REDCap using information from an extensive review of the currently available smoking prevention and cessation resources. We employed a pre-post study design with a mixed-methods approach among 53 CCPs in Peru and Colombia for pilot-testing the web-based algorithm during a 3-month period. Wilcoxon signed-rank test was used to compare the CCPs’ self-efficacy and practices before and after using the web-based algorithm. The usability of the web-based algorithm was quantitatively measured with the system usability scale (SUS), as well as qualitatively through the analysis of four focus groups conducted among the participating CCPs.

The pre-post assessments indicated that the CCPs significantly improved their self-efficacy and practices toward smoking prevention and cessation services after using the web-based algorithm. The overall average SUS score obtained among study participants was 82.9 (± 9.33) [Peru 81.5; Colombia 84.1]. After completing the qualitative analysis of the focus groups transcripts, four themes emerged: limited resources currently available for smoking prevention and cessation in oncology settings, merits of the web-based algorithm, challenges with the web-based algorithm, and suggestions for improving this web-based decision-making tool.

The web-based algorithm showed high usability and was well-received by the CCPs in Colombia and Peru, promoting a preliminary improvement in their smoking prevention and cessation self-efficacy and practices.

The online version contains supplementary material available at 10.1186/s13722-024-00462-w.