TABLE 1

Characteristics of the included studies and critical appraisal, by author

First author [ref.]Study designCountrySetting; populationInterventionSummary of appraisal
RvRVA
Aghi [49] #Qualitative study within an RCTIndiaPublic urban and rural schools; health educators, lead teachers and staffTobacco cessation+±
Aldinger [65]Qualitative (institutional ethnography)ChinaPrimary to vocational schools; administrators, staff, teachers, students, and parentsTobacco prevention within programme of health-promoting schools± 1±±+
Aldinger [66]Qualitative (institutional ethnography)ChinaPrimary to vocational schools; administrators, staff, teachers, students and parentsTobacco prevention within programme of health-promoting schools+±+
Asfar [64]Qualitative study within an RCTSyriaPrimary healthcare setting; physicians and medical studentsTobacco cessation+ 1?±
Assanangkornchai [82]Qualitative (action research)ThailandPrimary healthcare setting; healthcare workers (nurses, administrators, directors)Tobacco, alcohol and substance use screening and brief intervention± 1±±+
Bheekie [60]Qualitative study preparing for an RCTSouth AfricaPrimary healthcare setting; trained nurses, with a supervisory position as care coordinatorsTrain-the-trainer programme on implementation of respiratory guidelines on (obstructive) lung diseases+++±
Bteddini [63]Mixed-method, with quantitative survey and participatory approach for qualitative dataLebanonSeven public and seven private schools throughout the country; trained external facilitators training 10 sessions for 844 studentsWaterpipe smoking prevention/delay of starting to smoke± 1+++
Castaldelli-Maia [51]QualitativeBrazilUrban psychosocial care units (primary care) across the country; diverse health professionals (e.g. dentist, nurses, physicians, managers)Tobacco cessation+ 1±?±
Chatterjee [70]QualitativeIndiaRural villages; community members (programme managers, coordinators, health workers and stakeholders at village level)Tobacco-free village+ 1±±+
Cruvinel [52]Quantitative, survey design (correlations)BrazilUrban, primary healthcare; 149 diverse workers (e.g. community health workers, nurses, physicians)Training on tobacco, alcohol and drug use screening and brief intervention±++±
Elsey [78]Mixed-method, factors derived from qualitative data (action research)NepalUrban and rural primary healthcare; patients, healthcare providers, managers and policy makersTobacco cessation, behaviour support+ 1+++
Goenka [71]+Mixed-method study within an RCTIndia32 Urban, public and private schools; professionals with a Master's degree in psychology, sociology or nutrition who taught teachers and peer leadersTobacco prevention by teachers and peer-leaders±+±±
Groth-Marnat [85]QualitativeFijiTraditional village; community membersTobacco cessation+ 1±?±
Ishaak [58]Mixed-method, factors derived from qualitative dataSurinameUrban junior high school; management and teachersTobacco and other drug prevention±±±±
Khan [80]Mixed-method, embedded in RCT, factors derived from qualitative dataPakistan30 Primary and secondary level public healthcare facilities; care providers (15 received intervention, interviews in 4 of the centres)Integrated COPD/asthma care+ 1+++
Malan [61]QualitativeSouth AfricaPrimary care practice; care providers (nurses and physicians)Brief behaviour change counselling (“5As”) for tobacco, diet, physical activity and alcohol abuse± 1+++
Marsiglia [57]Qualitative for the factors reported, within a quantitative studyMexicoUrban public middle schools; teachersTobacco and other substance use prevention±?
Mash [62]Qualitative, prospective (outcome mapping)South AfricaUrban and rural, primary care to specialised care with a focus on the public sector; doctors, clinical nurse practitioners, pharmacists, National Council for Medical Schemes, the Department of Health, universities and training bodies patientsAsthma-guideline implementation and dissemination+ 1±?±
McAlister [81]Qualitative for the factors reported, within a quantitative studyRussiaCommunity level; hospital staff, intervention for community smokersStop smoking campaign+±?±
Medeiros [53]Mixed-methods, factors derived from qualitative dataBrazilUrban schools; teachers, school administrators, coaches, other stakeholders (e.g. municipality) and studentsTobacco prevention within a drug use prevention programme±+++
Mehanni [79]QualitativeNepalSmall rural hospital (managed through a public-private partnership)Quality improvement initiative for management of COPD+?±
Melson [77]Mixed-methods within pilot RCT; factors derived from qualitative data (quantitative data n.a., regard hypothetic factors prior to implementation). Pro- and retrospectiveMalaysiaSecondary school; studentsPeer-led anti-smoking intervention (smoke-free class)+ 1+++
Nagler [72]#Qualitative, formative pilot study preparing for an RCTIndiaOne public urban and one rural school, not included in the RCT; health educators and teachersTobacco cessation – school based±++±
Nichter [73]QualitativeIndia & IndonesiaLead public & private medical schools and outreach to their communitiesTraining network for tobacco prevention (curricula), outreach and clinic on smoking cessation+ 1?±
Ossip [56]Qualitative (Rapid Assessment Process)Dominican RepublicUrban, peri-urban & rural communities with active Community Technology Centers; a multidisciplinary team including specialists of psychology, anthropology, nursing, epidemiology, statistics and public health (from the US) and medicine (DR)Tobacco cessation – participatory approach+ 1±?±
Pawar [50]#Qualitative factors reported within a quantitative study, embedded in an RCTIndia72 Public urban and rural schools; health educators, lead teachers and staffTobacco cessation - lay interventionist teaching teachers±?
Pereira [54]Quantitative, population-based cross-sectional survey designBrazilUrban public and private schools; 263 school managers (headmasters, pedagogical coordinators, coordinators of the prevention programmes)Tobacco prevention within a drug use prevention programme± 1+±±
Perry [74]+Qualitative study (translational research) within an RCT following translational researchIndia32 urban schools, half were public and half were private; school administration, teachers, and peer-leadersTobacco prevention± 1?±
Persai [75]QualitativeIndiaAt district level; senior district officialsTobacco control± 1+++
Portes [55]Qualitative, retrospectiveBrazilUrban primary healthcare units in a medium-sized municipality; municipal programme coordinator, and senior health professionals trained on smoking cessation or local managersTobacco control – training healthcare professionals on facilitating treatment & prevention activities (Furthermore, interventions on governmental level, n.a. to our study)+ 1+++
Prasodjo [76]Mixed-method, factors derived from qualitative data (amongst which participatory action research)IndonesiaRural community; local institutions (policy makers, medical staff, community leaders and other stakeholders)Post-partum smoke (‘Sei’) traditions – Behavioural change communication campaign targeting household air pollution+±±
Rosati [83]Mixed-methods, factors derived from qualitative dataThailandUrban family setting; health educators towards familiesTobacco, alcohol and other substance abuse prevention, sex education± 1±±±
Sodhi [59]Mixed-methods, factors derived from qualitative dataMalawi30 urban and rural, government-funded and non-government funded health centres; primary healthcare workers: clinical officers, medical assistants, and nursesTrain-the-trainer on guideline use for providing integrated primary lung healthcare± 1±±+
Vitavasiri [84]Quantitative questionnaireThailand676 Thai hospitals; personnelSmoke-free hospitals+ 1?
Wang [67]QualitativeChinaCounty-level hospitals; health professionals, hospital president, director of preventive health, representatives of the hospitalsSmoke-free hospitals+ 1+++
Xiao [68]Mixed-method, factors concerned qualitative dataChina41 Hospital across the country, the majority from a tobacco control network; medical doctors and directorsSmoke-free hospitals± 1?+
Ziedonis [69]QualitativeChinaHospital-based mental health centre; personnel and patientsSmoke-free hospitals+ 1?±

Studies were prospective unless otherwise indicated. Rv: relevance; R: reliability; V: validity; A: applicability to a wider public health context. RCT=randomised controlled trial. Scored in appraisal as: +: high; ±: medium; −

: low; ?: unclear. Relevance '1': Evaluation of implementation was a primary outcome of the article. Articles with matching footnote indicators are from the same study. #: findings from Aghi et al. were excluded from the analysis, as Pawar et al. based their findings on the same study data and had higher appraisal scores. Nagler et al. based findings on a different study data (pilot study) and was included. +: findings from both studies were included as these were based on different study data.