To assess possible factors mediating the implementation of the TUPAC guidelines, we developed a questionnaire based on both the theoretical-domains framework [15 (link)] and the Finnish Current Care guidelines on TUPAC counselling [8 ]. The goal of the TDQ development was to measure each of the 12 domains, as well as the related key constructs within each domain.
First, we conducted a systematic literature review of published questionnaires on TUPAC counselling from PubMed using the following search terms: Topic = (tobacco OR smoking) AND Topic = (counselling OR counseling) AND Topic = (questionnaire OR survey) AND Topic = (dentist OR 'dental hygienist' OR hygienist OR nurse OR physician OR doctor OR 'healthcare provider' OR 'health care provider' OR 'general practitioner'). Of 1,240 articles (by 31 January 2009), we found about 60 different questionnaires that had served to assess the implementation of TUPAC guidelines among healthcare providers. Second, we contacted corresponding authors to request use of their questionnaire. Of the 25 questionnaires received, we found four questionnaires to be the most suitable, as they covered a wide range of implementation difficulties among healthcare providers [19 (link)-22 (link)]. Of these questionnaires, we assigned items under appropriate theoretical domains according to component constructs and elicited questions provided by the consensus group [15 (link)]. Because there were too few appropriate items for all domains, we created additional items (see Additional File1 ). To maximise the chance that items reflect the main component constructs of each domain while keeping the questionnaire as short as possible, we sought the advice of experts on behaviour change and tobacco dependency treatment. The final version of the questionnaire consisted of 35 items (two to six items per domain) and covered the following 10 domains: knowledge; skills; professional role and identity; beliefs about capabilities; beliefs about consequences; motivation and goals; memory, attention, and decision processes; environmental context and resources; social influences; and emotion.
The questionnaire was developed in English, then translated and back-translated by independent translators (English-Finnish-English and English-Swedish-English) by Language Services, University of Helsinki. If differences between the original and the back-translated versions appeared, the questionnaire underwent a further round of back-translation until the versions showed satisfactory agreement. The questionnaire was piloted among a sample of dentists and dental hygienists (n = 30) working in municipal dental clinics in Helsinki, Finland. Piloting indicated that the providers understood and received the questionnaire well, and no changes were necessary.
We decided to exclude the domain behavioural regulation because in the context of community dental settings, the component constructs of behavioural regulation, such as goal/target setting, goal priority, feedback, project management, and barriers and facilitators [15 (link)], showed too much overlap with the domain environmental context and resources and were mediated mainly by the clinical environment and chief dental officers. Thus, this domain was considered less important that it would be in other settings, such as in private clinics. The domain nature of behaviour was also excluded, as it relates more to an understanding of the behaviour itself than to influences on behaviour [23 ]. A list of the domains, constructs, and items appear in Additional File2 .
First, we conducted a systematic literature review of published questionnaires on TUPAC counselling from PubMed using the following search terms: Topic = (tobacco OR smoking) AND Topic = (counselling OR counseling) AND Topic = (questionnaire OR survey) AND Topic = (dentist OR 'dental hygienist' OR hygienist OR nurse OR physician OR doctor OR 'healthcare provider' OR 'health care provider' OR 'general practitioner'). Of 1,240 articles (by 31 January 2009), we found about 60 different questionnaires that had served to assess the implementation of TUPAC guidelines among healthcare providers. Second, we contacted corresponding authors to request use of their questionnaire. Of the 25 questionnaires received, we found four questionnaires to be the most suitable, as they covered a wide range of implementation difficulties among healthcare providers [19 (link)-22 (link)]. Of these questionnaires, we assigned items under appropriate theoretical domains according to component constructs and elicited questions provided by the consensus group [15 (link)]. Because there were too few appropriate items for all domains, we created additional items (see Additional File
The questionnaire was developed in English, then translated and back-translated by independent translators (English-Finnish-English and English-Swedish-English) by Language Services, University of Helsinki. If differences between the original and the back-translated versions appeared, the questionnaire underwent a further round of back-translation until the versions showed satisfactory agreement. The questionnaire was piloted among a sample of dentists and dental hygienists (n = 30) working in municipal dental clinics in Helsinki, Finland. Piloting indicated that the providers understood and received the questionnaire well, and no changes were necessary.
We decided to exclude the domain behavioural regulation because in the context of community dental settings, the component constructs of behavioural regulation, such as goal/target setting, goal priority, feedback, project management, and barriers and facilitators [15 (link)], showed too much overlap with the domain environmental context and resources and were mediated mainly by the clinical environment and chief dental officers. Thus, this domain was considered less important that it would be in other settings, such as in private clinics. The domain nature of behaviour was also excluded, as it relates more to an understanding of the behaviour itself than to influences on behaviour [23 ]. A list of the domains, constructs, and items appear in Additional File
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