Economically disadvantaged pregnant women are both more likely to smoke prior to becoming pregnant and less likely to quit during pregnancy than other women of childbearing age. Even when they do quit during pregnancy, they are likely to relapse postpartum. Therefore, pregnancy and the postpartum period is an important window of opportunity for interventions to motivate these women and accelerate their progress toward smoking cessation. Reducing smoking in pregnancy and postpartum would serve to reduce health risks for two individuals, mother and child. The proposed study is designed to develop, implement, and evaluate the impact of a stage-matched, individualized, multicomponent, multichannel intervention tailored for economically disadvantaged pregnant women compared to a standard care condition. The Stage-Matched Intervention will be based on existing theoretical concepts and behavior change techniques of the Transtheoretical model and is designed to accelerate progress toward smoking cessation in pregnant women. This intervention will be delivered in an integrated manner through two channels, the home and the community health clinic, and will involve multiple components, including expert system generated feedback reports, self-help manuals, and counseling. The stage-matched intervention will be provided on three occasions during pregnancy and once during the post-partum period.
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