This study evaluates the effectiveness of two levels of a pediatric intervention on smoking cessation and reduction for mothers of newborn babies. At the hospital after delivery, Minimal Intervention mothers will receive a brief message on the risks of smoking and of passive smoke exposure on the infant and a packet of materials. The Extended Intervention involves using regularly scheduled pediatric office visits during the first six months as opportunities to have pediatricians provide advice and materials to mothers about quitting smoking. This study evaluates the effectiveness of using the birth of a child as a """"""""teachable moment"""""""" to motivate mothers to reduce or quit smoking. In addition it will also assess reduction in passive smoke exposure in infants. Secondary aims of the project involve identifying variables that are related to changes in smoking status for mothers of newborns, assessing mothers' knowledge and attitudes regarding health effects of passive smoke exposure, and determining the cost effectiveness of both levels of the intervention. The study will enroll 1, 988 mothers of newborns who report current smoking or smoking prior to their last pregnancy. The two cell nested design involves random assignment of 40 pediatric practice groups to minimal or extended intervention after being matched by location and size of practice. The study involves four phases. In Phase One, written and video materials for the Extended Intervention will be developed, field-tested, and piloted, as well as recruitment of pediatricians. Phase Two of the study involves training pediatricians and their staff to carry out the enrollment and intervention, as well as actual implementation of the intervention. The intervention lasts six months for each mother. Phase Three involves assessment at 6 months (end of treatment) and at 12 months on smoking cessation efforts and passive smoke exposure. Non-respondents will be assessed by a phone interview. Additionally, a two-month phone survey on a 20% random sample of the Extended Intervention subjects will monitor provider adherence. Phase Four involves development of a training video and implementation manual to promote widespread dissemination. Also, pediatricians will be assessed on consumer satisfaction and self-efficacy measures and all pediatric practices will be provided materials for continuing the Extended Intervention.
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| Severson, H H; Andrews, J A; Lichtenstein, E et al. (1995) Predictors of smoking during and after pregnancy: a survey of mothers of newborns. Prev Med 24:23-8 |
| Severson, H H; Zoref, L; Andrews, J et al. (1994) Reducing environmental tobacco smoke (ETS) exposure for infants: a cessation intervention for mothers of newborns. Am J Health Promot 8:252-3 |
| Sheeshka, J D; Woolcott, D M (1994) An evaluation of a theory-based demonstration worksite nutrition promotion program. Am J Health Promot 8:263-4, 253 |
