Project 3 focuses on (a) public health care services as a channel to reach low-income, less-educated female smokers of child-bearing age; and (b) understanding formation of and changes in motivation to quit smoking among this more economically disadvantaged segment of the program project's target population. Project 3 will: 1. develop, implement, and evaluate a smoking cessation motivation intervention for women smokers in prenatal, family planning, and well- child public health clinics in metropolitan Chicago. The intervention will be evaluated in a matched-pair experimental design study in 24 clinics, with 12 clinics assigned to a control condition (No Intervention) and 12 matched clinics assigned to the experimental (Motivational Intervention) condition. Baseline data will be collected from 2,400 smokers through a self-administered questionnaire at the time of the clinic visit. Follow-up interviews will be conducted at 1, 3, 6, 12, and 18 months after the initial clinic visit. The main evaluation outcomes are (a) increased motivation to quit, (b) increased readiness to quit, (c) action toward quitting (e.g., calling a telephone number for assistance, reducing smoking, attempting to quit), and (d) quitting smoking. 2. use the panel data collected in the baseline and follow-up interviews to analyze changes in motivation level and stages of readiness to quit smoking over time, including how they are affected by exposure to the clinic intervention and by personal events in the women's lives. 3. systematically assess the continued implementation and institutionalization of the experimental intervention in the 18 months following the end of the research-assisted period and identify clinic and program factors that facilitate or deter the implementation and institutionalization process.
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