Nursing Smoking Cessation Intervention During Pregnancy

孕期戒烟护理干预

• 批准号: 6369419
• 负责人: LINDA F.C. BULLOCK
• 金额: $ 50.31万
• 依托单位: UNIVERSITY OF MISSOURI-COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-08-01 至 2005-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6369419
• 关键词: behavioral /social science research tag; clinical research; coping; embryo /fetus toxicology; female; human pregnant subject; human therapy evaluation; low socioeconomic status; nicotine; nursing intervention; pregnancy; prenatal care; saliva; smoking; smoking cessation; social support network; stressor; telemedicine; tobacco abuse education; violence; women's health

Problems related to smoking during pregnancy are entirely preventable. The imminent danger of smoking to mothers (i.e. abruptio placentae) and unborn children (i.e. low birthweight) calls for prompt and intensive intervention. Reasons for continued smoking during pregnancy vary by age and income. In this proposed study's low-income population, the most likely group to smoke throughout pregnancy, women suffer from stressful events in their lives, which they cite as difficult barriers to smoking cessation. Social support has been shown to be beneficial in general for coping with problems. AHCPR smoking guidelines call for a social support component in cessation programs that is delivered by healthcare providers. Unfortunately, the guidelines' recommendations for social support focus narrowly on smoking related problems alone. For low-income pregnant women, this tight focus means healthcare providers may not touch on the very topics that are key to their quitting smoking. Nurses' skills in assessment and providing support are extremely well matched to delivering the help women need to quit smoking during pregnancy. This study's primary aim is to determine whether a combination of an established smoking cessation educational program for pregnant women and a nurse- delivered telephone social support intervention (weekly telephone calls as well as having 24-hour pager access to research nurses) will increase pregnant womens' smoking cessation or smoking reduction rates. A sample of pregnant women who smoke will be recruited from WIC clinics in central Missouri. The outcome measure will be saliva cotinine values collected repeatedly every month from enrollment in the study until the last month of pregnancy. A secondary aim of the study will be to determine the prevalence of relapse among the women who quit smoking, when the relapse occurs, and associated stressors. A randomized controlled trial of four groups will be conducted using a repeated measures 2x2 factorial design with two levels of education (Present or Absent) and two levels of nurse-delivered telephone social support (Present or Absent). To determine significant group differences in quit rates, Chi-square analysis for each month will be used. A fixed-effects repeated measure ANOVA will be used to determine significant group differences in reduction in smoking and survival analysis will detect if there are significant group differences in time to relapse.

怀孕期间与吸烟有关的问题是完全可以预防的。 迫在眉睫的母亲（即胎盘胎盘）和未出生的儿童（即低出生体重）的迫在眉睫的危险要求迅速而密集的干预。怀孕期间继续吸烟的原因因年龄和收入而异。 在这项拟议的研究的低收入人群中，在整个怀孕期间最有可能吸烟的群体，妇女遭受生活中压力大的事件，她们认为这是戒烟的困难障碍。 社会支持已被证明对应对问题是有益的。 AHCPR吸烟指南要求医疗保健提供者提供的戒烟计划中的社会支持部分。不幸的是，该指南的社会支持建议仅关注与吸烟有关的问题。 对于低收入孕妇而言，这种紧密的重点意味着医疗保健提供者可能不会涉及戒烟关键的主题。 护士在评估和提供支持方面的技能与在怀孕期间提供戒烟所需的帮助非常匹配。 这项研究的主要目的是确定针对孕妇的固定戒烟教育计划与护士交付的电话社会支持干预措施（每周电话以及与研究护士的24小时Pager访问）是否会增加孕妇的吸烟戒烟或降低吸烟率。 将从密苏里州中部的WIC诊所招募吸烟的孕妇样本。 结果措施将是从研究入学到怀孕最后一个月，每月反复收集的唾液可替宁值。 该研究的次要目的是确定戒烟，复发以及相关压力源时戒烟的妇女复发的普遍性。 将使用重复测量的2x2阶乘设计进行四组的随机对照试验，并具有两个级别的教育（目前或缺席）和两个保养的电话社会支持（目前或缺少）。 为了确定退出率的显着群体差异，将使用每个月的卡方分析。 固定效应重复测量方差分析将用于确定吸烟减少的群体差异和生存分析的显着群体差异将检测是否存在明显的复发时间差异。