DESCRIPTION: Smoking cessation during pregnancy remains an elusive
public health goal. For poor and undereducated women, smoking may not
be a priority in light of other pressing life issues. The proposed
research evaluates the role of outreach health nurses in delivering a
novel smoking intervention to poor, high-risk pregnant women. The
smoking intervention will be conducted in the context of the Healthy
Baby Program (HBP), an innovative community based outreach program that
addresses basic life needs and medical care issues for pregnant women.
A quasi-experimental design will evaluate the impact of a motivational
intervention delivered via a well-established resource to reach women
who would not typically present themselves for smoking interventions.
A home visitation model will be used to deliver motivational and skills-
based intervention components designed to increase women's awareness of
smoking's impact on the fetus, their own health, and their household
The motivational intervention includes measurement and personalized
feedback about the woman's pulmonary function and carbon monoxide, her
household nicotine concentration, and linkages to the health care
system. The control group receives usual care, as currently delivered
by the HBP staff. Both groups will be followed for 12 months post-
partum. The primary outcome is reduction in 7-day point prevalence
smoking status. Secondary and intermediate outcomes include reduction
in household nicotine concentrations, movement in stages of change, and
smoking cessation attempts. Results will test the outcome and cost-
effectiveness of a motivational intervention delivered via an existing
social service program.
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