The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65386

Rebecca Donatelle, PhD, CHES¹, L. Deanne Hudson, RN, MPH, CHES¹, Susan Dobie, MA, CHES², and Monica L. Hunsberger, MPH³. (1) Department of Public Health, Oregon State University, 306 Waldo Hall, Corvallis, OR 97331-6406, (2) Division of Health, PE and Leisure Service, University of Northern Iowa, 203 Wellness and Recreation Center, Cedar Falls, IA 50613, 319-273-5930, susan.dobie@uni.edu, (3) Public Health, Oregon State University, Waldo Hall #264, Corvallis, OR 97331

The MISS Project (Maternal Interventions to Stop Smoking) is a randomized controlled trial testing the effectiveness of a 5 A’s approach in conjunction with contingency management/rewards to motivate women to stop smoking and to reinforce tobacco cessation, monthly, during pregnancy. Data were collected between February 2001 and February 2002 from prenatal care providers (CNMs and Obstetricians) across ten practices in Oregon prior to the implementation of the MISS Project. Prior to receiving 5 A’s training to deliver the MISS Project intervention, the providers completed a 17-question self-administered questionnaire describing their “usual practice” in delivering smoking cessation advice, information, assistance and referral to their pregnant, smoking patients. Training consisted of a 5 A’s Best Practice protocol based on the AHRQ/ACOG/DHHSPHS Clinical Practice Guideline. The results provide valuable information about the concerns/issues of prenatal care providers when implementing a Best Practice 5A’s approach to smoking cessation. Providers were asked to list their top three concerns about delivering tobacco cessation advice. Identified barriers included the following: time constraints, feelings of futility, lack of knowledge of available community resources/supports, lack of patient receptiveness, lack of practical strategies, and hesitation to “nag” their patients. The discussion includes the association between these barriers and the following: 1) the amount of time (in minutes) the provider indicated he/she currently spent encouraging prenatal smokers to quit smoking, and 2) the self-described priority the provider placed on delivering smoking cessation advice/information during pregnancy.

Learning Objectives:

• At the conclusion of this session, participants will be able to list 3 factors influencing implementation of a 5 A's Best Practice strategy.
• At the conclusion of this session, participants will be able to describe the importance of understanding both real and perceived barriers in implementing a 5 A's Best Practice approach.
• At the conclusion of this session participants will be able to identify 3 alternative strategies designed to enhance success of a provider-delivered smoking cessation message to low income, high-risk women

Keywords: Smoking Cessation, Prenatal Interventions

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.