Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #116782

Timothy Jordan, PhD, MEd¹, James. H Price, PhD, MPH¹, and Joseph A. Dake, PhD, MPH². (1) Department of Public Health, University of Toledo, 2801 W. Bancroft, Toledo, OH 43606, 419-530-4725, tjordan2@utnet.utoledo.edu, (2) Division of Health, Wayne State University, 262 Matthaei Bldg., Detroit, MI 48202

Purpose: To examine Ohio nurse midwives' perceptions and use of an evidence-based smoking cessation protocol (5 A's – ask, advise, assess, assist, and arrange) and NRT for pregnant smokers. Methods: A random sample of 300 nurse midwives was sent a valid and reliable 25-item confidential questionnaire. After a three wave mailing, 67% responded. Results: Virtually all (97%) of the nurse midwives indicated they regularly asked pregnant patients about their smoking status. Of 10 items assessing the use of 5 A's, 4 were done by the majority of respondents. While few perceived there were barriers to counseling pregnant smokers, the most common were lack of time (14%) and not knowing where to send the pregnant smoker for treatment (14%). The respondents (74%) believed that nicotine replacement therapy (NRT) would be the most effective activity to reduce pregnant smoking, yet few (26%) were confident in their ability to prescribe/recommend NRT. Nurse midwives more likely to use the 5 A's techniques were characterized by: fewer perceived barriers in talking with pregnant smokers; higher perceived efficacy expectations in their ability to communicate issues about the 5 A's; and higher outcome expectations regarding the effects of using the 5 A's. Conclusion: While nurse midwives asked about smoking status and encouraged cessation, most did not follow 5 A's recommendations regarding: arrangement of social support, presentation of cessation materials, cessation counseling, prescription/referral for NRT, follow-up contact after quit date, nor referral to outside agencies for assistance. Midwife education would benefit from the inclusion of 5 A's training.

Learning Objectives:

• Describe nurse midwives' use of the 5 A's and NRT regarding pregnant smokers.
• Describe nurse midwives' perceived self-efficacy in counseling pregnant smokers.
• Describe nurse midwives' perceived barriers to counseling pregant smokers.

Keywords: Smoking Cessation, Nurses

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.