189936 Assessment of an interventional tobacco dependence pilot program for pregnant women seeking care at an OB/GYN clinic in Newark, NJ

Monday, October 27, 2008

Heather M. Jordan, MPH, CHES, CTTS , Tobacco Dependence Program, School of Public Health, University of Medicine and Dentistry, Newark, NJ
Vasudha Nekkanti, MPHc , School of Public Health, University of Medicine and Dentistry, Newark, NJ
This study pilot-tested a tobacco dependence support group launched for pregnant smokers at an OB/GYN clinic in Newark, NJ. This study had four specific objectives:

#1) Determine the number of women who self-identify as recent quitters or current smokers among the clinic's pregnant population.

#2) Conduct a process evaluation of a pilot tobacco dependence support group intervention.

#3) Document self-reported smoking cessation rates among support group participants.

#4) Determine if support group participation changed knowledge, skills, beliefs about tobacco use.

Methods: To meet Objective #1, the research team tabulated frequencies based on self-reported data collected from a screening tool. To meet Objective #2, the research team conducted a feasibility study of a pilot support group intervention among self-identified pregnant smokers and recent quitters. The research team developed a process evaluation tool to obtain participant feedback about the intervention. To meet Objective #3, the research team assessed smoking cessation rates at 1- and 4-weeks post-intervention via a 7-day point prevalence estimate. To meet Objective #4, the research team analyzed data from a pre- and post-test assessing changes in knowledge, attitudes, beliefs.

Results: 14.6% of pregnant women seeking care at the clinic smoke; 23.1% quit after discovering they were pregnant. Due to poor support group participation rates, a few pregnant smoking women received prenatal obstetrician appointments and invited to attend one-to-one smoking cessation appointments. An insufficient amount of data was collected to analyze changes in knowledge, attitudes, beliefs.

Conclusions: The feasibility of a tobacco dependence support group for pregnant women in a busy OB/GYN clinic is questionable, considering the poor attendance of invited, eligible individuals. A change in delivery of tobacco dependence support is warranted and may include changing the format from a weekly, invitation-only group intervention to an obstetrician appointment-driven “piggy back” format. Furthermore, self-reported data may underestimate current smoking rates.

Learning Objectives:
1. Assess the feasibility of a support group for tobacco dependence among pregnant women in a high-patient volume clinic setting 2. Apply health educational models and precepts of behavior change to eliminate tobacco use among pregnant patient population 3. Identify and articulate any necessary amendments to standard care procedures and policies based upon clinic data of tobacco use among pregnant patient population

Keywords: Prenatal Interventions, Tobacco

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted the health services research underlined in the abstract as part of fieldwork project requirements for University of Medicine and Dentistry's public health degree program. I have worked as a research assistant for the Tobacco Dependence Clinic, Newark, NJ from March 2007 to present. Furthermore, I have also received Certified Tobacco Treatment Specialist training through the Tobacco Dependence Program, New Brunswick, NJ.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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