141st APHA Annual Meeting

In This section

289242
Smoking among pregnant women receiving standard prenatal care compared to an enhanced model with health system navigation

Sunday, November 3, 2013

Diane L. Bishop, MPH , Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA
Saba Masho, MD, MPH, DrPH , Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, VA
Lori Keyser-Marcus, PhD , Department of Psychiatry, Virginia Commonwealth University, Richmond, VA
Sara Varner, BA , Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, VA
Dace Svikis, PhD , Departments of Psychology, Psychiatry and Obstetrics/Gynecology, Virginia Commonwealth University, Richmond
Background: Smoking during pregnancy is a serious and preventable problem that impacts both the mother and her children. Objective: This study compares the effectiveness of standard prenatal care to an intervention that supplemented standard prenatal care with Health System Navigation (HSN). Methods: Pregnant African-American women who received prenatal care at an urban university-affiliated medical center that largely provides services to an under-served population were randomized to receive either standard prenatal care (n=78) or standard prenatal care plus HSN (n=72). Questionnaires were completed at baseline, third trimester, and at two post-partum time points and included self-reported measures of smoking in the past seven days. Results: At baseline, intervention and control study participants were similar. At the third trimester and first post-partum assessment, 41.9% and 58.7% of the intervention group reported smoking compared to 53.8% and 70.0% of the control group, respectively. The prevalence of reported smoking at the second post-partum assessment was 72.3% in the intervention group and 76.9% in the control group. Compared to the control group, women who received navigation were more likely to quit smoking. However, the smoking rate increased postpartum, after completion of the intervention. Conclusion: Although not statistically significant, these findings highlight the need for continued intervention beyond prenatal care to facilitate a reduction of smoking among women.

Learning Areas:
Public health or related research

Learning Objectives:
Discuss the utility of an enhanced prenatal care model with Health System Navigation to help facilitate a reduction of smoking among women.

Keywords: Prenatal Interventions, Smoking

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am MPH trained and have worked in full-time research positions since 2003. I have been part of multiple epidemiologic research projects in the area of maternal and child health.
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.