A pilot study to establish a randomized trial methodology to test the efficacy of a behavioural intervention.
How can pregnant women be helped to stop smoking? This was a pilot study of midwife home-based motivational interviewing. Clients were 100 consecutive self-reported smokers booking at clinics in Glasgow from March to May 1997. Smoking guidance is routinely given at booking. In addition, intervention clients received a median of four home-based motivational interviewing sessions from one specially trained midwife. All sessions (n = 171) were audio-taped and interviews (n = 49) from 13 randomly selected clients were transcribed for content analysis. Three 'experts' assessed intervention quality using a recognized rating scale. Cotinine measurement on routine blood samples confirmed self-reported smoking change from late pregnancy telephone interview. Postnatal telephone questionnaire measured client satisfaction. Focus groups of routine midwives explored acceptability, problems and disruption of normal care. Fisher exact, chi 2 and Mann-Whitney tests compared enrolment characteristics. Two-sample t-tests assessed outcome between groups. Motivational interviewing was satisfactory in more than 75% of transcribed interviews. In this pilot study, self-reported smoking at booking (100 of 100 available) corroborated by cotinine (93 of 100) compared with late pregnancy self-reports (intervention 47 of 48; control 49 of 49) and cotinine (intervention 46 of 48; control 47 of 49) showed no significant difference between groups. Tools have been developed to answer the question: 'Can proactive opportunistic home-based motivational interviewing help pregnant smokers reduce their habit?'.
Tappin
D M
DM
Scottish Cot Death Trust, Royal Hospital for Sick Children, Yorkhill, UK.
Lumsden
M A
MA
McIntyre
D
D
Mckay
C
C
Gilmour
W H
WH
Webber
R
R
Cowan
S
S
Crawford
F
F
Currie
F
F
D000328:Adult; D002755:Choice Behavior; D003376:Counseling; D005260:Female; D015438:Health Behavior; D006801:Humans; D009042:Motivation; D009721:Nurse Midwives; D009723:Nurse-Patient Relations; D010043:Outcome and Process Assessment, Health Care; D010865:Pilot Projects; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D012606:Scotland; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*; D000074606:Smoking Prevention