title: Psychosocial and spiritual factors associated with smoking and substance use during pregnancy in African American and White low-income women.
abstract: OBJECTIVE
  To determine the associations between sociodemographic, psychosocial, and spiritual factors to health risk behaviors during pregnancy in African American and White low-income women.
  
  
  METHODS
  Descriptive, using prenatal interviews and medical record review as data sources.
  
  
  METHODS
  An urban prenatal clinic in the Midwestern United States.
  
  
  METHODS
  One hundred thirty ethnically diverse low-income women.
  
  
  METHODS
  Smoking and substance use in pregnancy.
  
  
  RESULTS
  For the total sample, 39% reported smoking and 28% reported substance use in pregnancy. Significant predictors of smoking were White race, less than high school education, abuse, and religiosity. Abuse and depressive symptoms predicted substance use. African American women were significantly less likely to report smoking in pregnancy (28%) than were White women (55%) (p < .05). African American women who smoked during pregnancy were significantly more likely to report lower levels of education (p < .01), less social support from others (p < .01) and total social support (p < .01), higher levels of stress (p < .05), and more frequent substance use (56.5%) than African American women who did not smoke (12%) (p < .001). White women who used substances were significantly more likely to report smoking (p < .01), abuse (p < .05), and a history of delivering a preterm or low-birthweight infant (p < .01) than the White women who did not.
  
  
  CONCLUSIONS
  Integrating social support and stress-relieving activities in smoking cessation interventions, particularly for African American women, may reduce health risk behaviors, eliminate health disparities, and improve maternal and infant quality of life.
authors.affiliation: East Carolina University, Greenville, NC 27858, USA. jessed@mail.ecu.edu
authors.forename: D Elizabeth
authors.initials: DE
authors.lastname: Jesse
authors.forename: Marilyn
authors.initials: M
authors.lastname: Graham
authors.forename: Mel
authors.initials: M
authors.lastname: Swanson
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000193:education / Q000208:ethnology*; D001294:Attitude to Health / Q000208:ethnology; D003376:Counseling; D003431:Cross-Cultural Comparison; D003863:Depression / Q000208:ethnology; D005260:Female; D006801:Humans; D016015:Logistic Models; D015146:Midwestern United States / Q000453:epidemiology; D024802:Nurse's Role; D011203:Poverty / Q000208:ethnology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology* / Q000517:prevention & control; D012309:Risk-Taking; D012907:Smoking / Q000208:ethnology*; D000074606:Smoking Prevention; D012944:Social Support; D029181:Spirituality; D019966:Substance-Related Disorders / Q000208:ethnology* / Q000517:prevention & control; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data; D044465:White People / Q000193:education / Q000208:ethnology*