title: Models for Access to Maternal Smoking cessation Support (MAMSS): a study protocol of a quasi-experiment to increase the engagement of pregnant women who smoke in NHS Stop Smoking Services.
abstract: BACKGROUND
  Maternal smoking is a key cause of poor outcomes for mothers, babies and children and Wales has higher rates of smoking in pregnancy than any other UK country. Despite various improvements within the NHS Stop Smoking Service to strengthen the intervention for pregnant women, referrals and successful quit attempts for this group have continued to remain extremely low. A key element of UK national guidance for smoking cessation during pregnancy is to provide a flexible and tailored service to help increase levels of engagement. This study aims to test the effectiveness of three different models of service delivery to address the gap in the evidence base about how to deliver a flexible, tailored smoking cessation service to pregnant women.
  
  
  METHODS
  This study will adopt a quasi-experimental design over a 12 month period. The setting is four of Wales' seven Health Boards using an integrated approach between maternity services, local public health teams and the NHS Stop Smoking Service. Core recommendations from UK public health guidance are being implemented across intervention and usual care sites. Stop smoking support for pregnant women in intervention sites is being delivered more flexibly than in usual care sites. Both qualitative and quantitative approaches will be adopted to capture important contextual information and consider multiple perspectives. A health economic analysis will be undertaken using a cost-consequences analysis approach. The primary outcome measure is engagement with stop smoking services (defined as having at least one face-to-face therapeutic contact with a clinician).
  
  
  CONCLUSIONS
  Supporting pregnant women to stop smoking is a challenging area of public health. The proposed study will address several areas where there are key evidence gaps relating to smoking cessation interventions for pregnant women. Specifically, how best to encourage pregnant women to attend a specialist stop smoking support service, how to deliver the service and who should provide it.
authors.forename: Lorna
authors.initials: L
authors.lastname: Bennett
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University School of Medicine, 5th Floor Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK. GrantA2@cardiff.ac.uk.
authors.forename: Aimee
authors.initials: A
authors.lastname: Grant
authors.forename: Siobhan
authors.initials: S
authors.lastname: Jones
authors.forename: Mererid
authors.initials: M
authors.lastname: Bowley
authors.forename: Christian
authors.initials: C
authors.lastname: Heathcote-Elliott
authors.forename: Catrin
authors.initials: C
authors.lastname: Ford
authors.forename: Angela
authors.initials: A
authors.lastname: Jones
authors.forename: Rachel
authors.initials: R
authors.lastname: Lewis
authors.forename: Margaret
authors.initials: M
authors.lastname: Munkley
authors.forename: Carol
authors.initials: C
authors.lastname: Owen
authors.forename: Annie
authors.initials: A
authors.lastname: Petherick
authors.forename: Shantini
authors.initials: S
authors.lastname: Paranjothy
mesh_terms: D000293:Adolescent; D000328:Adult; D005190:Family; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications; D037841:Pregnant People; D015397:Program Evaluation / Q000706:statistics & numerical data*; D011634:Public Health; D012017:Referral and Consultation; D012107:Research Design; D012906:Smoke; D012907:Smoking; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data*; D013222:State Medicine / Q000706:statistics & numerical data*; D014852:Wales; D055815:Young Adult
chemical_list: D012906:Smoke