title: Randomized trial of a secondhand smoke exposure reduction intervention among hospital-based pregnant women.
abstract: OBJECTIVE
  This study sought to assess the effectiveness of a secondhand tobacco smoke (SHS) prevention program based on an expanded Health Belief Model (HBM) incorporating self-efficacy among pregnant women in a hospital setting in Taiwan.
  
  
  METHODS
  This study utilized a two-group longitudinal randomized controlled trial design. Participants in the intervention group (n=50) enrolled in a SHS prevention program based on the HBM, while participants in the comparison group (n=50) received standard government-mandated counseling care. Both groups were given questionnaires as a pre-test, two weeks into the intervention, and one month following the conclusion of the intervention. The questionnaire and intervention were developed based on the understanding gained through a series of in-depth interviews and a focus-group conducted among pregnant women. Exhaled carbon monoxide was also measured and used as a proxy for SHS exposure.
  
  
  RESULTS
  Intervention group scores were all significantly higher than comparison group scores (p<0.001), indicating a significant increase in knowledge, HBM scores, cues to action, self-efficacy, preventative behaviors, and a significant decrease in smoking exposure. These differences remained significant at the one-month follow-up assessment (p<0.001).
  
  
  CONCLUSIONS
  These results should encourage health professionals to educate pregnant women regarding the harms of SHS while both empowering and equipping them with the tools to confront their family members and effectively reduce their SHS exposure while promoting smoke-free social norms.
authors.affiliation: Department of Education & Research, Taipei City Hospital, Taiwan; Department of Information Management, Kang-Ning Junior College of Medical Care and Management, Taiwan.
authors.forename: Ying-Chen
authors.initials: YC
authors.lastname: Chi
authors.affiliation: Department of Information Management, Kang-Ning Junior College of Medical Care and Management, Taiwan; Department of Pediatrics, Landseed Hospital, Taiwan; School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taiwan. Electronic address: wulong1031@yahoo.com.tw.
authors.forename: Chen-Long
authors.initials: CL
authors.lastname: Wu
authors.affiliation: Department of Health Promotion and Health Education, National Taiwan Normal University, Taiwan.
authors.forename: Cheng-Yu
authors.initials: CY
authors.lastname: Chen
authors.affiliation: School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taiwan. Electronic address: sylyu@tmu.edu.tw.
authors.forename: Shu-Yu
authors.initials: SY
authors.lastname: Lyu
authors.affiliation: Department of Leisure and Recreation Management, Asia University, Taichung, Taiwan.
authors.forename: Feng-En
authors.initials: FE
authors.lastname: Lo
authors.affiliation: Department of Community Health Sciences, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA 90095, USA.
authors.forename: Donald E
authors.initials: DE
authors.lastname: Morisky
mesh_terms: D003376:Counseling / Q000379:methods*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007407:Interviews as Topic; D008137:Longitudinal Studies; D011247:Pregnancy; D037841:Pregnant People; D011795:Surveys and Questionnaires; D013624:Taiwan; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Health Belief Model; Pregnant women; Secondhand smoking prevention intervention program; Tobacco harm reduction