title: Supporting Aboriginal Women to Quit Smoking: Antenatal and Postnatal Care Providers' Confidence, Attitudes, and Practices.
abstract: BACKGROUND
  Tobacco use during pregnancy is substantially higher among Aboriginal women compared to non-Aboriginal women in Australia. However, no studies have investigated the amount or type of smoking cessation care that staff from Aboriginal antenatal and postnatal services provide to clients who smoke or staff confidence to do so. This study examined Aboriginal antenatal and postnatal staff confidence, perceived role and delivery of smoking cessation care to Aboriginal women and characteristics associated with provision of such care.
  
  
  METHODS
  Staff from 11 Aboriginal Maternal and Infant Health Services and eight Aboriginal Child and Family Health services in the Hunter New England Local Health District in Australia completed a cross-sectional self-reported survey (n = 67, response rate = 97.1%).
  
  
  RESULTS
  Most staff reported they assessed clients' smoking status most or all of the time (92.2%). However, only a minority reported they offered a quitline referral (42.2%), provided follow-up support (28.6%) or provided nicotine replacement therapy (4.7%) to most or all clients who smoked. Few staff felt confident in motivating clients to quit smoking (19.7%) and advising clients about using nicotine replacement therapy (15.6%). Staff confident with talking to clients about how smoking affected their health had significantly higher odds of offering a quitline referral [OR = 4.9 (1.7-14.5)] and quitting assistance [OR = 3.9 (1.3-11.6)] to clients who smoke.
  
  
  CONCLUSIONS
  Antenatal and postnatal staff delivery of smoking cessation care to pregnant Aboriginal women or mothers with young Aboriginal children could be improved. Programs that support Aboriginal antenatal and postnatal providers to deliver smoking cessation care to clients are needed.
  
  
  CONCLUSIONS
  Aboriginal antenatal and postnatal service staff have multiple opportunities to assist Aboriginal women to quit smoking during pregnancy and postpartum. However, staff confidence and practices of offering various forms of smoking cessation support to pregnant Aboriginal women is unexplored. This is the first study to examine the amount and type of smoking cessation support Aboriginal antenatal and postnatal service staff provide to Aboriginal women, staff confidence and their perceived role in delivering smoking cessation care. This information is valuable for developing strategies that assist antenatal and postnatal staff to improve their delivery of smoking cessation care to Aboriginal women.
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.|Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia.|Public Health, Hunter Medical Research Institute, New Lambton, Australia.
authors.forename: Flora
authors.initials: F
authors.lastname: Tzelepis
authors.affiliation: Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia.|Public Health, Hunter Medical Research Institute, New Lambton, Australia.
authors.forename: Justine
authors.initials: J
authors.lastname: Daly
authors.affiliation: Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia.|Public Health, Hunter Medical Research Institute, New Lambton, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Dowe
authors.affiliation: Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia.|Public Health, Hunter Medical Research Institute, New Lambton, Australia.
authors.forename: Alex
authors.initials: A
authors.lastname: Bourke
authors.affiliation: Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia.|Public Health, Hunter Medical Research Institute, New Lambton, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Gillham
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.|Public Health, Hunter Medical Research Institute, New Lambton, Australia.
authors.forename: Megan
authors.initials: M
authors.lastname: Freund
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D006303:Health Services, Indigenous; D006801:Humans; D008427:Maternal Health Services; D009042:Motivation; D011181:Postnatal Care / Q000379:methods*; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D037841:Pregnant People; D011295:Prenatal Care / Q000379:methods*; D012017:Referral and Consultation; D012907:Smoking / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods*; D011795:Surveys and Questionnaires; D061485:Tobacco Use Cessation Devices