Contingency Management Versus Psychotherapy for Prenatal Smoking Cessation: A Meta-Analysis of Randomized Controlled Trials
Contingency Management Versus Psychotherapy for Prenatal Smoking Cessation: A Meta-Analysis of Randomized Controlled Trials
复制标题
DOI：
10.1016/j.whi.2018.05.002
复制
发表时间：
2018-11-01
影响因子：
3.2
通讯作者：
Calhoun, Patrick S.
中科院分区：
文献类型：
--
作者：
Wilson, Sarah M.;Newins, Amie R.;Calhoun, Patrick S.
目的：产前吸烟是导致产科不良结局的主要可预防原因，但治疗选择有限。过去对产前戒烟的回顾往往将所有的咨询归为一个类别，这忽略了心理治疗不同于简短咨询的事实。本研究的目的是比较产前戒烟的两种强化干预措施的效果大小：应急管理（即，方法：使用PubMed、PsycINFO、Web of Science、科克伦图书馆和EMBASE完成对随机对照试验的系统检索，以测试应急管理或心理治疗的功效。独立评估者提取数据并评估试验的偏倚风险。治疗效果进行了分析，为三个时间点：怀孕后期，产后早期，产后晚期。结果：搜索产生了22项研究，荟萃分析结果表明，干预措施（与对照组相比）一般增加禁欲的几率。主持人分析表明，干预类型（应急管理与心理治疗）占效应量的变异。当比较治疗类型时，应急管理干预的效果显著大于心理治疗干预。虽然心理治疗并没有影响戒烟，应急管理干预措施有显着的治疗效果在所有三个时间points.Conclusions：应急管理似乎是一个安全有效的产前戒烟治疗。虽然单独的心理治疗并没有显示出对产前戒烟的影响，未来的研究可能会寻求联合收割机这种方法与应急管理，以促进产前戒烟。爱思唯尔公司出版代表雅各布妇女健康研究所
Objectives: Prenatal smoking is the leading preventable cause of poor obstetric outcomes, yet treatment options are limited. Past reviews of prenatal smoking cessation have often grouped all counseling into a single category, which ignores the fact that psychotherapy is distinct from brief counseling. The objective of this study was to compare the effect sizes of two intensive interventions for prenatal smoking cessation: contingency management (i.e., financial incentives for abstinence) and psychotherapy.Methods: A systematic search for randomized controlled trials testing the efficacy of contingency management or psychotherapy was completed using PubMed, PsycINFO, Web of Science, the Cochrane Library, and EMBASE. Independent raters extracted data and assessed trials for risk of bias. Treatment effects were analyzed for three times points: late pregnancy, early postpartum, and late postpartum.Results: The search yielded 22 studies, and meta-analytic results indicated that interventions (compared with control groups) generally increased the odds of abstinence. Moderator analyses indicated that intervention type (contingency management vs. psychotherapy) accounted for variability in effect sizes. When comparing treatment type, effects of contingency management interventions were significantly greater than those of psychotherapeutic interventions. Although psychotherapy did not affect smoking abstinence, contingency management interventions had significant treatment effects at all three time points.Conclusions: Contingency management seems to be a safe and efficacious prenatal smoking cessation treatment. Although psychotherapy alone did not show an effect on prenatal smoking abstinence, future research may seek to combine this approach with contingency management to promote prenatal smoking cessation. Published by Elsevier Inc. on behalf of Jacobs Institute of Women's Health.