PREVENTING FETAL/INFANT PASSIVE SMOKE EXPOSURE

这是一项演示研究，旨在开发和评估 减少孕妇吸烟的计划 是西北凯撒永久组织(NWKP)成员的女性。该项目 建立在我们之前门诊工作的坚实基础上， 低强度戒烟和我们正在进行的针对吸烟的试验 母亲通过儿科办公室的行为，以及在重要身体上的行为 支持医生建议和其他戒烟的文献 在包括孕妇在内的流动人口中采取的战略。怀孕了 考虑到吸烟和吸烟的风险，吸烟的女性是高危人群 母亲和被动吸烟暴露对胎儿和新生儿的风险。 这项研究将在区域范围内制定、实施和评估 干预最初针对的是怀孕母亲，并一直持续到 分娩和前六个月的儿科良好婴儿护理。这个 该计划基于促进健康的理念，包括 戒烟应该成为孕妇产前和产后的常规方面 产后护理，以及医疗保健机制成本效益 必须评估提供健康促进的护理系统。吸烟会 在每次访问时进行例行评估和记录。医生，护士， 护士从业者将传递简短的、适合舞台的信息 和材料，在大多数访问。一段量身定做的视频将在 产前和儿科(产后)阶段，给父亲的信，以及 邮寄的时事通讯，部分针对丈夫，也将被使用。 干预效果将使用准实验法进行评估 设计。对照组将对吸烟、孕妇进行评估 在同一诊所实施干预之前。中的更改 妇女在分娩后一年的吸烟率将 成为主要终点。次要目标包括评估可能性 丈夫吸烟的变化；分析戒烟的预测因素 妇女；评估提供者对该方案的可行性、有效性和 干预的价值；以及评估干预的维护 项目竣工后。

This is a demonstration study aimed at developing and evaluating a program for reducing cigarette smoking in the population of pregnant women who are members of Northwest Kaiser Permanente (NWKP). The project builds on a firm foundation of our previous work in outpatient, low-intensity smoking cessation and our ongoing trial addressing smoking behavior in mothers through pediatric offices, and on a significant body of literature supporting physician advice and other smoking cessation strategies in ambulatory populations, including pregnant women. Pregnant women who smoke constitute a high-risk group, given the risks for both mother and the passive smoke exposure risks for fetuses and newborns. The study will develop, implement, and evaluate a region-wide intervention initially aimed at pregnant mothers and continuing through delivery and the first six months of pediatric well-baby care. The program is based on the philosophy that health promotion, including smoking cessation should become a routine aspect of maternal prenatal and postnatal care, and that cost-effectiveness of mechanisms for medical care systems to deliver health promotion must be assessed. Smoking will be routinely assessed and recorded at each visit. Physicians, nurses, and nurse practitioners will deliver brief, stage-appropriate messages and materials at most visits. A tailor-made video will be shown during both prenatal and pediatric (postnatal) phases, letters to fathers, and mailed newsletters, partly aimed at husbands, will also be employed. Intervention efficacy will be evaluated using a quasi-experimental design. The comparison group will be smoking, pregnant women assessed prior to implementing intervention at the same clinics. Changes in smoking rates in the population of women at one year after delivery will be the primary end point. Secondary aims include evaluating possible changes in husband smoking; analyzing predictors of cessation among women; evaluating provider perceptions of the feasibility, efficacy, and value of the intervention; and evaluating maintenance of the intervention after project completion.