PREVENTING FETAL/INFANT PASSIVE SMOKE EXPOSURE

这是一项示范研究，旨在开发和评估 减少孕妇吸烟计划 西北凯撒永久医疗机构 (NWKP) 的女性成员。 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解决吸烟问题的试验 通过儿科办公室和重要机构了解母亲的行为 支持医生建议和其他戒烟的文献 针对流动人群（包括孕妇）的策略。 怀孕了 考虑到两者的风险，吸烟的女性构成高危人群 母亲以及胎儿和新生儿被动吸烟的风险。 该研究将制定、实施和评估区域范围内的 干预措施最初针对怀孕母亲，并持续到 分娩和前六个月的儿科婴儿护理。 的 该计划的理念是促进健康，包括 戒烟应成为产妇产前检查的常规内容 产后护理以及医疗机制的成本效益 必须评估提供健康促进的护理系统。 吸烟会 每次访视时均进行例行评估和记录。 医生、护士， 护士从业者将传达简短的、适合舞台的信息 大多数访问时提供材料。 期间将播放量身定制的视频 产前和儿科（产后）阶段，给父亲的信，以及 还将采用部分针对丈夫的邮寄通讯。 干预效果将使用准实验方法进行评估 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。 变化 产后一年妇女人口中的吸烟率将 为主要终点。 次要目标包括评估可能的 丈夫吸烟情况的变化；分析戒烟的预测因素 妇女；评估提供商对可行性、有效性和 干预的价值；并评估干预措施的维持 项目完成后。

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.