MOTIVATIONAL ENHANCEMENT THERAPY FOR PREGNANT SMOKERS

针对怀孕吸烟者的动机增强疗法

• 批准号: 6071701
• 负责人: Angela L Stotts
• 金额: $ 7.13万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2001-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6071701
• 关键词: behavior therapy; behavioral /social science research tag; clinical research; coping; drug related neoplasm /cancer; female; human pregnant subject; human therapy evaluation; motivation; outcomes research; pregnancy; smoking; smoking cessation; substance abuse related behavior; tobacco abuse prevention; women's health

Adverse health effects of cigarette smoking on pregnancy outcomes are significant and costly. Despite the well-publicized risks, almost one-quarter of women continue to smoke throughout pregnancy. Further, women from disadvantaged backgrounds are over-represented among pregnant smokers. Innovative smoking cessation interventions are needed to increase quit rates in pregnant smokers, particularly in low socioeconomic populations. The proposed study evaluates the feasibility and efficacy of theoretically innovative prenatal smoking cessation intervention based on Motivational Enhancement Therapy (MET). A randomized, controlled, pretest/posttest, between groups design will be employed to compare MET with usual care for reducing smoking rates among pregnant women. Sixty-seven pregnant smokers, at least 16 years of age and attending a university-based, public clinical will be assigned to each of the two groups. In addition to achieving higher abstinence rates, we expect that the MET intervention will produce significant changes in several domains of function (e.g. coping, self- efficacy, readiness to change). Smoking outcomes will be assessed via objective (saliva cotinine analyses) and self-report measures. Logistic regression procedures will be used to examine posttreatment smoking group differences. Repeated measures analysis of variance will be used to evaluate treatment related changes in other domains of functioning. MET strategies and techniques are implemented using an empathic, non- confrontational yet directive counseling style to enhance motivation and reduce ambivalence about change. The MET intervention consists of four counseling sessions and one stages of change based, personalized feedback letter delivered over 8-weeks. The first counseling session will occur at the clinic during a woman's first prenatal visit with the three subsequent sessions being conducted by telephone. Therapy manuals, trained counselors, competency checks, and adherence rating scales will be used to verify treatment fidelity. This research will contribute important theoretical and empirical information concerning the efficacy of a new and innovative intervention for pregnant smokers and will provide the basis for larger effectiveness trials.

吸烟对怀孕结果的不利健康影响是重大的，而且代价高昂。尽管吸烟的风险广为人知，但仍有近四分之一的女性在怀孕期间继续吸烟。此外，来自弱势背景的妇女在怀孕吸烟者中所占比例过高。需要创新的戒烟干预措施来提高怀孕吸烟者的戒烟率，特别是在社会经济地位较低的人群中。本研究旨在评估基于动机增强疗法（MET）的产前戒烟干预的可行性和有效性。采用随机、对照、前测/后测、组间设计比较MET与常规护理降低孕妇吸烟率的效果。67名怀孕的吸烟者，年龄至少16岁，在一所大学的公共诊所就诊，将被分配到两组中。除了达到更高的戒断率外，我们期望MET干预将在几个功能领域产生重大变化（例如应对，自我效能，准备改变）。吸烟结果将通过客观（唾液可替宁分析）和自我报告测量来评估。Logistic回归程序将用于检验治疗后吸烟组的差异。重复测量方差分析将用于评估治疗相关的其他功能领域的变化。MET策略和技术的实施采用移情、非对抗性和指导性的咨询风格，以增强动机和减少对改变的矛盾心理。MET干预包括四个咨询会议和一个基于改变的阶段，个性化反馈信在8周内送达。第一次咨询会议将在妇女第一次产前检查期间在诊所进行，随后的三次会议将通过电话进行。治疗手册、训练有素的咨询师、能力检查和依从性评定量表将被用来验证治疗的保真度。这项研究将提供重要的理论和经验信息，关于一种新的和创新的干预措施对怀孕吸烟者的有效性，并将为更大规模的有效性试验提供基础。