Maternal and Child Health Journal

, Volume 13, Issue 3, pp 395–406

Baby BEEP: A Randomized Controlled Trial of Nurses’ Individualized Social Support for Poor Rural Pregnant Smokers

  • Linda Bullock
  • Kevin D. Everett
  • Patricia Dolan Mullen
  • Elizabeth Geden
  • Daniel R. Longo
  • Richard Madsen
Article

DOI: 10.1007/s10995-008-0363-z

Cite this article as:
Bullock, L., Everett, K.D., Mullen, P.D. et al. Matern Child Health J (2009) 13: 395. doi:10.1007/s10995-008-0363-z
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Abstract

Objectives We tested the effect of nurse-delivered telephone individualized social support (“Baby BEEP”) and eight mailed prenatal smoking cessation booklets singly and in combination (2 × 2 factorial design) on smoking cessation in low-income rural pregnant women (N = 695; 75% participation). Methods Participants randomized to Baby BEEP groups (n = 345) received weekly calls throughout pregnancy plus 24-7 beeper access. Saliva cotinine samples were collected monthly from all groups by other nurses at home visits up to 6 weeks post-delivery. Primary outcomes were point prevalence abstinence (cotinine < 30 ng/ml) in late pregnancy and post-delivery. Results Only 47 women were lost to follow-up. Intent-to-treat analyses showed no difference across intervention groups (17–22%, late pregnancy; 11–13.5%, postpartum), and no difference from the controls (17%, late pregnancy; 13%, postpartum). Post hoc analyses of study completers suggested a four percentage-point advantage for the intervention groups over controls in producing early and mid-pregnancy continuous abstainers. Partner smoking had no effect on late pregnancy abstinence (OR = 1.7, 95% CI = 0.95, 3.2), but post-delivery, the effect was pronounced (OR = 3.2, 95% CI = 1.8, 5.9). Conclusions High abstinence rates in the controls indicate the power of biologic monitoring and home visits to assess stress, support, depression, and intimate partner violence; these elements plus booklets were as effective as more intensive interventions. Targeting partners who smoke is needed.

Keywords

PregnancySmoking cessationRuralLow-incomeTelephone social supportRandomized controlled trial

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Linda Bullock
    • 1
  • Kevin D. Everett
    • 2
  • Patricia Dolan Mullen
    • 3
  • Elizabeth Geden
    • 1
  • Daniel R. Longo
    • 4
  • Richard Madsen
    • 5
  1. 1.Sinclair School of NursingUniversity of MissouriColumbiaUSA
  2. 2.Department of Family and Community MedicineUniversity of Missouri Medical SchoolColumbiaUSA
  3. 3.Center for Health Promotion and Prevention ResearchUniversity of Texas School of Public Health HoustonUSA
  4. 4.Department of Family MedicineVirginia Commonwealth University School of Medicine RichmondUSA
  5. 5.Department of BiostatisticsUniversity of MissouriColumbiaUSA