Advertisement

Maternal and Child Health Journal

, Volume 18, Issue 1, pp 180–190 | Cite as

Effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Dissemination Project: A Science to Prenatal Care Practice Partnership

  • Richard WindsorEmail author
  • Jeannie Clark
  • Sean Cleary
  • Amanda Davis
  • Stephanie Thorn
  • Lorien Abroms
  • John Wedeles
Article

Abstract

This study evaluated the effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Program selected by the West Virginia—Right From The Start Project for state-wide dissemination. A process evaluation documented the fidelity of SCRIPT delivery by Designated Care Coordinators (DCC), licensed nurses and social workers who provide home-based case management to Medicaid-eligible clients in all 55 counties. We implemented a quasi-experimental, non-randomized, matched Comparison (C) Group design. The SCRIPT Experimental E Group (N = 259) were all clients in 2009–2010 that wanted to quit, provided a screening carbon monoxide (CO), and received a SCRIPT home visit. The (C) Group was derived from all clients in 2006–2007 who had the same CO assessments as E Group clients and reported receiving cessation counseling. We stratified the baseline CO of E Group clients into 10 strata, and randomly selected the same number of (C) Group clients (N = 259) from each matched strata to evaluate the effectiveness of the SCRIPT Program. There were no significant baseline differences in the E and (C) Group. A Process Evaluation documented a significant increase in the fidelity of DCC delivery of SCRIPT Program procedures: from 63 % in 2006 to 74 % in 2010. Significant increases were documented in the E Group cessation rate (+9.3 %) and significant reduction rate (+4.5 %), a ≥50 % reduction from a baseline CO. Perinatal health case management staff can deliver the SCRIPT Program, and Medicaid-supported clients can change smoking behavior, even very late in pregnancy. When multiple biases were analyzed, we concluded the SCRIPT Dissemination Project was the most plausible reason for the significant changes in behavior.

Keywords

Smoking Pregnancy Cessation Tobacco Evaluation 

Notes

Acknowledgments

This work was supported by the National Cancer Institute at the National Institutes of Health (R01 CA124429-01-A1). The Dissemination Project recognizes the contributions of the following colleagues who assisted in planning and implementation: Kalpana Ramiah, Anne Williams, Pat Moss, and Jackie Newson. We would also like to recognize members of the Dissemination Committee (SDC) for their contributions to the RFTS-SCRIPT Project: Brenda Johnson, Dee Meadows, Beverly Kitchen, Sandra Ellard, Mary Christian, Joan Dayoub, Charlita Atha, Patsy Parker, Lori Meadows, Suellen Friend, Paula Darby, Bobbie Paris, Lenaa Ryan and Janeen Masker.

Conflict of interest

There are no conflicts of interest for any author.

References

  1. 1.
    Simpson, W. (1957). A preliminary report on cigarette smoking and the incidence of prematurity. Obstetrical & Gynecological Survey, 73, 808–815.Google Scholar
  2. 2.
    U.S. Department of Health, Education and Welfare. (1979). Healthy people: The surgeon general’s report on health promotion and disease prevention. (DHEW PHS Pub. No. 79-55071). Washington, DC: Public Health Service. Retrieved from http://www.surgeongeneral.gov/library/reports/.
  3. 3.
    U.S. Department of Health and Human Services. (1990). Healthy people 2000: National health promotion and disease prevention objectives. Washington, DC: Public Health Service. Retrieved from http://www.cdc.gov/nchs/healthy_people/hp2000.htm.
  4. 4.
    U.S. Department of Health and Human Services. (2000). Healthy people 2010: Understanding and improving health (2nd ed.). Washington, DC: U.S. Government Printing Office. Retrieved from http://www.cdphe.state.co.us/ohd/HP2010.pdf.
  5. 5.
    Martin, J., Hamilton, B., Ventura, S., et al. (2011). Births: Final data for 2009. National Vital Statistics Reports, Volume 60, No.1. Hyattsville, MD: National Center for Health Statistics. Retrieved from http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdf.
  6. 6.
    Tong, V., Jones, J., Dietz, P., et al. (2009). Trends in smoking before, during and after pregnancy—Pregnancy risk assessment monitoring system (PRAMS), United States, 31 sites, 2000–2005. MMWR Morb Mortal Wkly Rep, 58 (SS04), 1–29. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5804a1.htm.
  7. 7.
    Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (2008). Results from the 2007 National Survey on Drug Use and Health: National Findings (NSDUH Series H-34, DHHS Publication No. SMA 08-4343). Rockville, MD. Retrieved from http://www.oas.samhsa.gov/nsduh/2k7nsduh/2k7results.cfm.
  8. 8.
    Goodwin, R., Keyes, K., & Simuro, N. (2007). Mental disorders and nicotine dependence among pregnant women in the United States. Obstetrics and Gynecology, 109, 875–883. doi: 10.1097/01.AOG.0000255979.62280.e6.CrossRefGoogle Scholar
  9. 9.
    Kendrick, J., Zahniser, S., Miller, N., et al. (1995). Integrating smoking cessation into routine public prenatal care. American Journal of Public Health, 85, 217–222. doi: 10.2105/AJPH.85.2.217.CrossRefGoogle Scholar
  10. 10.
    Windsor, R., Boyd, N., & Orleans, C. (1998). A meta-evaluation of smoking cessation intervention research among pregnant women: Improving the science and art. Health Education Research, 13, 419–438. doi: 10.1093/her/13.3.419.CrossRefGoogle Scholar
  11. 11.
    Russell, T., Crawford, M., & Woodby, L. (2004). Measurements for active cigarette smoke exposure in prevalence and cessation studies: Why simply asking pregnant women isn’t enough. Nicotine & Tobacco Research, 6(S2), S141–S151. doi: 10.1080/14622200410001669141.CrossRefGoogle Scholar
  12. 12.
    Windsor, R., Woodby, L., Miller, T., et al. (2000). Effectiveness of AHCPR clinical practice guidelines and patient education methods for pregnant smokers in Medicaid maternity care. American Journal of Obstetrics and Gynecology, 182, 68–75. Retrieved from http://www.ajog.org/.CrossRefGoogle Scholar
  13. 13.
    Dietz, P., Homa, D., England, L. J., et al. (2011). Estimates of nondisclosure of cigarette smoking among pregnant and nonpregnant women of reproductive age in the United States. American Journal of Epidemiology, 173, 355–359. Epub 2010 December 22.CrossRefGoogle Scholar
  14. 14.
    Institute of Medicine, Committee on Quality of Health Care in America. (2001). Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press. Retrieved from http://www.iom.edu/Reports/2001/Crossing-the-Quality-Chasm-A-New-Health-System-for-the-21st-Century.aspx.
  15. 15.
    Fiore, M., Bailey, W., Cohen, S., et al. (2000). Treating tobacco use and dependence. A clinical practice guideline. Rockville, MD: U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality (AHRQ publication No. 00-0032). Retrieved from https://www.blacknote.com/wp-content/uploads/2017/11/treating_tobacco_use.pdf.
  16. 16.
    Fiore, M., Jaen, C., Baker, T., et al. (2008). Treating tobacco use and dependence: 2008 Update. Clinical practice guideline. Rockville, MD: U.S. Department of Health and Human Services. Retrieved from http://www.ahrq.gov/clinic/tobacco/tobaqrg.pdf.
  17. 17.
    American College of Obstetricians and Gynecologists. (2010). Smoking cessation during pregnancy. Committee Opinion No. 471. Obstetrics & Gynecology, 116, 1241–1244. Retrieved from http://www.acog.org.
  18. 18.
    Windsor, R., Li, C., Lowe, J., et al. (1993). The dissemination of smoking cessation methods for pregnant women: achieving the year 2000 objectives. American Journal of Public Health, 83, 173–180. doi: 10.2105/AJPH.83.2.173.CrossRefGoogle Scholar
  19. 19.
    Ershoff, D. (Ed.). (2004). Helping pregnant woman quit smoking: progress and future directions. Nicotine & Tobacco Research, 6(S2), S95–S277. Retrieved from http://ntr.oxfordjournals.org/content/6/Suppl_2.toc.
  20. 20.
    Windsor, R. Behavioral Treatment Methods for Pregnant Smokers: The Evidence Base for Prenatal Care Programs and Professional Practice. In A. Handler, J. Kennelly, and N. Peacock (Eds.), Invited Chapter for textbook: The Evidence Base for Interventions in Reproductive and Perinatal Health Programs. School of Public Health, University of Illinois, Springer December 2010.Google Scholar
  21. 21.
    Windsor, R., Woodby, L., Miller, T., et al. (2011). Effectiveness of Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) methods in Medicaid-supported prenatal care: Trial III. Health Education & Behavior, 38, 412–422. doi: 10.1177/1090198110382503.CrossRefGoogle Scholar
  22. 22.
    West Virginia Department of Health and Human Resources. (2007). Reports on the Blueprint to improve West Virginia Perinatal Health: Final Report. Charleston, WV: WV Perinatal Wellness Study. Retrieved from http://www.wvperinatal.org/downloads/committee_reports_07/Reports_on-Blueprint_for-Perinatal-Health01_2008.pdf.
  23. 23.
    Thoenen, E. (2008). Two generations of low birth weight: A West Virginia Study. West Virginia Health Statistics Center. Retrieved from http://www.wvdhhr.org/bph/HSC/Pubs/Other/2Generations_Low_Birthweight/Two_Generations_of_Low_Birthweight_in_WV.pdf.
  24. 24.
    Hartmann, K., Thorpe, J., Pahel-Short, L., et al. (1996). A randomized controlled trial of smoking cessation intervention in pregnancy in an academic clinic. Obstetrics and Gynecology, 87, 621–626. doi: 10.1016/0029-7844(95)00492-0.CrossRefGoogle Scholar
  25. 25.
    Gebauer, C., Kwo, C., Haynes, E., et al. (1998). A nurse managed smoking cessation intervention during pregnancy. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 27, 47–53. doi: 10.1111/j.1552-6909.1998.tb02590.x.CrossRefGoogle Scholar
  26. 26.
    Windsor, R., Li, C., Boyd, N., et al. (1999). The use of significant reduction rates to evaluate health education methods for pregnant smokers: A new harm reduction behavioral indicator? Health Education & Behavior, 26, 648–662. doi: 10.1177/109019819902600506.CrossRefGoogle Scholar
  27. 27.
    Windsor, R. (2005). A pregnant woman’s guide to quit smoking. ISBN 0-935105-01-08. Washington, DC: Society for Public Health Education (SOPHE).Google Scholar
  28. 28.
    Windsor, R. (2005). Commit to quit smoking during and after pregnancy [Video] (2nd Ed.). Edited 2004. Washington, DC: Society for Public Health Education.Google Scholar
  29. 29.
    Parker, D., Windsor, R., Roberts, M., et al. (2007). Feasibility, cost, and cost-effectiveness of a telephone-based motivational intervention for underserved pregnant smokers. Nicotine & Tobacco Research, 9, 1043–1051. doi: 10.1080/14622200701591617.CrossRefGoogle Scholar
  30. 30.
    Windsor, R., Cutter, G., Morris, J., et al. (1985). Effectiveness of self-help smoking cessation interventions for pregnant women in public health maternity clinics: A randomized trial. American Journal of Public Health, 75, 1389–1392. doi: 10.2105/AJPH.75.12.1389.CrossRefGoogle Scholar
  31. 31.
    Windsor, R., Lowe, J., Perkins, L., et al. (1993). Health education for pregnant smokers: Its behavioral impact and cost benefit. American Journal of Public Health, 83, 201–206. doi: 10.2105/AJPH.83.2.201.CrossRefGoogle Scholar
  32. 32.
    Windsor, R. (2012). Evaluation of Health Promotion, and Disease Prevention and Management Programs (4th ed.). Silver Spring, MD: The Health Promotion Group.Google Scholar
  33. 33.
    Benowitz, N. L., Jacob, P, I. I. I., Ahijevych, K., et al. (2002). SRNT Subcommittee on Biochemical Verification. Biochemical verification of tobacco use and cessation. Nicotine & Tobacco Research, 4, 149–159. doi: 10.1080/14622200210123581.CrossRefGoogle Scholar
  34. 34.
    Cook, T., & Campbell, D. (1979). Quasi-experimentation: Design and analysis for field settings. Boston, MA: Houghton Mifflin.Google Scholar
  35. 35.
    Woodby, L. L., Windsor, R. A., Snyder, S. W., et al. (1999). Predictors of smoking cessation during pregnancy. Addiction, 94, 283–292. doi: 10.1046/j.1360-0443.1999.94228311.x.CrossRefGoogle Scholar
  36. 36.
    Windsor, R., Whiteside, H, Jr, Solomon, L., et al. (2000). A process evaluation model for patient education program for pregnant smokers. Tobacco Control, 9, iii29–iii35. doi: 10.1136/tc.9.suppl_3.iii29.CrossRefGoogle Scholar
  37. 37.
    Ware, J., & Hamel, M. (2011). Pragmatic Trials—Guides to better patient care? The New England Journal of Medicine, 364, 1685–1687. doi: 10.1056/NEJMp1103502.CrossRefGoogle Scholar
  38. 38.
    Lowe, J., Balanda, K., Stanton, W., et al. (2002). Dissemination of an antenatal smoking cessation program in public hospitals in Australia: A randomized controlled trial. Health Education & Behavior, 29, 608–619. doi: 10.1177/109019802237028.CrossRefGoogle Scholar
  39. 39.
    Cooke, M., Mattick, R., & Walsh, R. (2001). Differential uptake of a smoking cessation programme disseminated to doctors and midwives in antenatal clinics. Addiction, 96, 495–505. doi: 10.1046/j.1360-0443.2001.96349512.x.CrossRefGoogle Scholar
  40. 40.
    Center for Medicare and Medicaid Services. Counseling to Prevent Tobacco Use. CMS Manual System, Pub 100-04 Medicare Claims Processing. Transmittal 2058, Change Request 7133. September, 2010. Retrieved from http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R2058CP.pdf.

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Richard Windsor
    • 1
    Email author
  • Jeannie Clark
    • 2
  • Sean Cleary
    • 3
  • Amanda Davis
    • 1
  • Stephanie Thorn
    • 2
  • Lorien Abroms
    • 1
  • John Wedeles
    • 1
  1. 1.Department of Prevention and Community HealthThe George Washington University School of Public Health and Health ServicesWashingtonUSA
  2. 2.West Virginia Department of Health and Human Resources, Department of Perinatal ServicesCharlestonUSA
  3. 3.Department of Epidemiology and BiostatisticsThe George Washington University School of Public Health and Health ServicesWashingtonUSA

Personalised recommendations