A multicomponent behavioral intervention for smoking cessation during pregnancy: a nonconcurrent multiple-baseline design

Wen, Xiaozhong; Eiden, Rina D.; Justicia-Linde, Faye E.; Wang, Youfa; Higgins, Stephen T.; Thor, Nicolas; Haghdel, Arsalan; Peters, Ariel R; Epstein, Leonard H.

doi:10.1093/tbm/iby027

Cited by 20 publications

(13 citation statements)

References 33 publications

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“…Maternal smoking during pregnancy also consistently mediated the effects of both SES measures on childhood obesity. Our result was supported by two previous studies (37,38) smoking abstinence rate through a multicomponent intervention (41). In addition, we found that intervention-assisted maternal smoking cessation, especially if quitting occurred before 27 weeks, could substantially reduce the risk of rapid infant BMI gain (42).…”

Section: Maternal Smoking During Pregnancysupporting

confidence: 89%

“…It is effective and safe to use behavioral, pharmaceutical, and economic interventions to assist pregnant women to stop smoking (40). For example, our own smoking cessation intervention achieved a 63.3% smoking abstinence rate through a multicomponent intervention (41). In addition, we found that intervention‐assisted maternal smoking cessation, especially if quitting occurred before 27 weeks, could substantially reduce the risk of rapid infant BMI gain (42).…”

Section: Discussionmentioning

confidence: 99%

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Potentially modifiable mediators for socioeconomic disparities in childhood obesity in the United States

Wen

Wang

et al. 2022

Obesity

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Objective The aim of this study was to examine modifiable mediators for socioeconomic disparities in childhood obesity in the United States. Methods This study used the data of 1,211 mother‐child dyads from a US national birth cohort from pregnancy to 6 years post partum. Socioeconomic status was indicated by maternal education (college graduate vs. less) and family income (>185% vs. ≤185% of the poverty line). Single‐ and multiple‐factor mediation analyses were conducted for socioeconomic disparities in childhood obesity at 6 years, adjusting for demographics. Results The confounder‐adjusted relative risk of childhood obesity was 1.79 for low maternal education and 1.42 for low family income. Low‐maternal‐education‐related obesity was individually mediated by maternal preconception BMI (percentage of indirect effect, 8.8%), smoking during pregnancy (7.0%), infant weight gain (14.4%), child sleep duration (11.4%), and TV viewing during weekdays at 6 years (4.9%). Low‐family‐income‐related obesity was mediated by maternal preconception BMI (18.5%), smoking during pregnancy (6.3%), child sleep duration (12.8%), and the home learning environment at 6 years (26.2%). In multiple‐mediator analysis, significant mediators together mediated 54.0% of maternal‐education‐related or 39.4% of family‐income‐related disparities. Conclusions Maternal preconception BMI, smoking during pregnancy, infant weight gain, child sleep, TV viewing, and the home learning environment substantially mediated socioeconomic disparities in childhood obesity in the United States.

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Section: Maternal Smoking During Pregnancysupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Potentially modifiable mediators for socioeconomic disparities in childhood obesity in the United States

Wen

Wang

et al. 2022

Obesity

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“…Particularly, smoking cessation programs included messages describing how tobacco companies have knowingly worked to persuade smokers to use products without any regard to their health, a strategy termed tobacco industry denomalization [50]. In addition, smoking cessation programs targeting secondhand smoke have worked to hold smokers accountable for their actions around their family members or during pregnancy [51, 52]. However, this is its first report as an outcome of an intervention, holding individual smokers accountable for their behavior.…”

Section: Discussionmentioning

confidence: 99%

Revealing users’ experience and social interaction outcomes following a web-based smoking prevention intervention for adolescents: A qualitative study

et al. 2019

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BackgroundTobacco smoking remains a public health problem among adolescents in the United States. While Web-based interventions for smoking prevention have been successful at the individual level, there is still an urgent need to understand their engagement capabilities and their effects at the social level. In the current study, we aimed to (1) learn about adolescents’ subjective experience with a Web-based program called a smoking prevention interactive experience (ASPIRE), (2) obtain suggestions for improvement in ASPIRE content, (3) identify psychological outcomes of ASPIRE, and (4) explore outcomes of social interaction.Materials and methodsAfter a randomized controlled trial with 110 adolescents, 20 adolescent users of ASPIRE, aged 11–18, were randomly selected to participate in one-on-one interviews at four after-school programs in Houston, Texas. Interviews involved questions concerning adolescents’ experience with the intervention. Qualitative data were coded and analyzed using a constant comparison approach for the generation of themes.ResultsDescribing their experience with ASPIRE, participants expressed comfort in material that is tailored to their demographic and preferred interactive activities over entertaining videos. Presenting suggestions for improvement, participants mainly reported the need to include gaming features into ASPIRE. Presenting psychological outcomes, they expressed emotional engagement in the program, shifts in attitudes and beliefs, and unwillingness to smoke. Finally, as outcomes of social interaction, participants reported engagement with others in discussions about tobacco and their need to hold smokers accountable for their actions.ConclusionsAdolescents’ reports moved from their individual experience with ASPIRE to their active interactions with family members and friends and their attempt to persuade others to quit smoking. Future Web-based programs for adolescents may be designed with tailoring and game play in mind, in order to provide mobilization skills and foster social interactions against smoking.

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“…There may be a hard core of individual mothers/parents who are unable to stop smoking, even knowing the risks to their baby. Some evidence exists that specific behavioural techniques may have an impact on prenatal smoking cessation [47][48][49], but the complexities around cessation in relation to pregnancy and childbirth need further interventional analysis. Despite these limitations, there may still be the benefit of incorporating smoking cessation information into parent awareness packages [8], while awaiting more effective interventions and primary preventive packages.…”

Section: Smoking Cessation and Infant Mortalitymentioning

confidence: 99%

Parent-Carer Education: Reducing the Risks for Neonatal and Infant Mortality

Pillay¹

2019

Neonatal Medicine

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In this chapter, the role of engaging parents, family members, partners, significant others and carers (subsequently referred to as parent-carers) as key partners in targeted strategies for reducing the risks associated with neonatal mortality is discussed, especially within the context of less resource-constrained environments. Parent-carer education, sharing information on regionally prevalent risk factors and associations with death in the first 28 days of life and in infancy, can be potentially impactful and could drive behavioural changes, while promoting acquisition of newer life-saving skills such as basic life support training. Such education can be considered participatory learning and action. It affords parent-carers the confidence and knowledge on measures to key risks in infancy, such as the risk of sudden infant death, and how to recognize when their baby may be ill, facilitating timely access to appropriate healthcare services. Potentially, these then empower parent-carers to work with health services proactively in measures to reduce the risks for neonatal mortality.mortality is explored, especially in less resource-constrained environments, by focusing on parent-carer education around risks for neonatal mortality, while using learning points from around the world. Potentially, these initiatives empower parent-carers to acquire the necessary skills to manage their baby at risk and also engage in risk-reducing behaviours for the benefit of their baby. Reducing neonatal mortality through parent-carer educationBefore embarking on parent education, understanding the risk factors for neonatal mortality is important. In poorly resourced areas, key risk factors and associations are infection, hypothermia, lack of breastfeeding, failure to recognise signs of illness in their baby and failure to provide adequate basic resuscitation at birth. Education packages focused on improving neonatal mortality therefore include information on maintaining warmth; drying; wrapping; skin-to-skin contact; supporting breastfeeding; infection prevention including handwashing, cord care, recognising signs of illness in their newborn baby and infant and basic life support [7].For neonatal teams in relatively higher resourced environments, where access to public health facilities and general maternal education are less of an issue, and most of the above are routinely adopted, what are other key risk factors and what other kinds of initiatives are needed in order to make a difference to current neonatal mortality rates, and can they work?In attempting to address this, the key risk factors here for neonatal mortality need to be identified. The most significant of these is prematurity [8][9][10]. In a report on perinatal mortality from MBRRACE on 2016 deaths, approximately 70% of all extended perinatal deaths occurred preterm, and almost 40% were in less than 28 weeks' gestation [9]. Optimising place of birth for the most vulnerable preterm births less than 26 weeks gestation at birth does reduce their mortality rates [11] and op...

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A multicomponent behavioral intervention for smoking cessation during pregnancy: a nonconcurrent multiple-baseline design

Cited by 20 publications

References 33 publications

Potentially modifiable mediators for socioeconomic disparities in childhood obesity in the United States

Potentially modifiable mediators for socioeconomic disparities in childhood obesity in the United States

Revealing users’ experience and social interaction outcomes following a web-based smoking prevention intervention for adolescents: A qualitative study

Parent-Carer Education: Reducing the Risks for Neonatal and Infant Mortality

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