Differential uptake of a smoking cessation programme disseminated to doctors and midwives in antenatal clinics

Cooke, Margaret; Mattick, Richard P.; Walsh, Raoul A.

doi:10.1046/j.1360-0443.2001.96349512.x

Cited by 33 publications

(35 citation statements)

References 22 publications

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“…Similar concerns have been identified in other studies with AHWs, although they report feeling more comfortable discussing smoking with pregnant smokers than with other smokers [39,56,57]. In other antenatal settings, a perception that clients are not interested or do not expect advice, has been identified as a barrier [37,52], and midwives have expressed concern about potentially damaging their relationship with women if they address their smoking [28,31,50]. By contrast, women consider provision of smoking cessation advice within antenatal care to be acceptable [26], and state that it doesn't affect their relationships with their midwives [27].…”

Section: Discussionsupporting

confidence: 64%

“…Smoking cessation interventions are poorly covered in nursing curricula [46] and in training for Aboriginal Health Workers [47], which may explain the low level of knowledge and that approximately one fifth felt they didn't have the skills to provide advice. Perceived skill level is associated with provision of tobacco interventions [37,48], and lack of skills have repeatedly been identified as a barrier to smoking cessation counselling by practitioners [31,49-51]. In our study, both knowledge scores and perceptions of skills were related to level of smoking assessment, suggesting that provision of culturally appropriate, pregnancy-specific training and resources would increase confidence and skills and consequently assessment and management of antenatal smoking.…”

Section: Discussionmentioning

confidence: 55%

“…Pessimism about the effectiveness of interventions has been identified as a barrier to providing cessation counselling in other Australian antenatal settings [37,42,51] and internationally [38,43,44,52,53]. The poor knowledge of smoking cessation identified is likely to contribute to low efficacy of any advice provided, further contributing to a perception that advising cessation is futile.…”

Section: Discussionmentioning

confidence: 99%

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Knowledge, attitudes and other factors associated with assessment of tobacco smoking among pregnant Aboriginal women by health care providers: a cross-sectional survey

2012

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BackgroundAs with many Indigenous peoples, smoking rates among Aboriginal Australians are considerably higher than those of the non-Indigenous population. Approximately 50% of Indigenous women smoke during pregnancy, a time when women are more motivated to quit. Antenatal care providers are potentially important change agents for reducing the harms associated with smoking, yet little is known about their knowledge, attitudes or skills, or the factors associated with providing smoking cessation advice.MethodsThis paper aimed to explore the knowledge and attitudes of health care providers caring for pregnant Australian Aboriginal women with regard to smoking risks and cessation; and to identify factors associated with self-reported assessment of smoking. A cross-sectional survey was undertaken with 127 staff providing antenatal care to Aboriginal women from two jurisdictions: the Northern Territory and New South Wales, Australia. Measures included respondents' estimate of the prevalence of smoking among pregnant women; optimal and actual assessment of smoking status; knowledge of risks associated with antenatal smoking; knowledge of smoking cessation; attitudes to providing cessation advice to pregnant women; and perceived barriers and motivators for cessation for pregnant women.ResultsThe median provider estimate of the smoking prevalence was 69% (95%CI: 60,70). The majority of respondents considered assessment of smoking status to be integral to antenatal care and a professional responsibility. Most (79%) indicated that they assess smoking status in 100% of clients. Knowledge of risks was generally good, but knowledge of cessation was poor. Factors independently associated with assessing smoking status among all women were: employer service type (p = 0.025); cessation knowledge score (p = 0.011); and disagreeing with the statement that giving advice is not worth it given the low level of success (p = 0.011).ConclusionsAddressing knowledge of smoking risks and cessation counselling is a priority and should improve both confidence and ability, and increase the frequency and effectiveness of counselling. The health system must provide supports to providers through appropriate policy and resourcing, to enable them to address this issue.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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Knowledge, attitudes and other factors associated with assessment of tobacco smoking among pregnant Aboriginal women by health care providers: a cross-sectional survey

2012

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“…Regarding factors affecting the use of smoking cessation interventions in antenatal clinics, one study conducted in Australia investigated perceptions, knowledge, and the use of brief interventions in midwives and physicians working in 20 hospital antenatal clinics [23]. Results showed that the majority of antenatal clinic staff did not use the most effective forms of brief cessation interventions.…”

Section: Introductionmentioning

confidence: 99%

Tobacco cessation intervention for pregnant women in Argentina and Uruguay: study protocol

et al. 2013

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BackgroundArgentina and Uruguay are among the countries with the highest proportion of pregnant women who smoke. The implementation of an effective smoking cessation intervention would have a significant impact on the health of mothers and infants. The “5 A’s” (Ask, Advise, Assess, Assist, Arrange) is a strategy consisting of a brief cessation counseling session of 5–15 minutes delivered by a trained provider. The “5 A’s” is considered the standard of care worldwide; however, it is under used in Argentina and Uruguay.MethodsWe will conduct a two-arm, parallel cluster randomized controlled trial of an implementation intervention in 20 prenatal care settings in Argentina and Uruguay. Prenatal care settings will be randomly allocated to either an intervention or a control group after a baseline data collection period. Midwives’ facilitators in the 10 intervention prenatal clinics (clusters) will be identified and trained to deliver the “5 A’s” to pregnant women and will then disseminate and implement the program. The 10 clusters in the control group will continue with their standard in-service activities. The intervention will be tailored by formative research to be readily applicable to local prenatal care services at maternity hospitals and acceptable to local pregnant women and health providers. Our primary hypothesis is that the intervention is feasible in prenatal clinics in Argentina and Uruguay and will increase the frequency of women receiving tobacco use cessation counseling during pregnancy in the intervention clinics compared to the control clinics. Our secondary hypotheses are that the intervention will decrease the frequency of women who smoke by the end of pregnancy, and that the intervention will increase the attitudes and readiness of midwives towards providing counseling to women in the intervention clinics compared to the control clinics.Trial registrationClinicalTrials.gov. Identifier: NCT01852617

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“…Four papers provided no details regarding the design and construction of the survey tool (Bishop et al, 1998, Glover et al, 2008, Grange et al, 2006, Walsh et al 1995. Three papers described a development phase (Clasper & White 1995, Cooke et al, 2001, Ussher et al 2006. One paper reported that they used a survey that had been adopted in a previous study (Cooke et al, 1998) and one described the development of the tool from a review of the literature (Jordan et al, 2006).…”

Section: Quality Issuesmentioning

confidence: 99%

Factors relating to the uptake of interventions for smoking cessation among pregnant women: A systematic review and qualitative synthesis

Baxter

Everson-Hock

Messina

et al. 2010

Nicotine & Tobacco Research

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Differential uptake of a smoking cessation programme disseminated to doctors and midwives in antenatal clinics

Cited by 33 publications

References 22 publications

Knowledge, attitudes and other factors associated with assessment of tobacco smoking among pregnant Aboriginal women by health care providers: a cross-sectional survey

Knowledge, attitudes and other factors associated with assessment of tobacco smoking among pregnant Aboriginal women by health care providers: a cross-sectional survey

Tobacco cessation intervention for pregnant women in Argentina and Uruguay: study protocol

Factors relating to the uptake of interventions for smoking cessation among pregnant women: A systematic review and qualitative synthesis

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