Reducing Maternal Smoking and Relapse: Long-Term Evaluation of a Pediatric Intervention

Severson, Herbert H.; Andrews, Judy A.; Lichtenstein, Edward; Wall, Michael; Akers, Laura

doi:10.1006/pmed.1996.9983

Cited by 149 publications

(211 citation statements)

References 25 publications

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“…Residents in psychiatry were older than residents in pediatrics and medicine (mean age at baseline: 37. 30 , and a larger proportion of residents in pediatrics were female (63% at baseline) than residents in medicine (27%) and psychiatry (26%) ( 2 ϭ 10.787; P Ͻ .05).…”

Section: Demographic Characteristicsmentioning

confidence: 99%

“…Questions about tobacco were drawn from surveys used in the Community Intervention Trial for Smoking Cessation to assess changes in physician tobacco intervention behaviors, 30 and comparable questions were used to assess intervention on alcohol and other drugs. The survey was administered at baseline (1996) and at the end of the study (1999) to residents in pediatrics, psychiatry, and medicine (Table 1).…”

Section: Baseline Tobacco and Substance Abuse Intervention Survey Formentioning

confidence: 99%

“…A survey of parents in a pediatric practice setting 29 showed that almost all of the parents surveyed believed that the pediatrician should talk to parents about the effects of ETS on children and to children and adolescents about stopping smoking. Efforts to encourage parents of patients to quit smoking have not met with uniform success, 30 and pediatric officebased interventions on ETS, smoking cessation, and prevention of smoking onset remain important areas for research.…”

mentioning

confidence: 99%

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Pediatric Residency Training on Tobacco

Hymowitz¹,

Schwab

Eckholdt

2001

Pediatrics

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ABSTRACT. Objective. Pediatricians have a unique role to play in the antismoking arena. However, few pediatric residency training programs prepare residents to meet the tobacco challenge. This study evaluates the effects of a comprehensive pediatric residency training program on tobacco on resident tobacco intervention behaviors, as well as on changes in the behavior of patients and their parents/guardians.Methods. Pediatric residents were exposed to a comprehensive training program on tobacco. Baseline and follow-up surveys of residents, parents/guardians, and patients were used to assess the effects of the training program. A quasi-experimental design permitted unambiguous evaluation of the program's effects on resident intervention behaviors.Results. The comprehensive training program on tobacco led to marked and significant changes in resident intervention on tobacco. Many of these changes were supported by parents' and patients' reports. In turn, resident intervention on tobacco led to a significant increase in the likelihood that parents would maintain a "smokefree household." Significant changes in the prevalence of parental smoking were not found, although the trend during 3 years of follow-up was in the desired direction. A high proportion of residents reported that they intervened on tobacco in patients at baseline and follow-up, but too few patients were sampled to permit analysis of the impact on changes in smoking.Conclusions. Comprehensive training on tobacco had a positive and powerful effect on the tobacco intervention behavior of pediatric residents. In turn, intervention on tobacco by pediatric residents may have a significant impact on patients and their parents. These findings underscore the efficacy of pediatric residency training on tobacco, and it is hoped that they will serve as an impetus for other pediatric residency programs to introduce training on tobacco. Pediatrics 2001;108(1). URL: http://www. pediatrics.org/cgi/content/full/108/1/e8; tobacco control and prevention, cigarette smoking, environmental tobacco smoke, residency training.

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Section: Demographic Characteristicsmentioning

confidence: 99%

Section: Baseline Tobacco and Substance Abuse Intervention Survey Formentioning

confidence: 99%

mentioning

confidence: 99%

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Pediatric Residency Training on Tobacco

Hymowitz¹,

Schwab

Eckholdt

2001

Pediatrics

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“…Severson et al 77 reported that many mothers were more confident about smoking outside the home and restricting visitors' smoke in the house than about quitting. Although McIntosh et al 78 found that restricting smoking to outside the home wasn't necessarily an easier behavioral goal to implement than was cessation, physicians should be trained in both interventions.…”

Section: Harm Reductionmentioning

confidence: 99%

The Pediatrician's Role in Reducing Tobacco Exposure in Children

et al. 2000

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ABSTRACT. Objective. Pediatricians have a unique and important role to play in the prevention and treatment of childhood and adolescent tobacco use, the protection of patients from the harmful effects of environmental tobacco smoke, and the encouragement of smoking cessation among parents. However, because recent research indicates that physician training in tobacco dependence is woefully weak and lacks a model for training, this article constructs a useful approach to this problem.Methodology. A comprehensive review of the literature served as the basis for the development of a new model for pediatrician training in tobacco dependence.Results. A comprehensive model is presented for training pediatricians in the areas of reducing infant and child exposure to environmental tobacco smoke, preventing youth smoking initiation, and providing smoking cessation assistance for adolescents and parents.Conclusions. Pediatricians have been called on to play an active role in the antitobacco arena. Because of their unique opportunity to interact with children, adolescents, and parents, pediatricians can and should be antitobacco interventionists. For this to occur, however, additional guidance should be provided to pediatricians during their training to better prepare them to carry out effective assessment and intervention practices. Pediatrics 2000;106(5). URL: http://www.pediatrics.org/ cgi/content/full/106/5/e66; smoking initiation, smoking prevention, smoking cessation, environmental tobacco smoke, pediatricians.

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“…14 A pediatrics-based intervention was effective in helping women remain abstinent during the postpartum period, 15,16 but other research targeting relapse prevention has had mixed results. [17][18][19] Provider-delivered interventions are effective in promoting smoking cessation, 20,21 especially when there is an office system to cue providers.…”

Section: Smoking Cessation Counseling With Pregnant and Postpartum Womentioning

confidence: 99%

Smoking cessation counseling with pregnant and postpartum women: a survey of community health center providers

Zapka

Pbert²,

Stoddard³

et al. 2000

Am J Public Health

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Objectives. This study assessed providers' performance of smoking cessation counseling steps with low-income pregnant and postpartum women receiving care at community health centers.Methods. WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) program staff, obstetric clinicians, and pediatric clinicians at 6 community health centers were asked to complete surveys. Smoking intervention practices (performance), knowledge and attitudes, and organizational facilitators were measured. Factors associated with performance were explored with analysis of variance and regression analysis.Results. Performance scores differed significantly by clinic and provider type. Providers in obstetric clinics had the highest scores and those in pediatric clinics had the lowest scores. Nurse practitioners and nutritionists had higher scores than other providers. Clinic type, greater smoking-related knowledge, older age, and perception of smoking cessation as a priority were independently related to better counseling performance.Conclusions. Mean performance scores demonstrated room for improvement in all groups. Low scores for performance of steps beyond assessment and advice indicate a need for emphasis on the assistance and follow-up steps of national guidelines. Providers' own commitment to helping mothers stop smoking was important. (Am J

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Reducing Maternal Smoking and Relapse: Long-Term Evaluation of a Pediatric Intervention

Cited by 149 publications

References 25 publications

Pediatric Residency Training on Tobacco

Pediatric Residency Training on Tobacco

The Pediatrician's Role in Reducing Tobacco Exposure in Children

Smoking cessation counseling with pregnant and postpartum women: a survey of community health center providers

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