Page 85 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

Intervention Description
provider delivered counseling during the other 3 visits. Counseling about reason for maintaining cessation and help in developing a plan for doing so.
Reinforcement if they quit and if not, given encouragement and a plan to try to quit again.
Face-to-face in-hospital counseling sessions at birth, followed by 8 telephone follow-up sessions, home visits, or face-to-face visits outside the home during the first 3 mo pp. Delivered by a nurse. Sessions were weekly during the first mo pp and biweekly during the second and third mo pp. Counseling based on principles derived from Marlatt’s relapse model176 180. Aim counseling: teaching women to identify high-risk situations for smoking relapse and determining strategies to manage those situations, thereby strengthening their smoking cessation self-efficacy. The nurse supported efforts to maintain smoking abstinence, reviewing high-risk situations encountered and reviewed the lessons learned from any relapses. Supplemented with written materials.
Baseline values
All women had stopped smoking during pregnancy. 100% abstinence.
Weight Loss
(NS). Biochemically validated with cotinine.
Continuous abstinence rate at 3 and 6 mo pp was 38% in the I group, compared to 27% in the C group. OR 1.63, 95% CI 0.96-2.78.
At 6 mo pp, daily smoking was reported in 34% of the I group, compared to 48% of the C group, OR 1.80, 95% CI 108-2.99. Validated with CO in expired air.
At 12 mo, daily smoking was 41.2% in the I group and 50.4% in the C group, OR 1.45, 95% CI 0.87-2.43. Continuous abstinence rate at 6 and 12 mo pp was 12% in the I group and 18.5% in the C group, OR 1.17, 95% CI 0.62-2.22.
Significant intervention effect at 6 mo was not sustained at 12 mo pp.
Relapse rate in the I group was 63%, compared to 75% in the C group (NS).
Quit rate in the I group was 37%, compared to 25% in the C group (NS).
One brief (10-20 min) counseling session provided during the immediate pp hospitalization in the participants’ hospital room, delivered by a researcher. Using empowerment techniques, motivational interviewing193 194, identification of stressors and individual coping strategies, and educational material. Personal Rulers Worksheet61, Marlatt and Gordon’s relapse prevention model176 180. The participant received 4 different educational brochures developed by the American Lung Association and Agency for Health Care Policy and Research.
All non- smoking
3.1 Effect of Postpartum Lifestyle Interventions| 83
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