The Implementation Guide is a resource for implementing this program. It provides important information about the staffing and functions necessary for administering this program in the user's setting. Additionally, the steps needed to carry out the research-tested program, relevant program materials, and information for evaluating the program are included. The Implementation Guide can be viewed and downloaded in the Products page.
High Impact Therapy for Pregnant Smokers
|Program Title||High Impact Therapy for Pregnant Smokers|
|Purpose||Designed to promote smoking cessation among pregnant women. (2006)|
|Program Focus||Behavior Modification|
|Population Focus||Pregnant women|
|Age||Adolescents (11-18 years), Adults (40-65 years), Young Adults (19-39 years)|
|Race/Ethnicity||Black, not of Hispanic or Latino origin, Hispanic or Latino, White, not of Hispanic or Latino origin|
|Setting||Clinical, Urban/Inner City|
|Funded by||The Patrick and Catherine Weldon Donaghue Medical Research Foundation (Grant number(s) not available.)|
|User Reviews||(Be the first to write a review for this program)|
Training: A total of 40 hours of in-service training is required for the interventionists. This total includes 16 hours of initial group training and 24 hours of group clinical supervision focused on review of clinical cases.
Program Implementation: Implementation requires 90 minutes for the individual face-to-face counseling session and 10-30 minutes for each follow-up telephone session.
Interventionists should be licensed professionals with at least a master's degree in any area of mental health (e.g., licensed master's-level counselor, social worker, or clinical psychologist; predoctoral clinical psychology intern under the supervision of a licensed clinical psychologist). For information on training costs, please contact the developer.
The following materials are required:
-- High Impact Therapy for Pregnant Smokers Treatment Manual
-- Smoking Cessation Educational handout for clients (English and Spanish versions)
-- Counseling/Interviewing Packet
A randomized clinical study evaluated the effects on smoking abstinence which involved one-hundred-five pregnant women who smoke and were randomly assigned to one of two conditions: usual care only or usual care plus the High Impact Therapy for Pregnant Smokers interevention program. The usual care group was given an educational booklet and a personalized quit message at every prenatal visit. The intervention program consisted of a 90-minute face-to-face psychotherapy session with a mental health counselor and attempted bimonthly telephone follow-ups during pregnancy. The sample was 66% Hispanic, 17% Caucasian, and 11% African American with an average age of 26.1 years (range=18-42 years) at baseline. The majority of the participants (77%) had one or more children at the time of study entry, 61% were unemployed, 54% had less than a full high school education, 71% were between 12 and 24 weeks gestation (range=8-30 weeks gestation), 60% were unmarried, and 49% reported a household income of $15,000 per year or less.
Self-reported smoking status confirmed by a carbon monoxide breath test was obtained at baseline, end of pregnancy (defined as 36 +/- 2 weeks gestation), and 6 months postpartum. Although a carbon monoxide reading of <8ppm is typically used to define a nonsmoker, none of the participants who reported smoking abstinence for the prior 7 days at the end of pregnancy or at the 6 month postpartum followup had carbon monoxide readings >4ppm, and there were no cases of reported smoking abstinence contradicted by a positive carbon monoxide breath test.
A clinical interview at baseline obtained demographic information and medical, depression, drug, and smoking history. In addition to the smoking history, participants were evaluated using the following four measurement instruments:
-- Cigarette Smoking Timeline Followback: a semistructured, calendar-based interview that asks clients to retrospectively estimate their daily cigarette smoking for the past 30 days
-- Readiness to Change: participants identify one of three statements that fit them best
-- Smoking Self-Efficacy (confidence in ability not to smoke): nine items that describe various contexts in which smoking would likely take place are rated on a confidence scale of 1 (not at all confident) to 5 (extremely confident)
-- Fagerstrom Smoking Tolerance scale: eight-item instrument from which one item was used for this study: "How soon after you wake do you smoke your first cigarette?" (within or after 30 minutes)
There were no significant differences between conditions for any of the baseline smoking variables. Smoking status was obtained from 100% of the sample at the end of pregnancy and from 82% at 6 months postpartum.
- Participants assigned to the intervention group had higher reported smoking abstinence rates at the end of pregnancy compared with those assigned to the usual care group only (28.3% vs. 9.6%, respectively; p=.015). The highest abstinence rates were among participants younger than 25 years of age and whose gestation was less than 18 weeks at the time of study entry (60% intervention group vs. 0% usual care group only; p=.002).
- There were no significant differences between conditions in reported smoking abstinence rates at the 6-month postpartum assessment.
Dornelas EA, Magnavita J, Beazoglou T, Fischer EH, Oncken C, Lando H, Greene J, Barbagallo J, Stepnowski R, Gregonis E. (2006, Dec). Efficacy and cost-effectiveness of a clinic-based counseling intervention tested in an ethnically diverse sample of pregnant smokers. Patient Education and Counseling, 64(1-3), 342-349.
Fischer, E.H., Dornelas, E.A., Malchodi, C.S., & Oncken, C.A. (2006). Credibility of self-report for ethnic-minority pregnant smokers. Journal of Applied Social Psychology, 36 (12), 2825-2833.
Morasco, B.J., Dornelas, E.A., Fischer, E.H., Oncken, C., & Lando, H.A. (2006). Spontaneous smoking cessation during pregnancy among ethnic minority women: A preliminary investigation. Addiction Behaviors, 31(2), 203-210.
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