Effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Dissemination Project: A Science to Prenatal Care Practice Partnership

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• 作者：Richard Windsor (1)
  Jeannie Clark (2)
  Sean Cleary (3)
  Amanda Davis (1)
  Stephanie Thorn (2)
  Lorien Abroms (1)
  John Wedeles (1)
  
• 关键词：Smoking ; Pregnancy ; Cessation ; Tobacco ; Evaluation
• 刊名：Maternal and Child Health Journal
• 出版年：2014
• 出版时间：January 2014
• 年：2014
• 卷：18
• 期：1
• 页码：180-190
• 全文大小：1,004 KB
• 作者单位：Richard Windsor (1)
  Jeannie Clark (2)
  Sean Cleary (3)
  Amanda Davis (1)
  Stephanie Thorn (2)
  Lorien Abroms (1)
  John Wedeles (1)
  
  1. Department of Prevention and Community Health, The George Washington University School of Public Health and Health Services, 2175 K Street, Suite #701, Washington, DC, 20037, USA
  2. West Virginia Department of Health and Human Resources, Department of Perinatal Services, Charleston, WV, USA
  3. Department of Epidemiology and Biostatistics, The George Washington University School of Public Health and Health Services, Washington, DC, USA
  
• ISSN：1573-6628

文摘

This study evaluated the effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Program selected by the West Virginia—Right From The Start Project for state-wide dissemination. A process evaluation documented the fidelity of SCRIPT delivery by Designated Care Coordinators (DCC), licensed nurses and social workers who provide home-based case management to Medicaid-eligible clients in all 55 counties. We implemented a quasi-experimental, non-randomized, matched Comparison (C) Group design. The SCRIPT Experimental E Group (N?=?259) were all clients in 2009-010 that wanted to quit, provided a screening carbon monoxide (CO), and received a SCRIPT home visit. The (C) Group was derived from all clients in 2006-007 who had the same CO assessments as E Group clients and reported receiving cessation counseling. We stratified the baseline CO of E Group clients into 10 strata, and randomly selected the same number of (C) Group clients (N?=?259) from each matched strata to evaluate the effectiveness of the SCRIPT Program. There were no significant baseline differences in the E and (C) Group. A Process Evaluation documented a significant increase in the fidelity of DCC delivery of SCRIPT Program procedures: from 63?% in 2006 to 74?% in 2010. Significant increases were documented in the E Group cessation rate (+9.3?%) and significant reduction rate (+4.5?%), a ?0?% reduction from a baseline CO. Perinatal health case management staff can deliver the SCRIPT Program, and Medicaid-supported clients can change smoking behavior, even very late in pregnancy. When multiple biases were analyzed, we concluded the SCRIPT Dissemination Project was the most plausible reason for the significant changes in behavior.