TRAUMA & TRANSFORMATION WEEK ONE Presented By Mark Purcell, PsyD.
TEMPLATE DESIGN © 2008 Smoking Cessation with a Pregnancy Population: A Pilot Program Amy V....
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TEMPLATE DESIGN © 2008 www.PosterPresentations.com Smoking Cessation with a Pregnancy Population: A Pilot Program Amy V. Lukowski, PsyD, David Tinkelman, MD, Emma Goforth, MPH, Arnold Levinson, PhD, Emily Burns, MD, MSPH National Jewish Health, Colorado Department of Public Health and Environment, University of Colorado Health Sciences Center Abstract Results Conclusion Acknowledgements References Contact information The authors would like to thank their collaborators on this project. Special thanks to the outreach campaign work group (comprised of health and marketing experts and health care providers across Colorado), and to Mandy Bakulski for coordination of the work group. The Colorado QuitLine Pregnancy/postpartum program (PPP) is a telephone based individual- level treatment approach designed to improve smoking cessation effectiveness for pregnant and postpartum women. The overall goal of the PPP was to provide consistent and long-term interaction with smoking women during pregnancy and postpartum. Published evidence suggests that the longer callers participate in cessation programs, the more success they have in their quit efforts. Results: The results of this pilot program indicate that 55% of the PPP group were tobacco free at the end of their pregnancy. Of this group, 25% relapsed by 7 months following delivery leaving 46% of total PPP participants tobacco free at seven months postpartum (30-day abstinence). This compares favorably to reported relapse rates as high as 70% at 7 months postpartum. Conclusions: Given that PPP participants’ demographic characteristics (Table 1) put them at higher risk for smoking, i.e., they were younger, often single, less educated, and mostly Medicaid beneficiaries, the program had encouraging results. Further study with a larger population will be required to validate the findings of this pilot study. Methods The program incorporates evidence- based practices including providing at least 5 calls during pregnancy and at least 4 calls postpartum with a dedicated coach and providing incentives to participants vs. 5 total calls with no incentives for the standard quitline program. For this pilot study, descriptive data from Colorado QuitLine callers enrolled between July 1, 2010 and March 31, 2011 were analyzed. Results Ninety-nine women enrolled in the study, on average during the sixth month of pregnancy (range, 6 days to 8.2 months before due date). The survey response rate was 32.3%, with an average follow-up time of 7.7 months after due date. Among all enrollees, one in six completed a total of ten coaching calls (Table 2); respondents rated the importance of coaching a mean 5.6 on a 1-7 scale; other measures of coaches and coaching averaged in the top fifth of the scale range (Table 2). More than half (54.8%) of respondents retrospectively self- reported being tobacco free at the end of pregnancy, while one-fourth (23.5%) of those who quit relapsed by seven months postpartum . At seven months postpartum, 46.9% of total participants reported 30-day abstinence from tobacco use. The current program incorporated a number of evidence-based practices in a pregnancy/postpartum telephone- based pilot program to assess the effectiveness on 30-day point- prevalence abstinence rates at 7 months post-delivery. The results of the pilot program were encouraging on two fronts: the results showed that almost half of pregnant participants (46.1%) were tobacco free at seven months postpartum (30-day abstinence) compared with general, non-pregnant quitline participants (28.8%) and that 55.2% reported being tobacco free at the end of pregnancy with only 25% of participants relapsing by seven months postpartum. Previous reports show that the relapse rates for pregnant women within 6 months range from 50% to 70%. The Health Consequences of Smoking: A Report of the Surgeon Gen eral . Surgeon General’s Report on Smoking and Tobacco Use. Ershoff DH, et al. (2004). Lumley, J., Oliver, S. S., Chamberlain, C., & Oakley, L. (2004). Ershoff DH, et al. (2000). Fang WL, et al. (2004). Ma, Y., Goinis, K. V., Pbert, L., & Ockene, J. K. (2005). Boffetta P, Treédaniel J, Greco (2000). The Health Consequences of Involuntary Exposure to Tobacco Smoke . Rigotti NA , Park ER , Regan S , Chang Y , Perry K , Loudin B , & Quinn V . (2006). Gadomski, A., Adams, L., Tallman, N., Krupa, N., & Jenkins, P. (2011).. Melvin, C. L., & Gaffney, C. A. (2004). Adams, E. K., Melvin, C. L., & Raskind-Hood, C. L. (2008). Miller, W. R. & Rollnick, S., (2002). American Legacy Foundation (2006). Fiore MC, Jaen CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, et al. (2008). Solomon, L.J., Quinn, V.P. (2004). Edwards, N and Sims-Jones (1998). Solomon, L.J., Higgins, S. T., Heil, S. H., Badger, G. J., Thomas, C. S., & Bernstein, I. M. (2007). Hettema, J.E., & Hendricks, P.S. (2010). pregnant yes no total n= 32 n=67 n=99 race/ethnicity w hite 68.8 68.7 68.7 Latino 12.5 16.4 15.2 black 6.3 9.0 8.1 other 12.5 6.0 8.1 age group 18-24 43.8 22.4 29.3 25-34 46.9 59.7 55.6 35-44 6.3 14.9 12.1 45-54 3.1 3.0 3.0 m aritalstatus single 71.9 67.2 68.7 m arried 25.0 26.9 26.3 divorced 3.1 6.0 5.1 educationallevel <high school 9.4 25.4 20.2 H S grad orG ED 56.3 44.8 48.5 com e college orm ore 34.4 29.9 31.3 insurance status no insurance 6.3 14.9 12.1 Medicaid 68.8 58.2 61.6 private insurance 25.0 26.9 26.3 sm oking status atintake everyday 78.1 84.1 82.1 occasionally 0.0 3.2 2.1 notatall 21.9 12.7 15.8 cigarettes per day 0 0.0 3.6 2.5 1-9 46.2 21.8 29.6 10-15 26.9 34.6 32.1 16-20 23.1 30.9 28.4 >20 3.9 9.1 7.4 lifetim e quitattem pts* none 9.4 31.3 24.0 1-2 34.4 21.9 26.0 3-4 43.8 20.3 28.1 5 orm ore 12.5 26.6 21.9 tim e to sm oke w ithin 5 m inutes 31.3 52.2 45.5 6-30 21.9 23.9 23.2 m ore than 30 46.9 23.9 31.3 length oftim e sm oking 10 orfew eryears 53.1 41.8 45.5 m ore than 10 years 46.9 58.2 54.6 yes 17.9 no 82.1 com pleted f/u Table 1:C haracteristics,tobacco,and quitting history (percentages)ofallselected participants *p<0.05 betw een respondents and non-respondents m entalhealth problem /illness (am ong survey respondents only)
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Transcript of TEMPLATE DESIGN © 2008 Smoking Cessation with a Pregnancy Population: A Pilot Program Amy V....
TEMPLATE DESIGN © 2008
www.PosterPresentations.com
Smoking Cessation with a Pregnancy Population: A Pilot ProgramAmy V. Lukowski, PsyD, David Tinkelman, MD, Emma Goforth, MPH, Arnold Levinson, PhD, Emily Burns, MD, MSPH
National Jewish Health, Colorado Department of Public Health and Environment, University of Colorado Health Sciences Center
Abstract Results Conclusion
Acknowledgements
References
Contact information
The authors would like to thank their collaborators on this project. Special thanks to the outreach campaign work group (comprised of health and marketing experts and health care providers across Colorado), and to Mandy Bakulski for coordination of the work group.
The Colorado QuitLine Pregnancy/postpartum program (PPP) is a telephone based individual-level treatment approach designed to improve smoking cessation effectiveness for pregnant and postpartum women. The overall goal of the PPP was to provide consistent and long-term interaction with smoking women during pregnancy and postpartum. Published evidence suggests that the longer callers participate in cessation programs, the more success they have in their quit efforts. Results: The results of this pilot program indicate that 55% of the PPP group were tobacco free at the end of their pregnancy. Of this group, 25% relapsed by 7 months following delivery leaving 46% of total PPP participants tobacco free at seven months postpartum (30-day abstinence). This compares favorably to reported relapse rates as high as 70% at 7 months postpartum. Conclusions: Given that PPP participants’ demographic characteristics (Table 1) put them at higher risk for smoking, i.e., they were younger, often single, less educated, and mostly Medicaid beneficiaries, the program had encouraging results. Further study with a larger population will be required to validate the findings of this pilot study.
Methods
The program incorporates evidence-based practices including providing at least 5 calls during pregnancy and at least 4 calls postpartum with a dedicated coach and providing incentives to participants vs. 5 total calls with no incentives for the standard quitline program. For this pilot study, descriptive data from Colorado QuitLine callers enrolled between July 1, 2010 and March 31, 2011 were analyzed. There were a total of 1,644 study participants, including 1,545 men and women from the general QuitLine and 99 pregnancy and postpartum participants enrolled in the PPP.
Results
Ninety-nine women enrolled in the study, on average during the sixth month of pregnancy (range, 6 days to 8.2 months before due date). The survey response rate was 32.3%, with an average follow-up time of 7.7 months after due date.
Among all enrollees, one in six completed a total of ten coaching calls (Table 2); respondents rated the importance of coaching a mean 5.6 on a 1-7 scale; other measures of coaches and coaching averaged in the top fifth of the scale range (Table 2).
More than half (54.8%) of respondents retrospectively self-reported being tobacco free at the end of pregnancy, while one-fourth (23.5%) of those who quit relapsed by seven months postpartum . At seven months postpartum, 46.9% of total participants reported 30-day abstinence from tobacco use.
The current program incorporated a number of evidence-based practices in a pregnancy/postpartum telephone-based pilot program to assess the effectiveness on 30-day point-prevalence abstinence rates at 7 months post-delivery. The results of the pilot program were encouraging on two fronts: the results showed that almost half of pregnant participants (46.1%) were tobacco free at seven months postpartum (30-day abstinence) compared with general, non-pregnant quitline participants (28.8%) and that 55.2% reported being tobacco free at the end of pregnancy with only 25% of participants relapsing by seven months postpartum. Previous reports show that the relapse rates for pregnant women within 6 months range from 50% to 70%.
The Health Consequences of Smoking: A Report of the Surgeon General. Surgeon General’s Report on Smoking and Tobacco Use. Ershoff DH, et al. (2004).Lumley, J., Oliver, S. S., Chamberlain, C., & Oakley, L. (2004). Ershoff DH, et al. (2000). Fang WL, et al. (2004). Ma, Y., Goinis, K. V., Pbert, L., & Ockene, J. K. (2005). Boffetta P, Treédaniel J, Greco (2000).The Health Consequences of Involuntary Exposure to Tobacco Smoke. Rigotti NA, Park ER, Regan S, Chang Y, Perry K, Loudin B, & Quinn V. (2006). Gadomski, A., Adams, L., Tallman, N., Krupa, N., & Jenkins, P. (2011)..Melvin, C. L., & Gaffney, C. A. (2004). Adams, E. K., Melvin, C. L., & Raskind-Hood, C. L. (2008). Miller, W. R. & Rollnick, S., (2002).American Legacy Foundation (2006). Fiore MC, Jaen CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, et al. (2008).Solomon, L.J., Quinn, V.P. (2004). Edwards, N and Sims-Jones (1998). Solomon, L.J., Higgins, S. T., Heil, S. H., Badger, G. J., Thomas, C. S., & Bernstein, I. M. (2007). Hettema, J.E., & Hendricks, P.S. (2010). .
pregnantyes no total
n= 32 n=67 n=99race/ethnicitywhite 68.8 68.7 68.7Latino 12.5 16.4 15.2black 6.3 9.0 8.1other 12.5 6.0 8.1age group18-24 43.8 22.4 29.325-34 46.9 59.7 55.635-44 6.3 14.9 12.145-54 3.1 3.0 3.0marital statussingle 71.9 67.2 68.7married 25.0 26.9 26.3divorced 3.1 6.0 5.1educational level<high school 9.4 25.4 20.2HS grad or GED 56.3 44.8 48.5come college or more 34.4 29.9 31.3insurance statusno insurance 6.3 14.9 12.1Medicaid 68.8 58.2 61.6private insurance 25.0 26.9 26.3smoking status at intakeeveryday 78.1 84.1 82.1occasionally 0.0 3.2 2.1not at all 21.9 12.7 15.8cigarettes per day0 0.0 3.6 2.51-9 46.2 21.8 29.610-15 26.9 34.6 32.116-20 23.1 30.9 28.4>20 3.9 9.1 7.4lifetime quit attempts*none 9.4 31.3 24.01-2 34.4 21.9 26.03-4 43.8 20.3 28.15 or more 12.5 26.6 21.9time to smokewithin 5 minutes 31.3 52.2 45.56-30 21.9 23.9 23.2more than 30 46.9 23.9 31.3length of time smoking10 or fewer years 53.1 41.8 45.5
more than 10 years 46.9 58.2 54.6
yes 17.9no 82.1
completed f/u
Table 1: Characteristics, tobacco, and quitting history (percentages) of all selected participants
*p<0.05 betw een respondents and non-respondents
mental health problem/illness (among survey respondents only)
