Zapka J G, Pbert L, Stoddard A M, Ockene J K, Goins K V, Bonollo D
Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester 01655, USA.
Am J Public Health. 2000 Jan;90(1):78-84. doi: 10.2105/ajph.90.1.78.
This study assessed providers' performance of smoking cessation counseling steps with low-income pregnant and postpartum women receiving care at community health centers.
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.
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.
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.
本研究评估了在社区卫生中心接受护理的低收入孕妇和产后妇女的戒烟咨询步骤的实施情况。
要求6个社区卫生中心的妇女、婴儿和儿童特殊补充营养计划（WIC）项目工作人员、产科临床医生和儿科临床医生完成调查。测量了吸烟干预措施（实施情况）、知识和态度以及组织促进因素。通过方差分析和回归分析探讨与实施情况相关的因素。
不同诊所和提供者类型的实施情况得分存在显著差异。产科诊所的提供者得分最高，儿科诊所的提供者得分最低。执业护士和营养师的得分高于其他提供者。诊所类型、更多的吸烟相关知识、年龄较大以及将戒烟视为优先事项与更好的咨询实施情况独立相关。
所有组的平均实施情况得分都有改进空间。评估和建议之外步骤的实施得分较低表明需要强调国家指南中的协助和后续步骤。提供者自身帮助母亲戒烟的承诺很重要。
