Klerman Lorraine V, Spivey Crystal
Heller School for Social Policy and Management, Brandeis University, PO Box 9110/MS 035, Waltham, MA 02454-9110, USA.
Am J Prev Med. 2003 Aug;25(2):129-35. doi: 10.1016/s0749-3797(03)00117-x.
Convincing pregnant women who smoke to give up this behavior is one of the few universally agreed upon methods for improving pregnancy outcomes. An exploratory study was conducted to determine what public and quasi-public facilities serving pregnant women were doing to assist pregnant smokers in quitting, the reasons why more was not being done, and what could be done to increase smoking-cessation services.
Questionnaires eliciting information about pregnancy-related smoking prevention activities were mailed to home visitation projects, federally funded Healthy Start programs, CityMatCH members, and maternal and child health units in state health departments with a subsample of local health units. Responses were obtained from 354 programs.
Only about a quarter of the respondents thought they were doing enough to help pregnant smokers stop or reduce smoking, and most thought that the inadequacy was due to insufficient funds. Only about a quarter offered smoking-cessation classes or clinics. Almost all programs had policies restricting smoking in their offices. The nationally sponsored activity that the respondents felt might be most helpful in increasing their efforts was the provision of materials. Among the 313 programs that included home visits, 86% required the home visitors to conduct a needs assessment, and 97% of those expected the woman's smoking status to be recorded. Smoking status prior to pregnancy or by other household members was required less often. Less than half of the programs provided training on smoking-cessation/reduction methods to home visitors. Only 28% said smoking-cessation/reduction had a very high priority in comparison to other home visit objectives. CONCLUSIONS; Programs for pregnant women, including those with a home visit component, do not pay sufficient attention to the problem of smoking among their clients. Programs should make greater use of the evidence-based interventions now available.
说服吸烟的孕妇戒除这一行为是少数几个普遍公认的改善妊娠结局的方法之一。开展了一项探索性研究，以确定为孕妇服务的公共和准公共机构在协助孕妇戒烟方面正在做些什么、未采取更多行动的原因以及如何增加戒烟服务。
向家访项目、联邦资助的健康开端项目、城市母婴健康合作组织成员以及州卫生部门的母婴健康单位邮寄了调查问卷，询问有关与妊娠相关的吸烟预防活动的信息，并抽取了部分地方卫生单位作为子样本。共收到354个项目的回复。
只有约四分之一的受访者认为他们在帮助孕妇戒烟或减少吸烟方面做得足够，大多数人认为不足的原因是资金不足。只有约四分之一的机构提供戒烟课程或诊所。几乎所有项目都有在办公室限制吸烟的政策。受访者认为在加大力度方面可能最有帮助的全国性活动是提供材料。在包括家访的313个项目中，86%要求家访人员进行需求评估，其中97%期望记录女性的吸烟状况。对妊娠前吸烟状况或其他家庭成员吸烟状况的记录要求则较少。不到一半的项目为家访人员提供戒烟/减少吸烟方法的培训。与其他家访目标相比，只有28%的项目表示戒烟/减少吸烟具有非常高的优先级。结论：为孕妇提供服务的项目，包括那些有家访环节的项目，对其服务对象中的吸烟问题关注不足。各项目应更多地利用现有的循证干预措施。
