de Vries Hein, Bakker Martijntje, Mullen Patricia Dolan, van Breukelen Gerard
Department of Health Education, University of Maastricht, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Patient Educ Couns. 2006 Oct;63(1-2):177-87. doi: 10.1016/j.pec.2005.10.002. Epub 2006 Jan 6.
Smoking during pregnancy is an important problem in the Netherlands. We tested the effectiveness of a health counseling method by midwives using a RCT.
Four provinces with 42 practices including 118 midwives were randomly assigned to the experimental or control condition. Midwives in the experimental group provided brief health counseling, self-help materials on smoking cessation during pregnancy and early postpartum, and a partner booklet. Controls received routine care. The main outcome measures were 7-day abstinence, continuous abstinence, and partner smoking at 6 weeks post-intervention (T1) and 6 weeks postpartum (T2).
Multi-level analysis revealed significant differences between both conditions at T1 and T2 using intention-to-treat analysis. Nineteen percent of the experimental group reported 7-day abstinence compared to 7% of the control group at T1, and 21 and 12%, respectively, at T2. For continuous abstinence these percentages were 12% in the experimental group and 3% in the control group. The partner intervention was not successful.
The intervention resulted in significant effects on smoking behavior for pregnant women, but not for partner smoking.
The program realized short-term effects. An important precondition is that midwives need a proper training.
孕期吸烟在荷兰是一个重要问题。我们通过一项随机对照试验测试了助产士采用的一种健康咨询方法的有效性。
四个省的42家医疗机构（包括118名助产士）被随机分配到试验组或对照组。试验组的助产士提供简短的健康咨询、孕期及产后早期戒烟的自助材料以及一本针对伴侣的手册。对照组接受常规护理。主要结局指标为干预后6周（T1）和产后6周（T2）时的7天戒烟率、持续戒烟率以及伴侣吸烟情况。
多水平分析显示，采用意向性分析时，在T1和T2时两组之间存在显著差异。试验组在T1时有19%的人报告7天戒烟，而对照组为7%；在T2时，试验组和对照组分别为21%和12%。对于持续戒烟，试验组和对照组的这一比例分别为12%和3%。针对伴侣的干预未成功。
该干预对孕妇的吸烟行为产生了显著影响，但对伴侣吸烟没有影响。
该项目实现了短期效果。一个重要的前提条件是助产士需要接受适当的培训。
