Department of Public Health and Policy, Institute of Psychology, Health and Society, University of Liverpool, Waterhouse Building B, Liverpool, L69 3GL, UK.
Lancashire Care NHS Foundation Trust, Preston, UK.
BMC Pregnancy Childbirth. 2017 Nov 14;17(1):378. doi: 10.1186/s12884-017-1562-7.
Second-hand smoke (SHS) exposure during pregnancy is associated with poor pregnancy and foetal outcomes. Theory-based behaviour change interventions (BCI) have been used successfully to change smoking related behaviours and offer the potential to reduce exposure of SHS in pregnant women. Systematic reviews conducted so far do not evaluate the generalisability and scalability of interventions. The objectives of this review were to (1) report the BCIs for reduction in home exposure to SHS for pregnant women; and (2) critically appraise intervention-reporting, generalisability, feasibility and scalability of the BCIs employed.
Standard methods following PRISMA guidelines were employed. Eight databases were searched from 2000 to 2015 in English. The studies included used BCIs on pregnant women to reduce their home SHS exposure by targeting husbands/partners. The Workgroup for Intervention Development and Evaluation Research (WIDER) guidelines were used to assess intervention reporting. Generalisability, feasibility and scalability were assessed against criteria described by Bonell and Milat.
Of 3479 papers identified, six studies met the inclusion criteria. These studies found that BCIs led to increased knowledge about SHS harms, reduction or husbands quitting smoking, and increased susceptibility and change in level of actions to reduce SHS at home. Two studies reported objective exposure measures, and one reported objective health outcomes. The studies partially followed WIDER guidelines for reporting, and none met all generalisability, feasibility and scalability criteria.
There is a dearth of literature in this area and the quality of studies reviewed was moderate to low. The BCIs appear effective in reducing SHS, however, weak study methodology (self-reported exposure, lack of objective outcome assessment, short follow-up, absence of control group) preclude firm conclusion. Some components of the WIDER checklist were followed for BCI reporting, scalability and feasibility of the studies were not described. More rigorous studies using biochemical and clinical measures for exposures and health outcomes in varied study settings are required. Studies should report interventions in detail using WIDER checklist and assess them for generalisability, feasibility and scalability.
CRD40125026666.
孕妇在怀孕期间接触二手烟（SHS）与不良妊娠和胎儿结局有关。基于理论的行为改变干预（BCI）已成功用于改变与吸烟有关的行为，并有可能减少孕妇接触 SHS。到目前为止进行的系统评价并未评估干预措施的普遍性和可扩展性。本综述的目的是：（1）报告减少孕妇家庭内接触 SHS 的 BCI；（2）批判性地评价所采用的 BCI 的干预报告、普遍性、可行性和可扩展性。
采用 PRISMA 指南下的标准方法。从 2000 年到 2015 年，用英语在 8 个数据库中进行了搜索。这些研究使用 BCI 针对孕妇的丈夫/伴侣，以减少其家庭内 SHS 暴露。采用工作组干预开发和评估研究（WIDER）指南评估干预报告。针对 Bonell 和 Milat 描述的标准，评估普遍性、可行性和可扩展性。
在 3479 篇论文中，有 6 篇符合纳入标准。这些研究发现，BCI 导致了对 SHS 危害的更多了解，减少或丈夫戒烟，以及在家中减少 SHS 的易感性和行动水平的改变。有两项研究报告了客观的暴露测量值，一项研究报告了客观的健康结果。这些研究部分遵循了 WIDER 报告指南，但没有一项符合所有普遍性、可行性和可扩展性标准。
该领域文献匮乏，所审查研究的质量为中等至较低。BCI 似乎能有效减少 SHS，但研究方法薄弱（自我报告的暴露，缺乏客观的结果评估，随访时间短，缺乏对照组），无法得出确定的结论。WIDER 清单的某些部分适用于 BCI 报告，但研究的可扩展性和可行性并未描述。需要在不同的研究环境中使用生物化学和临床措施进行暴露和健康结果的更严格研究。研究应详细报告干预措施，使用 WIDER 清单评估其普遍性、可行性和可扩展性。
CRD40125026666。
