Weiland Stella, Jansen Danielle E M C, Welker Gera A, Berger Marjolein Y, Erwich Jan Jaap H M, Peters Lilian L
Department of Primary and Long-Term Care, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
Midwifery Academy Amsterdam Groningen, InHolland, Dirk Huizingastraat 3-5, 9713 GL Groningen, The Netherlands.
Health Promot Int. 2025 May 13;40(3). doi: 10.1093/heapro/daaf084.
This study aimed to develop and evaluate plans for the implementation of the Dutch guideline 'Treatment of tobacco addiction and smoking cessation support for pregnant women'. Participatory action research was used for the development and evaluation of implementation plans for maternity collaboration units in the north of the Netherlands. Mixed methods were used to evaluate the implementation by using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. The maternity collaboration units implemented the intervention to refer pregnant women who smoke to a counsellor from addiction care. Twenty-one of the 50 midwifery care practices (42%) and two of the five obstetrics departments (40%) referred women to addiction care. The results showed that of the 558 women who smoked during pregnancy in 2021, 73 women (13%) were referred to addiction care, 58 (10%) started a coaching trajectory and 12 women of the 48 (25%) who finished a coaching trajectory stopped smoking. The results of interviews and focus groups gave insight into the challenges for referral and indicated that the communication between the midwife/counsellor and the pregnant woman is important for counselling. A minority of maternal care professionals referred women to a counsellor from addiction care and a small percentage of women managed to stop smoking. Opportunities in the repetition of implementation strategies and increasing skills in motivational interviewing for maternity care professionals could improve adoption of interventions in future implementation. To increase the effectiveness of the intervention, the counsellors could consider combining their counselling with nicotine replacement therapy, feedback or incentives.
本研究旨在制定并评估荷兰指南“孕妇烟草成瘾治疗与戒烟支持”的实施计划。参与式行动研究用于荷兰北部产妇协作单位实施计划的制定与评估。采用混合方法，运用覆盖范围、有效性、采用率、实施情况和维持情况框架来评估实施情况。产妇协作单位实施干预措施，将吸烟的孕妇转介给成瘾治疗顾问。50家助产护理机构中的21家（42%）以及5家产科部门中的2家（40%）将孕妇转介给成瘾治疗机构。结果显示，在2021年孕期吸烟的558名女性中，73名女性（13%）被转介给成瘾治疗机构，58名女性（10%）开始了指导疗程，在完成指导疗程的48名女性中，有12名女性（25%）戒烟。访谈和焦点小组的结果深入了解了转介方面的挑战，并表明助产士/顾问与孕妇之间的沟通对咨询很重要。少数产妇护理专业人员将孕妇转介给成瘾治疗顾问，只有一小部分女性成功戒烟。重复实施策略以及提高产妇护理专业人员动机性访谈技能方面的机会，可能会在未来实施中提高干预措施的采用率。为提高干预措施的有效性，顾问可考虑将咨询与尼古丁替代疗法、反馈或激励措施相结合。
