
Evidence Tools
MCH Best. NPM 14.1: Smoking in Pregnancy


Strategy. Feedback
Approach. Provide feedback to support reduction or smoking cessation behaviors.
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Overview. Research indicates that using feedback incorporated into comprehensive smoking cessation interventions can enhance the reduction of smoking during pregnancy.1 Feedback interventions are those where a pregnant woman is provided information about the fetal health status or the results of measurement of tobacco smoking by-products to initiate or reinforce smoking cessation behaviors. This information or measurement includes ultrasound monitoring, and carbon monoxide or urine cotinine measurements, with the results shared at points in time with the pregnant woman.2,3
Evidence. Emerging. There is growing evidence that feedback is effective in reducing smoking during pregnancy. This strategy has been tested more than once and results trend positive overall. . Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).
Target Audience. Pregnant women who smoke.
Outcome. Smoking cessation during pregnancy. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.
Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.
Sample ESMs. Using the approach “Provide feedback to support reduction or smoking cessation behaviors,” here are sample ESMs you can use to model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):
Quadrant 1:
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Quadrant 2:
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Quadrant 3:
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Quadrant 4:
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Note. When looking at your ESMs, SPMs, or other strategies: (1) move from measuring quantity to quality; (2) move from measuring effort to effect; (3) Quadrant 1 strategies should be used sparingly, when no other data exists; and (4) the most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.
Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.
Reference:
1 Chamberlain C, O-Mara-Eves A, Porter J, Coleman T, Perlen SM, Thomas J, McKenzie JE. Psychosocial interventions for supporting women to stop smoking in pregnancy. Cochrane Database of Systematic Reviews 2017, Issue 2. Art No.: CD001055. https://doi.org/10.1002/14651858.CD001055.pub5.
2 Morgan H, Treasure E, Tabib M, Johnston M, Dunkley C, Ritchie D, Semple S, Turner S. An interview study of pregnant women who were provided with indoor air quality measurements of second hand smoke to help them quit smoking. BioMed Central Pregnancy Childbirth 2016 Oct 12;16(1):305.
3 Harris M, Reynolds B. A pilot study of home-based smoking cessation programs for rural, Appalachian, pregnant smokers. Journal of Obstetric, Gynecologic, & Neonatal Nursing: Clinical Scholarship for the Care of Women, Childbearing Families, & Newborns 2015;44:236-45.