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Strengthen the Evidence for Maternal and Child Health Programs

Evidence Tools
MCH Best. NPM 14.1: Smoking in Pregnancy

MCH Best Logo paper cutout people holding a used cigarette

Strategy. Social Support

Approach. Provide social support for quitting smoking during pregnancy.

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Overview. Research indicates that culturally appropriate smoking cessation campaigns have been found to be well-received and prompt quit attempts. Indigenous community health workers, called Aunties, can reach and mobilize ethnic minority women to promote access to health care programs and deliver cessation support or social support early in pregnancy.1 Social support for quitting via a “quitpal” has also be combined with health education using standard smoking cessation text messages to support pregnant women with promising results.2

Evidence. Emerging. There is growing evidence that social support is effective in reducing smoking during pregnancy. This strategy of feedback 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.

Outcomes. 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 social support for quitting smoking during pregnancy,” 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:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of pregnant women who feel supported by a “quitpal.”

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of pregnant women who feel supported by a “quitpal.”

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of pregnant women who quit or reduce smoking after receiving social support.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of pregnant women who quit or reduce smoking after receiving social support.

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 Glover M, Kira A, Smith C. Enlisting “Aunties” to support indigenous pregnant women to stop smoking: Feasibility study results. Nicotine & Tobacco Research 2016;18:1110-5.

2 Abroms LC, Johnson PR, Heminger CL, Van Alstyne JM, Leavitt LE, Schindler-Ruwisch JM, Bushar JA. Quit4baby: results from a pilot test of a mobile smoking cessation program for pregnant women. Journal of Medical Internet Research Mhealth Uhealth. 2015 Jan 23;3(1):e10. doi: 10.2196/mhealth.3846.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.