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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. Journaling

Approach. Engage in online journaling to support smoking cessation for pregnant women.

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Overview. Research indicates that behavioral interventions are effective in helping pregnant women quit smoking.1 Blogging combines various evidence-based behavioral strategies for tobacco cessation, such as journaling and getting support from others who use tobacco. A blog is a regularly updated website, typically run by an individual or small group, written in an informal or conversational style Being part of a blogging community of women who have experienced similar challenges can be therapeutic and help women gain confidence in their ability to change.2

Evidence. Emerging. There is growing evidence that journaling 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 “Engage in online journaling to support smoking cessation for pregnant women,” 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 received support for their quit journeys through blogging.
  • Number of pregnant women who reported an increased confidence in their ability to change due to journaling.

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

  • Percent of pregnant women who received support for their quit journeys through blogging.
  • Percent of pregnant women who reported an increased confidence in their ability to change due to journaling.

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

  • Number of pregnant women who reduced their smoking or are smoke free because of their experience journaling.

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

  • Percent of pregnant women who reduced their smoking or are smoke free because of their experience journaling.

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 Lumley J, Chamberlain C, Dowswell T, Oliver S, Oakley L, Watson L. Interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev. 2009;8(3):CD001055.

2 Minian N, Noormohamed A, Dragonetti R, Maher J, Lessels C, Selby P. Blogging to quit smoking: sharing stories from women of childbearing years in Ontario. Substance Abuse: Research and Treatment. 2016 Jan;10:SART-34551.

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.