Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2011 Aug;38(4):412-22.
doi: 10.1177/1090198110382503. Epub 2011 May 6.

Effectiveness of Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) methods in Medicaid-supported prenatal care: Trial III

Richard Windsor  1 , Lesa Woodby, Thomas Miller, Michael Hardin
Affiliations
Randomized Controlled Trial

Effectiveness of Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) methods in Medicaid-supported prenatal care: Trial III

Richard Windsor et al. Health Educ Behav. 2011 Aug.

Abstract

This two-phase evaluation documented the delivery and effectiveness of evidence-based health education methods by regular staff to pregnant smokers. During Phase 1, a total of 436 Medicaid patients were screened and 416 (95%) gave consent: 334 nonsmokers and 102 smokers. This historical Comparison (C) group was assessed to document the "normal" pretrial smoking prevalence, patient nondisclosure (deception), and cessation rates at the first prenatal visit and during care. After this study, a formative evaluation of SCRIPT methods was conducted among 139 experimental group patients and 126 control group patients. During Phase 2, a total of 6,514 patients were screened over a 36-month period: 1,736 (27%) were smokers and 1,340 (77%) gave consent. After randomization, 247 became ineligible. The remaining 1,093 smokers received brief routine advice to quit. The experimental group (n = 544) also received a Commit to Quit video, A Pregnant Woman's Guide to Quit Smoking, and counseling. Self-reports and saliva were collected at baseline, ≥60 days, and ≤90 days postpartum for cotinine analyses to document cessation and significant reduction (SR) rates. The Phase 1 formative evaluation documented a 24% nondisclosure rate at the onset of care. It also confirmed a significantly higher experimental (17.3%) versus control group (8.8%) cessation rate and experimental versus control group SR rates of 22% and 16%. During Phase 2, unplanned policy changes, and delivery of experimental group counseling procedures to 15% to 20% of control group patients, resulted in a final experimental group cessation rate of 12% and a control group rate of 10%. The experimental group SR rate of 18%, however, was significantly higher than the control group SR rate of 13%. Effectiveness varied by the stability of clinic infrastructure, and degree of fidelity of staff performance of assessment and intervention procedures. The methods and results of this study will assist future health education programs for pregnant smokers to plan and conduct process and impact evaluations in prenatal care.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors do not have any conflicts of interest in this study.

Figures

Form 1
Form 1
SCRIPT PROCEDURES *
See this image and copyright information in PMC

References

    1. Alabama Medicaid Maternity Care Program. Operational Manual. PO Box 5624, 50 Dexter Avenue, Montgomery, AL: Bureau of Family Health Services; 2002.
    1. Ahluwalia J. Reaching the medically underserved with the AHCPR Guideline. Tobacco Control. 1997;6(1):S29–S32. - PubMed
    1. Benowitz N, Henningfield J. Establishing a nicotine threshold for addiction: the implications for tobacco regulation. New England Journal of Medicine. 1994;331(2):123–125. - PubMed
    1. Crawford M, Woodby L, Russell T, Windsor R. Using formative evaluation to improve a smoking cessation intervention for pregnant women. Health Communication. 2005;17(3):265–281. - PubMed
    1. Davis R. Healthcare report cards and tobacco measures. Tobacco Control. 1997;6(1):570–577. - PubMed

Publication types