Factors associated with maternal depressive symptoms among low-income, African American smokers enrolled in a secondhand smoke reduction programme

Abstract

Introduction Maternal depressive symptoms increase the risk of poor maternal and child health outcomes, and are a primary barrier to health behaviour change. Social cognitive theory can guide our understanding of risk factors that may have an impact on maternal depressive symptoms. The aim of this paper was to understand the correlates of maternal depressive symptoms among low-income African American smokers completing a 16-week intervention trial to reduce young children's second-hand smoke exposure (SHSe). Methods This study presents a secondary analysis of depression symptoms among 227 maternal smokers completing the SHSe-reduction trial. The end-of-treatment Center of Epidemiologic Studies Depression Scale (CES-D) score was used to assess depressive symptoms (dichotomised as 0 = score of < 16 and 1 = score of ≥ 16). Multivariate logistic regression analysis was used to test the one-way hypothesis that odds of significant depressive symptoms would be associated with greater total number of household smokers, greater number of paediatric sick visits, greater daily exposure of child to cigarette smoke by their mother, greater life-event stress, and lower social support, marital status, employment status and level of educational attainment. Results Number of household smokers (OR = 1.57, P = 0.049), social support (OR = 0.88, P < 0.001) and life-event stress (OR = 1.04, P = 0.001) predicted significant maternal depressive symptoms; all other variables were not significant predictors in the model. Conclusion Number of household smokers is a novel risk factor for understanding significant maternal depressive symptoms in the context of a childhood SHSe-reduction trial. Improving our understanding of the household-level social milieu in the context of SHSe-reduction interventions will assist in reducing the risk of maternal depressive symptoms.

Keywords: household smokers; maternal depressive symptoms; social cognitive theory.