Psychosocial Well-Being and Efforts to Quit Smoking in Pregnant Women of Rural Appalachia

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Negative health effects on an unborn fetus have been related to cigarette smoking during pregnancy. Very little research examines stress, self-esteem, depression, and disordered eating in pregnant women who smoke. A study, Tennessee Intervention for Pregnant Smokers (TIPS), recruited pregnant women from five prenatal practices to help them quit smoking before giving birth. Using an expanded 5A’s (Ask, Advise, Assess, Assist, Arrange) model and motivational interviewing, the intervention was implemented by trained health educators over the course of 4 prenatal visits. Women in the study who successfully stopped smoking before delivery had significantly healthier infants than the women who did not. A subset of the sampled 1063 pregnant women with complete data on measures of interest will be analyzed for the current study. We hypothesize that the following factors will differ significantly among pregnant women who never smoked, women who smoked but quit prior to birth, and women who smoked and did not quit prior to birth: stress, as indicated by the stress subscale of the Prenatal Psychosocial Profile (PPP); self-esteem, as indicated by the self-esteem subscale of the PPP; depressive symptoms, as indicated by the Center for Epidemiologic Studies Depression Scale (CESD-10); and disordered eating, as indicated by the Eating Attitudes Test (EAT-26). Additionally, we hypothesize that the odds of pregnant women quitting smoking prior to birth will be predicted by stress, self-esteem, depressive symptoms, and disordered eating. One-way Analysis of Variance (ANOVA) tests will be conducted to compare scores on respective measures for the three groups based on smoking status. A logistic regression will be conducted to assess the degree to which aforementioned variables predict odds of smoking cessation in pregnant smokers. The implications of this research can be used to improve future intervention programs to reduce the adverse health effects of children born to mothers who smoke.


Johnson City, TN

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