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dc.contributor.author
Althabe, Fernando
dc.contributor.author
Alemán, Alicia
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Berrueta, Amanda Mabel
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Morello, Paola
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Gibbons, Luz
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Colomar, Mercedes
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Tong, Van T.
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Dietz, Patricia M.
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Farr, Sherry L.
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Ciganda, Alvaro
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Mazzoni, Agustina
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Llambí, Laura
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Becú, Ana
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Smith, Ruben A.
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Johnson, Carolyn
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Belizan, Jose
dc.contributor.author
Buekens, Pierre M.
dc.date.available
2018-05-14T20:08:35Z
dc.date.issued
2016-05
dc.identifier.citation
Althabe, Fernando; Alemán, Alicia; Berrueta, Amanda Mabel; Morello, Paola; Gibbons, Luz; et al.; A Multifaceted Strategy to Implement Brief Smoking Cessation Counseling During Antenatal Care in Argentina and Uruguay: A Cluster Randomized Trial; Oxford University Press; Nicotine And Tobacco Research; 18; 5; 5-2016; 1083-1092
dc.identifier.issn
1462-2203
dc.identifier.uri
http://hdl.handle.net/11336/45147
dc.description.abstract
Introduction: Argentina and Uruguay have a high prevalence of smoking during pregnancy. However, and despite national recommendations, pregnant women are not routinely receiving cessation counseling during antenatal care (ANC). We evaluated a multifaceted strategy designed to increase the frequency of pregnant women who received a brief smoking cessation counseling based on the 5As (Ask, Advise, Assess, Assist, and Arrange). Methods: We randomly assigned (1:1) 20 ANC clusters in Buenos Aires, Argentina and Montevideo, Uruguay to receive a multifaceted intervention to implement brief smoking cessation counseling into routine ANC, or to receive no intervention. The primary outcome was the frequency of women who recalled receiving the 5As during ANC at more than one visit. Frequency of women who smoked until the end of pregnancy, and attitudes and readiness of ANC providers towards providing counseling were secondary outcomes. Women’s outcomes were measured at baseline and at the end of the 14- to 18-month intervention, by administering questionnaires at the postpartum hospital stay. Self-reported cessation was verified with saliva cotinine. The trial took place between October 03, 2011 and November 29, 2013. Results: The rate of women who recalled receiving the 5As increased from 14.0% to 33.6% in the intervention group (median rate change, 22.1%), and from 10.8% to 17.0% in the control group (median rate change, 4.6%; P = .001 for the difference in change between groups). The effect of the intervention was larger in Argentina than in Uruguay. The proportion of women who continued smoking during pregnancy was unchanged at follow-up in both groups and the relative difference between groups was not statistically significant (ratio of odds ratios 1.16, 95% CI: 0.98–1.37; P = .086). No significant changes were observed in knowledge, attitudes, and self-confidence of ANC providers. Conclusions: The intervention showed a moderate effect in increasing the proportion of women who recalled receiving the 5As, with a third of women receiving counseling in more than one visit. However, the frequency of women who smoked until the end of the pregnancy was not significantly reduced by the intervention. Implications: No implementation trials of smoking cessation interventions for pregnant women have been carried out in Latin American or in middle-income countries where health care systems or capacities may differ. We evaluated a multifaceted strategy designed to increase the frequency of pregnant women who receive brief smoking cessation counseling based on the 5As in Argentina and Uruguay. We found that the intervention showed a moderate effect in increasing the proportion of women receiving the 5As, with a third of women receiving counseling in more than one visit. However, the frequency of women who smoked until the end of the pregnancy was not significantly reduced by the intervention.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
Oxford University Press
dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.subject
Smoking Cessation
dc.subject.classification
Salud Pública y Medioambiental
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Ciencias de la Salud
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CIENCIAS MÉDICAS Y DE LA SALUD
dc.title
A Multifaceted Strategy to Implement Brief Smoking Cessation Counseling During Antenatal Care in Argentina and Uruguay: A Cluster Randomized Trial
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2018-05-11T20:39:58Z
dc.journal.volume
18
dc.journal.number
5
dc.journal.pagination
1083-1092
dc.journal.pais
Reino Unido
dc.journal.ciudad
Oxford
dc.description.fil
Fil: Althabe, Fernando. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
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Fil: Alemán, Alicia. Unidad de Investigación Clínica y Epidemiológica Montevideo; Uruguay
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Fil: Berrueta, Amanda Mabel. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
dc.description.fil
Fil: Morello, Paola. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Colomar, Mercedes. Unidad de Investigación Clínica y Epidemiológica Montevideo; Uruguay
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Fil: Tong, Van T.. Centers for Disease Control and Prevention; Estados Unidos
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Fil: Dietz, Patricia M.. Centers for Disease Control and Prevention; Estados Unidos
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Fil: Farr, Sherry L.. Centers for Disease Control and Prevention; Estados Unidos
dc.description.fil
Fil: Ciganda, Alvaro. Unidad de Investigación Clínica y Epidemiológica Montevideo; Uruguay
dc.description.fil
Fil: Mazzoni, Agustina. Instituto de Efectividad Clínica y Sanitaria; Argentina
dc.description.fil
Fil: Llambí, Laura. Universidad de la República. Facultad de Medicina. Hospital de Clínicas; Uruguay
dc.description.fil
Fil: Becú, Ana. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Smith, Ruben A.. Centers for Disease Control and Prevention; Estados Unidos
dc.description.fil
Fil: Johnson, Carolyn. Tulane School of Public Health and Tropical Medicine; Estados Unidos
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Fil: Belizan, Jose. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
dc.description.fil
Fil: Buekens, Pierre M.. Tulane School of Public Health and Tropical Medicine; Estados Unidos
dc.journal.title
Nicotine And Tobacco Research
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1093/ntr/ntv276
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/ntr/article/18/5/1083/2511987
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