Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Other Person-to-Person Education, Peer Counselor, Motivational Interviewing, Telephone Support, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Consultation (Parent/Family)

Intervention Description: The goals were to describe a smoking cessation intervention, the Tennessee Intervention for Pregnant Smokers program, and examine the impact on quit rates compared to usual care. Additionally we sought to examine reduction in smoking levels and number of quit attempts related to the intervention and finally to examine the impact of the intervention on birth outcomes.

Intervention Results: Over 28% of intervention group women quit smoking, compared to 9.8% in the control group. Two thirds of intervention group women significantly reduced smoking by delivery, with 40%+ attempting to quit at least once. Compared to controls, intervention group women saw significantly better birth outcomes, including newborns weighing 270g more and 50% less likely to have a neonatal intensive care unit admission. Among intervention group participants, those who quit smoking had significantly better birth outcomes than those who did not quit smoking.

Conclusion: Findings point to the potential for appropriately tailored pregnancy smoking interventions to produce substantial improvements in birth outcomes within populations with health disparities.

Study Design: RCT

Setting: Prenatal care clinics

Population of Focus: Pregnant women smokers who receive Medicaid and prenatal care

Data Source: Self-report of smoking behavior, exhaled CO, urine cotinine

Sample Size: 1486

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Other Person-to-Person Education, Motivational Interviewing, Other Education, Intensive Therapy, Peer Counselor

Intervention Description: This report describes tobacco use prevalence among perinatal smokers identified through an "opt-out" inpatient smoking cessation clinical service.

Intervention Results: Between February 2014 and March 2016, 533 (10%) current and 898 (16%) former smokers were identified out of 5649 women admitted to the perinatal units. Current smokers reported an average of 11 cigarettes per day for approximately 12 years. Only 10% reported having made a quit attempt in the past year. The majority of smokers (56%) were visited by a bedside tobacco cessation counselor during their stay and 27% were contacted through the IVR system. Those counselled in the hospital were twice as likely (RR 1.98, CI 1.04-3.78) to be abstinent from smoking using intent-to-treat analysis at any time during the 30 days post-discharge.

Conclusion: This opt-out service reached a highly nicotine-dependent perinatal population, many of whom were receptive to the service, and it appeared to improve abstinence rates post-discharge. Opt-out tobacco cessation services may have a significant impact on the health outcomes of this population and their children.

Study Design: Quasi experimental cross sectional evaluation

Setting: Academic medical center

Population of Focus: Smokers admitted to the perinatal units

Data Source: In-patient records and follow up phone surveys

Sample Size: 5649

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Other Person-to-Person Education, CAREGIVER, Education/Training (caregiver), PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Motivational Interviewing, Motivational Interviewing/Counseling

Intervention Description: Intervention (INT) was a home-based asthma follow-up after ED visit and two visits for an environmental control educational program delivered by trained nurses and nurse practitioners to the child and caregiver. For caregivers of children with positive cotinine results, brief motivational interviewing sessions were conducted to implement total home smoking ban.

Intervention Results: Over half of children in the study tested positive for SHS. Targeting SHS exposure was major component of the intervention [but] no significant reduction in cotinine exposures was associated with the intervention at 12 months.

Conclusion: In this study, a home-based EC intervention was not successful in reducing asthma ED revisits in children with poorly controlled asthma with SHS exposure. Allergic sensitization, young age, and increased controller medication use were important predictors of asthma ED visits.

Study Design: Prospective randomized controlled trial

Setting: Home-based (following ED visit)

Population of Focus: Children with physician diagnosed persistent asthma, having two or more ED asthma visits or more than one hospitalization over the past 12 months and residing in the Baltimore metropolitan area

Data Source: For SHS exposure, child saliva samples collected during the ED visit and at 6- and 12-month follow up visits.

Sample Size: 222 inner city children ages 3-12

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Other Person-to-Person Education, PATIENT_CONSUMER, Educational Material, Provider Training/Education, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: This study was a controlled trial study with longitudinal design. The sample consisted of 156 women (intervention = 78, control = 78) who registered in hearing-impaired associations in Izmir, Turkey. The education about cervical cancer and Pap smear test was given to intervention group with face-to-face interviews by using Turkish sign language. Three months later, the women were contacted and asked whether they have had a Pap smear test, and the total knowledge score of intervention groups was evaluated.

Intervention Results: There was not a statistically significant difference between the mean total score of knowledge about cervical cancer and Pap smear test in intervention (0.6 ± 1.6) and control (1.1 ± 1.9) groups. After 3 months, having a Pap smear test was found to be statistically significantly higher between groups (intervention = 29.5%, control = %1.2), and the mean cervical cancer and Pap smear knowledge score of the intervention group (9.2 ± 1.4) was found to be statistically significantly higher than the score before education (0.6 ± 1.6).

Conclusion: Education of cervical cancer and Pap smear test increased knowledge level and behaviour of Pap smear test of the women.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Navigation, Other Person-to-Person Education, Referrals

Intervention Description: We pilot tested a Perinatal Wellness Navigator (PWN) program for a group of high-risk perinatal women (N = 50; n = 42 with OUD) that consisted of (a) one-on-one tobacco treatment, (b) comprehensive assessment of cessation barriers, and (c) linkage to clinical/social services.

Intervention Results: Outcome measures were assessed at baseline and postintervention. Participants smoked 10 fewer cigarettes per day (p = .05) at postintervention and were less dependent on nicotine (p < .01). Mean postnatal depression scores (p = .03) and perceived stress (p = .03) decreased postintervention. Participants received at least one referral at baseline (n = 106 total), and 10 participants received an additional 18 referrals at postintervention to address cessation barriers.

Conclusion: The PWN program was minimally effective in promoting total tobacco abstinence in a high-risk group of perinatal women, but participants experienced reductions in cigarettes smoked per day, nicotine dependence, stress, and depression.

Study Design: Quasi experimental cross sectional -pilot

Setting: University obstetric and gynecology clinics

Population of Focus: Pregnant women over 18, smoked and expressed interest in quitting

Data Source: Expired air carbon monoxide (EACO), self-report, standardized scales

Sample Size: 50

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Other Person-to-Person Education, Television Media, COMMUNITY, PATIENT/CONSUMER, Other Media, POPULATION-BASED SYSTEMS

Intervention Description: To test the effectiveness of a community intervention program to promote breast and cervical cancer screening.

Intervention Results: There were higher Pap smear completion rates for women under 40 years of age in the intervention community.

Conclusion: Although it is important to address the cultural needs of all Mexican American women, it is also important to understand the tangible environmental barriers faced by the older women.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Predominantly Mexican American neighborhoods in San Antonio and Houston, TX

Population of Focus: Mexican American women

Data Source: Self-report through personal interviews

Sample Size: Baseline (n=1,776) Intervention (n=882); Control (n=894) First Panel Follow-up (n=296) Intervention (n=153); Control (n=143) Second Panel Follow-up (n=145) Intervention (n=70); Control (n=75)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Other Person-to-Person Education, PROVIDER/PRACTICE, Outreach (Provider)

Intervention Description: This article describes the smoking behavior outcomes of a feasibility project testing a proactive approach, utilizing Māori voluntary community health workers to identify and reach Māori pregnant women who smoke and provide cessation support.

Intervention Results: The majority of women were Māori, 20-30 years old, had their first cigarette within 30 minutes of waking and 58% had not tried to quit during the current pregnancy. Of the participants who completed a follow-up interview 33% had stopped smoking while they were pregnant and 57% had cut down. There was an increase at follow-up of people who had used cessation support or products.

Conclusion: Aunties are well-placed to find pregnant women and provide cessation support and referral in a way consistent with traditional Māori knowledge and practices. This study suggests such an intervention could increase quit attempts and increase use of effective cessation methods. A more robust study is warranted to develop an enhanced Aunties intervention.

Study Design: Prospective intervention trial- evaluation

Setting: Home-based culturally tailored community health smoking cessation support

Population of Focus: Pregnant Māori women smokers

Data Source: In person questionnaires, interviews, and hospital birth records

Sample Size: 67

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Community-Based Group Education, Other Person-to-Person Education, Patient Navigation

Intervention Description: We conducted a cluster-randomized trial at 23 ethnic churches in the Baltimore, Maryland–Washington, DC, metropolitan area between 2010 and 2014. Trained CHWs enrolled 560 women. The intervention group received an individually tailored cancer-screening brochure followed by CHW-led health literacy training and monthly telephone counseling with navigation assistance. Study outcomes included receipt of an age-appropriate cancer screening test, health literacy, cancer knowledge, and perceptions about cancer screening at 6 months.

Intervention Results: The odds of having received a mammogram were 18.5 (95% confidence interval [CI] = 9.2, 37.4) times higher in the intervention than in the control group, adjusting for covariates. The odds of receiving a Papanicolaou test were 13.3 (95% CI = 7.9, 22.3) times higher; the odds of receiving both tests were 17.4 (95% CI = 7.5, 40.3) times higher. Intervention effects also included increases in health literacy and positive perceptions about cancer screening.

Conclusion: A health literacy–focused CHW intervention successfully promoted cancer-screening behaviors and related cognitive and attitudinal outcomes in Korean American women.

Setting: 23 ethnic churches in the Baltimore,MD-Washington, DC area

Population of Focus: Korean American women who had not had a pap test in 24 months and who could read and write Korean or English

Intervention Components (click on component to see a list of all articles that use that intervention): Pharmacotherapy (Nicotine), Referrals, Other Person-to-Person Education, PATIENT_CONSUMER, Incentives

Intervention Description: Monthly variability in smoking behaviors in caregivers of pediatric asthmatics yields questions of how much and when does smoking reduction result in improved environmental and clinical outcomes.

Intervention Results: Caregivers with 3 months of ≥25% decrease in cotinine levels had a significantly greater mean change in child cotinine levels (p = 0.018). “Low” caregiver cotinine levels did not significantly improve pediatric asthma control (OR 2.12 (95% CI: 0.62–7.25)). Caregiver anxiety and depression outcomes, measured by Patient Health Questionnaire (PHQ)-4 scores, was not significantly different based on cotinine categorization (p = 0.079);

Conclusion: Reduced pediatric cotinine levels were seen in caregivers who reduced their smoking for at least 3 months, but clinical outcome measures remained unchanged.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Other Person-to-Person Education, Motivational Interviewing, Group Education

Intervention Description: This study retrospectively evaluated the effect of smoking cessation intervention in pregnant women with smoking.

Intervention Results: After 12-week treatment, participants in the treatment group did not significantly reduce the number of participants quit smoking; decrease daily cigarettes consumption, and quit attempts in pregnant smokers, compared with subjects in the control group. At delivery, the comparison also did not show significant differences in the number of participants quit smoking, decreasing daily cigarettes consumption, and quitting attempts in pregnant smokers, as well as all infant outcomes between 2 groups.

Conclusion: The results of this retrospective study did not found that smoking cessation intervention may help to quit smoking for pregnant smokers.

Study Design: Cohort study- Retrospective observation

Setting: University hospital clinic

Population of Focus: Pregnant smokers aged from 18 to 40 years old, 12 to 24 weeks of gestation, with current cigarette consumption of more than 1 cigarette daily who could walk for 20 minutes daily

Data Source: Self-report, Urine cotinine

Sample Size: 176

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Other Person-to-Person Education, Patient Navigation

Intervention Description: A qualitative study design included: (i) a systematic review, in which 1,301 abstracts from five databases were screened and 41 publications included; (ii) soliciting 124 unpublished documents from governments and partner institutions; and (iii) conducting 27 key informant interviews. Data were extracted and analysed thematically. Additionally, first-dose coverage rates were categorised as above 90 %, 90–70 %, and below 70 %, and cross-tabulated with mobilisation timing, message content, materials and methods of delivery, and consent procedures.

Intervention Results: All but one delivery experience achieved over 70 % first-dose coverage; 60 % achieved over 90 %. Key informants emphasized the benefits of starting social mobilisation early and actively addressing rumours as they emerged. Interactive communication with parents appeared to achieve higher first-dose coverage than non-interactive messaging. Written parental consent (i.e., opt-in), though frequently used, resulted in lower reported coverage than implied consent (i.e., opt-out). Protection against cervical cancer was the primary reason for vaccine acceptability, whereas fear of adverse effects, exposure to rumours, lack of project/programme awareness, and schoolgirl absenteeism were major reasons for non-vaccination.

Conclusion: Despite some challenges in obtaining parental consent and addressing rumours, experiences indicated effective social mobilisation and high HPV vaccine acceptability in LMICs. Social mobilisation, consent, and acceptability lessons were consistent across world regions and HPV vaccination projects/programmes. These can be used to guide HPV vaccination communication strategies without additional formative research.

Study Design: A qualitative study design

Setting: Not specified

Data Source: A qualitative study design included: (i) a systematic review, in which 1,301 abstracts from five databases were screened and 41 publications included; (ii) soliciting 124 unpublished documents from governments and partner institutions; and (iii) conducting 27 key informant interviews.

Sample Size: 1452 studies/ abstracts reviewed/ interviews

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Community Health Workers (CHWs), PATIENT/CONSUMER, Home Visits, Educational Material, Other Person-to-Person Education, Peer Counselor, Motivational Interviewing, CAREGIVER, Home Visit (caregiver), Education/Training (caregiver), Educational Material (caregiver), Motivational Interviewing/Counseling

Intervention Description: We assessed the effectiveness of a community health worker intervention focused on reducing exposure to indoor asthma triggers.

Intervention Results: The high-intensity group improved significantly more than the low-intensity group in its pediatric asthma caregiver quality-of-life score (P=.005) and asthma-related urgent health services use (P=.026). Asthma symptom days declined more in the high-intensity group, although the across-group difference did not reach statistical significance (P= .138). Participant actions to reduce triggers generally increased in the high-intensity group. The projected 4-year net savings per participant among the high-intensity group relative to the low-intensity group were $189–$721.

Conclusion: Community health workers reduced asthma symptom days and urgent health services use while improving caregiver quality-of-life score. Improvement was greater with a higher-intensity intervention.

Study Design: RCT

Setting: Community (home)

Population of Focus: Families in low-income households with children with asthma

Data Source: In-home interviewing, dust sample and standardized home inspection

Sample Size: 274 randomized participants

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Other Person-to-Person Education, Telephone Support, Enabling Services, Educational Material, Motivational Interviewing, Peer Counselor

Intervention Description: This study evaluated a theory-guided cognitive-behavioral counseling (CBC) intervention for smoking cessation during pregnancy and postpartum. It also explored the mediating role of cognitive-affective variables on the impact of CBC.

Intervention Results: An intent-to-treat analysis found no differences between the two groups in 7-day point-prevalence abstinence. However, a respondents-only analysis revealed a significantly higher cessation rate in the CBC (37.3 %) versus the BP (19.0 %) condition at 5-months postpartum follow-up. This effect was mediated by higher quitting self-efficacy and lower cons of quitting.

Conclusion: CBC, based on the Cognitive-Social Health Information Processing model, has the potential to increase postpartum smoking abstinence by assessing and addressing cognitive-affective barriers among women who adhere to the intervention.

Study Design: RCT

Setting: University hospital prenatal care clinic

Population of Focus: Racial and ethnically diverse urban pregnant smokers

Data Source: Standard scales, self-report, urine cotinine

Sample Size: 277, 140 in the intervention group and 137 in the control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Incentives, Educational Material, Peer Counselor, Motivational Interviewing, Pharmacotherapy (Nicotine), Other Person-to-Person Education, Group Education, Community-Based Group Education

Intervention Description: To assess the feasibility and acceptability of implementing a culturally tailored, intensive smoking cessation program, including contingency-based financial rewards (CBFR), for pregnant Aboriginal women.

Intervention Results: Twenty-two of 38 eligible women (58%) enrolled in the program, with 19 (86% remaining at the end of their pregnancy. The program was highly acceptable to both women and providers. Feasibility issues included challenges providing twice-weekly visits for 3 weeks and running fortnightly support groups. Of the 19 women who completed the program, 15 (79%) reported a quit attempt lasting >=24 hours, and 8 (42%) were CO-confirmed as not smoking in late pregnancy. The rewards were perceived to help motivate women, but the key to successful quitting was considered to be the intensive support provided.

Conclusion: 'Stop Smoking in its Tracks' was acceptable and is likely to be feasible to implement with some modifications. The program should be tested in a larger study.

Study Design: Single group pre-post test

Setting: Aboriginal Maternal and Infant Health Services clinics

Population of Focus: Pregnant aboriginal women seeking prenatal care at health services sites who were smoking and older than 16 years and less than 20 weeks gestation who were local residents

Data Source: Self-reported smoking levels, breath CO

Sample Size: 38, 19 completed the program

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, Educational Material, Other Person-to-Person Education

Intervention Description: To examine human papillomavirus (HPV) vaccine intent and the effect of an educational intervention on vaccine uptake among female college students.

Intervention Results: At baseline, 41% intended to undergo HPV vaccination. Participants who were currently sexually active and lacked supplemental health insurance had decreased intent. Perceived parental approval regarding HPV vaccination, perceived vulnerability to HPV infection, and belief in health benefits of HPV vaccine were associated with increased intent. HPV vaccine uptake was low (5.5%) and did not differ by study group. However, baseline intent was significantly associated with HPV vaccine uptake.

Conclusion: Interventions to increase HPV vaccine uptake in college students should address HPV-related beliefs and broader barriers to vaccination.

Study Design: RCT

Setting: University Health Service Gynecology Clinic at the University of Michigan

Population of Focus: Full- or part-time female students visiting the clinic for a routine physical and had not received the first dose of the HPV vaccine series

Data Source: University of Michigan University Health Services medical records; self-report via a mailed survey, telephone interview, or email (if dates of vaccination were unavailable)

Sample Size: Total (n=256)4  Intervention (n=128)  Control (n=128)

Age Range: 18-26

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Motivational Interviewing, Educational Material, Other Person-to-Person Education

Intervention Description: This randomized controlled pilot study evaluated feasibility and potential efficacy of a social-cognitive theory (SCT)-based biomarker feedback intervention among pregnant Alaska Native (AN) smokers.

Intervention Results: High rates of treatment compliance, study retention, and treatment acceptability were observed in both groups. 7-day point prevalence smoking abstinence rates at delivery verified with urinary cotinine were the same in both study groups (20% intent-to-treat analysis, 26% per-protocol). SCT-based measures did not change differentially from baseline by study group.

Conclusion: This trial supports the feasibility and acceptability of providing biomarker feedback within the clinical care delivery system, but the intervention did not promote increased smoking cessation during pregnancy compared to usual care.

Study Design: RCT- pilot

Setting: Primary care center

Population of Focus: Pregnant Alaskan native women who smoked receiving prenatal care at a primary care center in Anchorage, AK

Data Source: Urine cotinine levels, phone interviews

Sample Size: 60 -30 intervention, 30 control

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Other Person-to-Person Education, Motivational Interviewing, Telephone Support, PATIENT_CONSUMER

Intervention Description: In this report, we provide a cohort profile, and 8-week prolonged abstinence (8-week PA) and relapse findings from the first year of follow-up (n = 233).

Intervention Results: We found: (1) 28.4% achieved 8-week PA, (2) At a median of 6.2 months of follow-up after achieving 8-week PA, 23.2% of enrolled subjects reported tobacco cessation, and (3) a high rate of loss to follow-up (44%). In addition, our modeling indicated that the odds of relapse/smoking after enrollment was significantly higher in young mothers, non-Hispanic mothers (White, Black/African-American), mothers in the first and third trimester, and rural mothers.

Conclusion: Formative quantitative and qualitative research on the CTTP cohort will consider the effects of a range of implementation science (number of intervention sessions, addition of a mHealth component, distance to care) and individual (partner/household smoking, birth outcomes, NICU) outcome measures for the purpose of scaling up the CTTP model.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Educational Material, Other Education, Other Person-to-Person Education

Intervention Description: Nurse-delivered telephone support, relapse prevention training, and information about the adverse effects of smoking and ETS.

Intervention Results: At 6 months postpartum, 36% remained abstinent; 26% smoking; and 38% smoking daily. At 12 months postpartum, 78.5% reported no difficulties in making homes smoke- free. By 12 months this % increased to 86.9%.

Conclusion: While regional legislative activity has been effective in reducing ETS in many public places,12 private homes cannot be easily regulated. Public health education remains the most effective means to protect children from ETS in their homes. While there is growing appreciation for the importance of smoke-free homes,133 there remain significant misperceptions about effective ways to enact this protection.

Study Design: RCT

Setting: Hospital (time of birth) and Community (telephone)

Population of Focus: Mothers who had quit smoking during pregnancy

Data Source: Interview data collection at birth and at 6 and 12 months postpartum.

Sample Size: 251 mothers

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Pharmacotherapy (Nicotine), Peer Counselor, Educational Material, Other Person-to-Person Education

Intervention Description: Exposing children to secondhand tobacco smoke (SHS) causes significant harm and occurs predominantly through smoking by caregivers in the family home. We report a trial of a complex intervention designed to reduce secondhand smoke exposure of children whose primary caregiver feels unable or unwilling to quit smoking.

Intervention Results: Outcomes were the change in average home air quality, significant reduction in number of cigarettes smoked in the home and HIS, threefold increase in the odds of making an attempt to quit during the 12 weeks of the study. Significant behavior change, improvement in indoor air quality and consequent reductions in exposure of young children to SHS as measured by salivary cotinine.

Conclusion: By reducing exposure to SHS in the homes of children who live with smokers unable or unwilling to quit, this intervention offers huge potential to reduce children’s’ tobacco-related harm.

Study Design: Open label, parallel, RCT

Setting: Home-based (educational home visits and feedback air quality) and telephone counseling

Population of Focus: Caregivers resident in Nottingham City and County, England who were at least 18 years old, the main caregiver of a child aged under 5 years living in their household, and reported that they were smoking tobacco inside their home

Data Source: Participant questionnaires, indoor air, saliva samples to measure child’s cotinine.

Sample Size: 205; 103 to intervention and 102 to usual care

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), PATIENT/CONSUMER, Home Visits, Other Person-to-Person Education, Educational Material

Intervention Description: To determine if low-cost air-quality monitors providing personalised feedback of household second-hand smoke (SHS) concentrations plus standard health service advice on SHS were more effective than standard advice in helping parents protect their child from SHS.

Intervention Results: 120 mothers were recruited of whom 117 were randomised. Follow up was completed after 1-month in 102 and at 6-months in 78 participants. There was no statistically significant reduction in PM2.5 concentrations by either intervention type at 1-month or 6-months, nor significant differences between the two groups at 1-month (p = 0.76) and 6-month follow-up (p = 0.16).

Conclusion: Neither standard advice nor standard advice plus personalised air-quality feedback were effective in reducing PM2.5 concentrations in deprived households where smoking occurred. Finding ways of identifying homes where air-quality feedback can be a useful tool to change household smoking behaviour is important to ensure resources are targeted successfully.

Study Design: RCT

Setting: Home-based

Population of Focus: Disadvantaged mothers who were exposed to SHS at home

Data Source: Air quality data, and caregiver selfreport

Sample Size: 117 mothers

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Other Person-to-Person Education, PROVIDER/PRACTICE, Provider Education, Designated Clinic/Extended Hours

Intervention Description: Evaluate the impact of a quality improvement project of implementing a Women's Preventive Health Clinic (WPHC) on addressing gaps identified by needs assessments: residents' comfort and knowledge with female preventive care and cervical cancer screening.

Intervention Results: There was a significant improvement in general knowledge (64% correct at pretest vs 73% at post-test, p=0.0002), resident comfort level in discussing women's health topics and performing gynaecological exams (p<0.0002). Cervical cancer screening rates among IM residents' patients improved from 54% (pre-WPHC initiation) to 65% (post-WPHC initiation period).

Conclusion: The results indicate that a focused resident preventive programme can meet gaps identified by education and needs assessments, and simultaneously have a positive impact on cervical cancer screening rates and thus may serve as a model for other residency programmes.

Study Design: QE: pretest-posttest

Setting: MetroHealth Medical Center in Cleveland, OH

Population of Focus: All women within eligible age range Second- and third-year internal medicine residents

Data Source: Electronic medical records

Sample Size: Total (=378) N=women Total (N=63) N=resident physicians

Age Range: 18-63

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Other Person-to-Person Education, Enabling Services, Other Media, Community Events, COMMUNITY, POPULATION-BASED SYSTEMS

Intervention Description: In a randomized controlled trial of 20 communities, the study examined whether a comprehensive intervention influenced cancer screening behaviors and lifestyle practices in rural communities in Eastern Washington State. Cross-sectional surveys at baseline and post-intervention included interviews with a random sample of approximately 100 households per community. The interview included questions on ever use and recent use of Pap test, mammogram, and fecal occult blood test (FOBT) and sigmoidoscopy/colonoscopy, fruit and vegetable consumption and smoking practices.

Intervention Results: The study found few significant changes in use of screening services for cervical (Pap test), breast (mammogram) or colorectal cancer (fecal occult blood test (FOBT) or sigmoidoscopy/colonoscopy) between intervention and control communities. Results showed no significant differences in fruit and vegetable consumption nor in smoking prevalence between the two groups. We found more awareness of and participation in intervention activities in the treatment communities than the control communities.

Conclusion: Our null findings might be attributable to the low dose of the intervention, a cohort effect, or contamination of the effect in non-intervention communities. Further research to identify effective strategies to improve cancer prevention lifestyle behaviors and screening practices are needed.

Study Design: Cluster RCT

Setting: Twenty communities in the Lower Yakima Valley of WA

Population of Focus: Women

Data Source: Self-report through personal interviews

Sample Size: Total (N=1,962) Analysis (n=1,851) Intervention (n=894); Control (n=957)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Motivational Interviewing, Educational Material, Other Person-to-Person Education, Community-Based Group Education, Group Education, Incentives

Intervention Description: Given serious consequences of maternal smoking, we aimed to develop and test a multicomponent behavioral intervention to enhance smoking cessation during pregnancy.

Intervention Results: The estimated smoking cessation rate was 70.0% (21/30) at the second week of the intervention, and 63.3% (19/30) at the conclusion of the 8-week intervention assuming the dropouts as smoking. In interrupted time series analysis, the mean daily number of cigarettes smoked among quitters decreased by 6.52, 5.34, and 4.67 among early, delayed, and late intervention groups, respectively. Quitters' mean urine cotinine level maintained stably high before the intervention but decreased rapidly to the nonsmoking range once the intervention was initiated. Most participants (85.7%) reported meeting or exceeding expectations, and 100% would recommend the program to others.

Conclusion: This pilot multicomponent intervention was feasible and acceptable to most participants, resulting in a high smoking cessation rate among pregnant smokers who were unlikely to quit spontaneously.

Study Design: Cohort-Multiple-baseline intervention pilot studymultiple interrupted time series approach

Setting: Community-based prenatal clinics

Population of Focus: English speaking pregnant women who are current smokers without alcohol or drug dependency or mental health disorders

Data Source: Urine cotinine, self-report calendar of cigarette use

Sample Size: 30

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Other Person-to-Person Education,

Intervention Description: Provider recommendations

Intervention Results: The study found that communication with healthcare providers about health and safety guidelines was positively associated with adherence to those guidelines. Trust in the healthcare provider was also positively associated with adherence. However, confidence in ability to follow the provider's advice and comfort talking to the provider about safety guidelines were not significantly associated with adherence.

Conclusion: Findings underscore the importance of provider communication about health/safety guidelines.

Study Design: Cross-sectional study.

Setting: The study was conducted online through Amazon Mechanical Turk (mTurk), a web service that enables researchers and businesses to collect data and complete tasks via paid workers.

Population of Focus: Parents of children under six years old.

Sample Size: 256 parents completed the survey.

Age Range: The children of the parents surveyed were under six years old, with a mean age of about 43 months or 3.5 years old.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Telephone Support, Other Person-to-Person Education, Peer Counselor, Motivational Interviewing, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family)

Intervention Description: Mobile-phone-based smoking cessation intervention has been shown to increase quitting among smokers.

Intervention Results: All findings were between intervention group B and control. No differences found between intervention group A and control or between groups A and B. Father self-reported smoking abstinence at 6 months was significantly increased in group B compared to control and even higher at 12 months. Although no reduction in self-reported exposure rates were found at 6 months, the rate as 12 months was significantly decreased in group B when compared to control group.

Conclusion: The findings suggest that adding mHealth interventions to traditional face-to-face health counseling may be an effective way to increase male smoking cessation and reduce mother and newborn SHS exposure in the home.

Study Design: Single-blind randomized control trial

Setting: Home-based (baseline, 6 months, 12 months with in person counseling); Mobile-based

Population of Focus: Parents of newborns

Data Source: Self-report survey data.

Sample Size: 342 (114 in each of the three groups)

Age Range: Not specified