Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Telephone Support, Educational Material, PROVIDER/PRACTICE, Community Health Workers (CHWs)

Intervention Description: To assess whether a theory-based, community health worker–delivered intervention for household smokers will lead to reduced secondhand smoke exposure to children in Chinese families.

Intervention Results: Of the 318 families randomized, 98 (60%) of 164 intervention group and 82 (53%) of 154 of controls completed 6-month follow-up assessment. At the 6-month follow-up, 62% of intervention and 45% of comparison group households adopted complete smoking restrictions at home (P = .022); total exposure (mean number of cigarettes per week ± standard deviation) from all smokers at home in the past 7 days was significantly lower among children in the intervention (3.29 ± 9.06) than the comparison (7.41 ± 14.63) group (P = .021); and mean urine cotinine level (ng/mL) was significantly lower in the intervention (0.030 ± .065) than the comparison (0.087 ± .027) group, P < .001). Participants rating of the overall usefulness of the intervention was 4.8 + 0.8 (1 standard deviation) on the 5 point scale (1 not at all and 5 = very useful). Conclusions

Conclusion: The findings of this very first study in China showed that smoking hygiene intervention was effective in reducing children's exposure to secondhand smoke. These findings have implications for the development of primary health care–based secondhand smoke exposure reduction and family oriented smoking cessation interventions as China moves toward a smoke-free society.

Study Design: RCT

Setting: Community (households)

Population of Focus: Smoking parents or caregivers who had a child aged 5 years or younger

Data Source: Health center records and parent selfreport.

Sample Size: 318 families

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Telephone Support, Peer Counselor

Intervention Description: To examine whether telephone counselling based on the stages of change component of Transtheoretical model of behaviour change together with educational materials could help non-motivated smoking parents of young children to cease.

Intervention Results: A total of 952 smoker fathers and mothers were randomized to the intervention (n = 467) and control (n = 485) groups. Most were daily smokers (92.4%) and the mean number of cigarettes smoked per day was 14.5 (SD = 8.9). By using intention-to-treat analysis, the 7 day point prevalence quit rate at 6 month follow up was significantly greater in the intervention group (15.3%; 68/444) than the control group (7.4%; 34/459) (P < 0.001). The absolute risk reduction was 7.9% (95% confidence interval: 3.78% to 12.01%). The number needed to treat to get one additional smoker to quit was 13 (95% CI: 8-26). The crude odds ratio of quitting was 2.3(95% CI: 1.5-3.5). The adjusted odds ratio was 2.1 (95% CI: 1.4-3.4) (adjusted for age, number of years smoked, and alcohol dependency).

Conclusion: Proactive telephone counselling is an effective aid to promote smoking cessation among parents of young children.

Study Design: RCT

Setting: Community (maternal and child health centers)

Population of Focus: Smoking mothers and fathers with young children aged 5 years

Data Source: 1997 Birth Cohort Study of the Department of Community Medicine, University of Hong Kong.

Sample Size: 952 families

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), PATIENT/CONSUMER, Educational Material, Telephone Support, Parent Engagement, Patient Reminder/Invitation

Intervention Description: This study aims to test the acceptability and feasibility of SmokefreeMOM, a national smoking cessation text-messaging program for pregnant smokers.

Intervention Results: Results indicate that the SmokefreeMOM program was highly rated overall and rated more favorably than the control condition in its helpfulness at 3-month follow-up (P<.01) and in its frequency of messaging at both 1-month and 3-month follow-ups (P<.001, P<.01, respectively). Despite the presence of technical problems, the vast majority of intervention participants read all program messages, and few participants unsubscribed from the program. There were no significant differences between groups on the use of extra treatment resources or on smoking-related outcomes. However, at the 3-month follow-up, some outcomes favored the intervention group.

Conclusion: SmokefreeMOM is acceptable for pregnant smokers. It is recommended that SmokefreeMOM be further refined and evaluated.

Study Design: RCT

Setting: Obstetrics-gynecology clinics

Population of Focus: Women who are currently pregnant, English proficient, with a mobile phone and unlimited text messaging, that are currently smoking or smoked in the past 2 weeks

Data Source: Surveys and saliva sample

Sample Size: 99 participants (55 in SmokefreeMOM intervention group and 44 in control group)

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), PATIENT/CONSUMER, Patient Reminder/Invitation, Educational Material, Telephone Support, Parent Engagement, Incentives

Intervention Description: The study aimed to demonstrate the feasibility and acceptability of Quit4baby for women currently enrolled in Text4baby, a perinatal health text messaging program.

Intervention Results: Most participants responded to the program favorably. Highly rated aspects included the content of the program, skills taught within the program, and encouragement and social support provided by the program. Participants reported that the program was helpful in quitting, that the program gave good ideas on quitting, and that they would recommend the program to a friend. Suggestions for improvement included increasing the message dose and making the quitpal more interactive.

Conclusion: This pilot test provides support for the feasibility and acceptability of Quit4baby. Future studies are needed to assess whether Quit4baby is effective for smoking cessation during pregnancy.

Study Design: Single group pre-post test evaluation pilot

Setting: Electronic phone application

Population of Focus: Women over 18 years of age who are currently pregnant, English proficient, that are currently smoking or smoked in the past 2 weeks

Data Source: Telephone surveys, retrospective computer records review of engagement with the technology

Sample Size: 20

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), PATIENT/CONSUMER, Patient Reminder/Invitation, Educational Material, Parent Engagement, Telephone Support

Intervention Description: The study tests whether an interactive and intensive text messaging program, Quit4baby, can promote smoking cessation for pregnant women already enrolled in a health text messaging program, Text4baby.

Intervention Results: Using an intention-to-treat analysis, 28.80% of the intervention group and 15.79% of the control group reported not smoking in the past 7 days at 1 month (p<0.01), and 35.20% of the intervention group and 22.67% of the control group reported not smoking in the past 7 days at 3 months (p<0.01). Biochemical verification of smoking status at 3 months indicated no significant differences between groups (15.60% in the intervention group and 10.93% in the control group [p=0.13]), although significant differences favoring the intervention were found for older smokers (p<0.05) and for those who enrolled in their second or third trimester of pregnancy (p<0.05). Self-report of late pregnancy 7- and 30-day point prevalence abstinence favored the intervention group (p<0.001, p<0.01). No significant differences were observed at the 6-month follow-up or in the postpartum period.

Conclusion: Results provide limited support of the efficacy of the Quit4baby text messaging program in the short term and late in pregnancy, but not in the postpartum period.

Study Design: RCT

Setting: Electronic phone application

Population of Focus: Women over 14 years of age who are currently pregnant, English proficient, that are currently smoking or smoked in the past 2 weeks, who were signed up for Text4Baby message

Data Source: Surveys and saliva sample

Sample Size: 497

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, Enabling Services

Intervention Description: Individually randomised controlled trial. All 3 124 women in three low-resource areas in Gothenburg, due for screening during the study period, were randomised to receive an offer of a free test or the standard invitation stating the regular fee of 100 SEK (≈11 €). The study was conducted during the first six months of 2013. Attendance was defined as a registered Pap smear within 90 days from the date the invitation was sent out.

Intervention Results: Attendance did not differ significantly between women who were charged and those offered free screening (RR 0.93; CI 0.85-1.02). No differences were found within the districts or as an effect of age, attendance after the most recent previous invitation or previous experience of smear taking.

Conclusion: Abolishment of a modest screening fee in socially disadvantaged urban districts with low coverage, after previous multiple systematic interventions, does not increase attendance in the short term. Other interventions might be more important for increasing attendance in low socio-economic status areas.

Study Design: RCT

Setting: Sweden

Population of Focus: Women with no Pap smear reported in the past 3 or 5 years

Data Source: Process Registry of the Swedish National Screening Registry

Sample Size: Total (N=3,124) Intervention (n=1,562); Control (n=1,562)

Age Range: 23-63

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Educational Material, Home Visits

Intervention Description: To assess the efficacy of peer counseling to promote exclusive breastfeeding (EBF) among low-income inner-city women in Hartford, Conn.

Intervention Results: Significantly more mothers in the control group had not initiated breastfeeding compared to mothers in the intervention group (RR= 2.48; 95% CI: 1.04-5.90)

Conclusion: Well-structured, intensive breastfeeding support provided by hospital and community-based peer counselors is effective in improving exclusive breastfeeding rates among low-income, inner-city women in the United States.

Study Design: RCT

Setting: 3 clinic teams providing prenatal care at the Women’s Ambulatory Health Services Clinic of Hartford Hospital (CT)

Population of Focus: First stage: Recruited mothers attending the prenatal clinic on mornings of 4 predetermined weekdays who were ≥ 18 years old, ≤ 32 weeks gestational age (GA), healthy, and did not have medical conditions likely to impair successful breastfeeding Second stage: Recruited mothers considering breastfeeding who planned to deliver at Hartford Hospital, and to stay in the area for three months after delivery, living in a household earning < 185% of the federal poverty level, and available to be contacted via telephone. Third stage (Postpartum): Recruited mothers free of any medical condition that would prevent her from exclusively breastfeeding with newborns at least 36 weeks GA, weighing ≥ 2500 gm, with no complications requiring treatment in the NICU, and Apgar scores of ≥ 6 at 1 and 5 minutes.

Data Source: Medical records and mother self-report

Sample Size: Randomized • Intervention (n=90) • Control (n=92) Stage 3 Screening After Delivery • Intervention (n=77) • Control (n=85)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PROVIDER/PRACTICE, Nurse/Nurse Practitioner

Intervention Description: To evaluate the efficacy of an early home-based intervention on the quality of maternal–infant attachment, maternal mood and child health parameters in a cohort of vulnerable families.

Intervention Results: At 4 month follow-up, 160 families (80 intervention, 80 control) were available for assessment. The intervention improved family functioning at 4 months. All aspects of the home environment, including the quality of maternal–infant attachment and mothers’ relationship with their child, were significantly enhanced. In particular, significant and positive differences were found in parenting with the intervention group feeling less restrictions imposed by the parenting role, greater sense of competence in parenting, greater acceptability of the child, and the child being more likely to provide positive reinforcement to the parent. Early differences in maternal mood were not maintained at 4 months. Various child health parameters were enhanced including immunization status, fewer parent-reported injuries and bruising, and researcher confirmed lack of smoking in the house or around the infant. The families were consistently more satisfied with their community health service.

Conclusion: This form of early home based intervention targeted to vulnerable families promotes an environment conducive for infant mental and general health and hence long-term psychological and physical well-being, and is highly valued by the families who receive it.

Study Design: RCT

Setting: Community (child health nurse home visits)

Population of Focus: Families with an infant and whose English literacy skills enabled them to complete a questionnaire

Data Source: Parent self-report and child’s personal health record book.

Sample Size: 181 families; Intervention (n=90), Control (n=91)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Peer Counselor, Telephone Support

Intervention Description: The objective of this study was to assess whether counseling both mothers and fathers reduces their infants’ exposure to secondhand smoke (SHS).

Intervention Results: The intervention was effective in reducing infant urinary cotinine levels (1-tailed p = .029). There was a greater decrease in the total daily cigarette consumption in the presence of the child in the intervention group compared with the control group, and the differences between the 2 groups were statistically significant (1-tailed p = .03). While the differences between home-smoking bans in the 2 groups were statistically significant (1-tailed p = .049), the differences between car-smoking bans did not reach significance.

Conclusion: Counseling similar to that employed in other countries can reduce infant exposure to SHS, suggesting generalizability.

Study Design: RCT

Setting: Recruited from health centers, intervention face-to-face and telephone

Population of Focus: Nonsmoking children aged less than 1 year, exposed to their fathers’ or mothers’ smoking, and recruited from a health center in southern Tehran

Data Source: Parental self-report and infant urinary cotinine.

Sample Size: 130 children

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, 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, Incentives

Intervention Description: The Centers for Medicare and Medicaid Services' Meaningful Use (MU) of Electronic Health Record (EHR) Incentive Program could increase rates of smoking assessment and cessation assistance among vulnerable populations. This study examined whether smoking status assessment, cessation assistance, and odds of being a current smoker changed after Stage 1 MU implementation.

Intervention Results: Non-pregnant patients had decreased odds of current smoking over time; odds for all other outcomes increased except for medication orders from 2010 to 2012. Among pregnant patients, odds of assessment and counseling increased across all years. Odds of discussing or ordering of cessation medications increased from 2010 compared with the other 2 study years; however, medication orders alone did not change over time, and current smoking only decreased from 2010 to 2012. Compared with non-pregnant patients, a lower percentage of pregnant patients were provided counseling.

Conclusion: Findings suggest that incentives for MU of EHRs increase the odds of smoking assessment and cessation assistance, which could lead to decreased smoking rates among vulnerable populations. Continued efforts for provision of cessation assistance among pregnant patients is warranted.

Study Design: Quasi experimental cross-sectional (Non- randomized evaluation of a policy change)

Setting: Community health centers (CHC)

Population of Focus: All smokers over 18 years of age with at least one primary care visit to one of the study CHCs in 2010, 2012, or 2014 as well as a subset of pregnant women

Data Source: Electronic health records

Sample Size: Review of health records for 16,802 participants in 2010, 17,631 in 2012 and 18,110 in 2014

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, PROVIDER/PRACTICE, Provider Education, Provider Audit/Practice Audit, Quality Improvement/Practice-Wide Intervention, Designated Clinic/Extended Hours

Intervention Description: Evaluation of a 5-year demonstration project testing a multicomponent (provider, system, and patient) intervention to increase cervical cancer screening among women who receive their health care through the Los Angeles County Department of Health Services, the second largest County Health Department in the nation.

Intervention Results: At the Hospital and Comprehensive Health Center (CHC) levels a statistically significant intervention effect was observed after controlling for baseline screening rates and case mix. No intervention effect was observed at the Public Health Center (PHC) level.

Conclusion: An intensive multicomponent intervention can increase cervical cancer screening in a large, urban, County health system serving a low-income minority population of under screened women.

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

Setting: Los Angeles County Department of Health Services (LACDHS) facilities: 2 large hospitals, 2 feeder Comprehensive Health Centers, and 6 of the health center’s feeder Public Health Centers

Population of Focus: Women attending LACDHS facilities

Data Source: Medical records and computerized databases held by the Los Angeles County Department of Health Services

Sample Size: Total (N=18,642) Intervention (n=9,492); Control (n=9,150) Baseline (n=5,249) Year 2 (n=5,470) Year 3 (n=5,365) First 6 months of Year 4 (n=2,558)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Midwife

Intervention Description: The aim of this study was to compare midwife-led (MLU) versus consultant-led (CLU) care for healthy, pregnant women without risk factors for labour and delivery.

Intervention Results: No significant difference in breastfeeding initiation between intervention and control groups (RR=0.97, 95% CI: 0.89-1.06)

Conclusion: Midwife-led care, as practised in this study, is as safe as consultant-led care and is associated with less intervention during labour and delivery.

Study Design: RCT

Setting: Our Lady of Lourdes Hospital in Drogheda and Cavan General Hospital in Cavan

Population of Focus: Women assessed at booking clinic at ≤ 24 weeks GA between 16-39 years of age, had ≤ 5 previous children, ≥ 152 cm in height, had a BMI between 18 and 29, did not have certain medical obstetrical or gynecological medical histories, were not current drug misusers, did not smoke ≥ 20 cigarettes per day, and did not have a latex allergy

Data Source: Medical record review

Sample Size: Intervention (n=1101) Control (n=552)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material

Intervention Description: This study evaluated the effect of MeFirst, an individually tailored, online educational intervention, on HPV vaccine-related knowledge, vaccination intention, and uptake among previously unvaccinated female university students.

Intervention Results: HPV vaccine uptake was similar in both the MeFirst and control groups at 3 months following the intervention (p = 0.98). Three months after the intervention, the proportion of participants with high knowledge regarding HPV vaccination increased from baseline (32% to 50%; p < 0.0001) but the proportion with favorable intention was unchanged.

Conclusion: We found that an individually tailored, online educational tool had similar effects as a nontailored factsheet on HPV-related knowledge, intention to HPV undergo vaccination, and HPV vaccine uptake among previously unvaccinated female university students.

Study Design: RCT

Setting: Online at a Midwestern university

Population of Focus: Full- or part-time female students with no prior receipt of any doses of the HPV vaccine and who were invited via email to participate

Data Source: Online surveys distributed via email

Sample Size: Total Baseline (n=661)  Intervention (n=330)  Control (n=331) Total Follow-up (Analysis) (n=332)  Intervention (n=175)  Control (n=157)

Age Range: 18-26

Intervention Components (click on component to see a list of all articles that use that intervention): Psychoprophylaxis, PATIENT/CONSUMER

Intervention Description: To study whether use of psychoprophylaxis during labor affects course of labor and experience of childbirth in nulliparous women.

Intervention Results: Use of psychoprophylaxis during labor was associated with a lower risk of emergency cesarean section (adjusted odds ratio (OR) 0.57; 95% confidence interval (CI) 0.37-0.88), but an increased risk of augmentation of labor (adjusted OR 1.68; 95% CI 1.23-2.28). No statistical differences were found in length of labor (adjusted OR 1.32; 95% CI 0.95-1.83), Apgar score < 7 at five minutes (adjusted OR 0.82; 95% CI 0.33-2.01), epidural analgesia (adjusted OR 1.13; 95% CI 0.84-1.53) or fearful childbirth experience (adjusted OR 1.04; 95% CI 0.62-1.74).

Conclusion: Psychoprophylaxis may reduce the rate of emergency cesarean section but may not affect the experience of childbirth.

Study Design: RCT

Setting: 15 antenatal clinics

Population of Focus: Nulliparous women with a planned vaginal delivery who gave birth after recruitment at antenatal clinics between October 2005 and January 2007

Data Source: Not specified

Sample Size: n=857

Age Range: Not Specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Pharmacotherapy (Nicotine)

Intervention Description: To determine the efficacy of 16 hour nicotine patches among pregnant smokers, with the dose individually adjusted according to saliva cotinine levels (potential range 10-30 mg/day).

Intervention Results: Complete abstinence was achieved by 5.5% (n=11) of women in the nicotine patch group and 5.1% (n=10) in the placebo patch group (odds ratio 1.08, 95% confidence interval 0.45 to 2.60). The median time to the first cigarette smoked after target quit day was 15 days in both groups (interquartile range 13-18 in the nicotine patch group, 13-20 in the placebo patch group). The point prevalence abstinence ranged from 8% to 12.5% in the nicotine patch group and 8% to 9.5% in the placebo patch group without statistically significant differences. The nicotine substitution rate did not differ from 100%, and the self reported median compliance rate was 85% (interquartile range 56-99%) in the nicotine patch group and 83% (56-95%) in the placebo patch group, assessed at 1016 visits. The mean birth weight was 3065 g (SE 44 g) in the nicotine patch group and 3015 g (SE 44 g) in the placebo patch group (P=0.41). Diastolic blood pressure was significantly higher in the nicotine patch group than in the placebo patch group. The frequency of serious adverse events was similar between the groups, although more non-serious adverse reactions, mainly of skin, occurred in the nicotine patch group.

Conclusion: The nicotine patch did not increase either smoking cessation rates or birth weights despite adjustment of nicotine dose to match levels attained when smoking, and higher than usual doses.

Study Design: RCT- Randomized, double blind, placebo controlled, parallel group, multicenter trial

Setting: Maternity wards

Population of Focus: Pregnant smokers aged more than 18 years and between 12 and 20 weeks’ gestation, who smoked at least five cigarettes a day and scored at least 5 on a motivational scale of quitting smoking (range 0-10)

Data Source: Saliva cotinine, birth records

Sample Size: 402 (203 to nicotine patches, 199 to placebo patches)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Motivational Interviewing, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: Premature infants are at high risk for respiratory disease, and secondhand smoke (SHS) exposure further increases their risk for developing respiratory illness and asthma. Yet, SHS exposure remains problematic in this vulnerable population. Our objective was to evaluate the effects of brief asthma education plus motivational interviewing counseling on reducing SHS exposure and improving respiratory outcomes in premature infants compared to asthma education alone.

Intervention Results: Caregivers in the treatment group reported significantly more home smoking bans (96% vs 84%, P = .03) and reduced infant contact with smokers after the intervention (40% vs 58%, P = .03), but these differences did not persist long term. At study end (8 months after neonatal intensive care unit discharge), treatment group infants showed significantly greater reduction in salivary cotinine versus comparison (−1.32 ng/mL vs −1.08 ng/mL, P = .04), but no significant differences in other clinical outcomes.

Conclusion: A community-based intervention incorporating motivational interviewing and asthma education may be helpful in reducing SHS exposure of premature infants in the short term. Further efforts are needed to support sustained protections for this high-risk group and ultimately, prevent acute and chronic respiratory morbidity. Strategies for successfully engaging families during this stressful period warrant attention.

Study Design: RCT

Setting: Community (home)

Population of Focus: Pre-term infants and SHSe

Data Source: Golisano Children’s Hospital. Rochester, NY

Sample Size: 165 caregivers and their infants born at ≤ 32 weeks’ gestational age, within 6 weeks of discharge from the NICU

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Lactation Consultant, Home Visits, Telephone Support

Intervention Description: To determine whether infants of women randomized to a prenatal and postpartum lactation support intervention incur fewer otitis media-, respiratory tract-, or gastrointestinal-related visits than controls.

Intervention Results: There was a significant interaction between treatment and Medicaid; among those not receiving Medicaid, the number of otitis media visits was higher among controls (P

Conclusion: Only the number of otitis media visits was reduced, in a subset of the intervention group. The intervention did not reduce visits for respiratory tract or gastrointestinal illness. Limited intervention contact and low exclusive breastfeeding rates may have attenuated intervention effects. Future interventions designed to yield markedly increased breastfeeding rates may show greater effects in low-income multiethnic samples. Health coverage for visits may moderate intervention effects.

Study Design: RCT

Setting: 2 urban community health centers in the Bronx, NY

Population of Focus: Women who were ≤ 24 weeks GA, spoke English or Spanish, had a twin or singleton birth, and who did not have medical or obstetric complications or longterm use of medications incompatible with breastfeeding

Data Source: Mother self-report

Sample Size: Randomized • Intervention (n=188) • Control (n=194) 26-Week Follow-Up • Intervention (n=115) • Control (n=136)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Lactation Consultant, Home Visits, Telephone Support, Provision of Breastfeeding Item, PROVIDER/PRACTICE, Other (Provider Practice)

Intervention Description: Determined the effectiveness of primary care-based, and pre- and postnatal interventions to increase breastfeeding.

Intervention Results: In Best Infant Nutrition for Good Outcomes (BINGO) at 3 months, high intensity was greater for the LC+EP (odds ratio [OR] = 2.72; 95% confidence interval [CI] = 1.08, 6.84) and LC (OR = 3.22; 95% CI = 1.14, 9.09) groups versus usual care, but not for the EP group alone. In PAIRINGS at 3 months, intervention rates exceeded usual care (OR = 2.86; 95% CI = 1.21, 6.76); the number needed to treat to prevent 1 dyad from nonexclusive breastfeeding at 3 months was 10.3 (95% CI = 5.6, 50.7).

Conclusion: LCs integrated into routine care alone and combined with EP guidance from prenatal care providers increased breastfeeding intensity at 3 months postpartum.

Study Design: RCT

Setting: Urban, prenatal clinic in the Bronx, NY

Population of Focus: Women who spoke English or Spanish, ≥ 18 years old, in the first or second trimester of a singleton pregnancy, without risk factors for a premature birth or maternal/infant condition that would prevent or complicate breastfeeding

Data Source: Mother self-report

Sample Size: Best Infant Nutrition for Good Outcomes (BINGO) • Lactation Consultant (LC) (n=77/73) • Electronically Prompted (EP) Guidance by Prenatal Care provider (n=236/223) • LC + EP (n=238/226) • Control (n=77/73)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Motivational Interviewing, Pharmacotherapy (Nicotine)

Intervention Description: Secondhand smoke exposure is associated with asthma onset and exacerbation. Latino children have higher rates of asthma morbidity than other groups. The current study compared the effectiveness of a newly developed smoking cessation treatment with existing clinical guidelines for smoking cessation.

Intervention Results: Intent-to-treat analyses showed that 20.5% of participants in the PAM condition and 9.1% of those in the BAM condition were continuously abstinent at 2 months posttreatment (OR = 2.54; 95% CI = 0.91–7.10), whereas 19.1% of participants in the PAM condition and 12.3% of those in BAM condition were continuously abstinent at 3 months posttreatment (OR = 1.68; 95% CI = 0.64–4.37). Secondhand smoke exposure decreased only in the BAM condition (p < .001), an effect due to less smoking around the child among nonquitters in this condition. Asthma morbidity showed significant decreases in the posttreatment period for the PAM group only (p < .001).

Conclusion: Results provide support for targeting specific populations with theory-based interventions.

Study Design: RCT

Setting: Hospital in-patient settings and clinics, and Latino cultural events

Population of Focus: Latino caregivers who smoked and had a child with asthma under 18 years of age

Data Source: Parental self-report data, passive nicotine monitors.

Sample Size: 133 caregivers

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing

Intervention Description: We tested two aims: (1) the teachable moment (TM): whether second-hand smoke exposure (SHSe) feedback motivates cessation in parents of children with asthma versus parents of healthy children (HC); and (2) whether greater intervention intensity [enhanced-precaution adoption model (PAM)] produces greater cessation than a previously tested intervention (PAM).

Intervention Results: Aim 1: The teachable moment was supported at 7 day and 2 month measurements. Aim 2: enhanced PAM was more likely to achieve 30-day ppa at the primary end-point, 4 months.

Conclusion: Smoking cessation intervention (Motivational Interviewing plus biomarker feedback) appear to motivate smoking cessation more strongly among parents of asthmatic children than among parents of healthy children. Increased intervention intensity yields greater smoking cessation among parents of asthmatic children and better asthma outcomes.

Study Design: RCT

Setting: Community (home and telephone)

Population of Focus: Parents of children with asthma and healthy children (ages 3-17 years)

Data Source: Parental self-report data, passive nicotine monitors.

Sample Size: 560 smoking primary caregivers of children with asthma and healthy children

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Lactation Consultant, PROVIDER/PRACTICE, Provider Training/Education

Intervention Description: To evaluate the efficacy of an intervention program to increase breast-feeding in a low-income, inner-city population.

Intervention Results: There was a markedly higher incidence of breast-feeding in the intervention group, as compared with that of the control group (61% vs 32%, respectively; P = .002). The duration of breast-feeding was also significantly longer in the intervention group (P = .005).

Conclusion: This lactation program increased the incidence and duration of breast-feeding in our low-income cohort. We suggest that similar efforts that are applied to analogous populations may increase the incidence and duration of breast-feeding in low-income populations in the United States.

Study Design: RCT

Setting: Maternal-Infant Lactation Center of Pittsburgh (PA)

Population of Focus: Women attending the prenatal clinic of The Mercy Hospital of Pittsburgh, English-speaking, and nulliparous

Data Source: Mother self-report

Sample Size: Intervention (n=51) Control (n=57)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Access to Provider through Hotline, HOSPITAL, Continuing Education of Hospital Providers, POPULATION-BASED SYSTEMS, INTER-HOSPITAL SYSTEMS, Maternal/In-Utero Transport Systems, STATE, Policy/Guideline (State), Consultation Systems (Inter-Hospital Systems), Consultation Systems (Hospital), Telemedicine Systems (Inter-Hospital Systems), Telemedicine Systems (Hospital)

Intervention Description: To examine the factors associated with delivery of preterm infants at neonatal intensive care unit (NICU) hospitals in Arkansas during the period 2001–2006, with a focus on the impact of a Medicaid supported intervention, Antenatal and Neonatal Guidelines, Education, and Learning System (ANGELS), that expanded the consulting capacity of the academic medical center's maternal fetal medicine practice.

Intervention Results: Perceived risk, age, education, and prenatal care characteristics of women affected the likelihood of use of the NICU. The perceived availability of local expertise was associated with a lower likelihood that preterm infants would deliver at the NICU. ANGELS did not increase the overall use of NICU, but it did shift some deliveries to the academic setting.

Conclusion: Perinatal regionalization is the consequence of a complex set of provider and patient decisions, and it is difficult to alter with a voluntary program.

Study Design: Time trend analysis

Setting: All Arkansas hospitals Five level III hospitals from 2001- 2005, six in 2006

Population of Focus: Infants born at <35 weeks GA

Data Source: Data from Medicaid claims for pregnancy linked to birth certificates for women covered by Medicaid in Arkansas

Sample Size: Total (n= 5,150) 2001 (n= 812) 2002 (n= 1,105) 2003 (n= 824) 2004 (n= 824) 2005 (n= 887) 2006 (n= 698) Infants born at <35 weeks GA

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Health Insurance Coverage

Intervention Description: We examined the association between health insurance coverage and both past month alcohol use and past month tobacco use in a nationally representative sample of women age 12-44 years old, by pregnancy status.

Intervention Results: Pregnancy status significantly moderated the relationship between health insurance and tobacco use (p-value≤0.01) and alcohol use (p-value≤0.01). Among pregnant women, being insured was associated with lower odds of alcohol use (adjusted odds ratio [AOR]=0.47; 95% confidence interval [CI]=0.27-0.82), but not associated with tobacco use (AOR=1.14; 95% CI=0.73-1.76). Among non-pregnant women, being insured was associated with lower odds of tobacco use (AOR=0.67; 95% CI=0.63-0.72), but higher odds of alcohol use (AOR=1.23; 95% CI=1.15-1.32).

Conclusion: Access to health care, via health insurance coverage is a promising method to help reduce alcohol use during pregnancy. However, despite health insurance coverage, tobacco use persists during pregnancy, suggesting missed opportunities for prevention during prenatal visits.

Study Design: Quasi experimental cross sectional

Setting: Participants in the National Survey of Drug Use and Health (NSDUH) 2010-2013

Population of Focus: Non-pregnant and pregnant women 12 to 44 years old with and without health insurance from large data set after passage of ACA

Data Source: National Survey of Drug Use and Health (NSDUH) 2010-2013

Sample Size: 97788

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Patient-Centered Medical Home, CAREGIVER, Home Visit (caregiver), PATIENT/CONSUMER, Home Visits, Outreach (caregiver), Nurse/Nurse Practitioner, Enabling Services

Intervention Description: (1) To improve connections to the medical home for infants from one low-income neighborhood (2) To increase the number of families enrolled in a local home visiting program, and (3) To improve communication between medical staff and home visitors.

Intervention Results: Outcomes were timeliness of well child care and enrollment in home visiting. Time series analyses compared patients from the intervention neighborhood with a demographically similar neighborhood. Mean age at newborn visit decreased from 14.4 to 10.1 days of age. Attendance at 2- and 4-month well child visits increased from 68 to 79% and 35 to 59 %, respectively. Rates did not improve for infants from the comparison neighborhood. Confirmed enrollment in home visiting increased. After spread to 2 more clinics, 43 % of infants in the neighborhood were reached.

Conclusion: Neighborhood-based newborn registries, proactive nursing outreach, and collaboration with a home visiting agency aligned multiple clinics in a low-income neighborhood to improve access to health-promoting services.

Study Design: Quasi-experimental: Nonequivalent control group

Setting: Primary care clinics and a home visiting program in a neighborhood defined by two zip codes

Population of Focus: All children born in the intervention and comparison neighborhoods

Data Source: Data from the local children’s hospital’s Emergency Department was used to identify the most common primary medical providers for children from the study zip codes • Newborn registry data (maintained manually with a Microsoft Excel spreadsheet) • Electronic health record data (with an automated newborn registry) • Manual chart review • Automated report of appointment data • Outcome measures using clinic data • Process measures using clinic and home visiting agency data

Sample Size: n=237 (cumulative number of babies on a registry); n=30 (cumulative number of families enrolled in home visiting)

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, Telephone Support, COMMUNITY, Community Health Services Policy, Distribution of Promotional Items (Classroom/School), Distribution of Promotional Items (Community), Educational Material

Intervention Description: The intervention consists of three mailings and one brief coaching call delivered by 2-1-1 staff over 6 weeks. Emphasizes establishing a smoke-free home rather than smoking cessation.

Intervention Results: Overall, 40.1% reported creating a full household smoking ban. Among the nonsmoking adults reached at follow-up, days of SHS exposure in the past week decreased from 4.9 to 1.2. Among the 1148 smokers reached for follow-up, 211 people quit, an absolute reduction in smoking of 18.4% (p < .0001), with no differences by gender. Among those reached for 2-month follow-up, the proportion who reported establishing a smoke-free home was comparable to or higher than smoke-free home rates in the prior controlled research studies.

Conclusion: Among those reached for 2-month follow-up, the proportion who reported establishing a smoke-free home was comparable to or higher than smoke-free home rates in the prior controlled research studies.

Study Design: RCTs; 1st was efficacy trial, 2nd was effectiveness trial, 3rd was a generalizability trial, [4th-5th not described in article]

Setting: Telephone counseling for an educational intervention

Population of Focus: 5 2-1-1 centers chosen via competitive applications for a national grants program

Data Source: Participant reports; Tracking Tool for programs to record process of project

Sample Size: 2345 households at five 2-1-1 organizations

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): PATIENT/CONSUMER, Home Visits, Motivational Interviewing, Peer Counselor, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: To test an air cleaner and health coach intervention to reduce secondhand smoke exposure compared with air cleaners alone or no air cleaners in reducing particulate matter (PM), air nicotine, and urine cotinine concentrations and increasing symptom-free days in children with asthma residing with a smoker.

Intervention Results: The overall follow-up rate was high (91.3%). Changes in mean fine and coarse particulate matter (PM) concentrations (baseline to 6 months) were significantly lower in both air cleaner groups compared with the control group. No differences were noted in air nicotine or urine cotinine concentrations. The health coach provided no additional reduction in PM concentrations. Symptom-free days were significantly increased in both air cleaner groups compared with the control group.

Conclusion: Although the use of air cleaners can result in a significant reduction in indoor PM concentrations and a significant increase in symptom-free days, it is not enough to prevent exposure to secondhand smoke.

Study Design: 3-arm RCT

Setting: Hospital and home

Population of Focus: Inner-city children with asthma and SHSe

Data Source: Caregiver self-report, urine cotinine levels, and air nicotine concentrations

Sample Size: 126 children

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

Intervention Description: Six hundred thirteen women of Mexican origin in 3 treatment sites were randomized among 4 study arms: the full AMIGAS program with a video and a flip chart (n = 151), the AMIGAS program without the video (n = 154), the AMIGAS program without the flip chart (n = 155), and a usual care control group (n = 153). Six months after enrollment, women were surveyed and reported whether or not they had been screened.

Intervention Results: Women in any of the intervention arms were statistically significantly more likely to report being screened than those in the usual care group in both an intent-to-treat analysis and a per-protocol analysis. In the intent-to-treat analysis, 25% of women in the control group and 52% in the full AMIGAS program group reported having had Pap tests (P < .001); in the per-protocol analysis, the percentages were 29% and 62%, respectively (P < .001).

Conclusion: AMIGAS was effective in increasing Pap test screening among women of Mexican descent when used in a 1-to-1 setting. Future research should compare the 1-on-1 intervention with the group-based intervention.

Study Design: RCT: pretest-posttest

Setting: El Paso, TX; Houston, TX; and Yakima Valley, WA

Population of Focus: Mexican women with no Pap smear reported in the past 3 years

Data Source: Self-report and validated through medical records review

Sample Size: Intent-to-Treat Analysis (n=613) Intervention Group 1 (n=151); Intervention Group 2 (n=154); Intervention Group 3 (n=155); Control (n=153) Per-Protocol Analysis (n=513) Intervention Group 1 (n=128); Intervention Group 2 (n=125); Intervention Group 3 (n=127); Control (n=133)

Age Range: ≥21

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, PROVIDER/PRACTICE, Provider Audit/Practice Audit, Nurse/Nurse Practitioner

Intervention Description: To assess the effects on cervical screening rates in one small general practice based on uptake and the benefits of multiple strategies.

Intervention Results: Over 18 months there was a 27% improvement from a biannual screening rate of 53% at baseline to 67.5% at the end of the audit. Over the past 6 months, 49% of women elected for the 'screening only' test provided by a nurse.

Conclusion: Strategies are feasible and associated with a considerable increase in screening rates. Patients can choose to have their test performed by a nurse in general practice. This study suggests that each strategy's improvement in uptake is independently additive.

Study Design: QE: pretest-posttest

Setting: General practice in Bundaberg, Queensland

Population of Focus: Women attending the practice living within Bundaberg

Data Source: Chart review

Sample Size: Baseline (n=1,540) Follow-up (n=1,431)

Age Range: 18-69

Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Motivational Interviewing/Counseling, PATIENT/CONSUMER, Motivational Interviewing, Educational Material, Pharmacotherapy (Nicotine), Educational Material (caregiver), Telephone Support

Intervention Description: In this randomized controlled trial, we tested a tobacco control intervention in families and specifically evaluated a tailored cessation intervention for the parents and/or caregivers (Ps/Cs) who were smokers while their children were simultaneously enrolled in tobacco prevention.

Intervention Results: Intervention group showed a larger increase in self-reported smoking abstinence over time than the control group. For cotinine, the intervention group showed a decrease from baseline and then maintenance through year 4, whereas the control group showed increases from baseline.

Conclusion: This study provides evidence that tailored cessation offered to Ps/Cs in their children’s schools during their children’s enrollment in tobacco prevention may contribute to more robust success in P/C cessation and a reduction of tobacco smoke exposure in children.

Study Design: 2-group RCT with repeated measures

Setting: Elementary school-based recruitment; Face-to-face or telephone motivational interviewing sessions

Population of Focus: Elementary schools with high enrollment percentages of African American children in fourth grade across 5 counties in a Southeastern state

Data Source: Parent and caregiver self-report, biochemical measures (saliva cotinine and exhaled carbon monoxide)

Sample Size: 453 parents and or caregivers

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Referrals

Intervention Description: To assess the impact of ‘opt-out’ referrals for pregnant smokers on SSS uptake and effectiveness, we conducted a ‘before–after’ service development evaluation.

Intervention Results: Approximately 2300 women attended antenatal care in each period. Before the implementation, 536 (23.4%) women reported smoking at ‘booking’ and 290 (12.7%) were referred to SSS. After the implementation, 524 (22.9%) women reported smoking at ‘booking’, an additional 156 smokers (6.8%) were identified via the ‘opt-out’ referrals and, in total, 421 (18.4%) were referred to SSS. Over twice as many women set a quit date with the SSS after ‘opt-out’ referrals were implemented (121 (5.3%, 95% CI 4.4% to 6.3%) compared to 57 (2.5%, 95% CI 1.9% to 3.2%) before implementation) and reported being abstinent 4 weeks later (93 (4.1%, 95% CI 3.3% to 4.9%) compared to 46 (2.0%, 1.5% to 2.7%) before implementation).

Conclusion: In a hospital with an ‘opt-in’ referral system, adding CO screening with ‘opt-out’ referrals as women attended ultrasound examinations doubled the numbers of pregnant smokers setting quit dates and reporting smoking cessation.

Study Design: Quasi experimental cross sectional

Setting: Antenatal clinics

Population of Focus: Data on Pregnant women who smoke receiving National Health Services (NHS) obstetric services

Data Source: UK National Health Service database

Sample Size: 2287 women who received care before initiation of CO breath test intervention, 2293 after

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Lactation Consultant, Telephone Support

Intervention Description: Evaluated whether telephone-based support could increase the duration of breastfeeding in obese women and, thereby, reduce offspring growth.

Intervention Results: The support group breastfed exclusively for a median of 120 d (25th-75th percentiles: 14-142 d) compared with 41 d (3-133 d) for control subjects (P = 0.003). Any breastfeeding was maintained for a median of 184 d (92-185 d) for the support group compared with 108 d (16-185 d) for control subjects (P = 0.002). Support increased the adjusted ORs for exclusive breastfeeding at 3 mo and the ratios for partial breastfeeding at 6 mo to 2.45 (95% CI: 1.36, 4.41; P = 0.003) and 2.25 (95% CI: 1.24, 4.08; P = 0.008, respectively). Although the duration of exclusive breastfeeding was inversely associated with infant weight (β = -4.39 g/d; 95% CI: -0.66, -8.11 g/d; P = 0.021) and infant length at 6 mo (β = -0. 012 cm/d; 95% CI: -0.004, -0.02 cm/d; P = 0.004), the breastfeeding support did not achieve a significant effect on infant growth at 6 mo (n = 192).

Conclusion: Telephone-based advisory support was very effective in prolonging breastfeeding in obese mothers who often terminate the breastfeeding of their infants prematurely. A longer duration of breastfeeding may decrease risk of noncommunicable diseases in these infants.

Study Design: RCT

Setting: Hvidovre Hospital in Copenhagen, Denmark

Population of Focus: Women who had previously participated in the Treatment of Obese Pregnant Women study, were <38 years old postpartum, with singleton, healthy infants born at term

Data Source: Mother self-report

Sample Size: Randomized • Intervention (n=108) • Control (n=118) 1,3,6-Month Follow-Up • Intervention (n=105) • Control (n=102)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Educational Material, Group Education, Home Visits, Telephone Support

Intervention Description: Evaluated the single and combined effects of introducing a motivational video and peer counseling into four matched WIC clinics on breastfeeding initiation and continuation at 7-10 days among African-American WIC participants.

Intervention Results: Significant differences in the percentage of women initiating breastfeeding in the video (50%), peer counselor (62%), and video + peer counselor (52%) groups vs control group (26%)

Conclusion: Overall, trends toward a positive impact of the breastfeeding promotion activities were evident but weak, and largely gone by 7-10 days postpartum.

Study Design: Cluster RCT

Setting: 4 WIC clinics in Baltimore, MD

Population of Focus: WIC eligible African American women starting prenatal care < 24 GA, with a singleton pregnancy, planning to keep the baby and stay in the clinic’s catchment area

Data Source: Mother self-report

Sample Size: Video (n=64) • Peer Counselor (n=55) • Video + Peer Counselor (n=66) • Control (n=57)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Nurse/Nurse Practitioner, PATIENT/CONSUMER, Patient Reminder/Invitation, Educational Material, CAREGIVER, Educational Material (caregiver)

Intervention Description: The aim of this study was to evaluate the effectiveness of a nursing educational intervention with mothers of sick children to decrease passive smoking exposure.

Intervention Results: Baseline comparison showed no significant differences between the two groups in the mothers’ actions to protect the children from passive smoking exposure. More mothers in the intervention group than the control group had always moved the children away when they were exposed to the fathers’ smoke at home at 3‐month follow up (78·4% vs. 71·1%; P = 0·01) but became non‐significant at 6 and 12 months.

Conclusion: A simple health education intervention provided by nurses to the mothers in a busy clinical setting can be effective in the short-term to motivate the mothers to take actions to protect the children from exposure to passive smoking produced by the fathers.

Study Design: RCT

Setting: Hospital (pediatric ward/outpatient departments)

Population of Focus: Non-smoking mothers of sick children admitted to the pediatric ward/smoking husbands living in the same household

Data Source: Parental self-report.

Sample Size: 1483 mothers of sick children

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, Motivational Interviewing, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: Individualized motivational intervention for 30 minutes with nurse counsellor; appropriate stage-matched intervention used to “increase motivation and lower resistance to quit”; telephone reminder 1 week after the intervention.

Intervention Results: Preliminary results showed that the quit rate in the intervention group was 7.5% (95% CI, 0–21) versus 2.5% (95% CI, 0–7) in the control group. A total of 15% of the intervention group versus 10% of the control group reduced smoking consumption by half; 20.0% of the intervention group versus 7.5% of the control group reported quit attempts in the past 30 days; and 17.5% of the intervention group versus 10% of the control group moved up the stage of readiness to quit. The results were not statistically significant because of the small sample size.

Conclusion: Preliminary results indicated that the IMI provided by nurses seemed to be effective in helping resistant parents of sick children stop smoking. They also suggested that it was acceptable and feasible to implement such intervention in a pediatric outpatient clinic/ward in Hong Kong.

Study Design: RCT

Setting: Hospital (pediatric ward/outpatient setting)

Population of Focus: Parents of sick children who smoked

Data Source: Parental self-report

Sample Size: 80 parents of sick children presenting to a clinic or admitted to a children’s ward of a major Hong Kong hospital

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Home Visits, Telephone Support, Provision of Breastfeeding Item

Intervention Description: To evaluate a specialized breastfeeding peer counseling (SBFPC) intervention promoting exclusive breastfeeding (EBF) among overweight/obese, low-income women.

Intervention Results: The intervention had no impact on EBF or breastfeeding continuation at 1, 3, or 6 months postpartum. In adjusted posthoc analyses, at 2 weeks postpartum the intervention group had significantly greater odds of continuing any breastfeeding (adjusted odds ratio [aOR]: 3.76 [95% confidence interval (CI): 1.07-13.22]), and giving at least 50% of feedings as breast milk (aOR: 4.47 [95% CI: 1.38-14.5]), compared with controls. Infants in the intervention group had significantly lower odds of hospitalization during the first 6 months after birth (aOR: 0.24 [95% CI: 0.07-0.86]).

Conclusion: In a Baby-Friendly hospital setting, SBFPC targeting overweight/obese women did not impact EBF practices but was associated with increased rates of any breastfeeding and breastfeeding intensity at 2 weeks postpartum and decreased rates of infant hospitalization in the first 6 months after birth.

Study Design: RCT

Setting: Hartford Hospital in Hartford, CT

Population of Focus: Pregnant women ≥ 18 years, with prepregnancy BMI ≥ 27, ≤ 36 weeks GA, singleton pregnancy, without medical conditions that may interfere with breastfeeding, ≤ 185% federal poverty level, planning to stay in the area for 6 months, and considering breastfeeding

Data Source: Mother self-report

Sample Size: Randomized Intervention (n=76) Control (n=78) 6-Month Follow-Up • Intervention (n=55) • Control (n=53)

Age Range: Not specified

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

Intervention Description: The aim of the "Don't smoke in our home" trial was to evaluate a counseling intervention focused on promoting totally smoke-free homes and cars (TSFHC) delivered to women with children resident in four Tuscan towns.

Intervention Results: Outcomes were: Reported smoking restrictions in home and car and change in smoking status reported. All participants independently of the study arm recorded significant increases of 12 and 15 percentage points in TSFH and TSFC, respectively. Few smokers quit smoking (7%), stopped smoking indoors (5%), and stopped smoking in cars (7%), with no differences between the intervention and control groups.

Conclusion: Adding brief counseling to written materials did not significantly increase TSFHC. However, delivering written materials only may produce modest but noteworthy TSFHC increases at the population level, even though the participants in the study did not represent a population-based sample, given the high proportion of highly educated women. Further studies are required to confirm these results.

Study Design: Two-group randomized controlled trial

Setting: Pediatric well visit

Population of Focus: Children exposed to SHS

Data Source: The trial staff recruited women aged 30-49 years with children in the waiting rooms of public health facilities, hospitals and outside of supermarkets

Sample Size: 218 women 30 to 49 years of age with children

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Group Education, Telephone Support, Educational Material, CAREGIVER, Education/Training (caregiver), Educational Material (caregiver)

Intervention Description: This study examined the effects of a parent–child interactive program on reducing children’s exposure to ETS at home and enhancing parents’ and children’s prevention strategies.

Intervention Results: The percentage of children with urine cotinine levels greater than or equal to 6ng/ml was significantly lower in the intervention group than it was in the control group at both the 8-week and 6-month assessments. The intervention significantly reduced parental smoking in the presence of children and increased parents’ prevention of children’s ETS exposure and children’s ETS avoidance behavior from the baseline to the 20-week assessment.

Conclusion: This is a preliminary study design aimed at creating a program for reducing children’s ETS exposure at home. Further research to produce evidence supporting the application of the parent–child interactive program in primary schools is suggested. The theoretical basis of the intervention design can serve as a reference for nursing education and the design of health education programs.

Study Design: Single-blind, two-group, repeated-measures clustered randomized controlled trial design

Setting: Community (schools)

Population of Focus: School-aged children’s reduction of SHSe

Data Source: Elementary schools were the unit of assignment

Sample Size: 75 parent and child dyads in 6 elementary schools (grades 3 to 6)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Motivational Interviewing, Telephone Support, Peer Counselor, Midwife, PROVIDER/PRACTICE, Nurse/Nurse Practitioner

Intervention Description: The aim of this pilot study was to evaluate the implementation of the American College of Obstetricians and Gynecologists' 5 A's smoking cessation intervention among pregnant women being cared for by 5 A's-trained midwives working with a team of nurse researchers in an effort to reduce prenatal smoking exposure. The evidence-based 5 A's smoking cessation program has been recommended for use in prenatal care by health care providers.

Intervention Results: Among the 35 women who enrolled in the study, 32 (91.4%) decreased smoking and 3 (8.6%) quit smoking by one month after the intervention. For those who continued to smoke, the average number of cigarettes smoked was reduced from 10 cigarettes per day at baseline to 8 cigarettes per day at one month, 7 cigarettes per day at 2 months, and 6 cigarettes per day by the end of pregnancy. The women further reduced their tobacco exposure by delaying the timing of initiating smoking in the morning and by increasing indoor smoking restrictions.

Conclusion: Midwives and nurses can be trained in the implementation of the evidence-based 5 A's smoking cessation program for incorporation into regular prenatal care of pregnant women who smoke. By guiding women in techniques aimed at reducing the amount and frequency of cigarette smoking, nurses and midwives facilitate a decrease in prenatal smoking exposure.

Study Design: Single group pre-post test evaluation pilot

Setting: Prenatal care clinics

Population of Focus: Pregnant women who smoked and were willing to quit or cut down smoking receiving prenatal care

Data Source: Surveys (self-report questionnaires)

Sample Size: 35

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, CAREGIVER, Educational Material (caregiver)

Intervention Description: To test a low-intensity physician's office-based intervention strategy using infant urine cotinine measurements, aimed at reducing infant exposure to environmental tobacco smoke.

Intervention Results: Follow-up urine cotinine measurements were obtained in 27 (52%) of 52 infants from the intervention group and in 29 (57%) of the 51 controls 2 months later. The mean log ratio of the follow-up to initial urine cotinine measurements was 6% lower in the intervention group than in the control group. This difference was not statistically significant.

Conclusion: The low-intensity intervention strategy did not significantly influence infant exposure to environmental tobacco smoke in the household.

Study Design: RCT

Setting: Pediatric well visit

Population of Focus: Infants exposed to second hand smoke

Data Source: Two hospital-based clinics in Portland Maine.

Sample Size: 103 mothers smoking ≥ 10 cigarettes/d with infants presenting to a well-baby check

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Oral Health Education, Oral Health Supplies, Assistance in Making Dental Appointment

Intervention Description: To test the effectiveness of an advanced practice nurse model of care to improve oral health in low-income pregnant women.

Intervention Results: At baseline, 30.1% of women in the control group and 27.4% of women in the experimental group had seen a dentist. At followup, the control group increased to 32.9% while the experimental group increased to 56.9% (p=0.006).

Conclusion: Implications for practice: Because adverse pregnancy outcomes have been linked to periodontitis in numerous research studies, pregnant women must be educated about the importance of oral health and the necessity of a check-up. APNs are in an ideal position to educate women and assist them to obtain necessary oral health services.

Intervention Components (click on component to see a list of all articles that use that intervention): Comprehensive School-Based PA Program, Electronic PA, Assessment (patient/consumer),

Intervention Description: Participants in the BOXVR group engaged in exercise with a virtual reality game, while participants in the guided video group engaged in exercise with a guided workout video. Both interventions consisted of 5 exercise sessions per week, for a total of 15 exercise sessions over a 3-week period. Each exercise session was 10 minutes in length

Intervention Results: The BOXVR group showed a significant improvement in stress levels and performance on a cognitive task (TMT B) compared to the control and guided video groups. Adolescents who participated in BOXVR reported significantly higher levels of enjoyment than those who participated in traditional boxing with a guided video. The control group was the only group that showed a significant reduction in anxiety, but this could be interpreted as possible changes in behavior simply due to being enrolled in a research study and asked about anxiety status. The study suggests that engagement and enjoyment in a 'play' setting may contribute to mental aspects of health in the short-term more than the level of effort

Conclusion: The study suggests that chronic exercise with a VR game may be an effective tool for reducing stress and improving cognitive performance in adolescents. The findings also highlight the importance of engagement and enjoyment in exercise programs for mental health benefits. Future studies should investigate what aspects of gaming in VR contribute the most to stress reduction and cognitive performance

Study Design: The study design is a Pilot Randomized Controlled Trial

Setting: The setting for the study was a public high school in suburban New York, and the study was conducted during the summer of 2021

Population of Focus: The target audience for the study was healthy high school students between the ages of 14 and 18 who were able to participate in physical activity of at least moderate intensity

Sample Size: The sample size for the study was 42 participants, who were randomized into one of three cohorts: a BOXVR group, a guided video group, or a nonintervention control group

Age Range: The age range of the participants was between 14 and 18 years old

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, Enabling Services, Access to Provider through Hotline

Intervention Description: To pilot-test a Phone-based Postpartum Continuing Care (PPCC) protocol in addition to the usual care for smoking cessation for pregnant women to demonstrate the feasibility of recruitment, randomization, assessment, and implementation of the PPCC intervention.

Intervention Results: PPCC was found to be feasible and acceptable to some participants but not all. There were no significant differences in tobacco products per day at 6 months postpartum between groups; however, effect sizes differed at 6 weeks compared with 6 months postpartum. Similarly, there were no significant differences between groups in cessation rate (24% in each group) and past 90-day tobacco use (59 days vs 55 days, for Control and Experimental groups respectively).

Conclusion: The PPCC intervention did not differentially reduce tobacco use postpartum compared with a controlled comparison group, though it was found to be acceptable among a subpopulation of low-income pregnant women and feasible with regard to recruitment, randomization, assessment procedures, and implementation. Further research is needed to identify an intervention that significantly improves smoking relapse rates postpartum.

Study Design: RCT pilot

Setting: Obstetrics clinic

Population of Focus: Low-income pregnant women attending their first prenatal visit at a single academic obstetrics clinic

Data Source: Urine testing, Surveys

Sample Size: 130

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Intensive Therapy, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: We tested the efficacy of a behavioral counseling approach with underserved maternal smokers to reduce infant’s and preschooler’s secondhand smoke exposure.

Intervention Results: Participation in Philadelphia Family Rules for Establishing Smokefree Homes (FRESH) behavioral counseling was associated with lower child cotinine (β=-0.18, p=0.03) and reported tobacco smoke exposure (β=-0.57, p=0.03) at the end of treatment. Mothers in behavioral counseling smoked fewer cigarettes/day (β=-1.84, p=0.03) and had higher bioverified quit rates compared with controls (13.8% vs 1.9%, χ(2)=10.56, p<0.01). There was no moderating effect of other smokers living at home.

Conclusion: FRESH behavioral counseling reduces child secondhand smoke exposure and promotes smoking quit rates in a highly distressed and vulnerable population.

Study Design: Two-arm randomized trial

Setting: Community (home and telephone)

Population of Focus: Underserved children’s exposure to tobacco smoke

Data Source: Participants were recruited from lowincome neighborhoods in North and West Philadelphia

Sample Size: 300 families

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), Outreach (Provider), PATIENT/CONSUMER, Motivational Interviewing, Telephone Support, Home Visits

Intervention Description: To evaluate the effectiveness of a lay delivered intervention to reduce Latino children’s exposure to environmental tobacco smoke (ETS). The a priori hypothesis was that children living in households that were in the intervention group would have lower exposure over time than measurement only controls.

Intervention Results: There were no significant condition-by-time interactions. Significant or near significant time main effects were seen for children’s hair cotinine and parent’s report of exposure.

Conclusion: Applying a lay promotora model to deliver the behavioural problem solving intervention unfortunately was not effective. A likely explanation relates to the difficulty of delivering a relatively complex intervention by lay women untrained in behaviour change theory and research methods.

Study Design: Two group, randomized control trial

Setting: Community (home)

Population of Focus: Latino children

Data Source: Recruited from community organizations and venues such as Head Start Programs and cultural fairs

Sample Size: 143 Latino parents of children aged 1 to 9 who reported smoking at least 6 cigarettes a week

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Pharmacotherapy (Nicotine)

Intervention Description: Nicotine replacement therapy (NRT) is effective for cessation outside pregnancy but efficacy and safety in pregnancy are unknown. We hypothesised that NRT would increase smoking cessation in pregnancy without adversely affecting infants.

Intervention Results: Smoking outcomes: at delivery, the validated, prolonged smoking cessation rate was 9.4% in the NRT and 7.6% in the placebo group (OR for cessation with NRT 1.26, 95% CI 0.82 to 1.96). At 1 month, the validated cessation rate was significantly higher in the NRT group (21.3% vs. 11.7%, OR for cessation with NRT 2.05, 95% CI 1.46 to 2.88). After delivery, there were no statistically significant differences in cessation. Self-reported prolonged abstinence since the quit date was: at 6 months, 5.4% in the NRT group and 3.2% in the placebo group; at 1 year, 3.7% and 2.1%; and, at 2 years, 2.9% and 1.7%, respectively.

Conclusion: Nicotine replacement therapy patches had no enduring, significant effect on smoking in pregnancy; however, 2-year-olds born to women who used NRT were more likely to have survived without any developmental impairment. Further studies should investigate the clinical effectiveness and safety of higher doses of NRT.

Study Design: Double-blind, randomized, placebo-controlled trial

Setting: Community (antenatal clinic)

Population of Focus: Pregnant women who smoked

Data Source: Caregiver self-reported, prolonged abstinence from smoking between a quit date and childbirth, validated at delivery by CO measurement and/or salivary cotinine (COT).

Sample Size: 1050 smoking 12- to 24-week pregnant women who currently smoke 5 or more cigarettes/d who smoked at least 10 cigarettes/d before pregnancy

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Lactation Consultant, Telephone Support, Hospital Policies, PROVIDER/PRACTICE, Other (Provider Practice)

Intervention Description: The purpose of this study was to determine whether implementing a program based on a clinical protocol affects breastfeeding rates within a pediatric primary care setting. Increasing breastfeeding rates is an important public health initiative identified by multiple agencies.

Intervention Results: The results of this evaluation were positive for exclusive breastfeeding, with group comparisons showing a statistically significant increase in exclusive breastfeeding rates at all 5 time points.

Conclusion: Our diverse patient population within a pediatric practice had increased initiation rates and exclusive breastfeeding rates after implementation of the ABM's breastfeeding-friendly protocol. Families who receive care in a pediatric primary care setting that has implemented the ABM clinical protocol may have increased rates of exclusive breastfeeding.

Study Design: QE: pretest-posttest

Setting: 2 locations (1 suburban, 1 rural) of a single practice in northern VA

Population of Focus: Women with healthy, singleton births of ≥ 37 GA , who entered the practice within the first week of birth and returned for health maintenance visits at 2, 4, and 6 months

Data Source: Medical record review

Sample Size: Pre-Intervention (n=376) Post-Intervention (n=381)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, CAREGIVER, Home Visit (caregiver)

Intervention Description: A health education program was evaluated which used child development specialists as home visitors and served a population of first-time mothers living in rural communities.

Intervention Results: Significant group differences were found on health and safety outcomes. As compared with controls, the intervention mothers (i) had safer homes; (ii) were more likely to use birth control, thus had fewer pregnancies since birth of their first child; (iii) reported smoking fewer cigarettes; (iv) knew more about effects of smoking on their child’s health and (v) were more likely to use health department services.

Conclusion: It is highly recommended that a program such as this be implemented as part of health delivery program with new mothers and infants.

Study Design: Quasi-experimental Design

Setting: Community (home)

Population of Focus: Pregnant women who smoked

Data Source: Mother’s self-report.

Sample Size: 355 pregnant women

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Telephone Support

Intervention Description: Pregnant smokers are advised to quit; however, many struggle to do so. Behavioral counseling can increase quitting success, but the efficacy of telephone counseling for pregnant smokers has not been established. This study tests the efficacy of pregnancy-specific counseling, embedded in the ongoing operations of a state quitline.

Intervention Results: Abstinence was higher for the intervention than the control group at the end of pregnancy (30-day abstinence, 29.6% vs 20.1%; p<0.001); 2 months postpartum (90-day abstinence, 22.1% vs 14.8%; p<0.001); and 6 months postpartum (180-day abstinence, 14.4% vs 8.2%; p<0.001). Cotinine-corrected (≤13 ng/mL) 7-day abstinence rates at the end of pregnancy supported the intervention effect (35.8% vs 22.5%, p<0.001).

Conclusion: A pregnancy-specific counseling protocol, embedded in a state quitline, was effective in helping pregnant smokers quit and stay quit postpartum. Wide adoption of this intervention could help reduce the rate of maternal smoking and prevent its devastating health consequences.

Study Design: RCT

Setting: Telephone

Population of Focus: Pregnant smokers in the first 27 weeks of gestation who are firsttime callers to a state quitline

Data Source: Self- report telephone interviews, saliva samples

Sample Size: 1173

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Motivational Interviewing, Telephone Support, CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling

Intervention Description: Evaluate a smoking cessation intervention for women.

Intervention Results: The main outcome measure was self-reported abstinence from smoking 12 months after enrollment in the study, defined as not smoking, even a puff, during the 7 days prior to assessment. At both follow-ups, abstinence rates were twice as great in the intervention group as in the control group. The 12-month difference was statistically significant.

Conclusion: A pediatric clinic smoking cessation intervention has long-term effects in a socioeconomically disadvantaged sample of women smokers. The results encourage implementation of evidence-based clinical guidelines for smoking cessation in pediatric practice.

Study Design: Two-arm randomized trial (usual care vs. intervention)

Setting: Pediatric clinics serving ethnically diverse population of low-income families

Population of Focus: Self-identified women smokers whose children received care at participating clinics

Data Source: Women smokers whose children received care at participating clinics self-report.

Sample Size: 303 women smokers

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Motivational Interviewing/Counseling, Assessment (caregiver), PATIENT/CONSUMER, Educational Material, Online Material/Education/Blogging, Motivational Interviewing, PARENT/FAMILY, Consultation (Parent/Family), Notification/Information Materials (Online Resources, Information Guide)

Intervention Description: A study was undertaken to determine the effectiveness of two brief multi-strategic child health nurse delivered interventions in: decreasing the prevalence of infants exposed to SHS; decreasing the prevalence of smoking amongst parent/carers of infants and increasing the prevalence of household smoking bans.

Intervention Results: When compared to the Control group at 12 months, no significant differences in the prevalence of infant exposure to SHS were detected from baseline to follow-up for Treatment condition 1 or Treatment condition 2. Similarly, no significant differences were detected in the proportion of parent/care givers who reported that they were smokers, or in the proportion of households reported to have a complete smoking ban.

Conclusion: Further research is required to identify effective interventions that can be consistently provided by child health nurses if the potential of such settings to contribute to reductions in child SHS exposure is to be realised.

Study Design: Cluster randomized controlled trial

Setting: Community well-child health clinics

Population of Focus: s Infants exposed to second hand smoke

Data Source: Data was collected via computer during the visit, child health clinic records

Sample Size: 1424 parents of children aged 0 to 4 years attending well-child health checks

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, CAREGIVER, Educational Material (caregiver), Outreach (caregiver), Telephone Support

Intervention Description: This study tested the value of a self-help guide tailored specifically for women with young children.

Intervention Results: Two indicators of smoking behavior change were used to compare the effectiveness of the self-help guides. 1) % of those who reported in the follow-up interview that they had made at least one serious attempt to stop smoking, and 2) % of those who were nonsmokers for at least 1 week at time of follow-up. There were no significant differences between subjects in the three groups in use of the self-help guides, methods used to attempt quitting, and quitting behavior.

Conclusion: Findings from this study do not support the hypothesis that using a tailored stop smoking guide increases the targeted audience's cessation rate or affects quitting-related behavior. However, it should be noted that the smokers who called were predominantly in the contemplation or action stages.

Study Design: Quasi-randomized

Setting: Telephone smoking cessation helpline

Population of Focus: Women smokers with young children (under the age of 6)

Data Source: Cancer Information Service calls.

Sample Size: 873 mothers

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

Intervention Description: To assess the effect of an invitation letter on the level of participation in a setting of mainly opportunistic screening for cervical cancer and to do a cost analysis of this intervention.

Intervention Results: 3% greater increase in number of women who received a Pap smear in intervention group than control group (95% CI: 2.6-3.4)

Conclusion: Within an opportunistic cervical cancer screening setting, the effect of a registry-based invitational programme to nonattenders increases the participation further, and at no extra cost compared with an invitational programme to all screen-eligible women irrespective of their screening status.

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

Setting: Limburg

Population of Focus: Women in the Limburg Cancer Registry who had no Pap smear reported in the past 30 months

Data Source: Limburg Cancer Registry

Sample Size: Intervention (n=43,523); Control (n=44,131) Intervention Group A (women 25-41) (n=17,224)

Age Range: 25-54

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, Educational Material, PROVIDER/PRACTICE, Designated Clinic/Extended Hours

Intervention Description: Evaluate the effectiveness of an invitation letter on cervical screening participation among unscreened women 30 to 69 years of age.

Intervention Results: Women who were sent an invitation letter were significantly more likely to have had a Pap test in the next 6 months compared with women who were not sent an invitation letter (odds ratio [OR]=2.60, 95% confidence interval [CI] 2.09-3.35, p<0.001).

Conclusion: Sending invitation letters increased cervical screening participation but because the overall effect was small, additional strategies that remove barriers to screening for unscreened women are also necessary.

Study Design: Cluster RCT

Setting: Manitoba

Population of Focus: Women who had no Pap smear reported since 2001 and had been registered in the screening registry for at least 5 years (as of June 2010), with no history of gynecological cancer or hysterectomy, and who were covered by provincial health care insurance

Data Source: Cervical cancer screening registry

Sample Size: Total (N=31,452) Intervention (n=17,068); Control (n=14,384)

Age Range: 30-69

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, Educational Material, PROVIDER/PRACTICE, Provider Reminder/Recall Systems, Quality Improvement/Practice-Wide Intervention, Designated Clinic/Extended Hours, Female Provider, Needs Assessment, PATIENT_CONSUMER, HOSPITAL

Intervention Description: Translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS).

Intervention Results: There was a statistically significant increase in Pap smear numbers during Plan-Do-Study-Act (PDSA) cycles, continuing at 10 months follow up.

Conclusion: he use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. This model is transferrable to other settings and other health issues.

Study Design: QE: pretest-posttest

Setting: An urban Aboriginal Community Controlled Health Service (ACCHS)

Population of Focus: All women within eligible age range

Data Source: Electronic medical records

Sample Size: Total (N=213)

Age Range: 18-70

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Midwife, Referrals

Intervention Description: This was a demonstration project designed to assess whether frequency of midwives’ smoking cessation advice within the home environment had an impact on smoking rates for the women and their wider household contacts over a 15 month period.

Intervention Results: Young and Māori women within this project were more likely to become smoke-free than others. A significant number of the women lived in households with other smokers, which may have made it more difficult for them to become smoke-free. The midwives provided smoking cessation interventions using the ABC to the women with varying frequency; however, the frequency of these interventions did not appear to be related to the likelihood of the women becoming smoke-free. The midwives did not provide ABC at every single visit for every woman; however, for some women it was provided more often than for others.

Conclusion: Although midwifery care is provided within, and acknowledges the woman’s context, the majority of women in this project faced considerable day-to-day challenges to becoming smoke- free, as they lived in households with others who also smoked. Broad strategies are needed to reduce smoking, that reach beyond the realm of midwifery practice and the health care sector, such as wider tobacco control policies, public health campaigns and smoke-free environments.

Study Design: Cohort /Prospective observational study

Setting: Home-based midwife services

Population of Focus: Pregnant women who smoked receiving midwife care in New Zealand

Data Source: Standard point of care data form

Sample Size: 6 midwives, 101 women

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support

Intervention Description: To assess whether a phone-based breastfeeding intervention delivered by lactation educators influenced exclusive breastfeeding rates amongst low-income Hispanic women in the USA.

Intervention Results: There were no differences between the groups in rates of breastfeeding initiation. There was a significant difference in the duration of exclusive breastfeeding among participants during the infant's first week of life. While not significant, after controlling for covariates and intent to breastfeed at third trimester, the duration of exclusive breastfeeding amongst all participants was, on average, longer for intervention group mothers than control group mothers. Additionally, , the intervention group mothers were more likely to report exclusive and only breastfeeding at all data points compared to the control group, and less likely to discontinue breastfeeding.

Conclusion: Findings from this study suggest that telephone-based breastfeeding interventions delivered by a lactation educator show promise as a cost-effective strategy for improving both the quantity and duration of breastfeeding among low-income Hispanic women in the USA. Intervention group mothers not only sustained breastfeeding for a longer durations, but also provided their infants with greater amounts of breast milk over these longer durations.

Study Design: RCT

Setting: 5 community health clinics in Los Angeles County, CA

Population of Focus: Women who were 26-34 weeks GA, insured by Medicaid, Hispanic, available via telephone, and not assigned to a WIC peer counselor

Data Source: Mother self-report

Sample Size: 3 rd Trimester • Intervention (n=128) • Control (n=125) 72-Hour Follow-Up • Intervention (n=81) • Control (n=87) 6-Month Follow-Up • Intervention (n=62) • Control (n=55)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Home Visits, Telephone Support, Motivational Interviewing

Intervention Description: The objective of this study was to determine whether a motivational intervention for smoking parents of young children will lead to reduced household passive smoke exposure.

Intervention Results: The 6-month nicotine levels were significantly lower in MI households. Repeated measures analysis of variance across baseline, 3-month, and 6-month time points showed a significant time-by-treatment interaction, whereby nicotine levels for the MI group decreased significantly and nicotine levels for the SH group increased but were not significantly different from baseline.

Conclusion: This study targeted a large sample of racially and ethnically diverse low-income families, in whom both exposure and disease burden is likely to be significant. This is the first study to our knowledge that has been effective in reducing objective measures of passive smoke exposure in households with healthy children. These findings have important implications for pediatric health care providers, who play an important role in working with parents to protect children's health. Providers can help parents work toward reducing household passive smoke exposure using motivational strategies and providing a menu of approaches regardless of whether the parents are ready to quit.

Study Design: Randomized control study

Setting: Recruitment at community health centers, home based intervention

Population of Focus: Diverse low-income populations

Data Source: Air nicotine assessments and assessment of the participant’s carbon monoxide level with caregiver selfreport.

Sample Size: 291 participants

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), PATIENT/CONSUMER, Educational Material, CAREGIVER, Educational Material (caregiver), Assessment (caregiver)

Intervention Description: An information programme on measures to prevent passive smoking by children, designed for use during well-child visits, was tested

Intervention Results: There was no significant difference between the groups with respect to change in smoking behavior. None of the families had contacted the smoking cessation resources provided to the intervention group.

Conclusion: We found no significant differences between the groups with respect to change in smoking behaviour.

Study Design: Randomized, parallel group, clinical trial

Setting: Clinic based well-child intervention

Population of Focus: Families bringing their children to the participating health centers for 6-week, 2 or 4 year well-child visits

Data Source: Self-report by parents

Sample Size: 443 families initially, 80 families dropped out

Age Range: Not specified

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): Assessment (patient/consumer), Assessment (Provider), Education on Disease/Condition,

Intervention Description: The study evaluated the impact of a community-based mobile crisis service intervention in Connecticut, which provides crisis stabilization and support, screening and assessment, suicide assessment and prevention, brief, solution-focused interventions, and referral and linkage to ongoing care.

Intervention Results: Youths who received mobile crisis services had a significant reduction in odds of a subsequent behavioral health ED visit compared with those who did not receive mobile crisis services.

Conclusion: The study provides evidence suggesting that community-based mobile crisis services, such as Mobile Crisis, reduce ED use among youths with behavioral health service needs.

Study Design: Quasi-experimental study

Setting: Connecticut, United States

Population of Focus: Healthcare providers, policymakers, and researchers interested in improving behavioral health services for youths.

Sample Size: Not specified

Age Range: Youths who were age 18 and younger, as well as older youths who were still attending high school.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Intensive Therapy, PATIENT_CONSUMER, Psychoeducation

Intervention Description: Higher rates of obstetric intervention and caesarean section (CS) are experienced in fearful women. The efficacy of interventions to reduce childbirth fear is unclear, with no previous randomised controlled trials reporting birth outcomes or postnatal psychological wellbeing following a midwife led intervention. The outcomes of the RCT on obstetric outcomes, maternal psychological well-being, parenting confidence, birth satisfaction, and future birth preference were analysed by intention to treat and reported here.

Intervention Results: Compared to controls the intervention group had a clinically meaningful but not statistically significant reduction in overall caesarean section (34 % vs 42 %, p = 0.27) and emergency CS rates (18 % vs 25 %, p = 0.23). Fewer women in the intervention group preferred caesarean section for a future pregnancy (18 % vs 30 %, p = 0.04). All other obstetric variables remained similar. There were no differences in postnatal depression symptoms scores, parenting confidence, or satisfaction with maternity care between groups, but a lower incidence of flashbacks about their birth in the intervention group compared to controls (14 % vs 26 %, p = 0.05). Postnatally women who received psycho-education reported that the ‘decision aid’ helped reduce their fear (53 % vs 37 %, p = 0.02).

Conclusion: Following a brief antenatal midwife-led psycho-education intervention for childbirth fear women were less likely to experience distressing flashbacks of birth and preferred a normal birth in a future pregnancy. A reduction in overall CS rates was also found. Psycho-education for fearful women has clinical benefits for the current birth and expectations of future pregnancies.

Study Design: RCT

Setting: 3 antenatal clinics in three teaching hospitals

Population of Focus: Nulliparous women with measured fear of childbirth who gave birth after recruitment between May 2012 and June 20132,4

Data Source: Not specified

Sample Size: Total (n=104) Intervention (n=51) Control (n=53)

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, Group Education

Intervention Description: The intervention consisted of breastfeeding education delivered by a trained counselor, along with incentive marketing using a truth or myth activity in a small group format, followed by instruction, discussion, and informational handouts. Specific incentives included an enhanced food package valued at over $50 per month and extended program eligibility for women who exclusively breastfed or did not receive formula. Additionally, mothers in the study who exclusively breastfed for at least 2 months were eligible for a $25 mall gift certificate. The control group received the standard prenatal education on the general benefits and barriers to breastfeeding, and clients in both groups were provided with educational materials and support.

Intervention Results: The results of the intervention showed mixed outcomes. While there was no significant difference in breastfeeding initiation rates between the intervention and control groups, the intervention group had a significantly higher percentage of women who exclusively breastfed (P=.025) and breastfed for a longer duration than the control group. The intervention also had a significant positive effect on breastfeeding knowledge and beliefs among participants. Although the intervention did not significantly impact total breastfeeding duration, the exclusive breastfeeding duration was significantly longer for the intervention group.

Conclusion: The study concluded that exposure to a single breastfeeding intervention with incentives had significant positive effects on exclusive breastfeeding rates and duration, as well as on breastfeeding attitudes and perceptions. The authors suggest that interventions plus incentives should be considered by dietitians and lactation educators to increase breastfeeding exclusivity and duration among WIC populations. However, the study had limitations, such as a high dropout rate in the intervention group, which may have led to confounding factors influencing the results.

Study Design: RCT

Setting: Western NY

Population of Focus: Women participating in WIC who spoke English, were pregnant, and HIV negative

Data Source: Mother self-report

Sample Size: Intervention (n=30/19)3 Control (n=30/29)

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 Media, COMMUNITY, POPULATION-BASED SYSTEMS

Intervention Description: Evaluate the effect of an educational intervention on four domains of health care utilization and cervical cancer prevention and screening in a Hispanic population.

Intervention Results: Educational interventions designed to meet the needs identified by the sample group led to an increase in HPV awareness throughout the entire population surveyed and an increase in health care service utilization and HPV vaccine acceptance for women living in the US for <5 years.

Conclusion: These tools should be promoted to reduce the cervical cancer burden on vulnerable populations.

Study Design: QE: pretest-posttest

Setting: Boston, MA

Population of Focus: Hispanic women in the Boston area

Data Source: Written survey in English or Spanish

Sample Size: Baseline (n=318) Follow-up (n=295)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, Telephone Support

Intervention Description: To evaluate the impact of text messaging on smoking cessation rates among pregnant women in addition to standard of care (SOC) smoking cessation services. Our SOC includes pharmacist-driven education with or without nicotine patch or bupropion.

Intervention Results: Of 49 randomized patients, 13 withdrew, and 6 were lost to follow-up. The remaining included 14 texting and 16 SOC patients. eCO-verified cessation was achieved by 57.1% in the texting group versus 31.3% in the control (P = 0.153). Overall, 64.3% of the texting group achieved an eCO below 8 ppm at ≥1 visit versus 37.5% in the control group (P = 0.143). No difference was found in birth outcomes. The study was underpowered because of slow enrollment and high drop-out rates.

Conclusion: Text messaging had minimal impact on improving smoking cessation rates in the obstetric population. However, further research is warranted because of the underpowered nature of this trial. Given the detrimental effects of smoking in pregnancy, more comprehensive cessation strategies are warranted.

Study Design: RCT- pilot

Setting: Maternal fetal care center

Population of Focus: English-speaking pregnant women at least 18 years old receiving care at the maternal fetal care center and were willing to set a smoking *quit* date prior to 35 weeks gestation.

Data Source: Self-report, exhaled carbon monoxide levels (eCO)

Sample Size: 49

Age Range: Not specified

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

Intervention Description: This study aimed to determine the influence of mid-pregnancy breastfeeding education on the proportions of women breastfeeding at hospital discharge, and on the duration of breastfeeding.

Intervention Results: Neither intervention increased breastfeeding initiation or duration compared with standard care. Rates at initiation were 97 percent (296/306) for the Practical Skills intervention, 95 percent (291/308) for the Attitudes intervention, and 96 percent (297/310) for standard care. Rates at 6 months were, respectively, 55 percent (162/297), 50 percent (146/293), and 54 percent (162/299).

Conclusion: In settings where breastfeeding initiation is already high, neither study intervention could be recommended as an effective strategy to increase breastfeeding initiation or duration.

Study Design: RCT

Setting: Royal Women’s Hospital in Melbourne

Population of Focus: Women who were public patients, having a first child, between 16- 24 weeks GA when recruited, and able to speak, read, and write English

Data Source: Mother self-report

Sample Size: Randomized • Practical Skills (n=327) • Attitudes (n=327) • Control (n=328) 6-Month Follow-Up • Practical Skills (n=297) • Attitudes (n=293) • Control (n=299)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Home Visits, CAREGIVER, Home Visit (caregiver), Education/Training (caregiver), Educational Material (caregiver), Assessment (caregiver), Motivational Interviewing/Counseling, Motivational Interviewing

Intervention Description: The aim of this study is to evaluate effects of the counseling method “Smoke-free children” that focuses on protection of infants.

Intervention Results: Forty-one mothers participated in the study, 26 in the intervention group and 15 in the control group. Cotinine was collected from 22 subjects in the intervention and 8 in the control group. Before the intervention, the mean cotinine level was 185 ng/mL in the intervention group and 245 ng/mL in the control group. After the intervention, cotinine levels were reduced in the intervention group (165 ng/mL) and increased in the control group (346 ng/mL). Yet, after the intervention, the mothers themselves reported more smoking in the intervention group than in the control group. Only weak correlations were found between self-reported smoking and cotinine.

Conclusion: The statistical analysis supports the view that a client-centered intervention, aimed at increasing self-efficacy, exerts a positive effect on maternal smoking in the prevention of infant exposure to ETS, when applied in a routine clinical setting.

Study Design: RCT

Setting: Child health centers

Population of Focus: Swedish mothers who had given birth to a healthy child

Data Source: Self-reporting of smoking; cotinine levels of mothers’ saliva

Sample Size: 26 mothers in the intervention group and 15 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, Home Visits, Motivational Interviewing, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Telephone Support, CAREGIVER, Home Visit (caregiver), Assessment (caregiver), Attestation (caregiver), Motivational Interviewing/Counseling

Intervention Description: This pilot study evaluated the effectiveness of a nurse-delivered home-visiting program during the postpartum period that included a low-intensity smoking relapse-prevention intervention.

Intervention Results: Although both groups showed significant relapse from being smoke free, the intervention group was twice as likely to be smoke free at 3 and 6 months, and three times as likely to be smoke free at both times. The cotinine verification revealed a misclassification rate of 37% at the 6-month follow-up (i.e., participants self-reported as abstinent but shown by cotinine not to be abstinent).

Conclusion: The effectiveness of this brief, low-cost, and potentially replicable intervention in improving the rate of persistent postpartum smoke-free status for women who quit smoking during pregnancy is encouraging. A randomized trial of the approach is warranted.

Study Design: Pilot study; Prospective two-group design

Setting: Birthing hospital plus home visit

Population of Focus: English-speaking women who delivered healthy babies, resided in Franklin County, Ohio, and reported quitting smoking during pregnancy and at least 7 days before delivery

Data Source: Questionnaire that included smoking history and attitudes and intent to stay smoke free administered at baseline. Saliva sample for maternal cotinine analysis collected at baseline and 3 and 6 months for all participants who self-reported abstinence (defined as no smoking for the previous 7 days)

Sample Size: 97 in the baseline group and 122 in the intervention group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Childbirth Education Classes, PROVIDER/PRACTICE, Active Management of Labor, Labor Support, Midwifery

Intervention Description: Active management of labor is a multifaceted program that, as implemented at the National Maternity Hospital in Dublin, is associated with a lower rate of cesarean delivery than the rate usually found in the United States. We conducted a randomized trial to evaluate the efficacy of this approach in lowering the rate of cesarean section among women delivering their first babies.

Intervention Results: Rate of CS among protocol-eligible women lower in AMOL group vs. control group (10.9% vs. 11.5%; p>0.05) after adjustment for epidural use and adoption of final protocol (three hours for second stage of labor with epidural); (OR=0.9, 95% CI: 0.4–1.9)

Conclusion: Active management of labor did not reduce the rate of cesarean section in nulliparous women but was associated with a somewhat shorter duration of labor and less maternal fever.

Study Design: RCT

Setting: 1 women’s hospital

Population of Focus: Nulliparous women who gave birth between June 10, 1991 and October 17, 1993

Data Source: Not specified

Sample Size: Total (n=1,915) Intervention (n=1,009) Control (n=906)

Age Range: Not Specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Lactation Consultant, Educational Material

Intervention Description: The aim of this study was to evaluate the effect of a breastfeeding support Internet intervention on breastfeeding outcomes on women living in regional Western Australia.

Intervention Results: Women enrolled in the intervention were significantly more likely to be exclusively breastfeeding at 6 months postpartum compared with control group participants. Those women experiencing breastfeeding problems were more likely to access the Internet.

Conclusion: This breastfeeding support intervention study demonstrated a positive effect on longer-term exclusive breastfeeding for those enrolled in the intervention group. Together with more traditional methods of support, the Internet provides another possible method for promoting positive long-term breastfeeding outcomes.

Study Design: QE: non-equivalent control group

Setting: Western Australia

Population of Focus: Women who delivered an infant without serious illness, could read and understand English, and lived in a regional area in western Australia6

Data Source: Mother self-report

Sample Size: Intervention (n=207) Control (n=207)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits

Intervention Description: The objective was to investigate the effect of a theory-based educational program in promoting exclusive breastfeeding for at least 6 months in asthmatic families.

Intervention Results: The proportion of women breastfeeding exclusively at 6 months was significantly higher in the intervention group than among the control group (21/44 [48%] versus 12/45 [27%]; odds ratio 2.91; 95% Confidence Interval [1.10-7.71] (p = 0.03), controlled for maternal age, education level, and breastfeeding experience.

Conclusion: This study provides evidence that the new program (written and oral advice about breastfeeding) is effective in improving the exclusive breastfeeding rates at 6 months in asthmatic families. A next step would be to make this program available for health professionals who support pregnant women who have a familial history of asthma.

Study Design: Cluster RCT

Setting: Southeastern region of the Netherlands

Population of Focus: Women < 7 months pregnant who had at least one first-degree relative with asthma

Data Source: Mother self-report

Sample Size: Randomized • Intervention (n=58) • Control (n=55) 6-Month Follow-Up • Intervention (n=44) • Control (n=45)

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, 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, Enabling Services, Educational Material, Community-Based Group Education, Designated Clinic/Extended Hours, PROVIDER/PRACTICE

Intervention Description: This paper summarizes impacts of a breast and cervical cancer screening intervention spearheaded by a Native Hawaiian community.

Intervention Results: Women in intervention community significantly more likely to be compliant with Pap smear guidelines than women in control community (X2=5.73. p=.02)

Conclusion: Positive changes in screening activities among women aware of the intervention support the importance of information diffusion by community consumers. Diffusion may occur beyond the boundaries of the community as defined.

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

Setting: Oahu, HI

Population of Focus: Native Hawaiian women

Data Source: Telephone survey

Sample Size: Total (N=1,260) Analysis (n=678) Intervention (n=318); Control (n=360)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Telephone Support

Intervention Description: To investigate whether offering volunteer support from counsellors in breast feeding would result in more women breast feeding.

Intervention Results: No differences in breastfeeding initiation between intervention and control groups (95% vs 96%; RR=.99, 95% CI: .84-1.16, p=.44)

Conclusion: Offering support in breast feeding did not significantly increase the prevalence of any breast feeding to six weeks (65% (218/336) in the intervention group and 63% (213/336) in the control group; relative risk 1.02, 95% confidence interval 0.84 to 1.24). Survival analysis up to four months confirmed that neither duration of breast feeding nor time to introduction of formula feeds differed significantly between control and intervention groups. Not all women in the intervention group contacted counsellors postnatally, but 73% (123/179) of those who did rated them as very helpful. More women in the intervention group than in the control group said that their most helpful advice came from counsellors rather than from other sources.

Study Design: RCT

Setting: 32 general practices in London and south Essex

Population of Focus: Women 28-36 GA who were considering breastfeeding, had not breastfed a previous child for 6 weeks, English-speaking, and planned to live in area until at least 4 months after the birth

Data Source: Mother self-report

Sample Size: Intervention (n=336) Control (n=336)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Collaboration with Local Agencies (State), STATE, POPULATION-BASED SYSTEMS

Intervention Description: As part of a larger randomized study of the Healthy Families America home visiting program being conducted in Oregon (Healthy Families Oregon, HFO), we conducted a telephone survey with a randomly selected group of mothers to assess early outcomes at children's 1-year birthday.

Intervention Results: Results found that mothers assigned to the Healthy Families program group read more frequently to their young children, provided more developmentally supportive activities, and had less parenting stress. Children of these mothers were more likely to have received developmental screenings, and were somewhat less likely to have been identified as having a developmental challenge. Families with more baseline risk had better outcomes in some areas; however, generally there were not large differences in outcomes across a variety of subgroups of families.

Conclusion: Implications of these results for understanding which short-term program impacts are most feasible for early prevention programs, as well as for understanding how these services might be better targeted are discussed.

Study Design: RCT

Setting: Seven Health Families Oregon program sites in Oregon

Population of Focus: First-born children from birth through 36 months of age

Data Source: Parent telephone survey

Sample Size: Telephone surveys (n=803 mothers) - Intervention (n=402) - Control (n=401)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, Home Visits, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Home Visit (caregiver)

Intervention Description: We conducted a randomized controlled trial to determine whether a home-based intervention program could reduce infant passive smoking and lower respiratory illness.

Intervention Results: 1) A significant difference in the amount of exposure to tobacco smoke—5.9 fewer cigarettes per day at 12 months; (2) no difference in infant cotinine excretion; (3) lower prevalence of persistent lower respiratory symptoms among intervention-group infants of smoking mothers whose head of household had no education beyond high school (14.6% versus 34.0%).

Conclusion: The prevalence of persistent lower respiratory symptoms was lower among intervention-group infants of smoking mothers whose head of household had no education beyond high school: intervention group, 14.6%; and controls, 34.0%.

Study Design: RCT

Setting: In the home

Population of Focus: Infants weighing at least 2000 g at birth, free of significant postnatal medical problems, and residing in Alamance or Chatham County in central North Carolina

Data Source: Urine collection from the infants; self-report about smoking and smoke exposure from the mother and other questions designed to identify maternal and family characteristics that might modify the effect of the intervention and to identify risk factors for infant lower respiratory disease.

Sample Size: 933 total started the study, 659 completed it; 168 infants in the reduced data collection groups

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Incentives

Intervention Description: This quasi-experimental study examines the impact of Idaho's wellness incentive program, which rewards children with CHIP (Children's Health Insurance Programs) who are up-to-date with well-child visits with $30 in credits per quarter for use toward their CHIP premiums.

Intervention Results: Between baseline and the second year of implementation, the percentage of CHIP children who were up-to-date with well-child visits increased by 116% (from 23% to 49%), compared with a 13% increase (from 29% to 32%) among children with Medicaid, who were not eligible for the incentive. The incentive program had a greater impact on children who were recommended to have one annual well-child visit compared with those recommended to have two to four annual visits. The program was not, however, more effective for those whose premiums were fully covered by the reward compared with those whose premiums were partially covered.

Conclusion: This study provides encouraging evidence to states about using consumer financial incentives for increasing preventive care use.

Study Design: QE: pretest-posttest

Setting: Idaho

Population of Focus: Children ages 1 to 18 years who received Medicaid or CHIP

Data Source: Claims data

Sample Size: Baseline (n=23,232) Year 1 (n= 24,313) Year 2 (n=23,392) N=adolescents ages 12-18

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing, Referrals, Educational Material

Intervention Description: Home visiting programs represent an important primary prevention strategy for adverse prenatal health behaviors; the various ways in which home visiting programs impact prenatal smoking cessation and reduction behaviors remain understudied.

Intervention Results: A program effect was seen for smoking cessation such that clients who smoked less than ten cigarettes per day and those who smoked 20 or more cigarettes per day during the first trimester were more likely to achieve third trimester cessation than comparison women (p <0.01 and p = 0.01, respectively). Only for heavy smokers (20 or more cigarettes during the first trimester) was there a significant reduction in number of cigarettes smoked by the third trimester versus comparison women (p = 0.01). Clients expressed the difficulty of cessation, but addressed several harm-reduction strategies including reducing smoking in the house and wearing a smoking jacket. Clients also described smoking education that empowered them to ask others to not smoke or adopt other harm reducing behaviors when around their children.

Conclusion: While a significant impact on smoking cessation was seen, this study finds a less-clear impact on smoking reduction among women in home visiting programs. As home visiting programs continue to expand, it will be important to best identify effective ways to support tobacco-related harm reduction within vulnerable families.

Study Design: Cohort - Mixed methods using a retrospective cohort of propensity score

Setting: Home visiting programs

Population of Focus: English or Spanish speaking mothers who smoked during pregnancy who currently participated in a home visiting program and received welfare benefits

Data Source: Enrollment data, in-person or telephone interviews, birth certificate data

Sample Size: 10,296 women: 2595 study participants and 7701 controls

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling, Motivational Interviewing, Patient Reminder/Invitation, PROVIDER/PRACTICE, Nurse/Nurse Practitioner

Intervention Description: To determine if mothers receiving a smoking cessation intervention emphasizing health risks of environmental tobacco smoke (ETS) for their children have a higher quit rate than 1) mothers receiving routine smoking cessation advice or 2) a control group.

Intervention Results: Complete data (baseline and both follow-ups) were available for 166 subjects. There was no impact of group assignment on the quit rate, cigarettes/day, or stage of change. The Child Health Group intervention had a sustained effect on location where smoking reportedly occurred (usually outside) and on improved knowledge of ETS effects.

Conclusion: Further research is needed to devise more effective methods of using the pediatric health care setting to influence adult smoking behaviors.

Study Design: RCT

Setting: Primary care center in a large urban children’s hospital

Population of Focus: Female caregivers (16 years and older) who accompanied a child (under 12 years) to the Primary Care Center of Columbus Children’s Hospital for a health care visit for any chief complaint or well-child examination

Data Source: Baseline data on demographics and smoking topics collected by questionnaire; and 1- and 6-month follow-ups.

Sample Size: 479 mothers

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Telephone Support

Intervention Description: This cross-sectional study examines Maryland's women, infants, and children (WIC) breastfeeding initiation rates by program participation.

Intervention Results: Reported breastfeeding initiation at certification was 55.4%. Multiple logistic regression analysis, controlling for relevant maternal and infant characteristics, showed that the odds of breastfeeding initiation were significantly greater among PC-exposed infants (OR [95% CI] 1.27 [1.18, 1.37]) compared to the reference group of SCG infants, but not significantly different between LC infants (1.04 [0.96, 1.14]) and the SCG. LC and SCG infants had similar odds of breastfeeding initiation. I

Conclusion: In the Maryland WIC program, breastfeeding initiation rates were positively associated with peer counseling.

Study Design: QE: non-equivalent control group

Setting: 19 WIC clinics in MD

Population of Focus: Women with infants newly certified in the Maryland WIC program from Jan 1, 2007-Jun 30, 2007

Data Source: Mother self-report

Sample Size: Lactation Consultant (n=4527) Peer Counselor (n=8747) Control (n=5515)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Home Visits, Telephone Support

Intervention Description: To estimate the causal effect of a Michigan peer counselor (PC) breastfeeding support program for low-income women on infant health outcomes.

Intervention Results: The PC program increased the fraction breastfeeding at birth by 19.3 percent and breastfeeding duration by 2.84 weeks. Program participation also reduced the fraction of infants with gastrointestinal disorders by a statistically significant 7.9 percent. The program, if anything, increased the overall health care utilization.

Conclusion: This Michigan PC breastfeeding support program resulted in improvements in breastfeeding and infant health outcomes as measured by the diagnosis of ailments while increasing health care utilization.

Study Design: QE: non-equivalent control group

Setting: 5 counties in MI

Population of Focus: Women with available Medicaid claims data, recruited prenatally

Data Source: State administrative data, including WIC, Medicaid, and Vital Records

Sample Size: Intervention (n=274) Control (n=572)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Access to Provider through Hotline, HOSPITAL, Continuing Education of Hospital Providers, POPULATION-BASED SYSTEMS, INTER-HOSPITAL SYSTEMS, Maternal/In-Utero Transport Systems, Consultation Systems (Inter-Hospital Systems), Consultation Systems (Hospital), Telemedicine Systems (Inter-Hospital Systems), Telemedicine Systems (Hospital), STATE, Policy/Guideline (State)

Intervention Description: Telemedicine has been used successfully for medical care and education but it has never been utilized to modify patterns of delivery in an established state network.

Intervention Results: Medicaid deliveries at the regional perinatal centers increased from 23.8% before the intervention to 33% in neonates between 500 and 999 grams (p<0.05) and was unchanged in neonates between 2001-2500 grams.

Conclusion: Telemedicine is an effective way to translate evidence based medicine into clinical care when combined with a general educational conference. Patterns of deliveries appear to be changing so that those newborns at highest risk are being referred to the regional perinatal centers.

Study Design: Time trend analysis

Setting: All Arkansas hospitals

Population of Focus: Infants born weighing 500-2499 gm. Data not given for other study years.

Data Source: Data from Arkansas Vital Statistics Data System linked with corresponding hospitalization records from Arkansas Hospital Discharge Data System.

Sample Size: Total (n= 12,258) 2001 (n= 2,965) 2004 (n= 3,154)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Telephone Support, Educational Material

Intervention Description: To test the efficacy of an aid to cessation/relapse prevention intervention for women postpartum.

Intervention Results: With regard to smoking cessation, 4 week point prevalence abstinent rates were higher in the treatment group at 6, 12, and 18 months (7% vs. 1%, 7% vs. 2%, and 9% vs. 1%, respectively). Sustained abstinence was higher in the treatment group at 6 months follow-up (3% vs. 0%). No difference was observed with regard to relapse prevention.

Conclusion: Regarding aid to cessation we observed small effects, regarding relapse prevention no effect. In order to capitalize on the opportunity childbirth poses with regard to smoking, theories on relapse prevention in smoking cessation that guide in designing interventions are needed.

Study Design: Two-armed randomized controlled trial

Setting: Maternity hospitals

Population of Focus: Women who gave birth in one of six hospitals In the study region, a part of Mecklenburg-West Pomerania

Data Source: Parent self-report.

Sample Size: Baseline data is available for 644 women; follow up assessments were available for 566 women after 6 months, 529 after 12, 490 after 18, and 483 after 24 months.

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing, Enabling Services, Telephone Support

Intervention Description: To evaluate a web-based contingency management program (CM) and a phone-delivered cessation counseling program (Smoking Cessation for Healthy Births [SCHB]) with pregnant smokers in rural Appalachia who were ≤12 weeks gestation at enrollment.

Intervention Results: For CM, two of seven (28.57%) of the participants achieved abstinence, and three of 10 (30%) of those enrolled in SCHB were abstinent by late in pregnancy. Participants in CM attained abstinence more rapidly than those in SCHB. However, those in SCHB experienced less relapse to smoking, and a greater percentage of these participants reduced their smoking by at least 50%.

Conclusion: Based on this initial evaluation, the web-based CM and SCHB programs appeared to be feasible for use with rural pregnant smokers with acceptable program adherence for both approaches. Future researchers could explore combining these programs to capitalize on the strengths of each, for example, rapid smoking cessation based on CM incentives and better sustained cessation or reductions in smoking facilitated by the counseling support of SCHB.

Study Design: RCT pilot

Setting: Home- based smoking cessation programs

Population of Focus: English speaking pregnant women less than 12 weeks of pregnancy at the beginning in rural Appalachia

Data Source: Questionnaires, standardized scales, urinary cotinine levels

Sample Size: 17

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Intensive Therapy, Peer Counselor, Motivational Interviewing, Telephone Support, CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling

Intervention Description: To develop and test an intervention to reduce children’s exposure to secondhand smoke (SHS) at homes in Yerevan, Armenia.

Intervention Results: Hair nicotine concentration in the child was 17% lower in the intervention group. The follow-up survey revealed an increased proportion of households with smoking restrictions and decreased exposure of children to SHS in both groups. The adjusted odds of children’s less-than-daily exposure to SHS was 1.87 times higher in the intervention group and the geometric mean of mothers’ knowledge scores at follow-up was 10% higher in that group.

Conclusion: Intensive intervention is effective in decreasing children’s exposure to SHS through educating mothers and promoting smoking restrictions at home. However, superiority over minimal intervention to decrease children’s exposure was not statistically significant.

Study Design: RCT

Setting: Home visits

Population of Focus: Households with a nonsmoking mother and at least 1 child 2-6 years of age residing with at least 1 daily smoker

Data Source: Measures of air quality and child hair nicotine; parent self-report.

Sample Size: 250 households

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Community-Based Group Education, Group Education, Telephone Support, Educational Material, CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), PARENT/FAMILY, Presentation/Meeting/Information Session/Event, Notification/Information Materials (Online Resources, Information Guide)

Intervention Description: The objective of this trial was to test if parents’ participation in an intervention based on an empowerment ideology and participatory experiences decreased the number of cigarettes smoked in homes.

Intervention Results: The median number of cigarettes smoked in the home daily decreased from 18 to 4 in the total sample (both groups about equally), however no statistically significant difference was detected between groups at 6 months follow-up.

Conclusion: Participation in the study, independent of group, may have resulted in parents decreasing the number of cigarettes smoked in the home. Valuable lessons were learned about recruiting and working with this group of parents, all of whom faced the challenges of tobacco and almost half of whom lived in poverty

Study Design: RCT

Setting: Community (home)

Population of Focus: Families connected with public health nursing offices, family resource centers, daycare centers, and kindergartens in Prince Edward Island, with at least one cigarette smoked daily in the home, children up to 5 years of age residing there, and one parent (smoker or not) willing to participate

Data Source: Data were collected in two intervieweradministered questionnaires competed in participants’ homes at baseline and 6-months follow-up.

Sample Size: 60 families

Age Range: Not specified

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

Intervention Description: To assess the clinical effectiveness and cost effectiveness of a policy to provide breastfeeding groups for pregnant and breastfeeding women.

Intervention Results: The number of breastfeeding groups increased from 10 to 27 in intervention localities, where 1310 women attended, and remained at 10 groups in control localities. No significant differences in breastfeeding outcomes were found.

Conclusion: A policy for providing breastfeeding groups in relatively deprived areas of Scotland did not improve breastfeeding rates at 6-8 weeks. The costs of running groups would be similar to the costs of visiting women at home.

Study Design: Pragmatic cluster RCT

Setting: 14 clusters of general practices

Population of Focus: Clusters of general practices that collected breastfeeding data through the Child Health Surveillance Program of the National Health Service Scotland from Oct 2002 forward

Data Source: Child Health Surveillance Programme

Sample Size: Intervention (n=7) Control (n=7) N=Clusters

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Assessment (patient/consumer)

Intervention Description: This study explored the victimization experiences of urban elementary school students to determine whether subsets of youth emerged with similar victimization profiles (e.g., no victimization, multiple types of victimization). It also evaluated whether multiple victimization was associated with greater psychological distress and lower academic performance.

Intervention Results: Cluster analysis suggested the existence of three distinct youth profiles: those with minimal victimization, those victimized primarily by their peers, and those with multiple types of victimizations. As hypothesized, youth with multiple victimizations experienced more psychological distress and earned lower grades than their peers.

Conclusion: Findings highlight the heterogeneity of youth victimization experiences and their relations to functioning, and have implications for treatment planning among practitioners working with youth.

Study Design: N/A

Setting: an urban, ethnically diverse school district in the Northeast

Data Source: Self-report

Sample Size: 689

Age Range: fifth grade students

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material

Intervention Description: This longitudinal study reports on the development and evaluation of a narrative intervention aimed at increasing human papillomavirus (HPV) vaccination among college women.

Intervention Results: The combined peer-expert narrative intervention nearly doubled vaccination compared to controls (22% vs. 12%). The pragmatic goal of increasing HPV vaccination and the theoretical predictions about message source were supported.

Conclusion: As predicted, the inclusion of peer and medical expert sources plays a critical role in promoting HPV vaccination among college women. Furthermore, the intervention increased HPV vaccination by increasing vaccine self-efficacy and intent. Theoretical and practical implications for designing effective HPV vaccine messages are discussed.

Study Design: RCT

Setting: Computer laboratory at a university

Population of Focus: Female university students who had not been seen at the campus university health center, had not been vaccinated against HPV, and were invited via email to participate

Data Source: Online pre-intervention survey administered in a computer lab and post-intervention survey distributed via email

Sample Size: Total (n=404)  Intervention Group 1 (n=101)  Intervention Group 2 (n=101)  Intervention Group 3 (n=50)  Control (n=152)

Age Range: 18-26

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Presentation/Meeting/Information Session/Event, Training (Parent/Family), CAREGIVER, Home Visit (caregiver), Education/Training (caregiver), Educational Material (caregiver), Motivational Interviewing/Counseling, Notification/Information Materials (Online Resources, Information Guide), PATIENT/CONSUMER, Pharmacotherapy (Nicotine), Home Visits, Educational Material, Motivational Interviewing, Peer Counselor, Telephone Support

Intervention Description: We tested a combined intervention to reduce children's secondhand smoke exposure (SHSe) and help parents quit smoking.

Intervention Results: Parents’ reports of their smoking and children’s exposure showed moderate and significant correlation with children’s urine cotinine levels and home air nicotine. 13 intervention group mothers and 4 controls reported quitting smoking for 7 days prior to 1 or more study measurements without biochemical contradiction. Results of generalized estimating equations showed significantly greater decrease in reported SHSe and mothers’ smoking in the counseled group compared with controls. Reported indoor smoking and children’s urine cotinine decreased, yet group differences for changes were not significant.

Conclusion: Nicotine contamination of the home and resulting thirdhand exposure may have contributed to the failure to obtain a differential decrease in cotinine concentration. Partial exposure to counseling due to dropouts and lack of full participation from all family members and measurement reactivity in both conditions may have constrained intervention effects. Secondhand smoke exposure counseling may have been less powerful when combined with smoking cessation.

Study Design: Two-group, repeated measures RCT

Setting: Community (home)

Population of Focus: WIC clients in San Diego, California

Data Source: 3 weekly baseline child urine cotinine measures collected before trial randomization then reported and urine cotinine measures at 3 (midintervention), 6 (post-intervention), 12, and 18 months

Sample Size: 150 families

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 Education, Telephone Support

Intervention Description: The purpose of this study was to compare breastfeeding duration in mothers after delivery who were assigned randomly to a behavioral educational intervention vs enhanced usual care.

Intervention Results: Mothers in the intervention arm breastfed for a longer duration than did the control subjects (median, 12.0 vs 6.5 weeks, respectively; P = .02) Mothers in the intervention arm were less likely to quit breastfeeding over the first 6 months after delivery (hazard ratio, 0.79; 95% confidence interval, 0.65-0.97).

Conclusion: A behavioral educational intervention increased breastfeeding duration among low-income, self-identified black and Latina mothers during the 6-month postpartum period.

Study Design: RCT

Setting: Large tertiary hospital in New York City, NY

Population of Focus: Black and Latina women ≥18 years old, who had infants with birthweights ≥ 2500 gm and 5- minute Apgar scores ≥ 7

Data Source: Mother self-report

Sample Size: Randomized • Intervention (n=270) • Control (n=270) 6-Month Follow-Up • Intervention (n=214) • Control (n=209)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Motivational Interviewing, Peer Counselor, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: Exposure to fine particulate matter in the home from sources such as smoking, cooking, and cleaning may put residents, especially children, at risk for detrimental health effects. A randomized clinical trial was conducted from 2011 to 2016 to determine whether real-time feedback in the home plus brief coaching of parents or guardians could reduce fine particle levels in homes with smokers and children.

Intervention Results: Intervention homes had significantly larger reductions than controls in daily geometric mean particle concentrations (18.8% reduction vs 6.5% reduction, p<0.001). Intervention homes’ average percentage time with high particle concentrations decreased 45.1% compared with a 4.2% increase among controls (difference between groups p<0.001).

Conclusion: Real-time feedback for air particle levels and brief coaching can reduce fine particle levels in homes with smokers and young children. Results set the stage for refining feedback and possible reinforcing consequences for not generating smoke-related particles.

Study Design: A randomized trial with two groups—intervention and control

Setting: Home-based

Population of Focus: Participants from predominantly low-income households with an adult smoker and a child under 14 years of age

Data Source: Real-time lights and sounds (programmed to emit a blinking yellow LED light and brief aversive auditory alert when levels of indoor particles reached a threshold as measured by a Dylos air monitor. Delayed particle feedback charts

Sample Size: 298 homes

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Parent Engagement, PROVIDER/PRACTICE, Maintenance of Certification Credits, Provider Training/Education, Patient-Centered Medical Home, Quality Improvement/Practice-Wide Intervention

Intervention Description: The Florida Pediatric Medical Home Demonstration Project, funded through the Children's Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant, aimed to implement and evaluate a Patient-Centered Medical Home (PCMH) model in selected pediatric practices. The project was carried out in two rounds, with Round 1 practices participating from 2011-2014 and Round 2 practices from 2013-2014. The American Academy of Pediatrics (AAP) provided quality improvement activities to the practices, which included learning sessions, monthly calls, quarterly reports, and listserv communication. Practices were eligible if they accepted Medicaid and CHIP and served at least 100 children with special health care needs.

Intervention Results: The evaluation results showed that over the course of the project, the Medical Home Index (MHI) scores increased for both Round 1 and Round 2 practices, indicating progress towards becoming PCMHs. Practices reported being able to make changes, improve teamwork, and enhance efficiency. However, staff turnover, communication with specialists, and maintaining parent partner relationships remained challenging. Physician-reported outcomes such as job satisfaction were higher than those reported by non-physician staff. Community stakeholders indicated room for improvement in communication with the practices. A cost study component with Round 2 practices revealed that the perceived costs of PCMH transformation varied greatly due to differences in activities undertaken by practices.

Conclusion: The Florida Pediatric Medical Home Demonstration Project evaluation showed that participating pediatric practices made significant progress in their PCMH transformation, as evidenced by increased MHI scores. Practices experienced successes in implementing changes, improving teamwork, and increasing efficiency. However, challenges persisted in areas such as staff turnover, specialist communication, and parent partnerships. Physician staff reported more positive outcomes compared to non-physician staff. Opportunities exist to further improve communication between practices and community stakeholders. Finally, the cost study highlighted the varying perceptions and experiences of practices regarding the financial implications of PCMH transformation.

Study Design: Not specified

Setting: Not specified

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Not specified

Age Range: Not specified

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

Intervention Description: Assess the effectiveness of a culturally customized program (Esperanza y Vida [Hope and Life]) in increasing breast and cervical cancer screening among Latinas, and to examine how screening rates related to changes in cancer knowledge, differences in ethnic origins, and geographic location.

Intervention Results: Screening rates were significantly higher for the intervention versus the control group for clinical breast examination (CBE; 48% vs. 31%; adjusted odds ratio [aOR], 2.2; 95% confidence interval [CI], 1.1-4.2), breast self-examination (45% vs. 27%; aOR, 2.3; 95% CI, 1.1-5.0), and Pap testing (51% vs. 30%; aOR, 3.9; 95% CI, 1.1-14.1), but not for mammography (67% vs. 58%; aOR, 0.7; 95% CI, 0.1-3.6).

Conclusion: Esperanza y Vida has the potential to reduce health disparities in breast and cervical cancer morbidity and mortality rates through increasing cancer screening and thereby increasing early detection.

Study Design: Cluster RCT

Setting: Arkansas and New York City, NY

Population of Focus: Latina women

Data Source: Telephone survey

Sample Size: Baseline (n=487) Intervention (n=308); Control (n=179) Follow-up (n=238)

Age Range: Mean: 39.3

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Policy/Guideline (Hospital), Assessment (patient/consumer), Screening in Nontraditional Settings

Intervention Description: The intervention described by the article to increase postpartum depression (PPD) screening is the implementation of a PPD screening program in a Pediatric Emergency Department (PED) setting . The study found that PED-based screening had a positive impact through PPD screening, education, and resources, and helped to identify PPD in mothers who had not been screened previously.

Intervention Results: The results found that 27% of mothers (n=209) screened positive for PPD, with 7% reporting suicidal thoughts . Additionally, 47% of mothers had never previously been screened for PPD, including 58% of PPD screen-positive mothers . The study also assessed maternal attitudes toward screening and found that PED-based screening had a positive impact through PPD screening, education, and resources, and helped to identify PPD in mothers who had not been screened previously

Conclusion: Approximately 1 in 4 mothers screened positive for PPD in a PED, with almost 1 in 10 reporting suicidal thoughts. The majority of PPD screen–positive mothers had not been screened previously. Our study helps to inform future efforts for interventions to support mothers of young infants who use the PED for care.

Study Design: To answer your question, the study design/type is a pilot cohort study of a convenience sample of mothers of infant patients

Setting: The study was conducted in a Pediatric Emergency Department (PED)

Population of Focus: The target audience for the study is healthcare providers, particularly those who work in pediatric emergency departments and are involved in the care of mothers and infants

Sample Size: The sample size for the study was 209 mothers of infant patients who presented to a PED from June 2015 to January 2016

Age Range: The study included mothers of infant patients 6 months or younger presenting to a Pediatric Emergency Department

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

Intervention Description: A targeted invitation to women not participating for the last 5 years in cervical screening was evaluated to determine whether it would decrease the number of these women. Increasing general practitioners' attention to the screening programme for cervical cancer was also evaluated to determine whether it would increase participation.

Intervention Results: The decline in non-attenders was 0.87% (95% CI 0.57% to 1.16%) after 9 months in favour of the intervention. A difference of 0.94% (95% CI 0.21% to 1.67%) in the change of coverage rate was observed at 6 months, which increased to 1.97% (95% CI 0.03% to 3.91%) at 9 months in favour of the intervention.

Conclusion: It is possible to decrease the proportion of non-attenders and increase the coverage rate in a screening programme for cervical cancer using a special targeted invitation to non-attenders combined with a visit to GPs.

Study Design: Cluster RCT

Setting: General practices (GPs) in the county of Aarhus

Population of Focus: Women who had not had a Pap smear in the last 5 years GPs in Aarhus

Data Source: Database that included women’s Pap smear information, regardless of where she had received the screening

Sample Size: Total (N=117,129) Intervention (n=57,946); Control (n=59,183)

Age Range: 23-59

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

Intervention Description: This randomized controlled trial examined whether a personalized form (PF) letter containing generic cancer information and a personalized tailored (PT) letter containing minimally tailored individualized risk factor information based on medical records data affected breast and cervical cancer screening among 1574 urban low-income and minority women.

Intervention Results: The personalized form-letter group was significantly more likely to schedule a screening appointment and to have undergone a Pap test and mammography within 1 year after the intervention than were the tailored letter and control groups (P<0.001 for all comparisons).

Conclusion: Personalized tailored letters that contain individualized cancer risk factor information may decrease the likelihood of receiving cancer screening among medically underserved low-income and minority women, but personalized form letters that contain generic cancer information may improve these rates in this disadvantaged population.

Study Design: RCT

Setting: Two urban community health centers in Houston, TX

Population of Focus: African American, Mexican American, and non-Hispanic white women who were registered at participating health centers

Data Source: Database provided by woman’s primary care provider

Sample Size: Total (N=1,574) Analysis (n=1,483) Intervention Group 1 (n=524); Intervention Group 2 (n=460); Control (n=499)

Age Range: 18-64

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

Intervention Description: The 1,574 women participating in the randomized controlled trial were assigned to one of three groups: (1) PF letter, (2) PT letter, (3) control (no letter).

Intervention Results: Logistic regression analyses show that (1) personalized-tailored letters containing individualized references to recipients' cancer risk factors failed to increase rates of recommended cancer screening behaviors, especially among non-Hispanic white women; and that (2) in contrast, a personalized-form letter with general breast and cervical cancer screening messages increased cancer screening rates in this population, especially among non-Hispanic white and Mexican-American women

Conclusion: Recent reports suggesting that cancer death rates in women have stabilized since 2000 after a number of years of decline, alongside reported ongoing declines in cancer death rates for men,38 suggest that aggressive and effective efforts to control cancer risk in women are still needed. TPC focusing on individual factors important in behavioral change has been a strategy used to improve the relevancy of a message for a specific person. From a practice perspective, the findings of the present study suggest that physicians and others involved in cancer screening services may want to be cautious about including risk-related information gleaned from medical records in prompting messages sent to patients for the purposes of promoting compliance with screening recommendations

Study Design: RCT

Setting: Two urban community health centers in Houston, TX

Population of Focus: African American, Mexican American, and non-Hispanic white women who were registered at participating health centers

Data Source: Database provided by woman’s primary care provider

Sample Size: Total (N=1,574) Analysis (n=1,483) Intervention Group 1 (n=524); Intervention Group 2 (n=460); Control (n=499)

Age Range: 18-65

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): PATIENT/CONSUMER, Home Visits, Telephone Support

Intervention Description: To test the effects of the Healthy Steps for Young Children program (HS) (which supports parents managing children's developmental and behavioral issues)-with and without a prenatal component-on child health and development, parenting practices, and parental well-being.

Intervention Results: Intervention was associated with positive outcomes in timely well-child care, immunization rates, breastfeeding, television viewing, injury prevention, and discipline strategies. Prenatal initiation of services was associated with larger expressive vocabularies at age 24 months. Mothers who received the intervention reported more depressive symptoms, but there was no increase in the proportion with clinically significant depression.

Conclusion: For members of an integrated delivery system, the HS intervention was associated with positive effects on children's health and parenting practices. There was little evidence of any additional benefit of HS services initiated during the prenatal period.

Study Design: RCT

Setting: Integrated delivery system in the Pacific Northwest

Population of Focus: Pregnant women <22 weeks GA at enrollment, <45 years old, English speaking, and planning to attend a study clinic for pediatric care

Data Source: Mother self-report

Sample Size: Healthy Steps (HS) only (n=117) HS + PrePare (n=122) Control (n=104)

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

Intervention Description: Letters were sent to 15,691 unscreened and 6,995 under-screened women from Cape Breton Island encouraging them to obtain a Pap test. Controls were 61,510 unscreened women and 32,996 under- screened women in mainland Nova Scotia who were not sent letters.

Intervention Results: For this cohort study, the provincial Health Card Number database and Provincial Cytology Registry were linked. Having a Pap smear was associated with having received a letter (OR = 1.64), having been previously under-screened rather than unscreened (OR = 1.85), with youth and with higher income (OR = 1.13). After receiving a letter, women in Aboriginal, Mixed Black, Acadian, and rural communities had smear rates similar to those of other women.

Conclusion: Being previously unscreened, rather than under-screened, was associated with higher rates of abnormalities (OR = 1.62), indicating greater need for early detection and treatment to prevent invasive cancer. While one-time letters to women improved the Pap smear screening rates, multiple, continuous interventions are needed to make a more substantive improvement in these rates.

Study Design: RCT

Setting: Cape Breton Island and Mainland Nova Scotia

Population of Focus: Women who were either unscreened (no Pap smear recorded from January 1988- letter mailing date) or underscreened (at least one Pap smear recorded between January 1988- January 1995 but none recorded from January 1995-letter mailing date)

Data Source: Provincial Cytology Registry

Sample Size: Total (N=360,587) Analysis (n=113,426) Intervention (n=21,601); Control (n=91,825) Additional control group (n=1,218)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Home Visits, Telephone Support

Intervention Description: To assess the effectiveness of a peer support worker (PSW) service on breast-feeding continuation.

Intervention Results: No significant difference in exclusive breastfeeding at 6 months between the intervention and control group (17.8% vs 19.6%)

Conclusion: Universal antenatal peer support and postnatal peer support for women who initiated breast feeding did not improve breast-feeding rates up to 6 months in this UK population.

Study Design: Cluster RCT

Setting: Primary Care Trust (PCT) health district in Birmingham

Population of Focus: All pregnant women registered with a general practice within the PCT, with an approximate due date between Feb 1, 2007 – July 31, 2007

Data Source: Mother self-report

Sample Size: • Intervention (n=33) • Control (n=33) N=clinics Randomized • Intervention (n=1267) • Control (n=1457) 6-Month Follow-Up • Intervention (n=271) • Control (n=301) N=women

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, PROVIDER/PRACTICE, Provider Reminder/Recall Systems, Financial Incentives, Nurse/Nurse Practitioner

Intervention Description: Before-and-after comparisons of the time-appropriate delivery rates of cervical and breast cancer screening using the automated and NP-augmented strategies of the P-PROMPT reminder and recall system.

Intervention Results: Before-and-after comparisons of time-appropriate delivery rates (< 30 months) of cancer screening showed the rates of Pap tests and mammograms for eligible women significantly increased over a 1-year period by 6.3% (P < .001) and 5.3% (P < .001), respectively. The NP-augmented strategy achieved comparable rate increases to the automated strategy alone in the delivery rates of both services.

Conclusion: The use of provider and patient reminders and pay-for-performance incentives resulted in increases in the uptake of Pap tests and mammograms among eligible primary care patients over a 1-year period in family practices in Ontario.

Setting: Eight primary care network practices and 16 family health network practices in southwestern Ontario

Population of Focus: Practicing physicians from the participating primary care network and family health network groups

Data Source: CytoBase (consortium of main laboratories in Ontario), combined with rosters of eligible patients

Sample Size: Total (N=246) Analysis (n=232) N=physicians

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, Access to Provider through Hotline

Intervention Description: We tested the efficacy of a minimal intervention to create smoke-free homes in low-income households recruited through the United Way of Greater Atlanta 2-1-1, an information and referral system that connects callers to local social services.

Intervention Results: Participants were mostly smokers (79.7%), women (82.7%), African American (83.3%), and not employed (76.5%), with an annual household income of $10 000 or less (55.6%). At 6-months postbaseline, significantly more intervention participants reported a full ban on smoking in the home than did control participants (40.0% vs 25.4%; P = .002). The intervention worked for smokers and nonsmokers, as well as those with or without children.

Conclusion: Minimal intervention was effective in promoting smoke-free homes in low income households and offers a potentially scalable model for protecting children and adult nonsmokers from secondhand smoke exposure in their homes.

Study Design: RCT

Setting: Community (2-1-1 Information and Referral System)

Population of Focus: Families with smoke-free homes in low-income households

Data Source: 2-1-1 line agents and interview data

Sample Size: 498 randomized into Intervention (246) and Control (252)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, PATIENT/CONSUMER

Intervention Description: To determine whether a low-cost prenatal education video improves hospital rates of breastfeeding initiation and exclusivity in a low-income population.

Intervention Results: Exposure to the intervention did not affect breastfeeding initiation rates or duration during the hospital stay. The lack of an effect on breastfeeding initiation persisted even after controlling for partner, parent, or other living at home and infant complications (adjusted odds ratio [OR] = 1.05, 95% CI, 0.70-1.56). In addition, breastfeeding exclusivity rates during the hospital stay did not differ between the groups (P = .87).

Conclusion: This study suggests that an educational breastfeeding video alone is ineffective in improving the hospital breastfeeding practices of low-income women. Increasing breastfeeding rates in this at-risk population likely requires a multipronged effort begun early in pregnancy or preconception.

Study Design: RCT

Setting: University of Virginia Health System and the Virginia Commonwealth University Health System

Population of Focus: Women 24-41 weeks GA, income ≤185% FPL, English-speaking, with a singleton pregnancy, and no known contraindication to breastfeeding

Data Source: Medical record review

Sample Size: Intervention (n=249/174)3 Control (n=248/172)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Transition Assistance, PATIENT/CONSUMER, HOSPITAL, Continuing Education of Hospital Providers, POPULATION-BASED SYSTEMS, INTER-HOSPITAL SYSTEMS, Neonatal Back-Transport Systems, Consultation Systems (Inter-Hospital Systems), Consultation Systems (Hospital), Telemedicine Systems (Inter-Hospital Systems), Telemedicine Systems (Hospital)

Intervention Description: Assessed a telemedicine (TM) network's effects on decreasing deliveries of very low birth weight (VLBW, <1500 g) neonates in hospitals without Neonatal Intensive Care Units (NICUs) and statewide infant mortality.

Intervention Results: Deliveries of VLBW neonates in targeted hospitals decreased from 13.1 to 7.0% (P=0.0099); deliveries of VLBW neonates in remaining hospitals were unchanged. Mortality decreased in targeted hospitals (13.0% before TM and 6.7% after TM). Statewide infant mortality decreased from 8.5 to 7.0 per 1000 deliveries (P=0.043).

Conclusion: TM decreased deliveries of VLBW neonates in hospitals without NICUs and was associated with decreased statewide infant mortality.

Study Design: QE: pretest-posttest

Setting: All Arkansas hospitals (Nine selected as telemedicine hospitals due to high patient volume)

Population of Focus: Infants born weighing <1500 gm

Data Source: Medicaid data for VLBW infants as indicated by ICD-9 diagnosis codes from hospital and physician claims for pregnancy. Data infant with birth and infant death certificates.

Sample Size: Pretest (n= 383) Posttest (n= 384)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Telephone Support

Intervention Description: This study examined the effect of support from trained peer counselors on breastfeeding initiation, duration, and exclusivity among low-income urban women.

Intervention Results: Women in the counselor group had significantly greater (p < .05) breastfeeding initiation (93 percent vs. 70 percent), exclusivity (77 percent vs. 40 percent), and duration (mean of 15 weeks vs. mean of 8 weeks) than women in the no-counselor group.

Conclusion: The findings suggest that peer counselors, well-trained, and with on-going supervision, can have a positive effect on breastfeeding practices among low-income urban women who intend to breastfeed.

Study Design: QE: non-equivalent control group

Setting: The Perinatal Center at Cook County Hospital in Chicago, IL

Population of Focus: Women planning to deliver at Cook County Hospital, English or Spanish speaking, who were planning to breastfeed and had requested a peer counselor

Data Source: Mother self-report

Sample Size: Intervention (n=59) Control (n=43)

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

Intervention Description: In the context of a new adolescent preventive health program in a family practice setting, we compared attendance rates using two invitation protocols, the protocols differing in their emphasis on adolescent autonomy vs parental responsibility.

Intervention Results: The spontaneous response rate was 21%, the agreement to attend rate was 75%, and the attendance rate was 44%. Attendance rates were higher for the girls compared with the boys (54% vs 35%, P = .08) and for the seventh graders compared with the tenth graders (53% vs 31%, P = .03). The spontaneous response rate was lower among the tenth graders using protocol 2 (8% vs 37.5% with protocol1, P = .04), while the agreement to attend rate and attendance rate did not differ for the two protocols.

Conclusion: Nearly one half of this population of adolescents attended preventive health visits at the family nurse's and physician's initiative. A follow-up telephone call after the initial written invitation resulted in increased participation, while approaching the teenager or parent initially did not make a difference in attendance. This pilot study shows the potential for initiating an adolescent health program in the family practice setting.

Study Design: QE: non-equivalent control group

Setting: Family practice clinic in an urban, mainly lower-middle class, Jewish neighborhood in West Jerusalem

Population of Focus: Teenagers ages 12 to 18 (7th graders and 10th graders) years who live with their parents in the neighborhood (all patients have national health insurance and visits are free of charge)

Data Source: Clinic attendance records

Sample Size: Total (N=106) Protocol 1: (n=47) Protocol 2: (n=59)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Lactation Consultant, Educational Material, Home Visits

Intervention Description: This study examined the effectiveness of a breast-feeding promotion program to increase the continuation of breast-feeding.

Intervention Results: The 3-month breast-feeding rate was 32% in the intervention and 38% in the control groups (OR = 0.79, 95% CI = 0.58-1.08).

Conclusion: The program was not effective. We discuss possible explanations from the design and execution of the trial and give some points for improvement of our program, such as the categories of caregivers involved and the number and duration of contacts after parturition.

Study Design: Cluster RCT

Setting: 10 maternity and child health centers within home health care organizations in Limburg

Population of Focus: Pregnant women who applied for maternity care in one of the participating centers who gave birth to infants ≥2000 g

Data Source: Mother self-report

Sample Size: • Intervention (n=5) • Control (n=5) N=clinics • Intervention (n=371) • Control (n=330) N=women

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Assessment (patient/consumer)

Intervention Description: We examined the effects on infant growth and health of 3 compared with 6 mo of exclusive breastfeeding.

Intervention Results: From 3 to 6 mo, weight gain was slightly greater in the 3-mo group [difference: 29 g/mo (95% CI: 13, 45 g/mo)], as was length gain [difference: 1.1 mm (0.5, 1.6 mm)], but the 6-mo group had a faster length gain from 9 to 12 mo [difference: 0.9 mm/mo (0.3, 1.5 mm/mo)] and a larger head circumference at 12 mo [difference: 0.19 cm (0.07, 0.31 cm)]. A significant reduction in the incidence density of gastrointestinal infection was observed during the period from 3 to 6 mo in the 6-mo group [adjusted incidence density ratio: 0.35 (0.13, 0.96)], but no significant differences in risk of respiratory infectious outcomes or atopic eczema were apparent.

Conclusion: Exclusive breastfeeding for 6 mo is associated with a lower risk of gastrointestinal infection and no demonstrable adverse health effects in the first year of life.

Study Design: observational cohort study nested within a large randomized trial

Setting: Belarus

Data Source: N/A

Sample Size: 3483 infants

Age Range: Infants under 1 year

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, Home Visits

Intervention Description: To assess the impact of a supportive intervention on the duration of breastfeeding.

Intervention Results: Mothers in the intervention group had a 14% lower cessation rate (HR = 0.86 CI: 0.75-0.99). Similar results were seen for primipara, and multipara with previously short breastfeeding experience. Mothers in the intervention group received their first home visit earlier, had more visits and practical breastfeeding training within the first 5 weeks. Babies in the intervention group were breastfed more frequently, fewer used pacifiers, and their mothers reported more confidence in not knowing the exact amount of milk their babies had received when being breastfed.

Conclusion: Home visits in the first 5 weeks following birth may prolong the duration of exclusive breastfeeding. Postnatal support should focus on both psychosocial and practical aspects of breastfeeding. Mothers with no or little previous breastfeeding experience require special attention.

Study Design: Cluster RCT

Setting: 22 municipalities in Western Denmark

Population of Focus: All mothers living within the 22 municipalities with singleton birth at ≥37 weeks GA

Data Source: Mother self-report

Sample Size: Randomized • Intervention (n=780) • Control (n=815) 6-Month Follow-Up9 • Intervention (n=766) • Control (n=815)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Lactation Consultant, Home Visits, Telephone Support

Intervention Description: To determine the effectiveness of a breastfeeding support service attached to a general practice.

Intervention Results: There was a high, breastfeeding initiation rate for both baseline (94.6%) and intervention (93.4%) groups. There were significantly higher breastfeeding rates in the intervention group at 24 and 26 weeks (63.3% vs 51.2% at 24 weeks [p = 0.015] and 64.7% vs 50.6% at 26 weeks [p = 0.018]). While there was no significant difference in the total number of breastfeeding problems encountered by either group significantly more mothers from the baseline group suffered from engorgement and/or too much milk. Evaluation of the service indicated a high degree of satisfaction. Over 94% of the mothers found the service friendly, supportive, and useful.

Conclusion: This service provides an effective method for the support and protection of breastfeeding.

Study Design: QE: non-equivalent control group

Setting: A general practice in Happy Valley, Adelaide

Population of Focus: Pregnant patients registered in the practice

Data Source: Mother self-report

Sample Size: Intervention (n=119) Control (n=168)

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, Educational Material, Peer Counselor, Telephone Support, Other Education, Motivational Interviewing, CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Motivational Interviewing/Counseling, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Consultation/Counseling (Parent/Family), Counseling (Parent/Family)

Intervention Description: We hypothesized that a multilevel treatment model integrating pediatric clinic-level AAR with individual-level, telephone counseling would promote greater long-term (12-month) child TSE reduction and parent smoking cessation than clinic-level AAR alone.

Intervention Results: Child TSE (urine cotinine) declined significantly in both intervention and control groups from baseline to 12-months with no between-group differences. There was s statistically significant effect on 12-month bioverified quit status-intervention group participants were 2.47 times more likely to quit smoking than those in the control group.

Conclusion: Pediatrician advice alone may be sufficient to increase parent protections of children from TSE. Integrating clinic-level intervention with more intensive individual-level smoking intervention is necessary to promote parent cessation.

Study Design: RCT

Setting: Telephone counseling

Population of Focus: Parents/caregivers

Data Source: Self-reported interview data

Sample Size: 327 were randomized (164-control and 163-intervention)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Oral Health Education, Oral Health Supplies, PROVIDER/PRACTICE, Designated Clinic/Extended Hours, Quality Improvement/Practice-Wide Intervention

Intervention Description: The state of New Hampshire created a pilot project to integrate preventive oral health care for low-income women and children through local sites of the Women, Infants and Children (WIC) program.

Intervention Results: Preliminary data suggest promising results. Among the approximately 3,900 children served by the three pilot locations, 573 children (14 percent) received an oral health screening; 175 (31 percent) of those children were under age one. Of those screened, 48 children (8 percent) had untreated decay, 490 (86 percent) received a fluoride varnish application, and 80 (14 percent) received a dental sealant. A total of 857 pregnant women are served in the WIC program across all three pilot locations. Out of those women, 123 (14 percent) received an oral health screening. Of those screened, 88 (72 percent) showed untreated decay, and 46 (37 percent) were referred to a dentist for urgent needs. Out of the women who received an oral health screening, 114 (93 percent) received a fluoride varnish application, and 92 (75 percent) received sealants.

Conclusion: This profile details New Hampshire’s experiences and offers considerations for state agencies, federal policymakers, and other interested stakeholders to explore alternative channels for reaching low-income populations with oral health care and education.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Oral Health Education, Oral Health Supplies, PROVIDER/PRACTICE, Designated Clinic/Extended Hours, Quality Improvement/Practice-Wide Intervention

Intervention Description: The state of New Hampshire created a pilot project to integrate preventive oral health care for low-income women and children through local sites of the Women, Infants and Children (WIC) program.

Intervention Results: Preliminary data suggest promising results. Among the approximately 3,900 children served by the three pilot locations, 573 children (14 percent) received an oral health screening; 175 (31 percent) of those children were under age one. Of those screened, 48 children (8 percent) had untreated decay, 490 (86 percent) received a fluoride varnish application, and 80 (14 percent) received a dental sealant. A total of 857 pregnant women are served in the WIC program across all three pilot locations. Out of those women, 123 (14 percent) received an oral health screening. Of those screened, 88 (72 percent) showed untreated decay, and 46 (37 percent) were referred to a dentist for urgent needs. Out of the women who received an oral health screening, 114 (93 percent) received a fluoride varnish application, and 92 (75 percent) received sealants.

Conclusion: This profile details New Hampshire’s experiences and offers considerations for state agencies, federal policymakers, and other interested stakeholders to explore alternative channels for reaching low-income populations with oral health care and education.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Incentives

Intervention Description: We examined whether pregnant and newly postpartum smokers at risk for postpartum depression respond to an incentive-based smoking-cessation treatment and how the intervention impacts depression ratings.

Intervention Results: The intervention increased smoking abstinence independent of depression status (p < .001), and it decreased mean postpartum BDI ratings as well as the proportion of women scoring in the clinical range (≥17 and >21) compared with the control treatment (ps ≤ .05). Treatment effects on depression ratings were attributable to changes in Dep+ women.

Conclusion: These results demonstrate that depression-prone pregnant and newly postpartum women respond well to this incentive-based smoking-cessation intervention in terms of achieving abstinence, and the intervention also reduces the severity of postpartum depression ratings in this at-risk population.

Study Design: Quasi experimental cross sectional- repeated measures secondary data analysis

Setting: Obstetric practices and Women, Infants, and Children (WIC) program

Population of Focus: English speaking Women, Infants, and Children (WIC) program recipients who were pregnant and newly postpartum smokers at risk for postpartum depression

Data Source: Depression scale scores, breath CO, urine cotinine

Sample Size: 289

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Incentives

Intervention Description: We examined whether impulsiveness moderates response to financial incentives for cessation among pregnant smokers.

Intervention Results: Neither delay discounting (DD) nor Barratt Impulsiveness Scale (BIS) predicted smoking status in the single or combined trials. Receiving abstinence-contingent incentives, lower baseline smoking rate, and a history of quit attempts prepregnancy predicted greater odds of antepartum abstinence across the single and combined trials. No variable predicted postpartum abstinence across the single and combined trials, although a history of antepartum quit attempts and receiving abstinence-contingent incentives predicted in the single and combined trials, respectively.

Conclusion: Overall, this study provides no evidence that impulsiveness as assessed by DD or BIS moderates response to this treatment approach while underscoring a substantial association of smoking rate and prior quit attempts with abstinence across the contingent incentives and control treatment conditions.

Study Design: Cohort- prospective single trial data combined with random group assignment cohorts

Setting: University outpatient research clinic

Population of Focus: English speaking Women, Infants, and Children (WIC) program recipients who were pregnant smokers who resided in the county and did not move for 6 months, no other substance use reported

Data Source: Questionnaires, breath CO & urine cotinine, delay discounting task scores (DD), Barratt Impulsiveness Scale (BIS)

Sample Size: 236

Age Range: Not specified

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

Intervention Description: This study examined the feasibility and efficacy of Salud Es Vida – a promotora-led, Spanish-language educational group session on cervical cancer screening (Pap tests), self-efficacy (belief in ability to schedule and complete a Pap test), and knowledge among immigrant Hispanic/Latina women from farmworker backgrounds.

Intervention Results: While there was no statistically significant difference in cervical cancer screening self-efficacy scores between the group participants, both groups scored higher at follow-up, adjusting for the baseline scores.

Conclusion: The group intervention approach was associated with increased cervical cancer knowledge, but not uptake of Pap test. More intensive interventions using patient navigation approaches or promotoras who actively follow participants or conducting one-on-one rather than group sessions may be needed to achieve improved screening outcomes with this population.

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

Setting: 4 rural counties in Southeast GA

Population of Focus: Hispanic/Latino immigrant women ages 21-65 who had not had a Pap test in 2 years or more

Data Source: Written survey; cervical cancer screening questions were derived from the Health Information National Trends Survey

Sample Size: Baseline (n=176) Intervention (n=86); Control (n=90) Follow-up/Analysis (n=90) Intervention (n=38); Control (n=52)

Age Range: 21-65

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Home Visits

Intervention Description: To assess the effectiveness of an antenatal service using community based breastfeeding peer support workers on initiation of breast feeding.

Intervention Results: The groups did not differ for initiation of breast feeding: 69.0% (747/1083) in the intervention group and 68.1% (896/1315) in the control groups; cluster adjusted odds ratio 1.11 (95% confidence interval 0.87 to 1.43). Ethnicity, parity, and mode of delivery independently predicted initiation of breast feeding, but randomisation to the peer support worker service did not.

Conclusion: A universal service for initiation of breast feeding using peer support workers provided within antenatal clinics serving a multiethnic, deprived population was ineffective in increasing initiation rates.

Study Design: Cluster RCT

Setting: Prenatal clinics

Population of Focus: Women registered with practices in the primary care trust

Data Source: Medical record review

Sample Size: Intervention (n=33) • Control (n=33) N=practice clusters • Intervention (n=1083) • Control (n=1315) N=women

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PROVIDER/PRACTICE, Quality Improvement/Practice-Wide Intervention

Intervention Description: To measure progress toward the collaborative aim, the HV CoIIN developed a common group of measures that local implementing agencies (LIAs) report and analyze monthly. HV CoIIN measures were selected to capture steps in the process of promotion, early detection, and intervention.

Intervention Results: Within the first 9 months, the HV CoIIN is generating promising movement toward breakthrough change across indicators, for example: By instituting mechanisms to track and provide ongoing surveillance of developmental and behavioral well-being, home visitors are asking over 80% of parents about their child’s development, behavior, or learning at every home visit. By standardizing and measuring efficacy of processes for developmental and behavioral screening, programs are screening approximately 70% of children at appropriate intervals. By incorporating protocol and practice for intentionally supporting children with a positive screen or parental concerns, home visitors are providing 80% or more of families with individualized support related to their child’s development, behavior, or learning within regularly scheduled home visits.

Conclusion: The HV CoIIN’s theory of change includes a comprehensive approach for the development and implementation of reliable and effective systems for surveillance, screening, referral, follow-up, and intervention, with the goal of supporting all children’s development and getting vulnerable children access to appropriate and timely supports.

Study Design: Quality improvement time series design

Setting: Maternal, Infant, and Early Childhood Home Visiting Programs within 8 states and one Tribe: AR, MI, IN, NJ, GA, OH, PA, FL and White Earth Home Health Agency

Population of Focus: Prenatal to age 5 children and families

Data Source: Local team data registries

Sample Size: • Phase I – 11 sites (n≈1019) • Phase II – 5 sites (n≈676) N=families per month

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PROVIDER/PRACTICE, Quality Improvement/Practice-Wide Intervention

Intervention Description: To measure progress towards the SMART aim, the HV CoIIN developed a common group of measures that LIAs report and analyze monthly. HV CoIIN measures were selected to capture key steps in the process of breastfeeding.

Intervention Results: The HV CoIIN’s theory of change includes a comprehensive approach to increasing the percentage of mothers that exclusively breastfeed their infants until they are three and six months of age by redesigning the ways we engage mothers, provide breastfeeding support in home visits, and ensure seamless linkages for mothers to access and engage in peer and community breastfeeding supports. Within the first eleven months, the HV CoIIN is generating promising movement toward breakthrough change across indicators, On average, 74% of all home visitors within the breastfeeding collaborative across 11-months, are being trained in lactation and infant feeding, with a trend in the data towards meeting our overall Process AIM. Over the last four months, the average has increased to more than 89%. On average, 69% of mothers with an identified need for breastfeeding support are receiving professional or peer breastfeeding support across the collaborative. Efforts in Action period three will aim to strengthen community and peer supports for families. The average percent of women exclusively breastfeeding is 16%, up 13 percentage points from the baseline of 3% of women.

Conclusion: The HV CoIIN’s theory of change includes a comprehensive approach for the development and implementation of reliable and effective systems for surveillance, screening, referral, follow-up, and intervention, with the goal of supporting all children’s development and getting vulnerable children access to appropriate and timely supports.

Study Design: Quality improvement time series design

Setting: Maternal, Infant, and Early Childhood Home Visiting Programs within FL, MI, OH, PA, RI, VA, WI

Population of Focus: Prenatal to age 3 children and families

Sample Size: • Phase 1 – 11 local teams (n≈1074) • Phase II – 9 sites (n≈873) N=families per month

Age Range: Not specified

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

Intervention Description: The project aims to evaluate the effectiveness of an educational group intervention performed by primary healthcare professionals in increasing the proportion of mother-infant pairs using exclusive breastfeeding at six months compared to routine practice.

Intervention Results: Group education is an instrument used by professionals in primary care that favors the acquisition of skills and modification of already-acquired behavior, all making it a potential method of choice to improve rates of exclusive breastfeeding in this period.

Conclusion: We must implement strategies with scientific evidence to improve the percentage of exclusive breast-feeding at six months in our environment as established by the WHO.

Study Design: community-based cluster randomised trial

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor

Intervention Description: Peer counseling (PC) has been associated with increased breastfeeding initiation and duration, but few analyses have examined the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) model for peer counseling or the continuation of breastfeeding from birth through 12 months postpartum. Objectives Identify associations between Minnesota WIC Peer Breastfeeding Support Program services and breastfeeding initiation and continuation.

Intervention Results: Among women who accepted referral into a PC program, odds of initiation were significantly higher among those who received peer services (Odds Ratio (OR): 1.66; 95% CI 1.19–2.32), after adjusting for confounders. Women who received peer services had a significantly lower hazard of breastfeeding discontinuation from birth through 12 months postpartum than women who did not receive services. (Hazard Ratio (HR) month one: 0.45; 95% CI 0.33–0.61; months two through twelve: 0.33; 95% CI 0.18–0.60). The effect of peer counseling did not differ significantly by race and ethnicity, taking into account mother’s country of origin.

Conclusion: Receipt of peer services was positively associated with breastfeeding initiation and continued breastfeeding from birth through 12 months postpartum. Making peer services available to more women, especially in communities with low initiation and duration, could improve maternal and child health in Minnesota.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Midwife, Educational Material, Home Visits, Telephone Support

Intervention Description: To evaluate the effects of an extended midwifery support (EMS) programme on the proportion of women who breast feed fully to six months.

Intervention Results: Findings: there was no difference between the groups at six months postpartum for either full breast feeding [EMS 43.3% versus SMS 42.5%, relative risk (RR) 1.02, 95% confidence interval (CI) 0.87-1.19] or any breast feeding (EMS 63.9% versus SMS 67.9%, RR 0.94, 95%CI 0.85-1.04).

Conclusion: The EMS programme did not succeed in improving breast-feeding rates in a setting where there was high initiation of breast feeding. Breast-feeding rates were high but still fell short of national goals.

Study Design: RCT

Setting: King Edward Memorial Hospital (KEMH), Perth, Western Australia

Population of Focus: Women who gave birth at KEMH who intended to breastfeed

Data Source: Mother self-report

Sample Size: Randomized • Intervention (n=425) • Control (n=424) 6-Month Follow-Up • Intervention (n=393) Control (n=389)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, CAREGIVER, Home Visit (caregiver)

Intervention Description: To examine the potential impact of paraprofessional home visitors in promoting breastfeeding initiation and continuation among a high-risk population.

Intervention Results: Breastfeeding initiation increased by 1.5% for each 1-point increase in the percentage of prenatal home visits that included breastfeeding discussions. Breastfeeding continuation during the first 6 months also increased with the percentage of earlier home visits that included breastfeeding discussions. Additionally, if a participant receives 1 more home visit during the third month, her likelihood of breastfeeding at 6 months increases by 11%. Effect sizes varied by months postpartum.

Conclusion: Delivering a breastfeeding message consistently during regular home visits is important for increasing breastfeeding rates. Given that home visiting programs target new mothers least likely to breastfeed, a more consistent focus on breastfeeding in this supportive context may reduce breastfeeding disparities.

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

Intervention Description: Patient navigation is a patient-centered intervention that uses trained personnel to facilitate comprehensive and timely access to health services. Short-term assistance and health education are two facets of patient navigation; however, it seeks to sustainably eliminate health inequity by fostering the trust and skills patients need to stay engaged with care in the long term.

Intervention Results: Existing studies examining the efficacy of patient navigation interventions show particularly striking benefits in the realm of cancer care, including gynecological oncology; patient navigation has been demonstrated to increase access to screening, shorten time to diagnostic resolution, and improve cancer outcomes, particularly in health disparity populations. Because of the successes in cancer care at reducing disparities in health care access and health outcomes, patient navigation has the potential to improve care and reduce disparities in obstetric and benign gynecological care.

Conclusion: Because of the successes in cancer care at reducing disparities in health care access and health outcomes, patient navigation has the potential to improve care and reduce disparities in obstetric and benign gynecological care.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Lactation Consultant, Educational Material, Group Education, Telephone Support

Intervention Description: The aim of this study was to evaluate the effectiveness of a multiphased midwifery intervention called the 'Milky Way' on any breastfeeding rates until six months.

Intervention Results: There were no significant differences in the antenatal baseline data between the groups. Compared to standard care, women in the Milky Way group had higher rates of breast feeding at one (83.7%, n=144 versus 61.3%, n=119, p<0.001), four (64.5%, n=111 versus 37.1%, n=72, p<0.001) and six months (54.3%, n=94 versus 31.4%, n=61 p<0.001).

Conclusion: Assignment to the Milky Way intervention was associated with significantly higher rates of breastfeeding compared with assignment to standard care only.

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

Setting: Tertiary hospital in South Western Sydney Area Health Services

Population of Focus: Nulliparous women ≥19 years old with basic English literacy

Data Source: Mother self-report

Sample Size: Enrolled • Intervention (n=172) • Control (n=194) 6-Month Follow-Up • Intervention (n=149) • Control (n=189)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, PROVIDER/PRACTICE, Educational Material (Provider), Online Material/Education/Blogging

Intervention Description: This study examined the degree to which the pregnant or postpartum women, in the process of quitting smoking, felt that writing in a blog about their smoking cessation journeys helped them in their efforts to become or remain smoke free.

Intervention Results: Participants were asked to complete an online survey, which had closed-ended questions regarding their sociodemographic and smoking characteristics. Once they completed the survey, semistructured qualitative interviews were conducted over the phone. Findings suggest that blogging might combine several evidence-based behavioral strategies for tobacco cessation, such as journaling and getting support from others who use tobacco.

Conclusion: Being part of a blogging community of women who have experienced or are experiencing similar challenges can be therapeutic and help women gain confidence in their ability to quit smoking. In conclusion, blogging may help pregnant and postpartum women quit smoking by increasing their social support and promoting self-reflection.

Study Design: Quasi experimental cross sectional - survey

Setting: Online forum for pregnant women

Population of Focus: Pregnant women in an online forum

Data Source: Survey, phone interview

Sample Size: 5

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider), Expert Support (Provider), Screening Tool Implementation Training, Office Systems Assessments and Implementation Training, Data Collection Training for Staff

Intervention Description: To determine the impact of the Healthy Steps for Young Children Program on quality of early childhood health care and parenting practices.

Intervention Results: Percentage of children with developmental assessments was 83.1% for intervention and 41.4% for control group (OR=8.00; 95% CI=6.69, 9.56; P<.001)

Conclusion: Universal, practice-based interventions can enhance quality of care for families of young children and can improve selected parenting practices.

Study Design: RCT and QE: nonequivalent control group

Setting: Pediatric practices in 14 states (6 randomization sites: San Diego, CA; Iowa City, IA; Allentown, PA; Pittsburgh, PA; Florence, SC; Amarillo, TX. 9 QE sites: Birmingham, AL/Chapel Hill, NC; Grand Junction, CO/Montrose, CO; Chicago, IL; Kansas City, KS; Boston, MA; Detroit, MI; Kansas City, MO; New York, NY; Houston, TX/Richmond, TX)

Population of Focus: Children ages 0-36 months

Data Source: Child medical record

Sample Size: Randomization Sites: - Intervention (n=832) - Control (n=761) - Total (n=1593) Quasi-Experimental Sites: - Intervention (n=1189) - Control (n=955) - Total (n=2144) Total: - All families (n=3737) - Intervention: (n=2021) - Control (n=1716)

Age Range: Not specified

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

Intervention Description: Between the pretest and posttest surveys, women in the intervention group participated in the educational program over three weekly educational sessions. The intervention group churches served as the education sites, with women participating in the educational sessions at the churches from which they were recruited. Each educational session lasted approximately two hours. Women participating in the educational sessions received a token payment of $5 for each session they attended. To implement the cervical cancer education program, we constituted 20 groups with 8 to 14 women per group. Women in the control group received the cervical cancer education booklets after the posttest surveys.

Intervention Results: Overall, there was a significant intervention effect, with intervention compared with control group women twice (adjusted odds ratio = 2.0, 95% confidence interval = 1.3–3.2, p<.01) as likely to self-report Pap smear use at the posttest.

Conclusion: The findings support the efficacy of the multifaceted, theory-guided, culturally tailored community-based participatory cervical cancer education program for Samoan women in effecting positive changes in Pap smear use and cervical cancer-related knowledge and attitudes.

Study Design: Cluster RCT

Setting: Twenty-six Samoan-speaking churches on the main island of Tutulia in the American Samoa

Population of Focus: Samoan women a with no selfreported Pap smear in the past 2 years, no history of cervical cancer or hysterectomy, and plans to stay in the Territory throughout the study period

Data Source: Personal interviews

Sample Size: Total (N=416) Analysis (n=398) Intervention (n=201); Control (n=197)

Age Range: ≥20

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Home Visits, Midwife, Feedback

Intervention Description: Maternal smoking can cause health complications in pregnancy. Particulate matter (PM2.5) metrics applied to second hand smoke (SHS) concentrations provide indoor air quality (IAQ) measurements and have been used to promote smoking behaviour change among parents of young children. Here, we present the qualitative results from a study designed to use IAQ measurements to help pregnant women who smoke to quit smoking.

Intervention Results: There were 39 women recruited (18 in Aberdeen and 21 in Coventry) and qualitative interviews were undertaken with nine of those women. Diverse accounts of smoking behaviours and experiences of participation were given. Many women reported changes to their smoking behaviours during pregnancy. Most women wanted to make further changes to their own behaviour, but could not commit or felt constrained by living with a partner or family members who smoked. Others could not envisage quitting. Using themes emerging from the interviews, we constructed a typology where women were classified as follows: 'champions for change'; 'keen, but not committed'; and 'can't quit, won't quit'. Three women reported quitting smoking alongside participation in our study.

Conclusion: Pregnant women who smoke remain hard to engage,. Although providing IAQ measurements does not obviously improve quit rates, it can support changes in smoking behaviour in/around the home for some individuals. Our typology might offer a useful assessment tool for midwives.

Study Design: Mixed methods case series

Setting: UK National Health Services (NHS) antenatal clinics

Population of Focus: Pregnant women who smoked receiving NHS antenatal services

Data Source: Indoor air quality measurements (IAQ), interviews

Sample Size: 39

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits

Intervention Description: To establish the relative cost effectiveness of postnatal support in the community in addition to the usual care provided by community midwives.

Intervention Results: At six weeks there was no significant improvement in health status among the women in the intervention group. At six weeks the mean total NHS costs were pound 635 for the intervention group and pound 456 for the control group (P=0.001). At six months figures were pound 815 and pound 639 (P=0.001). There were no differences between the groups in use of social services or personal costs. The women in the intervention group were very satisfied with the support worker visits.

Conclusion: There was no health benefit of additional home visits by community postnatal support workers compared with traditional community midwifery visiting as measured by the SF-36. There were no savings to the NHS over six months after the introduction of the community postnatal support worker service.

Study Design: RCT

Setting: University teaching hospital and women’s homes

Population of Focus: Women ≥ 17 years old who delivered a live baby and lived in the area served by community midwives

Data Source: Mother self-report

Sample Size: Randomized • Intervention (n=311) • Control (n=312) 6-Month Follow-Up • Intervention (n=260) • Control (n=233)

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

Intervention Description: Ninety thousand under-screened women were randomised to be mailed a 48-month reminder letter to have a Pap test (n=60,000), or not to be mailed a letter (n=30,000). Differences in Pap test rates were assessed by Kaplan-Meier survival analysis, by chi2 tests of significance between Pap test rates in letter versus no-letter groups, and by proportional hazards regression modelling of predictors of a Pap test with letter versus no-letter as the main study variable. T-tests were conducted on mean time to Pap test to assess whether time to Pap test was significantly different between the intervention and control groups.

Intervention Results: After 90 days following each mail-out, Pap test rates in the letter group were significantly higher than in the non-letter group, by approximately two percentage points. After controlling for potential confounders, the hazard ratio of a Pap test within 90 days of a mail-out in the letter group was 1.5 compared with 1.0 in the no-letter group. Hazard ratios of having a Pap test within 90 days decreased significantly with time since last Pap test (p<0.0001); were significantly higher than 1.0 for most non-metropolitan areas of NSW compared with metropolitan areas; and increased significantly with age (p<0.0001). Pap test hazard ratios were not associated with socio-economic status of area of residence, but the hazard ratio was significantly higher than 1.0 if the reminder letter was sent after the Christmas/New Year break. No significant differences in mean time to Pap test were found between the letter and no-letter groups.

Conclusion: Being sent a reminder letter is associated with higher Pap testing rates in under-screened women.

Study Design: RCT

Setting: New South Wales

Population of Focus: Women who had not had a Pap test in 4 years or more

Data Source: New South Wales Pap Test Register

Sample Size: Total (N=90,247) Intervention (n=60,189); Control (n=30,058) Analysis (n=89,699) Intervention (n=59,780); Control (n=29,919)

Age Range: 20-69

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

Intervention Description: A 48-month community intervention was conducted to improve breast and cervical cancer (BCC) screening among Korean American (KA) women in Alameda County (AL), California. KA women in Santa Clara (SC) County, California served as a comparison group.

Intervention Results: After adjusting for all covariates, no significant difference in Pap smear rates between intervention and comparison counties.

Conclusion: Although our overall intervention did not appear to enhance screening practices at the community-level, attendance at a women's health workshop appears to have increased cervical cancer screening.

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

Setting: Alameda County and Santa Clara County, CA

Population of Focus: Korean American women

Data Source: Telephone survey

Sample Size: Total (N=2,176) Baseline (n=1,093); Follow-up (n=1,083) Analysis (participated in baseline or follow-up) (n=1,902) Baseline (n=818) Intervention (n=404); Control (n=414) Follow-up (n=1,084) Intervention (n=418); Control (n=458)

Age Range: ≥18

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), CAREGIVER, Educational Material (caregiver), PATIENT/CONSUMER, Telephone Support

Intervention Description: To determine whether informing families about their children’s urinary cotinine levels curtailed the exposure of children to ETS. Material and methods

Intervention Results: The intervention group contained 65 children of average age of 24.4 ±8.9 months, of whom 46 (70.8%) were male. The non-intervention group contained 69 children of average age of 25.3 ±9.8 months (p > 0.05), of whom 52 (75.4%) were male. The urinary cotinine levels at the time of the second interview were lower in both groups. The number of cigarettes that fathers smoked at home decreased in the intervention group (p = 0.037).

Conclusion: Presenting objective evidence on ETS exposure to families draws attention to their smoking habits. Measurement of cotinine levels is cheap, practical, and noninvasive. Combined with education, creating awareness by measuring cotinine levels may be beneficial.

Study Design: RCT

Setting: Allergy and Immunology Department of Dr. Behcet Uz Children’s Hospital

Population of Focus: Children younger than 3 years with episodic wheezing whose parents did not smoke in space shared by children but did have a smoker in the home

Data Source: Questionnaire data and urinary cotinine levels

Sample Size: 193 randomized into intervention and control groups

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, Motivational Interviewing, Educational Material

Intervention Description: To estimate the effectiveness of pregnancy smoking cessation support delivered by short message service (SMS) text message and key parameters needed to plan a definitive trial.

Intervention Results: Using the validated, continuous abstinence outcome, 5.4% (11 of 203) of MiQuit participants were abstinent versus 2.0% (four of 204) of usual care participants [odds ratio (OR) = 2.7, 95% confidence interval (CI) = 0.93-9.35]. The Bayes factor for this outcome was 2.23. Completeness of follow-up at 36 weeks gestation was similar in both groups; provision of self-report smoking data was 64% (MiQuit) and 65% (usual care) and abstinence validation rates were 56% (MiQuit) and 61% (usual care). The incremental cost-per-quitter was £133.53 (95% CI = -£395.78 to 843.62).

Conclusion: There was some evidence, although not conclusive, that a text-messaging programme may increase cessation rates in pregnant smokers when provided alongside routine NHS cessation care.

Study Design: RCT

Setting: Women, Infants and Children clinics in Ohio

Population of Focus: Women 16 years and over, less than 25 weeks pregnant, who had smoked at least five cigarettes daily before pregnancy and at least one per day at enrolment, able to understand written English and owned a mobile phone with text messaging functionality

Data Source: Surveys, data from mobile text system, exhaled breath CO, saliva cotinine

Sample Size: 407 -203 to MQUIT, 204 to usual care

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, PROVIDER/PRACTICE, Provider Reminder/Recall Systems, Provider Education

Intervention Description: A three‐year intervention targeting Vietnamese physicians in solo practice in California.

Intervention Results: After the intervention, performance rates increased significantly for smoking cessation counseling (p = 0.02), Pap testing (p = 0.004), and pelvic examinations (p = 0.01).

Conclusion: The results demonstrate the efficacy of an intervention targeting Vietnamese primary care physicians in promoting smoking cessation counseling, Pap testing, and pelvic examinations, but not other cancer prevention activities.

Study Design: RCT

Setting: Private practices with physicians who were members of the Vietnamese Physicians’ Associations in Northern and Southern CA

Population of Focus: Physicians in solo practice who had received their medical training in Vietnam

Data Source: Physicians’ medical records

Sample Size: Total (N=48) Analysis (n=20) Intervention (n=9); Control (n=11) N=physicians

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education, Patient Navigation, Enabling Services, PROVIDER/PRACTICE, Provider Reminder/Recall Systems, Provider Education, Designated Clinic/Extended Hours, Female Provider, COMMUNITY, Television Media, Other Media, POPULATION-BASED SYSTEMS

Intervention Description: Development and implementation of a multifaceted intervention using community-based participatory research (CBPR) methodology and evaluated with a quasi-experimental controlled design with cross-sectional pre-intervention (2000) and post-intervention (2004) telephone surveys. Data were analyzed in 2005.

Intervention Results: Significantly greater odds of Pap smear for women in intervention county than in control county (OR=2.02, 95% CI: 1.37-2.99)

Conclusion: A multifaceted community-based participatory research (CBPR) intervention was associated with increased Pap test receipt among Vietnamese-American women in one community.

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

Setting: Santa Clara County, CA and Harris County, TX

Population of Focus: Vietnamese women living in either county

Data Source: Computer-assisted telephone interviewing system

Sample Size: Baseline(n=1,566) Intervention (n=798); Control (n=768) Follow-up (n=2,009) Intervention (n=1,004); Control (n=1,005)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): STATE, Policy/Guideline (State), Funding Support, POPULATION-BASED SYSTEMS, PATIENT/CONSUMER, Educational Material

Intervention Description: The goal of this study was to examine state measurements and improvements in risk-appropriate care for very low birth weight (VLBW) infants.

Intervention Results: Regulation of regionalization programs, data surveillance, review of adverse events, and consideration of geography and demographics were identified as mechanisms facilitating better measurement of risk-appropriate care. Antenatal or neonatal transfer arrangements, telemedicine networks, acquisition of funding, provision of financial incentives, and patient education comprised state actions for improving risk-appropriate care.

Conclusion: Guidelines should be collaboratively developed by healthcare providers and public health officials for consistent and suitable measures of perinatal risk-appropriate care.

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

Intervention Description: The current study is a randomized trial of a promotora-led educational intervention focused on cervical cancer in a local Hispanic community.

Intervention Results: Follow-up data revealed significant improvements in all outcome measures.

Conclusion: The observed association between cervical cancer knowledge and Pap smear receipt underscores the importance of educating vulnerable populations about the diseases that disproportionately affect them.

Study Design: RCT: pretest-posttest

Setting: South Philadelphia, PA

Population of Focus: Hispanic women

Data Source: In-person interview administered in Spanish by the promotoras

Sample Size: Total (N=120) Intervention (n=60); Wait-List Control (n=60) Analysis (n=70) Intervention (n=34); Wait-List Control (n=36)

Age Range: 18-65

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Motivational Interviewing, PROVIDER/PRACTICE, Provider Training/Education

Intervention Description: We assessed whether smoking cessation improved among pregnant smokers who attended Women, Infants and Children (WIC) Supplemental Nutrition Program clinics trained to implement a brief smoking cessation counseling intervention, the 5As: ask, advise, assess, assist, arrange.

Intervention Results: Of 71,526 pregnant smokers at WIC enrollment, 23% quit. Odds of quitting were higher among women who attended a clinic after versus before clinic staff was trained (adjusted odds ratio, 1.16; 95% confidence interval, 1.04–1.29). The adjusted mean infant birth weight was, on average, 96 g higher among women who reported quitting (P < 0.0001), regardless of clinic training status.

Conclusion: Training all Ohio WIC clinics to deliver the 5As may promote quitting among pregnant smokers, and thus is an important strategy to improve maternal and child health outcomes.

Study Design: Quasi experimental cross sectional

Setting: Women, Infants and Children clinics in Ohio

Population of Focus: All pregnant women in their first trimester who reported smoking attending a Women, Infants and Children clinic in Ohio that was trained to use the 5A’s smoking cessation package

Data Source: Self-report, medical records

Sample Size: 71526

Age Range: Not specified

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

Intervention Description: The purpose of this study is to test in a clinical prenatal care setting the effectiveness of the Smoke-Free Moms intervention, which provides pregnant women a series of financial incentives for smoking cessation.

Intervention Results: Of 175 eligible pregnant women enrolled, 134 women were followed to the postpartum visit (Intervention n=66, Control n=68). The quit rates during pregnancy did not differ between groups (Intervention 36.4%, Control 29.4%, p=0.46). However, significantly more intervention mothers quit and continued as nonsmokers postpartum (Intervention 31.8%, Control 16.2%, p=0.04). In a logistic regression model including baseline sociodemographic, depressed mood, stress, and readiness to quit items, confidence in being able to quit predicted both cessation outcomes. The financial incentive intervention was an independent predictor of cessation in pregnancy through postpartum.

Conclusion: Financial incentives with existing smoking-cessation counseling by staff in low-income clinical prenatal programs led to cessation that continued during the postpartum period. Further study in larger populations is indicated.

Study Design: Cohort- control trial with non-random assignment

Setting: Prenatal clinics in federally qualified health centers

Population of Focus: Low income pregnant smokers served in clinic settings who had not spontaneously quit on learning of their pregnancy and were still smoking at the time of their first prenatal visit

Data Source: Surveys, urine cotinine

Sample Size: 175 started program, 134 followed through to postpartum visit

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Counseling (Parent/Family), PATIENT/CONSUMER, Motivational Interviewing, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: Our objectives were to determine the effectiveness of a brief primary care intervention directed at parents who smoke in reducing babies’ TSP exposure, and to establish variables related to greater exposure.

Intervention Results: During follow-up, TSP-avoidance strategies improved more in the IG than in the CG: 35.4% and 26.9% ( p=0.006) at home, and 62.2% and 53.1% in cars (p=0.008). Logistic regression showed adjusted ORs for appropriate measures in the IG versus CG of 1.59 (95% CI 1.21 to 2.09) at home and 1.30 (95% CI 0.97 to 1.75) in cars. Hair samples showed that 78.7% of the babies tested were exposed. Reduced nicotine concentration was associated with improved implementation of effective strategies reported by parents at home (p=0.029) and in cars (p=0.014).

Conclusion: The intervention produced behavioural changes to avoid TSP exposure in babies. The proportion of babies with nicotine (>=1ng/mg) in hair samples at baseline is a concern.

Study Design: RCT

Setting: Primary care well-child visit

Population of Focus: Babies whose parents were smokers

Data Source: Outcomes were measured by parents’ reported strategies to avoid TSP exposure. Baseline clinical data and characteristics of each baby’s TSP exposure were collected, along with infant hair samples and parents’ tobacco use and related attitudes/ behaviors.

Sample Size: 1101 families

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, Home Visits

Intervention Description: Evaluate the efficacy of a lay health advisor (LHA) intervention for improving Pap testing rates, to reduce cervical cancer, among women in need of screening.

Intervention Results: Based on medical record review, more women in the LHA arm had a Pap test by the end of the study compared to those randomized to usual care.

Conclusion: LHA interventions show promise for improving screening behaviors among non-adherent women from underserved populations.

Study Design: RCT

Setting: Fourteen Ohio Appalachian clinics

Population of Focus: Women living in Ohio Appalachia, who were not pregnant, and who were in need of a Pap test based on riskappropriate guidelines

Data Source: Medical record review and self-report

Sample Size: Total (N=286) Analysis Medical Record Review (n=270) Intervention (n=139); Control (n=131) Self-Report (n=233) Intervention (n=115); Control (n=118)

Age Range: ≥18

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): PROVIDER/PRACTICE, Patient-Centered Medical Home, Continuity of Care (Caseload), PATIENT/CONSUMER, Enabling Services

Intervention Description: In light of the transition of the Alabama Medicaid program to a primary care case management model, we assessed the level to which children had access to a medical home before and after implementation of that model.

Intervention Results: In general, Medicaid-enrolled children in Alabama did not meet our definition of medical home either before or after implementation of a primary care case management model. Only 11.8% of children saw a single provider and had a well child visit from that provider during the baseline year. A majority of children (49.9%) however had both a primary care provider and received a well child visit. Sixteen percent of children saw a primary care physician but received no identifiable well visit, while 11% had well child care but did not see a primary care physician. Of particular concern, 23% neither saw a primary care physician nor had a well child visit during the baseline year. These figures changed only slightly in the 26 counties examined before and after implementation of the primary care case management model.

Conclusion: State Maternal and Child Health programs are required to report as a performance measure “the percent of children with special health care needs in the state who have a medical/health home” as part of their Block Grant application. Using Medicaid data, this simple measurement strategy can provide an indication of the extent to which at least one population of children receive care through a medical home.

Study Design: Quasi-experimental: Pretestposttest

Setting: Alabama Medicaid-financed primary care

Population of Focus: Children with Medicaid in 26 counties

Data Source: Medicaid administrative/claims data

Sample Size: n=60752 (enrolled during baseline); n=64789 (enrolled during postimplementation period)

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), PATIENT/CONSUMER, Educational Material

Intervention Description: The objective of this study was to reduce postpartum smoking relapse and prolong breastfeeding duration during the first 8 weeks postpartum in mothers who quit smoking just before or during pregnancy and have newborns admitted to the Neonatal Intensive Care Unit (NICU).

Intervention Results: More mothers were smoke free (81 vs 46%, P<0.001) and breastfeeding (86 vs 21%, P<0.001) in the intervention than in the control group at 8 weeks postpartum.

Conclusion: Interventions to support mother–infant bonding during a newborn's hospitalization in the NICU are associated with reduced rates of smoking relapse and prolonged duration of breastfeeding during the first 8 weeks postpartum.

Study Design: Prospective randomized clinical trial; RCT

Setting: NICU

Population of Focus: Mothers of infants admitted to the NICU at Loma Linda University Children’s Hospital, who had a history of tobacco use during or within 1 year before pregnancy but who were not currently smoking

Data Source: Smoking status was evaluated by three methods: (1) mother’s report (2) CO-oximetry and (3) salivary cotinine levels

Sample Size: 54 enrolled in study and randomized

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Pharmacotherapy (Nicotine), PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), CAREGIVER, Motivational Interviewing/Counseling, Motivational Interviewing

Intervention Description: Although many Latinos in the US smoke, they receive assistance to quit less often than non-Latinos. To address this disparity, we recruited Latino couples into a randomized controlled trial and provided a smoking cessation program during a teachable moment, when men’s partners were pregnant.

Intervention Results: We found high rates of cessation but no arm differences in smoking rates at the end of pregnancy (0.31 vs. 0.30, materials only vs. counseling, respectively) and 12 months after randomization (postpartum: 0.39 vs. 0.38). We found high quit rates among nondaily smokers but no arm differences (0.43 vs. 0.46 in pregnancy and 0.52 vs. 0.48 postpartum). Among daily smokers, we found lower quit rates with no arm differences but effects favoring the intervention arm (0.13 vs. 0.16 in pregnancy and 0.17 vs. 0.24 postpartum).

Conclusion: A less intensive intervention promoted cessation equal to more intensive counseling. Postpartum might be a more powerful time to promote cessation among Latino men. Impact Less intensive interventions when delivered during teachable moments for Latino men could result in a high smoking cessation rate and could reduce disparities.

Study Design: RCT

Setting: Community (home)

Population of Focus: Pregnant Latinas and their partners who smoked from 10 county health departments

Data Source: Surveys at end of pregnancy, 3-mo postpartum and 12-mo postpartum; also saliva samples for cotinine analysis.

Sample Size: 348 randomized couples

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), PATIENT/CONSUMER, Educational Material, CAREGIVER, Educational Material (caregiver)

Intervention Description: Exposure to second-hand smoke (SHS) is a major public health problem and a risk factor for morbidity and mortality. The objective of this randomized trial was to estimate the impact of a culturally-sensitive intervention to reduce SHS exposure in Mexican-American households.

Intervention Results: Ambient nicotine levels significantly decreased over the 12 study months (F=13.6, DF=147; p<0.001); with a significantly greater decrease in the EI households compared to the SC households (F=4.1, DF=72; p<0.05). At 12 months, 73% of EI households had banned smoking vs. 56% of SC households. Ambient nicotine levels, measured using nicotine air sampling monitors, were significantly associated with self-reported SHS exposure at the 12-month follow-up. Knowledge of the health effects of SHS increased from baseline to 6 and 12 months in the EI condition but not in the SC condition (F=6.0, DF=238; p<0.01), and smokers and quitters in the EI group reported an increased perception of health vulnerability compared to those in the SC group.

Conclusion: Our low-cost intervention impacted SHS-related knowledge and exposure among Mexican Americans. This culturally-appropriate intervention has the potential to decrease SHS-related health problems in the target population substantially.

Study Design: RCT

Setting: Home-based intervention

Population of Focus: 91 households (with a child under 18 years of age and two adults, one of whom was a smoker)

Data Source: 74 households (83%) provided baseline, 6-month, and 12-month survey and nicotine monitor data. An ambient air monitor, for assessing levels of nicotine due to secondhand smoke, was installed in each participating residence at baseline.

Sample Size: 91 households randomized

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), CAREGIVER, Educational Material (caregiver), Education/Training (caregiver), PATIENT/CONSUMER, Educational Material, Other Education

Intervention Description: The purpose of this longitudinal, five-week, quasi-experimental pilot study was to determine whether “smoking hygiene,” an educational intervention, reduces the frequency of respiratory symptoms experienced by infants whose mothers both smoke and breastfeed.

Intervention Results: Of the 21 mother-infant pairs who completed the study, 66% of the nine infants in the control group experienced respiratory illness, compared to 42% of the 12 infants in the intervention group (x2 .814; p > .05). Thus, the difference was statistically nonsignificant in this small sample, but the trend worsened the anticipated direction. The study demonstrates some of the difficulties of intervening with this group of mothers. The findings of this study suggest that, with modification, smoking hygiene may become a valuable educational tool that can be used by health care professionals to help women who smoke and breastfeed decrease the health risks to their infants.

Conclusion: The study demonstrates some of the difficulties of intervening with this group of mothers.

Study Design: Longitudinal quasiexperimental pilot study

Setting: Maternity patients

Population of Focus: Mothers who smoked >5 cigarettes a day prenatally, planned to breastfeed, planned to be discharged with the baby, and had no significant health problems

Data Source: Questionnaire to determine mother’s smoking habits at week 5. The infant respiratory signs and symptoms that were queried at each of the three home visits (Weeks 2, 3, and 5) included wheezing, cough, upper respiratory infection (cold), ear infection, pneumonia, bronchitis, and hospitalization.

Sample Size: 29 mother-infant pairs

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), PATIENT/CONSUMER, Referrals, CAREGIVER, Educational Material (caregiver), Educational Material, Telephone Support

Intervention Description: We sought to evaluate the efficacy of a brief intervention with smoking parents on smoking cessation rates after child hospitalization with a randomized, controlled trial.

Intervention Results: Sixty smoking parents participated in the study. The majority of study participants were uninsured women under age 30 who smoked approximately half of a pack per day. There were no statistically significant differences between control and intervention groups for our outcomes. However, 45% (CI: 33–57%) of all participants reported at least one quit attempt during the 2-month study period and 18% (CI: 10–30%) of participants were quit at study conclusion.

Conclusion: Willingness to quit smoking was much higher than expected in this population of parenting smokers.

Study Design: RCT

Setting: Community (hospital)

Population of Focus: Parents who smoke of a hospitalized children

Data Source: Telephone interview at 2 months and self-report of quit status

Sample Size: 62 parents randomized; 41 completed study

Age Range: Not specified

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): PATIENT/CONSUMER, Educational Material, Online Material/Education/Blogging, Peer Counselor

Intervention Description: The aim of this randomized controlled trial was to determine whether a behavioural intervention in pregnancy supported by online information would improve smoking cessation rates However, due to a number of challenges, recruitment to this trial was reluctantly halted.

Intervention Results: We aimed to recruit 220 maternal smokers within 2 years and after screening 1995 women, just 22 enrolled over a 8-month period. Only three women accessed the online element of the intervention and, at follow up, no women reported quitting.

Conclusion: We report our findings as they may inform the design and powering of future smoking cessation interventions in pregnancy.

Study Design: RCT

Setting: Antenatal clinics

Population of Focus: Self-reported smokers who were aged over 18 years, less than 17 weeks gestation, understood English, had access to the Internet, and had capacity to give consent

Data Source: Breath CO, website statistics, survey, medical records

Sample Size: 22- 13 intervention group, 9 control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Educational Material, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), CAREGIVER, Education/Training (caregiver), Home Visit (caregiver), Educational Material (caregiver)

Intervention Description: Secondhand smoke (SHS) and other air pollutants adversely affect the health of pregnant women and infants. A feasibility study aimed at reducing air pollution in homes of pregnant women or infants living with a smoker was completed.

Intervention Results: Post-intervention, 70% of participants reported smokers were less likely to smoke indoors, and 77% had at least one air purifier turned on at the final visit. Participant satisfaction was high (91%) and 98% would recommend air purifiers. Indoor PM2.5 was significantly decreased (P < 0.001). Salivary cotinine was significantly decreased for non-smoking women (P < 0.01) but not infants, and no significant change in air nicotine occurred (P = 0.6).

Conclusion: Air purifiers with SHS education is a feasible intervention in homes of women and infants. These data demonstrate reduction in indoor PM2.5 and salivary cotinine in non-smoking adults. Air purifiers are not an alternative for smoking cessation and a home/car smoking ban. Smoking cessation should be strongly encouraged for all pregnant women, and nonsmoking mothers with infants should be counseled to completely avoid SHS exposure. This study provides support for a future intervention evaluating clinical endpoints.

Study Design: A single arm, unmasked clinical trial

Setting: Home-based (4 home-visits during the 5 week study)

Population of Focus: Women > 18 years of age and either pregnant nonsmokers or post-partum (any smoking status) with an infant age 0-12 months

Data Source: Air quality assessment, salivary cotinine

Sample Size: 50 women, 32 had infants and 18 were pregnant at time of enrollment

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Oral Health Education, Assistance in Making Dental Appointment, Motivational Interviewing

Intervention Description: This study tested a behavioral intervention to increase dental attendance among rural Oregonian low-income women and their children.

Intervention Results: After the intervention, dental attendance for women in the prenatal period was 92.4% for those in the motivational interviewing (MI) group compared to 94.4% for those in the health education (HE) group (RR = 0.98; 95% CI = 0.93-1.04). No significant difference was observed between the two groups at follow-up.

Conclusion: High attendance may be attributable to the counselors' patient navigator function.

Intervention Components (click on component to see a list of all articles that use that intervention): SCHOOL, School-Based Health Centers, PROVIDER/PRACTICE, Patient-Centered Medical Home, Nurse/Nurse Practitioner, PATIENT/CONSUMER, Referrals, Peer Counselor

Intervention Description: We describe the implementation of an "expanded medical home" partnering a primary care practice (the Ypsilanti Health Center [YHC]) with local school-based health centers (the Regional Alliance for Healthy Schools [RAHS]), and to assess whether this model improves access to and quality of care for shared patients.

Intervention Results: At baseline, patients seen at YHC/RAHS had higher compliance with most quality metrics compared with those seen at YHC only. The proportion of shared patients significantly increased because of the intervention (P < .001). Overall, patients seen in the expanded medical home had a higher likelihood of receiving quality metric services than patients in YHC only (odds ratio, 1.8; 95% confidence interval, 1.57-2.05) across all measures.

Conclusion: Thoughtful and intentional implementation of an expanded medical home partnership between primary care physicians and school-based health centers increases the number of shared high-risk adolescent patients. Shared patients have improved compliance with quality measures, which may lead to long-term improved health equity.

Study Design: Quasi-experimental: Nonequivalent control group; Qualitative

Setting: Michigan primary care and consortium of school-based health centers

Population of Focus: Adolescents

Data Source: • Record review of preventive health measures • University of Michigan Health System Quality Management Program quality measures • Qualitative data

Sample Size: n=2200 adolescents; 9338 visits

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Assessment, PARENT/FAMILY, Counseling (Parent/Family), PATIENT/CONSUMER, Motivational Interviewing, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: Tobacco smoke exposure (TSE) harms children, who are often “captive smokers” in their own homes. Project Zero Exposure is a parent-oriented, theory-based intervention designed to reduce child TSE. This paper reports on findings from the pilot study, which was conducted in Israel from 2013 to 2014

Intervention Results: Twenty-six of the 29 recruited families completed the study. The intervention was feasible to implement and acceptable to participants. Among the 17 children with reliable hair samples at baseline and follow-up, log hair nicotine dropped significantly after the intervention (P = .04), hair nicotine levels decreased in 64.7% of children, and reductions to levels of nonexposed children were observed in 35.3% of children. The number of cigarettes smoked by parents (P = .001) and parent-reported child TSE declined (P = .01). Logistical issues arose with measurement of all objective measures, including air nicotine, which did not decline; home air particulate matter; and hair nicotine.

Conclusion: A program based on motivational interviewing and demonstrating TSE and contamination to parents in a concrete and easily understandable way is a promising approach to protect children from TSE. Further research is needed to enhance current methods of measurement and assess promising interventions.

Study Design: Single group pre- and post-test design

Setting: Home-based with child biomarker and home air quality feedback

Population of Focus: Parents from families in which smoking occurred were recruited from areas adjacent to NA’AMAT child day care centers by using the snowball technique

Data Source: Baseline questionnaire (reported exposure, child health, demographics). Objective assessments of child TSE via biomarkers (hair nicotine) and measurement of home air quality (air nicotine, particulate matter). Motivational interviewing action plan. Follow-up questionnaire (reported exposure).

Sample Size: 26 of the 29 recruited families completed the study

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Group Education

Intervention Description: The rate of breastfeeding among immigrant Vietnamese women in Western countries is low compared to those in Vietnam. To counteract this trend, a language and culture specific education program was developed.

Intervention Results: Results suggested that the education program had significant effects on knowledge, attitudes, planned and actual behaviour towards breastfeeding. However, the effect did not sustain until 6 months postpartum.

Conclusion: Implications for nursing practice and further research are discussed.

Study Design: QE: non-equivalent control group

Setting: Western and South Western Sydney, New South Wales

Population of Focus: Vietnamese women who were at least 12 weeks pregnant

Data Source: Mother self-report

Sample Size: Intervention (n=108) Control (n=86)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Intensive Therapy, PATIENT_CONSUMER, Psychoeducation, HOSPITAL, Hospital Laborist

Intervention Description: To compare the numbers of vaginal deliveries and delivery satisfaction among women with fear of childbirth randomised to either psychoeducation or conventional surveillance during pregnancy.

Intervention Results: Women randomised to the intervention group more often had spontaneous vaginal delivery (SVD) than did controls (63.4% versus 47.5%, P = 0.005) and fewer caesarean sections (CSs) (22.9% versus 32.5%, P = 0.05). SVD was more frequent and CSs were less frequent among those who actually participated in intervention (n = 90) compared with controls who had been referred to consultation (n = 106) (SVD: 65.6% versus 47.2%, P = 0.014; CS: 23.3% versus 38.7%, P = 0.031). Women in intervention more often had a very positive delivery experience (36.1% versus 22.8%, P = 0.04, n = 219).

Conclusion: To decrease the number of CSs, appropriate treatment for fear of childbirth is important. This study shows positive effects of psychoeducative group therapy in nulliparous women with severe fear of childbirth in terms of fewer CSs and more satisfactory delivery experiences relative to control women with a similar severe fear of childbirth.

Study Design: RCT

Setting: 1 maternity unit

Population of Focus: Nulliparous women with a measured fear of childbirth who gave birth after enrollment at antenatal clinics between October 2007 and August 20095

Data Source: Not specified

Sample Size: Total (n=371) Intervention (n=131) Control (n=240)

Age Range: Not Specified

Intervention Components (click on component to see a list of all articles that use that intervention): Intensive Therapy, PATIENT/CONSUMER, PATIENT_CONSUMER

Intervention Description: To compare intensive and conventional therapy for severe fear of childbirth.

Intervention Results: Birth-related concerns decreased in the intensive therapy group but increased in the conventional therapy group (linear interaction between the group and birth-concerns P =.022). Labor was shorter in the intensive therapy group (mean +/- standard deviation 6.8 +/- 3.8 hours) compared with the conventional group (8.5 +/- 4.8 hours, P =.039). After intervention, 62% of those originally requesting a cesarean (n = 117) chose to deliver vaginally, equally in both groups. Cesarean was more frequent for those who refused to fill in the questionnaires than for those who completed them (57% compared with 27%, P =.001). In the log-linear model, parous women who had conventional therapy and refused to fill in the questionnaires chose a cesarean more often than expected (standardized residual 2.54, P =.011). There were no differences between groups in satisfaction with childbirth or in puerperal depression.

Conclusion: Both kinds of therapy reduced unnecessary cesareans, more so in nulliparous and well-motivated women. With intensive therapy, pregnancy- and birth-related anxiety and concerns were reduced, and labors were shorter.

Study Design: RCT

Setting: 1 university hospital

Population of Focus: Nulliparous women with a measured fear of childbirth who gave birth after enrollment between August 1996 and July 19992,6

Data Source: Not specified

Sample Size: Total (n=90) Intervention (n=44) Control (n=46)

Age Range: Not Specified

Intervention Components (click on component to see a list of all articles that use that intervention): Technology-Based Support, Education on Disease/Condition, Assessment (patient/consumer),

Intervention Description: Youth account for half of new sexually transmitted infections (STIs) in the United States annually. Barriers to STI prevention include a lack of accurate sexual and reproductive health (SRH) education and low STI testing. We sought to obtain youth feedback on a digital health platform prototype designed to address these barriers. The platform prototype included SRH content, free STI testing and treatment, and anonymous question submission. Five focus group discussions, each lasting 45-60 minutes with 5-6 youth living in a high-prevalence STI region (Baltimore, Maryland), were conducted. Thematic analysis was conducted.

Intervention Results: There were 28 participants with a mean age of 15.9 years (range 14-19), among whom 89% self-identified as female, 57% Black/African American, 29% Asian American, 14% White, and 7% Hispanic/Latino. Youth felt that the prototype platform was comprehensive and understandable. They suggested adding peer reviews to increase trustworthiness.

Conclusion: Youth reported that the platform (violetproject.org) was an acceptable tool for SRH education and STI testing. Participants expressed enthusiasm and willingness to use the platform as a reliable SRH educational tool to combat medical misinformation on the Internet and a non-clinic-based source of STI testing. This platform could fill gaps in access to SRH care and education for youth.

Study Design: Qualitative study

Setting: Public high schools and community colleges in Baltimore, Maryland

Population of Focus: Adolescents and young adults living in Baltimore, Maryland

Sample Size: 28 adolescents and youth

Age Range: Adolescents and youth 14-19 years of age

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

Intervention Description: As asthma is the most common chronic disease in childhood, much attention is directed towards primary prevention. Here, the clinical effectiveness of a multifaceted educational prevention was studied.

Intervention Results: The results of this study indicate that the intervention was able to reduce exposure to mite, pet and food allergens, but not to passive smoking. Despite this reduction, there was no effect on either parentally reported or GP-observed symptoms during first 2 yrs of life, nor on total and specific IgE at 2 yrs. However, asthma-like symptoms at the end of the 2nd yr were less frequently reported in the intervention group.

Conclusion: In conclusion, the intervention used in this study was not effective in reducing asthma-like symptoms in high-risk children during the first 2 yrs of life, although it was modestly effective at 2 yrs. Follow-up is necessary to confirm whether the intervention can actually prevent the development of asthma.

Study Design: RCT

Setting: Community

Population of Focus: Pregnant moms whose child would be high-risk for developing asthma

Data Source: Parental and GP report of asthma-like symptoms using questionnaires Measurement of mite, cat and dog allergen levels at baseline and 1 year.

Sample Size: 476 randomized to intervention and control groups

Age Range: Not specified

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

Intervention Description: To test the effectiveness of tailored quitline (telephone) counselling among smoking parents recruited into cessation support through their children's primary schools.

Intervention Results: Parents who received quitline counselling were more likely to report 7-day point-prevalence abstinence at 12-month assessment [34.0 versus 18.0%, odds ratio (OR) = 2.35, confidence interval (CI) = 1.56–3.54] than those who received a standard self-help brochure. Parents who received quitline counselling were more likely to use nicotine replacement therapy (P < 0.001) than those who received a standard self-help brochure. Among parents who did not achieve abstinence, those who received quitline counselling smoked fewer cigarettes at 3-month (P < 0.001) and 12-month assessment (P < 0.001), were more likely to make a quit attempt (P < 0.001), to achieve 24 hours' abstinence (P < 0.001) and to implement a complete home smoking ban (P < 0.01).

Conclusion: Intensive quitline support tailored to smoking parents is an effective method for helping parents quit smoking and promoting parenting practices that protect their children from adverse effects of smoking.

Study Design: RCT

Setting: Home-based telephone counseling

Population of Focus: Smoking parents

Data Source: Parent and child each completed a separate questionnaire. The primary outcome measure was 7-day pointprevalence abstinence at 12-month follow-up.

Sample Size: 512 parents who were smokers enrolled in RCT with children between the 9 and 12 years old

Age Range: Not specified

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

Intervention Description: To determine the effects of a partner-supported, incentive-based educational program on rates and duration of breast-feeding among low-income women.

Intervention Results: Women in the intervention group reported a higher percentage of breast-feeding at all measurement times.

Conclusion: These findings suggest that incentives, such as donated prizes, can be used to attract primiparous women from lower socioeconomic groups, along with their partners, to participate in educational interventions designed to promote breast-feeding. Participation by couples in breast-feeding promotion activities can dramatically increase the rate and duration of breast-feeding.

Study Design: QE: non-equivalent control group

Setting: 2 WIC clinics in Flagstaff, AZ

Population of Focus: Primiparous women with an expected due date between May and Dec 1992

Data Source: Mother self-report

Sample Size: Intervention (n=26) Control (n=26)

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): PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), PATIENT/CONSUMER, Educational Material, CAREGIVER, Education/Training (caregiver)

Intervention Description: Pediatric well-care visits provide a clinical opportunity to counsel new mothers about their smoking and the deleterious effects of environmental tobacco smoke (ETS) on infant health.

Intervention Results: The intervention reduced smoking (5.9% vs 2.7%) and relapse (55% vs 45%) at 6-month follow-up, but logistic regression analysis at 12 months revealed no significant treatment effect. The intervention had a positive effect on secondary outcome variables, such as readiness to quit and attitude toward and knowledge of ETS. Multiple logistic regression analysis indicated that husband/partner smoking was the strongest predictor of maternal quitting or relapse.

Conclusion: A pediatric office-based intervention can significantly affect smoking and relapse prevention for mothers of newborns, but the effect decreases with time. Consistent prompting of the provider to give brief advice and materials at well-care visits could provide a low-cost intervention to reduce infant ETS exposure.

Study Design: RCT

Setting: Pediatric well-care visits

Population of Focus: Mothers of newborns who were currently smoking or had quit for pregnancy

Data Source: Outcome data were obtained from 6- and 12-month follow-up questionnaires mailed to all participants.

Sample Size: 2,901 randomized to minimal (usual care) and Extended (received advice and materials)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor

Intervention Description: This study examined the effect of a peer counseling program on breastfeeding initiation and duration in a low-income rural population in West Tennessee.

Intervention Results: Breastfeeding initiation and duration at 6 weeks were increased in the peer counselor group (n = 156) compared with women in the no-peer counselor group (n = 135) (53% vs. 33%, p < 0.001, and 26% vs. 13%, p = 0.006, respectively). Multivariate analysis revealed that women in the peer counselor group were significantly more likely to initiate breastfeeding (OR = 2.43, 95% CI = 1.23-4.67) and to be breastfeeding at 6 weeks (OR = 2.78, 95% CI = 2.08-9.51), than those in the no-peer counselor group.

Conclusion: This study demonstrates the efficacy of a peer counselor program in improving both breastfeeding initiation and duraation in a rural, low-income population.

Study Design: QE: non-equivalent control group

Setting: 9 health departments in West Tennessee

Population of Focus: Women between 6 weeks and 6 months postpartum who registered antepartum for WIC at one of the participating health departments

Data Source: Mother self-report

Sample Size: Intervention (n=156) Control (n=135)

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, Telephone Support, Educational Material, Patient Reminder/Invitation

Intervention Description: This study explores the views of women who received a tailored text messaging cessation intervention (MiQuit) during pregnancy, focusing on acceptability, perceived impact, and suggestions for improvements.

Intervention Results: Three main themes were identified: "impact", "approach," and "optimization." Participants described an immediate, yet often short-lived, impact from the texts that distracted and delayed them from smoking and they perceived that texts focusing on the development of and risk to the baby generated more enduring emotional impacts. Most women found receiving support by text preferable to face-to-face cessation support, with participants citing the greater regularity, convenience, and non-judgmental style as particular advantages. Participants would have preferred a longer support program with increased tailoring, greater customization of text timings and consideration of cutting down as an alternative/precursor to quitting.

Conclusion: Pregnancy-specific cessation support by text message was well received and participants considered the support increased their motivation to stop smoking. The focus on the developing baby, the regularity of contact and the provision of gentle, encouraging messages were highlighted as particularly important elements of the program.

Study Design: Qualitative interview

Setting: Mobile based

Population of Focus: Pregnant women smokers aged 17- 37 who had received the MiQuit text messaging intervention as part of a larger RCT

Data Source: Telephone interviews

Sample Size: 15

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Telephone Support

Intervention Description: We aimed to improve rates of any and exclusive breastfeeding at 1 and 6 months using a low-intensity peer counseling intervention beginning prenatally. We also planned to study the interaction of breastfeeding attitude and self-efficacy with the intervention.

Intervention Results: Women with positive attitudes had significantly higher rates of initiation (93% vs 61%) and breastfeeding at 1 and 6 months (79% vs 25% and 12% vs 0%, respectively) than those with negative attitudes, regardless of intervention. After adjusting for self-efficacy, women who received peer counseling had significantly higher breastfeeding rates at 1 month (odds ratio = 3.2; 95% confidence interval, 1.02-9.8). The intervention group was marginally more likely to achieve their breastfeeding goal (43% vs 22%, P = .073).

Conclusion: Breastfeeding rates in all women improved during the study period. Breastfeeding attitude was more strongly associated with breastfeeding behavior than peer support. Peer counseling supported women with low self-efficacy and helped women achieve their breastfeeding goals.

Study Design: RCT

Setting: Westown Physician Center in Cleveland, OH

Population of Focus: Women ≥18 years old who were ≥28 weeks GA, English speaking, without any diagnoses that would prohibit them from breastfeeding

Data Source: Mother self-report

Sample Size: Intervention (n=50) Control (n=53)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Online Material/Education/Blogging, Peer Counselor, Educational Material

Intervention Description: The aim of the presented study was not only to develop an internet based, professionally e-mail accompanied platform for alcohol or tobacco consuming pregnant women ("IRIS Platform") but also to analyse the beneficiary profiles and investigate the practicability and acceptance of the platform among women and referring gynaecologists.

Intervention Results: The offer comprised three 12-week counselling programmes (alcohol, tobacco, combined consumption). Altogether 32 women registered within the recruitment period of 20 weeks, only 9 of them at the suggestion of gynaecologists. Thirty were enrolled. The average age was 31 years. Ten women were pregnant for the first time, 14 unplanned. Most of them were smokers (n = 29). 75 % (n = 12 of 16) of them had smoked in the previous pregnancies, 5 of 16 women had suffered miscarriages. Six women completed the entire 12 week programme. The abstinence rate after 3 months was min. 18.5 % (ITT) in the tobacco group, while in the alcohol programme 3 women achieved abstinence. Satisfaction was reported especially for the eCoach initiative.

Conclusion: The results demonstrate that an internet-based service like IRIS can be a useful form of support for tobacco or alcohol consuming pregnant women. A particular challenge is the accessibility of the persons concerned and the form in which alcohol consuming pregnant women are approached in daily medical practice. The individual contact to the eCoach can be a decisive form of support and aid to motivation.

Study Design: RCT- pilot

Setting: Internet based

Population of Focus: Adult pregnant women with at least one instance of consumption of alcohol and/or tobacco in pregnancy, adequate knowledge of German

Data Source: Website data, survey, nicotine dependence scales

Sample Size: 25

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Technology-Based Support, Assessment (patient/consumer), Expert Support (Provider),

Intervention Description: ChilledOut Online is a treatment program based on the Cool Kids and Chilled anxiety management program developed at Macquarie University, Sydney, Australia [52]. The program teaches CBT strategies for adolescents through eight online modules of approximately 30 minutes, with a focus on psychoeducation, cognitive restructuring and graded exposure. To allow for flexibility and personal learning preferences, adolescents were able to access all modules at treatment start. To guide progress through the program, adolescents were however encouraged to complete all eight modules (and module content) in the order they appeared within the 14-week intervention period, after which they would have access to the web site for another three months. Program content such as goal setting, realistic thinking, problem solving, and assertiveness, is presented through a combination of multimedia formats, i.e. text, audio, illustrations, cartoons, worksheets, and video vignettes.

Intervention Results: Lending support to our main hypothesis, participants receiving ICBT demonstrated significant improvements at post-treatment compared to participants in the WL condition across all raters on diagnostic severity and level of anxiety symptoms (CSR and SCAS). The between-group ES’s found for CSRprim and CSRall in the present study (d = 0.65 and d = 0.83, respectively) are in the lower end of those found in other similar WL controlled studies.

Conclusion: This study demonstrated the Danish version of ChilledOut Online to be efficacious and feasible in relieving symptoms of anxiety in adolescents. As such, the study supports previous findings of similar guided ICBT interventions and helps build a strong foundation for future research in and implementation of ICBT in mental health services for adolescents with anxiety disorders.

Study Design: Randomized controlled trial

Setting: Online

Population of Focus: Adolescents with anxiety disorders

Sample Size: 70

Age Range: 13-17 years old

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Childbirth Education Classes, PATIENT_CONSUMER

Intervention Description: The objective of this study was to examine the associations between attendance at childbirth education classes and maternal characteristics (age, income, educational level, single parent status), maternal psychological states (fear of birth, anxiety), rates of obstetric interventions, and breastfeeding initiation.

Intervention Results: Older, more educated, and nulliparous women were more likely to attend childbirth education classes than younger, less educated, and multiparous women. Attending prenatal education classes was associated with higher rates of vaginal births among women in the study sample. Rates of labor induction and augmentation and use of epidural anesthesia were not significantly associated with attendance at childbirth education classes.

Conclusion: Future studies might explore the effect of specialized education programs on rates of interventions during labor and mode of birth.

Study Design: Prospective cohort

Setting: Perinatal Services British Columbia data

Population of Focus: Nulliparous women who gave birth after prenatal survey completion between May 2005 and July 20072

Data Source: Not specified

Sample Size: Total (n=372) Intervention (n=311) Control (n=61)

Age Range: Not Specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Motivational Interviewing, PARENT/FAMILY, Counseling (Parent/Family), Telephone Support

Intervention Description: The intervention was a randomized-controlled pilot study of a brief, motivational SHS exposure intervention was conducted with mothers of infants hospitalized in a NICU, with the primary aim of reducing household SHS exposure via the implementation of home and car smoking bans. Caregivers were randomized to two sessions of motivational interviewing conducted in the hospital, usual care, or usual care-reduced measurement with follow-up at 1- and 6-months post discharge. The motivational interviewing group had 2 hospital-based sessions of approximately 40 minutes each, 2 personalized letters, and 2 phone feedback sessions targeting infant ETS reduction.

Intervention Results: Lower rates of total smoking bans (both home and car) in the usual care-reduced measurement group but not significantly different for home alone. 63.6% receiving motivational interviewing had a ban by 1-month post-discharge compared to 20% of the usual care group. Six months’ post discharge, fewer smoking bans were noted in the usual care-reduced measurement relative to motivational interviewing and usual care. While report of smoking bans increased in frequency, no differences were detected in household nicotine levels. However, there was a 10.8% decrease in household nicotine level from 1-6 months’ post-discharge. Participant report or smoking bans and results from nicotine monitors are two distinct measures of SHS exposure, with different sources of error and will not necessarily demonstrate identical data patterns.

Conclusion: We conclude that recruitment and intervention with NICU parents in a SHSe study is feasible, although improvements are needed. MI as implemented did not increase effects over assessment alone. Thus, assessment and discussion of SHSe in the NICU may increase the likelihood of a smoke-free home post-discharge, yet more intensive intervention is needed to strengthen effects. Effective interventions to reduce SHSe in households with NICU infants at high respiratory risk could result in substantial decreases in adverse health effects and the very large associated costs. This study was supported by grant R40MC08962 through the U.S. Department of Health and Human Services, Maternal and Child Health Research Program.

Study Design: Three-group RCT

Setting: Ill-child healthcare setting (NICU, respiratory)

Population of Focus: Primary caregivers of infants at high respiratory risk in the NICU who reported a smoker in the household

Data Source: Air nicotine monitors; infant endtidal carbon monoxide; intervieweradministered questionnaire at baseline and all follow-up assessments to determine smoking bans; and psychosocial and infant severity measures for cognitive and behavioral processes using the Experiential and Behavioral Subscales.

Sample Size: 144 mothers with infants in the NICU

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), PATIENT/CONSUMER, Educational Material, CAREGIVER, Educational Material (caregiver), Counseling (Parent/Family), Peer Counselor, Motivational Interviewing/Counseling

Intervention Description: We report on a randomized controlled trial conducted between 1996 and 2001 to evaluate a minimal contact behavioral counseling intervention to decrease household SHS exposure among children with asthma from low-income, predominantly ethnic minority families.

Intervention Results: The intervention was unsuccessful with respect to reduction of household smoking and household SHS exposure of these children. In addition, while most households that remained in the study reported full household smoking bans by the end of the study, the study team found no difference in control/intervention households citing a ban on smoking.

Conclusion: Despite these results, our study provided several important insights. The “null” results of our trial suggest that a minimal intervention with limited contact may not suffice to achieve a reduction in household tobacco exposure among low income minority families that have children with asthma. However, although no intervention/control group differences were found, our study suggests that it is possible to implement household restrictions that were not previously in place, including among low-income and minority families, since most households reported implementing full smoking bans by the end of the study (136 of the original 242 at baseline, 56%). This is significant in light of the implications of such restrictions for reduced exposure [43] and the association of bans with smoking cessation and decreased cigarette consumption. Our research also points to the need for further study of the process by which change occurs, i.e., what changes families believe they are making and actually achieve.

Study Design: RCT

Setting: Community (home)

Population of Focus: Children 2-14 years of age with asthma and a parent or guardian from each child’s household

Data Source: Parental survey (baseline data); urine cotinine; air nicotine monitor readings; and in-person follow-up.

Sample Size: 242 child/adult dyads

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

Intervention Description: To assess the impact of a managed care-based patient reminder/recall system on immunization rates and preventive care visits among low-income adolescents.

Intervention Results: Significantly higher rates of annual preventive care visits in the mailed reminder group vs control group (Hazard ratio=1.2; CI=1.1- 1.3; p<.01 Significantly higher rates of annual preventive care visits in the telephone reminder group vs control group (Hazard ratio=1.1; CI=1.0-1.2; p<.05)

Conclusion: Managed care-based mail or telephone reminder/recall improved adolescent immunizations and preventive visits, with modest costs and modest impact.

Study Design: RCT

Setting: Monroe Plan for Medical Care, a not-for-profit managed care organization in upstate New York

Population of Focus: Adolescents ages 10.5 through 17 years enrolled in Monroe Plan on December 31, 2009, with a primary care provider in a participating practice

Data Source: Managed care organization’s claims files

Sample Size: Total (N=4115) Mailed reminder (n=1396) Telephone reminder (n=1423) Control (n=1296)

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, Home Visits, Transportation Assistance

Intervention Description: To assess the impact of a tiered patient immunization navigator intervention (immunization tracking, reminder/recall, and outreach) on improving immunization and preventive care visit rates in urban adolescents.

Intervention Results: Significant increase in preventive care visit rates in the intervention group vs control group (p<.01)

Conclusion: A tiered tracking, reminder/recall, and outreach intervention improved immunization and preventive care visit rates in urban adolescents.

Study Design: RCT

Setting: 8 urban primary care practices in Rochester, New York

Population of Focus: Adolescents ages 11-15 enrolled in one of the practices

Data Source: Medical record review

Sample Size: Total (N=7546) Intervention (n=3707) Control (n=3,839)

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

Intervention Description: To measure the effect of telephone-based reminder/recall on immunization and well-child care (WCC) visit rates among adolescents in urban practices.

Intervention Results: No significant increase in adolescent well visit rates

Conclusion: An intensive telephone reminder and recall system was only minimally successful in improving immunization and WCC visit rates among urban adolescents. Lack of success was largely owing to changed or inaccurate telephone numbers.

Study Design: RCT

Setting: 4 urban primary care clinics in Rochester, New York

Population of Focus: Adolescents ages 11-14 with one or more visits at each site

Data Source: Medical record review

Sample Size: Total (N=3006) Intervention (n=1496) Control (n=1510)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Incentives, Telephone Support, Pharmacotherapy (Nicotine), Peer Counselor

Intervention Description: To assess the efficacy of a financial incentive added to routine specialist pregnancy stop smoking services versus routine care to help pregnant smokers quit.

Intervention Results: Recruitment was extended from 12 to 15 months to achieve the target sample size. Follow-up continued until September 2013. Of the 306 women randomised, three controls opted out soon after enrolment; these women did not want their data to be used, leaving 306 intervention and 303 control group participants in the intention to treat analysis. No harms of financial incentives were documented. Significantly more smokers in the incentives group than control group stopped smoking: 69 (22.5%) versus 26 (8.6%). The relative risk of not smoking at the end of pregnancy was 2.63 (95% confidence interval 1.73 to 4.01) P<0.001. The absolute risk difference was 14.0% (95% confidence interval 8.2% to 19.7%). The number needed to treat (where financial incentives need to be offered to achieve one extra quitter in late pregnancy) was 7.2 (95% confidence interval 5.1 to 12.2). The mean birth weight was 3140 g (SD 600 g) in the incentives group and 3120 (SD 590) g in the control group (P=0.67).

Conclusion: This phase II randomised controlled trial provides substantial evidence for the efficacy of incentives for smoking cessation in pregnancy; as this was only a single centre trial, incentives should now be tested in different types of pregnancy cessation services and in different parts of the United Kingdom.

Study Design: RCT

Setting: Hospital and community-based health care clinics

Population of Focus: English speaking pregnant women who smoked receiving obstetrical care through UK National Health Services (NHS)

Data Source: Breath CO, Nicotine dependence scale, self-report, cotinine levels (blood, urine and saliva)

Sample Size: 609 -306 intervention, 303 control

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), PROVIDER/PRACTICE, Patient-Centered Medical Home, Educational Material (Provider), Continuity of Care (Caseload), CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), PATIENT/CONSUMER, Referrals, Other Education

Intervention Description: This study examines the effect of a provider alliance on service utilization, satisfaction , self efficacy, and attachment to a regular source of care for participating low income urban children and their families.

Intervention Results: The use of Physician Assistants and community health workers to expand community outreach, primary care services, pediatric sub-specialty care, and service coordination within and between care settings improved health services utilization, satisfaction with health services, parental self efficacy in navigating the health care system for their children, and service convenience for an at-risk population. Also, the use of Physician Assistants to provide pediatric sub-specialty services did not have a negative effect on parental satisfaction with a child's care.

Conclusion: Parents were slightly more satisfied with services received from a Physician Assistant in comparison with the physician sub- specialists in cardiology and nephrology clinics.

Study Design: Prospective quasiexperimental; Survey

Setting: South Central Los Angeles primary and specialty care clinics

Population of Focus: Children between the ages of 0-18 (“or are adolescents”) who reside within the geographic area of South Los Angeles

Data Source: A 30 item parent survey to assess parents’ perceived difficulty in accessing services and their satisfaction with the services received • Patient database was used to collect service utilization and financial data from operational and administrative tracking instruments and reports at both the primary and specialty care sites

Sample Size: Estimated 727,000 children in the service area; n=11,533 children reach during outreach events; n=80,000 (10% of children in service area) children attached to a medical home; n=8545 children enrolled in available payer sources

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

Intervention Description: Explore the impact of invitation and reminder letters on cervical cancer screening participation among eligible Ontario women 30 to 69 years of age.

Intervention Results: At 9-month follow-up, intervention group, including women with invalid addresses, significantly more likely to have Pap test (p<.05)

Conclusion: The invitation and reminder letter strategy increased cervical cancer screening participation.

Study Design: QE: pretest-posttest

Setting: Ontario

Population of Focus: Women who had not had a Pap test in the previous 36 months

Data Source: Cytobase and the Ontario Health Insurance Plan’s Claims History Databases

Sample Size: Total (N=273,534) 2014 (n=135,770); 2013 (n=137,764) Analysis (n=27,269) 2014 (n=16,196)6 ; 2013(n=11,073)

Age Range: 30-69

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Patient Navigation, Enabling Services, Home Visits

Intervention Description: A randomized controlled trial to evaluate the effectiveness of two alternative cervical cancer screening interventions for Chinese women living in North America.

Intervention Results: Women in both intervention groups significantly more likely to have Pap smear than women in control group (39% in outreach worker group vs 15% in control, p<.001; 25% in direct mail group vs 15% in control, p=.03)

Conclusion: Culturally and linguistically appropriate interventions may improve Pap testing levels among Chinese women in North America.

Study Design: RCT

Setting: Seattle, WA and Vancouver, British Columbia

Population of Focus: Women who spoke Cantonese, Mandarin, or English, with no history of cervical cancer or hysterectomy, who were defined as underutilizers of cervical cancer screening (no Pap test in the past 2 years and/or did not intend to have a Pap test in the next 2 years)

Data Source: Self-report through personal interviews and verified through medical record review

Sample Size: Total (N=402) Intervention Group 1 (n=129); Intervention Group 2 (n=139); Control (n=134)

Age Range: 20-69

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Home Visits

Intervention Description: Evaluate the effectiveness of a cervical cancer control intervention for Vietnamese American women that used lay health workers.

Intervention Results: Ever-screened experimental group women were significantly more likely to report Pap testing (P < .02) and to have records verifying Pap testing (P < .04) than were ever-screened control group women. There were no significant differences between the trial arms for women who had never been screened.

Conclusion: Lay health worker–based interventions for Vietnamese American women are feasible to implement and can increase levels of Pap testing use among ever-screened women but not among never-screened women.

Study Design: RCT

Setting: Seattle, Washington

Population of Focus: Vietnamese women who spoke Vietnamese or English, and who had not received a Pap test in the past 3 years

Data Source: Self-report through personal interviews and verified through medical record review

Sample Size: Total (N=234) Intervention (n=118); Control (n=116)

Age Range: 20-89

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Patient Navigation, Enabling Services, COMMUNITY, Community Events, POPULATION-BASED SYSTEMS, Home Visits

Intervention Description: A group-randomized controlled trial to evaluate a cervical cancer screening intervention program targeting Seattle’s Cambodian refugee community.

Intervention Results: The proportion of women in the intervention group reporting recent cervical cancer screening increased from 44% at baseline to 61% at follow-up (+17%). The corresponding proportions among the control group were 51 and 62% (+11%). These temporal increases were statistically significant in both the intervention (P < 0.001) and control (P = 0.027) groups.

Conclusion: This study was unable to document an increase in Pap testing use specifically in the neighborhood-based outreach intervention group; rather, we found an increase in both intervention and control groups. A general awareness of the project among women and their health care providers as well as other ongoing cervical cancer screening promotional efforts may all have contributed to increases in Pap testing rates.

Study Design: Cluster RCT

Setting: Seattle, Washington

Population of Focus: Cambodian women

Data Source: Self-report through personal interviews and verified through medical record review

Sample Size: Total (N=370) Analysis (n=289) Intervention (n=144); Control (n=145)

Age Range: ≥18

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, Other Education

Intervention Description: To determine the effectiveness of a physical activity intervention for smoking cessation during pregnancy.

Intervention Results: No significant difference was found in rates of smoking abstinence at end of pregnancy between the physical activity and control groups (8% v 6%; odds ratio 1.21, 95% confidence interval 0.70 to 2.10). For the physical activity group compared with the control group, there was a 40% (95% confidence interval 13% to 73%), 34% (6% to 69%), and 46% (12% to 91%) greater increase in self reported minutes carrying out physical activity per week from baseline to one week, four weeks, and six weeks post-quit day, respectively. According to the accelerometer data there was no significant difference in physical activity levels between the groups. Participants attended a median of four treatment sessions in the intervention group and three in the control group. Adverse events and birth outcomes were similar between the two groups, except for significantly more caesarean births in the control group than in the physical activity group (29% v 21%, P=0.023).

Conclusion: Adding a physical activity intervention to behavioural smoking cessation support for pregnant women did not increase cessation rates at end of pregnancy. During pregnancy, physical activity is not recommended for smoking cessation but remains indicated for general health benefits. Trial registration Current Controlled Trials ISRCTN48600346.

Study Design: RCT

Setting: Hospital antenatal clinics

Population of Focus: Pregnant smokers ages 16-50 years at 10-24 weeks of gestation, cigarette consumption of five or more daily before pregnancy, currently smoking one or more cigarettes daily, and able to walk continuously for 15 minutes

Data Source: Surveys, exhaled CO, salivary cotinine, accelerometer

Sample Size: 784-392 intervention

Age Range: Not specified

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

Intervention Description: To examine the effectiveness and cost-effectiveness of a PA intervention plus standard behavioural support for smoking cessation relative to behavioural support alone for achieving smoking cessation at the end of pregnancy.

Intervention Results: In total, 789 women were randomised (n = 394 PA, n = 395 control). Four were excluded post randomisation (two had been enrolled twice in sequential pregnancies and two were ineligible and randomised erroneously). The intention-to-treat analysis comprised 785 participants (n = 392 PA, n = 393 control). There was no significant difference in the rate of abstinence at the end of pregnancy between the PA group (7.7%) and the control group (6.4%) [odds ratio for PA group abstinence 1.21, 95% confidence interval (CI) 0.70 to 2.10]. For the PA group compared with the control group, there was a 33% (95% CI 14% to 56%), 28% (95% CI 7% to 52%) and 36% (95% CI 12% to 65%) significantly greater increase in self-reported minutes of moderate- and vigorous-intensity PA from baseline to 1 week, 4 weeks and 6 weeks respectively. Accelerometer data showed that there was no significant difference in PA levels between the groups. There were no significant differences between the groups for change in maternal weight, depression, withdrawal symptoms or urges to smoke. Adverse events and birth outcomes were similar between the groups except for there being significantly more caesarean births in the control group than in the PA group (28.7% vs. 21.3%; p < 0.023). The PA intervention was less costly than the control intervention by £35 per participant. This was mainly attributable to increased health-care usage in the control group. However, there was considerable statistical uncertainty around this estimate.

Conclusion: During pregnancy, offering an intervention combining supervised exercise and PA counselling does not add to the effectiveness of behavioural support for smoking cessation. Only 10% of participants had PA levels accessed by accelerometer and it is, therefore, unclear whether or not the lack of an effect on the primary outcome is the result of insufficient increases in PA. Research is needed to identify the smoking populations most suitable for PA interventions and methods for increasing PA adherence.

Study Design: RCT

Setting: Community hospital antenatal clinics

Population of Focus: Women between 10 and 24 weeks’ gestation smoking 5 or more cigarettes a day before pregnancy and one or more during pregnancy

Data Source: Self-report, carbon monoxide and/ salivary cotinine, survey

Sample Size: 785- 392 intervention, 393 control

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Nurse/Nurse Practitioner, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), PATIENT/CONSUMER, Educational Material, CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling, Motivational Interviewing, Peer Counselor

Intervention Description: We conducted a population-based trial to evaluate the efficacy of an intervention aimed at preventing exposure of young children to parental tobacco smoke.

Intervention Results: A strong association was found between social class and smoking behavior, in particular smoking during meals at home. The intervention itself had limited effectiveness in decreasing the number of smokers. The effect was stronger in mothers and in higher social groups. Among the "white-collar" families belonging to the intervention group, the proportion of mothers who stopped smoking was 3 times higher than in the control group (not statistically significant).

Conclusion: Educational interventions against smoking should be planned taking into account the difference in efficacy according to social class.

Study Design: Control trial with nonrandom assignment

Setting: Community (population based survey) and well-child health care visit

Population of Focus: Parents of newborn babies living in the town of Rivoli before 3 month compulsory vaccination

Data Source: Baseline (pre-intervention) and followup (2 and 4 years post-intervention) questionnaires

Sample Size: 1015 parents with 402 in the intervention group and 613 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, Patient Reminder/Invitation, Enabling Services, Designated Clinic/Extended Hours, PROVIDER/PRACTICE

Intervention Description: (1). to assess the cost-effectiveness of three interventions to deliver breast and cervical cancer screening to women unscreened for >or=3 years and (2). to determine the relation of an invasive cervical cancer diagnosis to the interval since the last true screening test.

Intervention Results: Significantly greater odds of Pap smear for women in phone/phone and letter/phone intervention groups than in control group (phone/phone OR=4.77, letter/phone OR=5.57, p<.0001)

Conclusion: Letter reminder, followed by a telephone appointment call, was the most cost-effective approach to screening rarely screened women. Lack of accurate information on prior hysterectomy adds substantial unnecessary costs to a screening reminder program.

Study Design: RCT

Setting: Portland, OR metropolitan area

Population of Focus: Women who were members of Northwest Kaiser Permanente (NWKP) for at least 3 years, with no history of cervical cancer or hysterectomy, who had not received a Pap smear in the same 3 years they had been members of NWKP

Data Source: Radiology and cytology database

Sample Size: Total (N=1,200) Intervention Group 1 (n=288); Intervention Group 2 (n=308); Intervention Group 3 (n=303); Control (n=301)

Age Range: 18-70

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

Intervention Description: To examine the long-term maintenance of a previously reported behavioral counseling intervention to reduce asthmatic children's exposure to environmental tobacco smoke (ETS).

Intervention Results: The originally reported analysis of baseline to 12 months was reanalyzed with a more robust restricted maximum likelihood procedure. The 2-year follow-up period was analyzed similarly. Significantly greater change occurred in the counseling group than the control groups and was sustained throughout the 2 years of follow-up. Further exploratory analyses suggested that printed counseling materials given to all participants at month 12 (conclusion of the original study) were associated with decreased exposure in the control groups.

Conclusion: Such long-term maintenance of behavior change is highly unusual in the general behavioral science literature, let alone for addictive behaviors. We conclude that ETS exposure can be reduced and that a clinician-delivered treatment may provide substantial benefit.

Study Design: Three-group RCT

Setting: Ill-child healthcare setting (pediatric allergy clinic)

Population of Focus: Families of children with asthma (6 to 17 years) including at least one parent who smoked in the home

Data Source: Interview data, pulmonary function testing, daily peak flow measures, symptom diary recordings, urinary cotinine, environmental air sampling, and permanent product (e.g., cigarette butt counts).

Sample Size: 91 families

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), CAREGIVER, Educational Material (caregiver), PATIENT/CONSUMER, Educational Material, Telephone Support

Intervention Description: Since most smoker parents of children with asthma are unable to quit, an alternative measure that would reduce their children's exposure to environmental tobacco smoke (ETS) is to ban smoking in the home.

Intervention Results: At 6 months, 49.2% of the intervention group reported having banned smoking in the home compared with 41.9% of controls, but the differential rate of change from baseline was not significant (P = 0.40). At follow-up, there were no significant differences between groups in the percentage reporting bans on smoking in the car, the mean reduction from baseline in total daily consumption or consumption in front of the child, children's urinary cotinine level, or parental smoking cessation.

Conclusion: The intervention did not change parents' propensity to create or maintain bans on smoking in their homes or otherwise change smoking habits to reduce their children's exposure to ETS. More intensive interventions may be required to achieve change among low-income smoker parents of children with asthma.

Study Design: Control trial with alternation by week of attendance at clinic

Setting: Ill-child healthcare setting (hospital outpatient clinics for children with asthma)

Population of Focus: Families with children between 1 and 11 years of age with doctorconfirmed asthma who attended pediatric outpatient clinics at two metropolitan hospitals

Data Source: Baseline and follow-up questionnaires; child’s urinary cotinine levels.

Sample Size: Of 378 eligible, 292 participated with 143 in the intervention group and 149 in the control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Counseling (Parent/Family), CAREGIVER, Motivational Interviewing/Counseling, Home Visit (caregiver), PATIENT/CONSUMER, Home Visits, Motivational Interviewing

Intervention Description: Secondhand smoke (SHS) is a significant cause of acute respiratory illness (ARI) and 5 times more common in indigenous children. A single-blind randomized trial was undertaken to determine the efficacy of a family centered SHS intervention to reduce ARI in indigenous infants in Australia and New Zealand.

Intervention Results: Two hundred and ninety-three mother/infant dyads were randomized and followed up. Three quarters of mothers smoked during pregnancy and two thirds were smoking at baseline (as were their partners), with no change for more than 12 months. Reported infant exposure to SHS was low (≥95% had smoke-free homes/cars). Infant CCRs were higher if one or both parents were smokers and if mothers breast fed their infants. There was no effect of the intervention on ARI events [471 intervention vs. 438 usual care (reference); incidence rate ratio = 1.10, 95% confidence intervals (CI) = 0.88–1.37, p = .40].

Conclusion: Despite reporting smoke-free homes/cars, mothers and their partners continue to smoke in the first year of infants’ lives, exposing them to SHS. Emphasis needs to be placed on supporting parents to stop smoking preconception, during pregnancy, and postnatal.

Study Design: Single-blind randomized trial

Setting: Community (homes)

Population of Focus: Indigenous mothers/infants from homes with more than one smoker

Data Source: Baseline data at home visit; Baseline, 2 month, and 3 month quantitative and qualitative process evaluation indicators; outcome data from face-toface home visits and urine samples

Sample Size: 293 mother/infant dyads

Age Range: Not specified

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): PATIENT/CONSUMER, Home Visits, Community-Based Group Education, Telephone Support

Intervention Description: To evaluate the effect of two forms of postnatal social support for disadvantaged inner city mothers on maternal and child health outcomes.

Intervention Results: At 12 and 18 months, there was little impact for either intervention on the main outcomes: child injury (SHV: relative risk 0.99; 95% confidence intervals 0.68 to 1.45, CGS: 0.91; 0.61 to1.36), maternal smoking (SHV: 0.86; 0.62 to 1.19, CGS: 0.97; 0.72 to 1.33) or maternal depression (SHV: 0.86; 0.62 to1.19, CGS: 0.93; 0.69 to 1.27). SHV women had different patterns of health service use (with fewer taking their children to the GP) and had less anxious experiences of motherhood than control women. User satisfaction with the SHV intervention was high. Uptake of the CGS intervention was low: 19%, compared with 94% for the SHV intervention.

Conclusion: There was no evidence of impact on the primary outcomes of either intervention among this culturally diverse population. The SHV intervention was associated with improvement in some of the secondary outcomes.

Study Design: RCT with two intervention groups

Setting: Community (Well-child visit)

Population of Focus: Women from culturally diverse background with infants in two disadvantaged boroughs of London, UK

Data Source: Questionnaires at baseline, 12 and 18 month follow-ups.

Sample Size: 731 mothers with 183 allocated to support health visitor intervention, 184 to community group services intervention, and 364 to control group

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

Intervention Description: A community intervention program was launched in 1996 to improve breast and cervical cancer screening among Korean American women in Alameda County, California.

Intervention Results: No significant differences in Pap smear rates between the intervention and comparison counties

Conclusion: After 18 months, interim program assessment revealed that mammograms improved, but Pap smears, breast self-examinations, and clinical breast examinations did not change significantly. However, results were similar for the control county probably because the program was not implemented fully. Several strategies for improving program implementation are discussed including recommendations for researchers planning community intervention projects.

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

Setting: Alameda County and Santa Clara County, CA

Population of Focus: Korean American women

Data Source: Telephone survey

Sample Size: Baseline (n=818) Intervention (n=404); Control (n=414)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Partner-Level Intervention

Intervention Description: A randomized controlled trial in which expectant fathers (n = 59) were assigned randomly to attend either a 2-hour intervention class on infant care and breastfeeding promotion (intervention) or a class on infant care only (control group). Couples were recruited during the second trimester from a university obstetrics practice.

Intervention Results: Overall, breastfeeding was initiated by 74% of women whose partners attended the intervention class, as compared with 41% of women whose partners attended the control class (P = .02).

Conclusion: Expectant fathers can be influential advocates for breastfeeding, playing a critical role in encouraging a woman to breastfeed her newborn infant.

Study Design: RCT

Setting: Johns Hopkins Hospital in Baltimore, MD

Population of Focus: Women who sought prenatal care at the resident and faculty practices

Data Source: Mother self-report

Sample Size: Intervention (n=27) Control (n=32)

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), PATIENT/CONSUMER, Educational Material, Telephone Support

Intervention Description: We tested a health education intervention program to reduce passive smoking in infancy. The aim was to develop an instrument for study of tobacco smoke exposure and childhood respiratory illness.

Intervention Results: There was a reduction in maternal smoking associated with contact with research staff, but this was not statistically significant (mother reported quitting: intervention 6%, control 2.2%). There were no differences between the groups in the exposure of infants to tobacco smoke.

Conclusion: There was a reduction in maternal smoking associated with contact with research staff, but this was not statistically significant. There were no differences between the groups in the exposure of infants to tobacco smoke. Reasons for this finding may include the timing of the intervention, the heterogeneity of the target group, and the manner in which information was presented on health risks caused by parental smoking.

Study Design: RCT

Setting: Well-child healthcare setting (maternity hospital, peripartum)

Population of Focus: Parents of newborn babies whose mothers smoked during pregnancy

Data Source: Questionnaires and urinary cotinine assays.

Sample Size: 184 parents

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 Education, Provision of Breastfeeding Item, PROVIDER/PRACTICE, Hospital Policies, Other (Provider Practice), POPULATION-BASED SYSTEMS, COMMUNITY, Other (Communities), Provider Training/Education

Intervention Description: A breastfeeding promotion program conducted on the Navajo reservation.

Intervention Results: Based on medical records review of feeding practices of all the infants born the year before (n = 988) and the year after (n = 870) the intervention, the program was extremely successful.

Conclusion: This combination of techniques, including qualitative and quantitative research into local definitions of the problem, collaboration with local institutions and individuals, reinforcement of traditional understandings about infant feeding, and institutional change in the health care system, is an effective way of facilitating behavioral change.

Study Design: QE: pretest-posttest

Setting: Shiprock, NM

Population of Focus: All mothers with infants born at the Shiprock hospital

Data Source: Medical record review

Sample Size: Preintervention (n=988) Postintervention (n=870)

Age Range: Not specified

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

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits

Intervention Description: This experimental field study was performed with the aim of evaluating the efficacy of training given to women about cervical cancer risk factors and primary and secondary prevention precautions.

Intervention Results: No significant changes in Pap smear rates between baseline and follow-up

Conclusion: Women were in need of knowledge about risk factors related to cervical cancer, prevention from and early diagnosis of cervical cancer, but there was no significant increase in the rate of having a Pap smear test despite the increase in the knowledge level with the training given.

Study Design: QE: pretest-posttest

Setting: Evka 4 Health Care Center in Izmir

Population of Focus: Women who were literate, married, had social security, and were registered at the Evka 4 Health Care Center

Data Source: Written questionnaire

Sample Size: Baseline (n=254) Follow-up (n=227)

Age Range: 25-29

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Home Visits, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), Telephone Support, Motivational Interviewing, CAREGIVER, Motivational Interviewing/Counseling, Outreach (caregiver), Home Visit (caregiver)

Intervention Description: The aim of this randomized-controlled trial was to evaluate the effectiveness of an intensive intervention to reduce children’s environmental tobacco smoke (ETS) exposure at their home compared with a minimal intervention.

Intervention Results: The levels of cotinine in the intensive intervention and minimal intervention groups in the final follow-up were significantly lower than the initial levels. The proportion of mothers reporting a complete smoking ban at home in the final follow-up was higher in the intensive intervention group than the minimal intervention group. This increase was statistically significant. The education provided during the home visits and the reporting of the urinary cotinine levels of the children were effective in lowering the children’s exposure to ETS at their home. The decrease in cotinine levels was higher in the intensive intervention group than the minimal intervention group but the difference was not statistically significant.

Conclusion: The education provided during the home visits and the reporting of the urinary cotinine levels of the children were effective in lowering the children’s exposure to ETS at their home.

Study Design: RCT

Setting: Community (home and hospital)

Population of Focus: Mothers of children aged 1-5 who lived in the Cengizhan district of Izmir in Turkey, who smoked and/or whose spouses smoked

Data Source: Urinary cotinine samples and forms

Sample Size: 80 mothers with 40 in the intensive intervention group and 40 in the minimal intervention group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Incentives

Intervention Description: Analysis of four controlled clinical trials on the efficacy of financial incentives for smoking cessation to determine whether pregnant and newly postpartum smokers at risk for postpartum depression respond to an incentive-based smoking-cessation treatment and how the intervention impacts depression ratings. Women were assigned either to an intervention wherein they earned vouchers exchangeable for retail products contingent on abstaining from smoking or to a control condition wherein they received vouchers of comparable value independent of smoking status. Depression ratings were applied antepartum and postpartum, across 7 assessments.

Intervention Results: Financial incentives that were contingent on smoking cessation significantly increased 7-day, point-prevalence abstinence rates compared to the non-contingent control condition at each assessment through 24 weeks postpartum.

Conclusion: The study concludes that depression-prone pregnant and newly postpartum women respond well to this incentive-based smoking-cessation intervention in terms of achieving abstinence, and the intervention also reduces the severity of postpartum depression ratings in this at-risk population.

Study Design: Quasi experimental cross sectional

Setting: Women, Infants and Children clinic obstetrical practices

Population of Focus: Economically-disadvantaged pregnant and newly postpartum smokers at risk for depression.

Data Source: Depression scales, survey, cotinine levels

Sample Size: 289

Age Range: Not specified