Learning Objectives: Understand a systems approach to clinical interventions with pregnant and postpartum smokers
Abstract:
Problem/Objective:
There are many negative consequences of smoking/environmental tobacco smoke on a fetus and children. The leading causes of hospitalization for children are respiratory diseases including asthma. Although these effects are preventable, the solutions are complex, requiring a broad-based approach. Ideally the interventions should focus on all the causes of this problem including biological, behavioural, environmental, social, and the health care system.
Methods:
Surveys were conducted at training events with health care professionals. A consensus conference was held to elicit feedback from tobacco experts in clinical care, research and policy. Pilot training in smoking interventions with pregnant women is currently being carried out with service providers in a Toronto hospital. Evaluation of the training will measure impact on knowledge, attitudes and behaviour with respect to smoking interventions with pregnant smokers.
Results:
A draft framework was developed based on the Precede-Proceed Model outlining the components required to address the problem. Data from the training will be available by October 2003. The final framework will identify areas to be addressed, including research, training, policy and community-based approaches.
Conclusions:
Training health care providers is one component required to address the problem and may not the most effective intervention. Research on clinical interventions with this population is limited; there is inconsistent knowledge and skills among practitioners, limited resources and lack of coordination/collaboration of various partners. The framework proposed will help establish a network to address the problem and will provide suggestions for a broad-based approach.
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