Efficacy and cost-effectiveness of a clinic-based counseling intervention tested in an ethnically diverse sample of pregnant smokers

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1、PatientEducationandCounseling64(2006)342–349www.elsevier.com/locate/pateducouEfficacyandcost-effectivenessofaclinic-basedcounselinginterventiontestedinanethnicallydiversesampleofpregnantsmokersEllenA.Dornelasa,b,*,JeffreyMagnavitac,TryfonBeazogloud,EdwardH.Fischera

2、,bea,baCherylOncken,HarryLando,JohnGreene,JeremyBarbagallo,aaRoxanneStepnowski,ElizabethGregonisaHartfordHospital,DepartmentofMedicine,Hartford,CT,USAbUniversityofConnecticutSchoolofMedicine,DepartmentofMedicine,Farmington,CT,USAcUniversityofHartford,GraduateSchoo

3、lofProfessionalPsychology,Hartford,CT,USAdUniversityofConnecticutSchoolofMedicine,DepartmentofPediatricDentistry,Farmington,CT,USAeUniversityofMinnesota,DivisionofEpidemiology,SchoolofPublicHealth,Minneapolis,MN,USAReceived19December2005;receivedinrevisedform18Feb

4、ruary2006;accepted24March2006AbstractObjective:Ratesofcigarettesmokingarehigheramongwomenwhoreceiveobstetriccarethroughpubliclyfundedprenatalclinics.Thisstudycomparedsmokingoutcomesforpregnantwomen(n=105)whowererandomizedtoreceiveeitherusualcare(standardcessationa

5、dvicefromthehealthcareprovider)oraninterventionconductedintheprenatalclinicconsistingof1.5hofcounselingplustelephonefollow-updeliveredbyamasterspreparedmentalhealthcounselor.Methods:Subjectswere105lowincome,predominantlyHispanic,pregnantpatientsinanurbanprenatalcl

6、inic.Smokingoutcomeswereassessedatendofpregnancyand6monthspost-partum.Results:Atfollow-up,28.3%and9.4%ofparticipantsintheexperimentalinterventionand9.6%and3.8%ofpatientsinusualcarewereabstinentatendofpregnancy(p=.015)and6monthspost-partum,respectively(p=.251).Cost

7、oftheinterventionwas$56perpatientandcosttoproduceanon-smokeratendofpregnancywas$299.Conclusions:Thismodelforinterventionwascost-effectiveandwasassociatedwithsignificantlylowersmokingratesatendofpregnancy.Practicalimplications:Ifthesefindingsarereplicated,prenatalcli

8、nicscouldoffertheoptionforintensivesmokingcessationtreatmentbytrainingmentalhealthcounselorstodeliveroneextendedsmokingcessationcounselingsession.#2006E