Using formative evaluation to improve a smoking cessation intervention for pregnant women

Triangulation analysis was used to assess qualitative data collected to examine smoking cessation materials and methods prior to a large randomized clinical trial with pregnant smokers. The patient education program's components were tested with 265 patients receiving Medicaid-insured care in 9 public clinics. The formative evaluation process conducted during this pilot study of the Smoking Cessation and Reduction in Pregnancy Trial included assessment of A Pregnant Woman's Guide to Stop Smoking (Windsor et al., 2002), a companion video, clinic reinforcement, and patient-centered counseling. Focus groups were conducted, with 23 (82%) of the nurses and social workers who provided the intervention. Twenty-nine (20.8%) of the women who received the intervention were interviewed individually. The qualitative data were examined to identify convergence and divergence among and between providers and patients about presentation, use of components, and program impact. Findings were used to refine the intervention to enhance patient and staff receptivity, specifically to ensure participant comprehension and shorten time required of busy staff.