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Helping Low Income Pregnant Women Quit Smoking: Improving the First Breath Program
Kristine Alaniz1, Bruce Christiansen2, Katharina Stewart3
1Wisconsin Women's Health Foundation, Madison, Wisconsin.
WMJ : Official Publication of the State Medical Society of Wisconsin
|November 5, 2019
Summary
The revised First Breath program improved reach and diversity for pregnant smokers. While postpartum relapse occurred, it did not increase beyond one month, showing sustained abstinence for mothers in this smoking cessation initiative.
Area of Science:
- Public Health
- Implementation Science
- Maternal Health
Background:
- Maternal smoking during pregnancy poses significant risks to mother and child.
- The First Breath program, established in 2000, targeted low-income pregnant women for smoking cessation.
- Program modifications were driven by healthcare reimbursement changes and high postpartum relapse rates.
Purpose of the Study:
- To revise the First Breath program using implementation science principles.
- To improve postpartum smoking cessation support for pregnant women.
- To address challenges in healthcare delivery and reduce relapse rates.
Main Methods:
- Incorporated focus groups with program clients.
- Conducted a randomized control trial for new postpartum services.
- Implemented a project to test novel delivery methods for the First Breath program.
Main Results:
- Expanded program reach by 34% and added 88 new sites, increasing diversity.
- Biochemically verified abstinence decreased from 13.6% to 7.3% at 1-month postpartum.
- No additional relapse was observed between 1-month and 6-months postpartum.
Conclusions:
- Continuous improvement based on outcomes is vital for community-based tobacco interventions.
- The First Breath program demonstrates a model for supporting underserved pregnant smokers.
- Adaptability to healthcare system changes is key for sustained public health programs.
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