Factors associated with the effectiveness and reach of NHS stop smoking services for pregnant women in England
| Autor: | Samantha J Fahy, Sue Cooper, Lisa Szatkowski, Linda Bauld, Tim Coleman, Jo Leonardi-Bee, Luis R. Vaz |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent media_common.quotation_subject Population Smoking Prevention Health administration Cigarette Smoking 03 medical and health sciences Young Adult 0302 clinical medicine Outcome variable Nursing Pregnancy Surveys and Questionnaires Medicine Humans 030212 general & internal medicine education Disadvantage media_common education.field_of_study business.industry Health Policy Nursing research Public health lcsh:Public aspects of medicine Smoking lcsh:RA1-1270 Abstinence medicine.disease United Kingdom Treatment Outcome 030228 respiratory system Stop smoking services Female Smoking Cessation business Demography Research Article |
| Zdroj: | BMC Health Services Research BMC Health Services Research, Vol 17, Iss 1, Pp 1-11 (2017) Vaz, L R, Coleman, T, Fahy, S J, Cooper, S, Bauld, L, Szatkowski, L & Leonardi-Bee, J 2017, ' Factors associated with the effectiveness and reach of NHS stop smoking services for pregnant women in England ', BMC Health Services Research, vol. 17, no. 1 . https://doi.org/10.1186/s12913-017-2502-y |
| ISSN: | 1472-6963 |
| Popis: | Background The UK National Health Service provides Stop Smoking Services for pregnant women (SSSP) but there is a lack of evidence concerning how these are best organised. This study investigates influences on services’ effectiveness and also on their propensity to engage pregnant smokers with support in stopping smoking. Methods Survey data collected from 121/141 (86%) of SSSP were augmented with data from Hospital Episode Statistics and the 2011 UK National Census. ‘Reach’ or propensity to engage smokers with support was defined as the percentage of pregnant smokers setting a quit date with SSSP support, and ‘Effectiveness’ as the percentage of women who set a quit date who also reported abstinence at four weeks later. A bivariate (i.e. two outcome variable) response Markov Chain Monte Carlo model was used to identify service-level factors associated with the Reach and Effectiveness of SSSP. Results Beta coefficients represent a percentage change in Reach and Effectiveness by the covariate. Providing the majority of one-to-one contacts in a clinic rather than at home increased both Reach (%) (β: 6.97, 95% CI: 3.34, 10.60) and Effectiveness (%) (β: 7.37, 95% CI: 3.03, 11.70). Reach of SSSP was also increased when the population served was more deprived (β for increase in Reach with a one unit increase in IMD score: 0.55, 95% CI: 0.25, 0.85), had a lower proportion of people with dependent children (β: -2.52, 95% CI: -3.82, −1.22), and a lower proportion of people in managerial or professional occupations (β: -0.31, 95% CI: -0.59, −0.03). The Effectiveness of SSSP was decreased in those areas that had a greater percentage of people >16years with no educational qualifications (β: -0.51, 95% CI: -0.95, −0.07). Conclusions To engage pregnant smokers and to encourage them to quit, it may be more efficient for SSSP support to be focussed around clinics, rather than women’s homes. Reach of SSSP is inversely associated with disadvantage and efforts should be made to contact these women as they are less likely to achieve abstinence in the short and longer term. |
| Databáze: | OpenAIRE |
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