Barriers and Promoters of an Evidenced-Based Smoking Cessation Counseling During Prenatal Care in Argentina and Uruguay

• Autores: Colomar, Mercedes; Tong, Van T.; Morello, Paola; Farr, Sherry L.; Lawsin, Catalina; Dietz, Patricia M.; Aleman, Alicia; Berrueta, Amanda Mabel; Mazzoni, Agustina; Becu, Ana; Buekens, Pierre; Belizan, Jose; Althabe, Fernando
• Año de publicación: 2014
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: Smoking Cessation
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

In Argentina and Uruguay, 10.3 and 18.3 %, respectively, of pregnant women smoked in 2005. Brief cessation counseling, based on the 5A’s model, has been effective in different settings. This qualitative study aims to improve the understanding of factors influencing the provision of smoking cessation counseling during pregnancy in Argentina and Uruguay. In 2010, we obtained prenatal care providers’, clinic directors’, and pregnant smokers’ opinions regarding barriers and promoters to brief smoking cessation counseling in publicly-funded prenatal care clinics in Buenos Aires, Argentina and Montevideo, Uruguay. We interviewed six prenatal clinic directors, conducted focus groups with 46 health professionals and 24 pregnant smokers. Themes emerged from three issue areas: health professionals, health system, and patients. Health professional barriers to cessation counseling included inadequate knowledge and motivation, perceived low self-efficacy, and concerns about inadequate time and large workload. They expressed interest in obtaining a counseling script. Health system barriers included low prioritization of smoking cessation and a lack of clinic protocols to implement interventions. Pregnant smokers lacked information on the risks of prenatal smoking and underestimated the difficulty of smoking cessation. Having access to written materials and receiving cessation services during clinic waiting times were mentioned as promoters for the intervention. Women also were receptive to non-physician office staff delivering intervention components. Implementing smoking cessation counseling in publicly-funded prenatal care clinics in Argentina and Uruguay may require integrating counseling into routine prenatal care and educating and training providers on best-practices approaches.
Fil: Colomar, Mercedes. Hospital de Clínicas ; Uruguay
Fil: Tong, Van T.. Centers for Disease Control and Prevention; Estados Unidos
Fil: Morello, Paola. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Farr, Sherry L.. Centers for Disease Control and Prevention; Estados Unidos
Fil: Lawsin, Catalina. University of Sydney; Australia
Fil: Dietz, Patricia M.. Centers for Disease Control and Prevention; Estados Unidos
Fil: Aleman, Alicia. Hospital de Clínicas ; Uruguay
Fil: Berrueta, Amanda Mabel. University of Sydney; Australia
Fil: Mazzoni, Agustina. University of Sydney; Australia
Fil: Becu, Ana. University of Sydney; Australia
Fil: Buekens, Pierre. University of Tulane; Estados Unidos
Fil: Belizan, Jose. University of Sydney; Australia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Althabe, Fernando. University of Sydney; Australia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina