Process measures in an antenatal smoking cessation trial: another part of the picture

Walsh, Raoul A.; Redman, Selina; Byrne, Jennifer; Melmeth, A; Brinsmead, Maxwell

doi:10.1093/her/15.4.469

Cited by 29 publications

(41 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Process evaluation is a useful technique for understanding how well programmes are being implemented, and can be useful for identifying factors that contribute to or detract from smooth implementation[23,24]. This study showed that the implementation of the birth plans intervention was successful, but that providers need more training and support to implement other aspects of the focused ANC model.…”

Section: Discussionmentioning

confidence: 99%

How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania

Magoma

Requejo

Merialdi

et al. 2011

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

BackgroundMany women in Sub-Saharan African countries do not receive key recommended interventions during routine antenatal care (ANC) including information on pregnancy, related complications, and importance of skilled delivery attendance. We undertook a process evaluation of a successful cluster randomized trial testing the effectiveness of birth plans in increasing utilization of skilled delivery and postnatal care in Ngorongoro district, rural Tanzania, to document the time spent by health care providers on providing the recommended components of ANC.MethodsThe study was conducted in 16 health units (eight units in each arm of the trial). We observed, timed, and audio-recorded ANC consultations to assess the total time providers spent with each woman and the time spent for the delivery of each component of care. T-test statistics were used to compare the total time and time spent for the various components of ANC in the two arms of the trial. We also identified the topics discussed during the counselling and health education sessions, and examined the quality of the provider-woman interaction.ResultsThe mean total duration for initial ANC consultations was 40.1 minutes (range 33-47) in the intervention arm versus 19.9 (range 12-32) in the control arm p < 0.0001. Except for drug administration, which was the same in both arms of the trial, the time spent on each component of care was also greater in the intervention health units. Similar trends were observed for subsequent ANC consultations. Birth plans were always discussed in the intervention health units. Counselling on HIV/AIDS was also prioritized, especially in the control health units. Most other recommended topics (e.g. danger signs during pregnancy) were rarely discussed.ConclusionAlthough the implementation of birth plans in the intervention health units improved provider-women dialogue on skilled delivery attendance, most recommended topics critical to improving maternal and newborn survival were rarely covered.

show abstract

Section: Discussionmentioning

confidence: 99%

How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania

Magoma

Requejo

Merialdi

et al. 2011

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…Our use of direct observation data collection method is also a study limitation because of the potential for participants’ reactivity owing to the field investigator’s presence in the counseling room (Bentley et al, 1994; Curtis et al, 1993; Patton, 1990; Redman, Dickinson, Cockburn, Hennrikus, & Sanson-Fisher, 1989; Walsh et al, 2000). To address reactivity, the research design included observing many (at least 20) counseling sessions for each nurse to give the nurse and field investigator time to get used to each other’s presence in the room and for the nurse to return to her habitual counseling behaviors (Patton, 1990).…”

Section: Discussionmentioning

confidence: 99%

“…Use of direct observation methods is also a strength of our study because it is an effective approach to assess program implementation (Patton, 1990; Walsh et al, 2000). A few researchers reported using this method to observe health provider’s infant-feeding counseling behaviors (Chopra et al, 2005; Chopra & Rollins, 2008; Horizon Program, 2002).…”

Section: Discussionmentioning

confidence: 99%

“…We used direct observations of infant-feeding counseling sessions between nurses and mothers, and interviews with nurses, to assess nurses’ implementation adherence to the infant-feeding counseling protocol (Bentley, Boot, Gittelsohn, & Stallings, 1994; Patton, 1990; Walsh, Redman, Byrne, Melmeth, & Brinsmead, 2000). Five trained field investigators independently audio-recorded, wrote field notes, and completed an implementation checklist of each counseling session observed.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Evaluating Nurses' Implementation of an Infant-Feeding Counseling Protocol for HIV-Infected Mothers: The Ban Study in Lilongwe, Malawi

Ferguson¹,

Eng²,

Bentley³

et al. 2009

AIDS Education and Prevention

View full text Add to dashboard Cite

A process evaluation of nurses' implementation of an infant-feeding counseling protocol was conducted for the Breastfeeding, Antiretroviral and Nutrition (BAN) Study, a prevention of motherto-child transmission of HIV clinical trial in Lilongwe, Malawi. Six trained nurses counseled HIVinfected mothers to exclusively breastfeed for 24 weeks postpartum and to stop breastfeeding within an additional four weeks. Implementation data were collected via direct observations of 123 infant feeding counseling sessions (30 antenatal and 93 postnatal) and interviews with each nurse. Analysis included calculating a percent adherence to checklists and conducting a content analysis for the observation and interview data. Nurses were implementing the protocol at an average adherence level of 90% or above. Although not detailed in the protocol, nurses appropriately counseled mothers on their actual or intended formula milk usage after weaning. Results indicate that nurses implemented the protocol as designed. Results will help to interpret the BAN Study's outcomes.

show abstract

“…Ultimately, this information can inform researchers, policy makers and practitioners about how the intervention might be implemented in future. We could only identify a few smoking cessation and pregnancy trials which have reported process data and there was very limited information about the experience of those delivering the intervention [4–6]. …”

Section: Introductionmentioning

confidence: 99%

Lessons learned from the London Exercise and Pregnant (LEAP) Smokers randomised controlled trial process evaluation: implications for the design of physical activity for smoking cessation interventions during pregnancy

et al. 2017

View full text Add to dashboard Cite

BackgroundThe challenges of delivering interventions for pregnant smokers have been poorly documented. Also, the process of promoting a physical activity intervention for pregnant smokers has not been previously recorded. This study describes the experiences of researchers conducting a randomised controlled trial of physical activity as an aid to smoking cessation during pregnancy and explores how the effectiveness of future interventions could be improved.MethodsTwo focus groups, with independent facilitators, were conducted with six researchers who had enrolled pregnant smokers in the LEAP trial, provided the interventions, and administered the research measures. Topics included recruitment, retention and how the physical activity intervention for pregnant smokers was delivered and how it was adapted when necessary to suit the women. The focus groups were audio-recorded, transcribed verbatim and subjected to thematic analysis.ResultsFive themes emerged related to barriers or enablers to intervention delivery: (1) nature of the intervention; (2) personal characteristics of trial participants; (3) practical issues; (4) researchers’ engagement with participants; (5) training and support needs. Researchers perceived that participants may have been deterred by the intensive and generic nature of the intervention and the need to simultaneously quit smoking and increase physical activity. Women also appeared hampered by pregnancy ailments, social deprivation, and poor mental health. Researchers observed that their status as health professionals was valued by participants but it was challenging to maintain contact with participants. Training and support needs were identified for dealing with pregnant teenagers, participants’ friends and family, and post-natal return to smoking.ConclusionsFuture exercise interventions for smoking cessation in pregnancy may benefit by increased tailoring of the intervention to the characteristics of the women, including their psychological profile, socio-economic background, pregnancy ailments and exercise preferences. Delivering an effective physical activity intervention for smoking cessation in pregnancy may require more comprehensive training for those delivering the intervention, particularly with regard to dealing with teenage smokers and smokers’ friends and family, as well as for avoiding post-natal return to smoking.Trial registration ISRCTN48600346, date of registration: 21/07/2008.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4013-5) contains supplementary material, which is available to authorized users.

show abstract

Process measures in an antenatal smoking cessation trial: another part of the picture

Cited by 29 publications

References 35 publications

How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania

How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania

Evaluating Nurses' Implementation of an Infant-Feeding Counseling Protocol for HIV-Infected Mothers: The Ban Study in Lilongwe, Malawi

Lessons learned from the London Exercise and Pregnant (LEAP) Smokers randomised controlled trial process evaluation: implications for the design of physical activity for smoking cessation interventions during pregnancy

Contact Info

Product

Resources

About