Development of a pregnancy-tailored decisional balance measure for smoking cessation.

The Transtheoretical Model suggests that perception of pros and cons of smoking (decisional balance) is related to quitting. This study examined the underlying structure of decisional balance items to aid in development of a pregnancy-tailored measure. A sample of 281 low-income, pregnant women attending public maternity clinics who smoked or had recently quit smoking completed a decisional balance measure. The measure included items from the general decisional balance scale plus pregnancy-related decisional balance items. Confirmatory factor analysis examining the general-plus-pregnancy-related items suggested a four-factor solution, with factors representing general pros, pregnancy-related pros, cons related to disapproval from others, and health-related cons. Perceptions of pregnancy-related pros and disapproval-related cons differed significantly across stages of change. Findings suggest that inclusion of pregnancy-related items could provide additional information about concerns that are salient during pregnancy.