PURPOSE: To use direct observations of first prenatal visits to describe obstetric providers' adherence to the evidence-based clinical practice guideline for smoking cessation counseling recommended by the American College of Obstetricians and Gynecologists, the 5 A's (Ask, Advice, Assess, Assist, and Arrange). DESIGN: Observational study using audio recordings of first obstetric visits. SETTING: An urban academic hospital-based clinic. PARTICIPANTS: Obstetric care providers and pregnant women attending their first obstetric visit. METHOD: First obstetric visits were audio recorded. Visits were identified in which patients reported smoking, and discussions were analyzed for obstetric providers' use of the 5 A's in smoking cessation counseling. RESULTS: Obstetric providers asked about smoking in 98% of the 116 visits analyzed, but used 3 or more of the 5 A's in only 21% (24) of visits. In no visits did providers use all 5 A's. In 54% of the visits, providers gave patients information about smoking, most commonly about risks associated with perinatal smoking. CONCLUSION: Few obstetric care providers performed the recommended 5 A's smoking cessation counseling with their pregnant smokers. Effective and innovative methods are needed to improve obstetric providers' use of the 5 A's.
PURPOSE: To use direct observations of first prenatal visits to describe obstetric providers' adherence to the evidence-based clinical practice guideline for smoking cessation counseling recommended by the American College of Obstetricians and Gynecologists, the 5 A's (Ask, Advice, Assess, Assist, and Arrange). DESIGN: Observational study using audio recordings of first obstetric visits. SETTING: An urban academic hospital-based clinic. PARTICIPANTS: Obstetric care providers and pregnant women attending their first obstetric visit. METHOD: First obstetric visits were audio recorded. Visits were identified in which patients reported smoking, and discussions were analyzed for obstetric providers' use of the 5 A's in smoking cessation counseling. RESULTS: Obstetric providers asked about smoking in 98% of the 116 visits analyzed, but used 3 or more of the 5 A's in only 21% (24) of visits. In no visits did providers use all 5 A's. In 54% of the visits, providers gave patients information about smoking, most commonly about risks associated with perinatal smoking. CONCLUSION: Few obstetric care providers performed the recommended 5 A's smoking cessation counseling with their pregnant smokers. Effective and innovative methods are needed to improve obstetric providers' use of the 5 A's.
Authors: Kathryn I Pollak; Kimberly S H Yarnall; Barbara K Rimer; Isaac Lipkus; Pauline R Lyna Journal: J Natl Med Assoc Date: 2002-05 Impact factor: 1.798
Authors: Sara S Johnson; Patricia H Castle; Deborah Van Marter; Anne Roc; David Neubauer Journal: J Clin Sleep Med Date: 2015-03-15 Impact factor: 4.062
Authors: Amber L Hill; Elizabeth Miller; Sonya Borrero; Sarah Zelazny; Summer Miller-Walfish; Janine Talis; Galen E Switzer; Kaleab Z Abebe; Judy C Chang Journal: J Womens Health (Larchmt) Date: 2021-01-18 Impact factor: 3.017
Authors: Michelle D Stevenson; Jonathan M Mansbach; Eugene Mowad; Michelle Dunn; Sunday Clark; Pedro A Piedra; Ashley F Sullivan; Carlos A Camargo Journal: Acad Pediatr Date: 2015-11-06 Impact factor: 3.107
Authors: Felix Naughton; Sarah Hopewell; Lesley Sinclair; Dorothy McCaughan; Jennifer McKell; Linda Bauld Journal: Br J Health Psychol Date: 2018-05-15
Authors: Megan E Passey; Jo M Longman; Catherine Adams; Jennifer J Johnston; Jessica Simms; Margaret Rolfe Journal: BMC Pregnancy Childbirth Date: 2020-04-15 Impact factor: 3.007