Sandra F Oude Wesselink1, Hester F Lingsma2, Petra G J Reulings3, H Renske Wentzel3, Vicki Erasmus2, Paul B M Robben4, Johan P Mackenbach2. 1. Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands; s.oudewesselink@erasmusmc.nl. 2. Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands; 3. Dutch Health Care Inspectorate, Utrecht, The Netherlands; 4. Dutch Health Care Inspectorate, Utrecht, The Netherlands; Institute of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands.
Abstract
INTRODUCTION:Smoking-cessation counseling during pregnancy is important to prevent smoking-related harm in pregnant smokers and their children. Therefore we evaluated the effects of an Inspectorate's supervision programme on the provision of smoking-cessation counseling by midwifery practices in the Netherlands. The supervision programme consisted of 3 elements: A) A deadline was announced by which all practices should comply with professional norms on such counseling (2011); B) A set of randomly selected practices were assessed using a questionnaire and a personal feedback report (2010); C) Another set of randomly selected practices were assessed through a site visit and a personal feedback report (2012). METHODS: Programme A was evaluated in a before-after study, Programmes B and C were evaluated in a randomized controlled trial (RCT) with only a post-intervention measurement. Primary outcome was provision of smoking-cessation counseling through a minimal-intervention strategy (V-MIS). Linear and logistic regression models were used to analyze data from 233 primary-care midwifery practices. RESULTS: A) After announcement of the deadline, Dutch midwifery practices reported significantly more provision of smoking-cessation counseling. For example, the use of V-MIS increased substantially from 28% to 80%; B) In practices that were assessed with a questionnaire, the provision of counseling improved partially compared to controls; C) The provision of counseling did not differ between practices that were visited and their controls. While the training participation rate in counseling by midwifery practices did not differ between the intervention and control groups, the rate increased significantly in all practices after the start of the supervision programme. CONCLUSIONS: The provision of smoking-cessation counseling improved spectacularly in Dutch midwifery practices. Despite some limitations of our study, the Inspectorate's supervision programme is likely to have contributed to the improvements in provision of counseling.
RCT Entities:
INTRODUCTION: Smoking-cessation counseling during pregnancy is important to prevent smoking-related harm in pregnant smokers and their children. Therefore we evaluated the effects of an Inspectorate's supervision programme on the provision of smoking-cessation counseling by midwifery practices in the Netherlands. The supervision programme consisted of 3 elements: A) A deadline was announced by which all practices should comply with professional norms on such counseling (2011); B) A set of randomly selected practices were assessed using a questionnaire and a personal feedback report (2010); C) Another set of randomly selected practices were assessed through a site visit and a personal feedback report (2012). METHODS: Programme A was evaluated in a before-after study, Programmes B and C were evaluated in a randomized controlled trial (RCT) with only a post-intervention measurement. Primary outcome was provision of smoking-cessation counseling through a minimal-intervention strategy (V-MIS). Linear and logistic regression models were used to analyze data from 233 primary-care midwifery practices. RESULTS: A) After announcement of the deadline, Dutch midwifery practices reported significantly more provision of smoking-cessation counseling. For example, the use of V-MIS increased substantially from 28% to 80%; B) In practices that were assessed with a questionnaire, the provision of counseling improved partially compared to controls; C) The provision of counseling did not differ between practices that were visited and their controls. While the training participation rate in counseling by midwifery practices did not differ between the intervention and control groups, the rate increased significantly in all practices after the start of the supervision programme. CONCLUSIONS: The provision of smoking-cessation counseling improved spectacularly in Dutch midwifery practices. Despite some limitations of our study, the Inspectorate's supervision programme is likely to have contributed to the improvements in provision of counseling.
Authors: Einar Hovlid; Jan C Frich; Kieran Walshe; Roy M Nilsen; Hans Kristian Flaatten; Geir Sverre Braut; Jon Helgeland; Inger Lise Teig; Stig Harthug Journal: BMJ Open Date: 2017-09-05 Impact factor: 2.692
Authors: Sandra F Oude Wesselink; Annemiek Stoopendaal; Vicki Erasmus; Déan Smits; Johan P Mackenbach; Hester F Lingsma; Paul B M Robben Journal: BMC Health Serv Res Date: 2017-04-13 Impact factor: 2.655
Authors: Gunnar Husabø; Roy Miodini Nilsen; Erik Solligård; Hans Kristian Flaatten; Kieran Walshe; Jan C Frich; Gunnar Tschudi Bondevik; Geir Sverre Braut; Jon Helgeland; Stig Harthug; Einar Hovlid Journal: BMJ Open Date: 2020-10-20 Impact factor: 2.692