Veena A Satyanarayana1, Cath Jackson2, Kamran Siddiqi3, Prabha S Chandra4, Rumana Huque5, Mukesh Dherani6, Shammi Nasreen7, Pratima Murthy4, Atif Rahman6. 1. Department of Clinical Psychology, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bangalore, 560029, India. veena.a.s@gmail.com. 2. Valid Research Limited, Sandown House, Sandbeck Way, Wetherby, West Yorkshire, LS22 7DN, UK. 3. Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, Y010 5DD, UK. 4. Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bangalore, 560029, India. 5. Department of Economics, University of Dhaka and ARK Foundation, House No 6, Road NO 109, Gulshan 2, Dhaka, Bangladesh. 6. Institute of Psychology, Health and Society, University of Liverpool, Liverpool, L69 3BX, UK. 7. ARK Foundation, House No 6, Road NO 109, Gulshan 2, Dhaka, Bangladesh.
Abstract
BACKGROUND: Home exposure to secondhand smoke (SHS) is highly prevalent amongst pregnant women in low- and middle-income countries like India and Bangladesh. The literature on the efficacy of behaviour change interventions to reduce home exposure to SHS in pregnancy is scarce. METHODS: We employed a theory and evidence-based approach to develop an intervention using pregnant women as agents of change for their husband's smoking behaviours at home. A systematic review of SHS behaviour change interventions led us to focus on developing a multicomponent intervention and informed selection of behaviour change techniques (BCTs) for review in a modified Delphi survey. The modified Delphi survey provided expert consensus on the most effective BCTs in reducing home exposure to SHS. Finally, a qualitative interview study provided context and detailed understanding of knowledge, attitudes and practices around SHS. This insight informed the content and delivery of the proposed intervention components. RESULTS: The final intervention consisted of four components: a report on saliva cotinine levels of the pregnant woman, a picture booklet containing information about SHS and its impact on health as well strategies to negotiate a smoke-free home, a letter from the future baby to their father encouraging him to provide a smoke-free home, and automated voice reminder and motivational messages delivered to husbands on their mobile phone. Intervention delivery was in a single face-to-face session with a research assistant who explained the cotinine report, discussed key strategies for ensuring a smoke-free environment at home and practised with pregnant women how they would share the booklet and letter with their husband and supportive family members. CONCLUSION: A theory and evidence-based approach informed the development of a multicomponent behaviour change intervention, described here. The acceptability and feasibility of the intervention which was subsequently tested in a pilot RCT in India and Bangladesh will be published later.
BACKGROUND: Home exposure to secondhand smoke (SHS) is highly prevalent amongst pregnant women in low- and middle-income countries like India and Bangladesh. The literature on the efficacy of behaviour change interventions to reduce home exposure to SHS in pregnancy is scarce. METHODS: We employed a theory and evidence-based approach to develop an intervention using pregnant women as agents of change for their husband's smoking behaviours at home. A systematic review of SHS behaviour change interventions led us to focus on developing a multicomponent intervention and informed selection of behaviour change techniques (BCTs) for review in a modified Delphi survey. The modified Delphi survey provided expert consensus on the most effective BCTs in reducing home exposure to SHS. Finally, a qualitative interview study provided context and detailed understanding of knowledge, attitudes and practices around SHS. This insight informed the content and delivery of the proposed intervention components. RESULTS: The final intervention consisted of four components: a report on saliva cotinine levels of the pregnant woman, a picture booklet containing information about SHS and its impact on health as well strategies to negotiate a smoke-free home, a letter from the future baby to their father encouraging him to provide a smoke-free home, and automated voice reminder and motivational messages delivered to husbands on their mobile phone. Intervention delivery was in a single face-to-face session with a research assistant who explained the cotinine report, discussed key strategies for ensuring a smoke-free environment at home and practised with pregnant women how they would share the booklet and letter with their husband and supportive family members. CONCLUSION: A theory and evidence-based approach informed the development of a multicomponent behaviour change intervention, described here. The acceptability and feasibility of the intervention which was subsequently tested in a pilot RCT in India and Bangladesh will be published later.
Entities:
Keywords:
Behaviour change intervention; LAMI; Pregnancy; Secondhand smoke; Smoke exposure at home
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