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Effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Dissemination Project: A Science to Prenatal Care Practice Partnership

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Abstract

This study evaluated the effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Program selected by the West Virginia—Right From The Start Project for state-wide dissemination. A process evaluation documented the fidelity of SCRIPT delivery by Designated Care Coordinators (DCC), licensed nurses and social workers who provide home-based case management to Medicaid-eligible clients in all 55 counties. We implemented a quasi-experimental, non-randomized, matched Comparison (C) Group design. The SCRIPT Experimental E Group (N = 259) were all clients in 2009–2010 that wanted to quit, provided a screening carbon monoxide (CO), and received a SCRIPT home visit. The (C) Group was derived from all clients in 2006–2007 who had the same CO assessments as E Group clients and reported receiving cessation counseling. We stratified the baseline CO of E Group clients into 10 strata, and randomly selected the same number of (C) Group clients (N = 259) from each matched strata to evaluate the effectiveness of the SCRIPT Program. There were no significant baseline differences in the E and (C) Group. A Process Evaluation documented a significant increase in the fidelity of DCC delivery of SCRIPT Program procedures: from 63 % in 2006 to 74 % in 2010. Significant increases were documented in the E Group cessation rate (+9.3 %) and significant reduction rate (+4.5 %), a ≥50 % reduction from a baseline CO. Perinatal health case management staff can deliver the SCRIPT Program, and Medicaid-supported clients can change smoking behavior, even very late in pregnancy. When multiple biases were analyzed, we concluded the SCRIPT Dissemination Project was the most plausible reason for the significant changes in behavior.

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Acknowledgments

This work was supported by the National Cancer Institute at the National Institutes of Health (R01 CA124429-01-A1). The Dissemination Project recognizes the contributions of the following colleagues who assisted in planning and implementation: Kalpana Ramiah, Anne Williams, Pat Moss, and Jackie Newson. We would also like to recognize members of the Dissemination Committee (SDC) for their contributions to the RFTS-SCRIPT Project: Brenda Johnson, Dee Meadows, Beverly Kitchen, Sandra Ellard, Mary Christian, Joan Dayoub, Charlita Atha, Patsy Parker, Lori Meadows, Suellen Friend, Paula Darby, Bobbie Paris, Lenaa Ryan and Janeen Masker.

Conflict of interest

There are no conflicts of interest for any author.

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Authors and Affiliations

  1. Department of Prevention and Community Health, The George Washington University School of Public Health and Health Services, 2175 K Street, Suite #701, Washington, DC, 20037, USA

    Richard Windsor, Amanda Davis, Lorien Abroms & John Wedeles

  2. West Virginia Department of Health and Human Resources, Department of Perinatal Services, Charleston, WV, USA

    Jeannie Clark & Stephanie Thorn

  3. Department of Epidemiology and Biostatistics, The George Washington University School of Public Health and Health Services, Washington, DC, USA

    Sean Cleary

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  1. Richard Windsor
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  2. Jeannie Clark
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  3. Sean Cleary
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  4. Amanda Davis
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  5. Stephanie Thorn
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  6. Lorien Abroms
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  7. John Wedeles
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Corresponding author

Correspondence to Richard Windsor.

Appendix: Teleforms (Tobacco Screening, SCRIPT Visit, and Tobacco Follow-up)

Appendix: Teleforms (Tobacco Screening, SCRIPT Visit, and Tobacco Follow-up)

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Windsor, R., Clark, J., Cleary, S. et al. Effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Dissemination Project: A Science to Prenatal Care Practice Partnership. Matern Child Health J 18, 180–190 (2014). https://doi.org/10.1007/s10995-013-1252-7

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  • DOI: https://doi.org/10.1007/s10995-013-1252-7

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