J-2 Laboratories, located in Tucson, AZ, conducted saliva cotinine measurement by method of gas chromatographic thermionic specific detector. Intervention conditions selleck chemicals Ponatinib BP counseling. ��BP�� counseling is based on the Agency for Healthcare Research Quality practice guidelines for identifying patients who smoke and intervening for smoking cessation (Katz, Muehlenbruch, Brown, Fiore, & Baker, 2004; Windsor et al., 2000). Best practices is a five-step strategy, referred to as the ��5 A��s,�� which involves: (a) asking all patients about smoking status, (b) advising patients to quit, (c) assessing readiness to quit, (d) assisting through counseling or referral, and (e) arranging for follow-up. Participants were also given American Cancer Society literature on prenatal smoking cessation and the toll-free number for the quit smoking hotline.
Nurses at UCRC were trained by investigators in the use of this counseling strategy. All nurses attended two training sessions prior to study initiation and a refresher in-service midstudy. Nurses were instructed to keep counseling sessions to 10�C15 min whenever possible to mimic what would likely occur in usual practice. All BP counseling sessions were tape-recorded and monitored by investigators. Ultrasound feedback. In addition to providing routine ultrasound results, the ultrasound session was designed to provide information regarding cigarette smoke��s adverse effects on the fetus using a motivational style.
Four certified sonographers at the University of Texas Medical School Faculty Obstetrics and Gynecology clinic were trained to deliver risk messages related to smoking during the course of a comprehensive real-time fetal ultrasound with two initial 1-hr training sessions and a subsequent booster session. Sonographers were issued a laminated card containing major intervention messages to carry in their lab coat pockets for reference. They had the opportunity to practice and become comfortable with the delivery of the intervention messages via 30 pilot cases. Ultrasound sessions were tape-recorded for quality control, and sonographers were retrained as necessary. Ultrasound sessions lasted approximately 30 min.
Smoking risk messages were incorporated into discussion of anatomical features and included mention of the vasoconstricting effects of nicotine in the umbilical cord and placenta, reducing oxygen and nutrients to the fetus; accumulation of the poisonous gas CO in amniotic fluid and ingested by the fetus; possible premature Carfilzomib separation of the placenta from the uterus; and smoking effects that lead to premature delivery and/or low birth weight. For the majority of ultrasounds in which no complications were discovered, sonographers summarized by confirming that the baby was okay or unaffected at the time, noting, however, that the third trimester was the most likely time for problems to develop.