The Effect of Contingency Management and Educational Entertainment on Tobacco Abstinence in Postpartum Women Study
1/13/2013 – 12/30/2014
The purpose of this pilot study is to evaluate a contingency management intervention on the maintenance of cigarette smoking abstinence among high risk postpartum women. The importance of tobacco cessation in the prenatal and postpartum period is well documented. Infant exposure to tobacco is detrimental to child health and development, contributing to the incidence of Sudden Infant Death Syndrome (SIDS), asthma, bronchitis, pneumonia, middle ear infection, and other diseases (DHHS, 2006). Despite the fact that many women are motivated to and successfully quit smoking during the prenatal period approximately 80% resume smoking by the time their infants are one year of age (Colman & Joyce, 2003; Yunsheng, Goins, Pbert, & Ockene, 2005).
The study employs Contingency Management (CM) and Entertainment Education. CM is an evidence-based treatment approach based on positive reinforcement to alter an individual’s daily behavior, and has been shown to help initiate smoking cessation as well as decrease rates of smoking over time (Heil et al., 2008; Meredith et al., 2011). One type of contingency management intervention is Voucher-Based Reinforcement Therapy (VBRT). VBRT is a CM intervention that has been demonstrated to significantly and positively impact substance use, including tobacco in various populations and settings (Heil et al., 2008; Meredith, et al., 2011). VBRT enables patients to receive monetary rewards contingent upon documented abstinence from a designated substance. Entertainment education is a strategy that utilizes the media to educate the audience. Entertainment education, which is the process of including educational messages into entertainment programs, has been shown to influence people in a variety of community settings (Singhal & Rogers, 2001). Entertainment education messages provide examples of healthy behavior through a specific pattern of communication that encourages viewers to model the healthy behavior shown, and increases their confidence so they can adopt such behaviors (Bandura 2001; Singhal & Rogers, 2004).
The project is based at Parent Child Assistance Program (PCAP) sites in Spokane and Yakima. PCAP is an intervention and prevention program serving women at risk for or experiencing alcohol and/or drug addiction. PCAP case managers visit clients in their homes, treatment facilities and/or PCAP program site, helping clients’ access housing, health, vocational and legal services. The PCAP program serves women until their infants’ 3rd birthday.
Women will be followed 12 weeks postpartum, and the effect of the CM and Entertainment Education on postpartum tobacco use will be assessed using saliva cotinine tests.