Effects of voucher-based incentives on abstinence from cigarette smoking and fetal growth among pregnant women

被引:149
作者
Heil, Sarah H. [1 ,2 ]
Higgins, Stephen T. [1 ,2 ]
Bernstein, Ira M. [3 ]
Solomon, Laura J. [2 ,4 ]
Rogers, Randall E. [1 ]
Thomas, Colleen S.
Badger, Gary J.
Lynch, Mary Ellen [1 ]
机构
[1] Univ Vermont, Dept Psychiat, Burlington, VT 05401 USA
[2] Univ Vermont, Dept Psychol, Burlington, VT 05401 USA
[3] Univ Vermont, Dept Obstet & Gynecol, Burlington, VT 05401 USA
[4] Univ Vermont, Dept Family Practice, Burlington, VT 05401 USA
关键词
contingency management; fetal growth; pregnant women; smoking cessation; vouchers;
D O I
10.1111/j.1360-0443.2008.02237.x
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Aims This study examined whether voucher-based reinforcement therapy (VBRT) contingent upon smoking abstinence during pregnancy is an effective method for decreasing maternal smoking during pregnancy and improving fetal growth. Design, setting and participants A two-condition, parallel-groups, randomized controlled trial was conducted in a university-based research clinic. A total of 82 smokers entering prenatal care participated in the trial. Intervention Participants were assigned randomly to either contingent or non-contingent voucher conditions. Vouchers exchangeable for retail items were available during pregnancy and for 12 weeks postpartum. In the contingent condition, vouchers were earned for biochemically verified smoking abstinence; in the non-contingent condition, vouchers were earned independent of smoking status. Measurements Smoking outcomes were evaluated using urine-toxicology testing and self-report. Fetal growth outcomes were evaluated using serial ultrasound examinations performed during the third trimester. Findings Contingent vouchers significantly increased point-prevalence abstinence at the end-of-pregnancy (41% versus 10%) and at the 12-week postpartum assessment (24% versus 3%). Serial ultrasound examinations indicated significantly greater growth in terms of estimated fetal weight, femur length and abdominal circumference in the contingent compared to the non-contingent conditions. Conclusions These results provide further evidence that VBRT has a substantive contribution to make to efforts to decrease maternal smoking during pregnancy and provide new evidence of positive effects on fetal health.
引用
收藏
页码:1009 / 1018
页数:10
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