Smoking cessation counseling with pregnant and postpartum women: A survey of community health center providers

Objectives. This study assessed providers' performance of smoking cessation counseling steps with low-income pregnant and postpartum women receiving c afe at community health centers. Methods. WIC (Special Supplemental Nutrition Program for Women, infants, an d Children) program staff, obstetric clinicians, and pediatric clinicians a t 6 community health centers were asked to complete surveys. Smoking interv ention practices (performance), knowledge and attitudes, and organizational facilitators were measured. Factors associated with performance were explo red with analysis of variance and regression analysis. Results. Performance scores differed significantly bq clinic and provider t ype. Providers in obstetric clinics had the highest scores and those in ped iatric clinics had the lowest scores. Nurse practitioners and nutritionists had higher scores than other providers. Clinic type, greater smoking-relat ed knowledge, older age, and perception of smoking cessation as a priority were independently related to better counseling performance. Conclusions. Mean performance scores demonstrated room for improvement in a ll groups. Low scores performance of steps beyond assessment and advice ind icate a need for emphasis on the assistance and follow-up steps of national guidelines. Providers' own commitment to helping mothers stop smoking was important.