A pilot study to establish a randomized trial methodology to test the efficacy of a behavioural intervention

How can pregnant women be helped to stop smoking? This was a pilot study of midwife home-based motivational interviewing. Clients were 100 consecutive self-reported smokers booking at clinics in Glasgow from March to May 1997 . Smoking guidance is routinely given at booking. In addition, intervention clients received a median of four home-based motivational interviewing ses sions from one specially trained midwife. All sessions (n = 171) were audio -taped and interviews (n = 49) from 13 randomly selected clients were trans cribed for content analysis. Three 'experts' assessed intervention quality using a recognized rating scale. Cotinine measurement on routine blood samp les confirmed self-reported smoking change from late pregnancy telephone in terview Postnatal telephone questionnaire measured client satisfaction. Foc us groups of routine midwives explored acceptability, problems and disrupti on of normal care. Fisher exact, chi(2) and Mann-Whitney tests compared enr olment characteristics. Two-sample t-tests assessed outcome between groups. Motivational interviewing was satisfactory in more than 75% of transcribed interviews. In this pilot study, self-reported smoking at booking (100 of 100 available) corroborated by cotinine (93 of 100) compared with late preg nancy self-reports (intervention 47 of 48; control 49 of 49) and cotinine ( intervention 46 of 48; control 47 of 49) showed no significant difference b etween groups. Tools have been developed to answer the question: 'Can proac tive opportunistic home-based motivational interviewing help pregnant smoke rs reduce their habit?'.