Design

Prospective data collection during pregnancy

among women followed longitudinally until

delivery.

Setting

Women were recruited from six prenatal practices in

the rural Southeastern United States.

Patients/Participants

Study participants were 1,040 prenatal patients

oversampled for smoking, 707 who smoked

throughout pregnancy, 103 who entered prenatal

care as smokers but quit smoking by 27 weeks ges-

tation, and 230 who were nonsmokers.

Methods

Women were recruited at entry to prenatal care, and

detailed demographic, smoking, and substance

use information was collected. Smoking status was

ascertained at each prenatal visit and at delivery.

Infant birth outcomes were extracted from hospital

delivery charts.

Results

Compared with women who continued to smoke, wo-

menwhoquit by the third trimestergave birth to babies

who were signi¢cantly heavier, longer, and with great-

er head circumferences. In fact, babies born to women

who quit were virtually identical in size to babies born

towomenwhodidnot smokeatall. Aftercontrol for po-

tentially confounding background variables, including

drug and alcohol use, babies of those who quit smok-

ing were still signi¢cantly heavier at birth (adj. mean

di¡erence5163 g) and had signi¢cantly greater head

circumferences (adj. mean di¡erence5 .5 cm).

Conclusion/Implications for Nursing Practice

In the current sample, quitting smoking during

pregnancy was associated with a signi¢cant in-

crease in newborn size, even when considering the

background di¡erences between women who quit

and women who continue to smoke. Findings are

encouraging as they suggest that e¡orts to inter-

vene with pregnant smokers can lead to direct

improvements in birth outcomes, and that quitting

even later in pregnancy can be bene¢cial.

Dads Championing Breastfeeding

Poster Presentation

Objective

To improve the rates of breastfeeding duration

and exclusive breastfeeding by providing edu-

cation, support, and encouragement for breast-

feeding to signi¢cant male partners during the

mother’s postpartum hospital stay.

Design

A blinded, prospective parallel group, randomized

clinical trial.

Setting

A 26 bed postpartum unit in a large academic med-

ical center.

Patients/Participants

Twenty-seven mother/baby/signi¢cant male part-

ner triads who met inclusion/exclusion criteria.

Methods

Based on randomized group assignment signi¢cant

male partners were provided with an individualized

breastfeeding education, support, and encourage-

ment session. Both a brochure and ‘‘letter from

baby’’ highlighting a father’s critical role were pro-

vided. Follow-up phone calls with mothers were

conducted at 4, 8,12 weeks and 6 months postpar-

tum to ascertain feeding method, level of breast-

feeding, perceived male support, and work status.

Results

While there was no signi¢cant di¡erence between

‘‘any breastfeeding’’ and ‘‘not breastfeeding’’ at

all time points studied, more intervention than control

subjects were breastfeeding at each time point.

Statistical signi¢cance was demonstrated between

exclusive breastfeedingandanyother formof feeding

at 4 and12 weeks (p 5 .0120 and .011) and at 8 and12

weeks for those subjects remaining in the study

(p 5 .041 and .003). A nearly signi¢cant di¡erence

was shown at 12 weeks in the distribution of hours

worked with more subjects in the intervention group

working 40 hours/week (p 5 .083). At 12 weeks, the

intervention group showed a marginally signi¢cant

di¡erence (p 5 .055) with respect to complete male

partner support. At 6 months, no signi¢cant di¡er-

ences in any category were demonstrated.

Judy G. McCook, PhD, CNS,

RN-BC, Department of Family

Community Nursing, College

of Nursing, East Tennessee

State University, Johnson

City, TN

Andrea D. Clements, PhD,

Department of Psychology,

East Tennessee State Univer-

sity, Johnson City, TN

Lana McGrady, MS, Depart-

ment of Family Medicine, East

Tennessee State University,

Johnson City, TN

Keywordspregnancy smokingsmoking cessation

interventionbirth outcomes

Childbearing

Mary P. Byas, MPH, BSN,

RN, Northshore University

Health System, Evanston, IL

Hongyan Du, MS, Research

Institute, Northshore Univer-

sity Health System,

Evanston, IL

KeywordsBreastfeedingdurationexclusivefathersmalesupport.

Childbearing

JOGNN 2011; Vol. 40, Supplement 1 S99

Byas, M. P. and Du, H. R E S E A R C H

Proceedings of the 2011 AWHONN Convention

Conclusion/Implications for Nursing Practice

A positive e¡ect on breastfeeding was demon-

strated at all time points with the greatest impact

occurring at 12 weeks. An unexpected result at 12

weeks showed that while signi¢cantly more women

exclusively breastfed in the intervention group, they

also tended to work full time. This ¢nding lends im-

portant credence to male partner education and

support that can be easily incorporated into post-

partum breastfeeding education at the bedside.

Perinatal Mental Health Model: Design,

Implementation, and Acceptability of a

Community-Based Collaborative Care Intervention

Poster Presentation

Objective

Maternal depression (MD), intimate partner vio-

lence (IPV), and substance use (ATOD) impair

maternal functioning. Because the incidence of these

risks overlaps, assessment and intervention during

the perinatal period should be linked. This paper

describes the design and implementation of the

Perinatal Mental Health Model (PMH) a culturally

and linguistically appropriate intervention for low-

income women.This model provides assessment and

referral partnerships for use in community obstetric/

gynecologic (OB/GYN) settings to speci¢cally ad-

dress these multiple mental health risks.

Design

Mixed method design using a staged process that

led sequentially from convening an advisory group,

key informant interviews and focus groups, and a

feasibility study with a sample of low-income ethni-

cally diverse pregnant women.

Setting

Community-based OB/GYN clinics located in a

large metropolitan city in Southern California.

Patients/Participants

Convenience sample of low-income culturally

diverse pregnant women accessing perinatal

care.

Methods

Interviews and Focus groups: A transcripted interview

guide included open-ended questions to learn about

participants’ understanding and experiences with

MD, IPV, and ATOD. Interviews were tape recorded

and transcribed for analysis. Assessment battery in-

cluding standardized measures: EPDS; Abuse

Assessment Screen; TWEAK; DAST-10; and tobacco

use administered to obtain information about severity

of MD, IPV, and ATOD.

Results

The advisory team identi¢ed appropriate assess-

ments for MD, IPV, and ATOD; existing community

resources; and assistance in problem-solving

health system-related issues. From focus groups

and key informant interviews recurrent themes

emerged including motherhood, a time of joy;

di⁄culty in talking with family; and stigma. Feasibil-

ity data derived from 50 low-income mothers,

approximately 88% Latina, 6% White, and 6%

other race/ethnicity. Mean age 5 25.2 (SD 5 5.76).

EPDS scores ranged from 0 to 17 (m 5 3.85,

SD 5 4.14); 14% scored positive for MD. TWEAK

scores ranged from 1 to 7 (m 5 4.25, SD 51.77);

28% scored risk for harmful drinking. Eleven

(22%) reported some drug use; 2 reported smok-

ing. Maternal health advisors (MHAs) proactively

contacted positive mothers and linked them with re-

sources; 100% reported satisfaction with MHA

contact.

Conclusion/Implications for Nursing Practice

Assessment and treatment of perinatal depression

and co-occurring mental health risks are possible

in populations of women with numerous system,

community, and individual barriers. Inclusion of

consumer perspectives and other advisory group

members promoted enthusiasm for the project; the

intervention was feasible and acceptable to our

sample of low-income ethnicity diverse women.

Cynthia D. Connelly, PhD,

RN, FAAN, Hahn School of

Nursing and Health Science,

University of San Diego,

San Diego, CA

Keywordsperinatal depressionIPVATODcommunity-basedcollaborative care model

Childbearing

S100 JOGNN, 40, S85-S119; 2011. DOI: 10.1111/j.1552-6909.2011.01243.x http://jognn.awhonn.org

R E S E A R C H

Proceedings of the 2011 AWHONN Convention