Postpartum Smoking Cessation and Relapse Prevention Intervention
Identifieur interne : 001191 ( Istex/Corpus ); précédent : 001190; suivant : 001192Postpartum Smoking Cessation and Relapse Prevention Intervention
Auteurs : K. Röske ; A. Schumann ; W. Hannöver ; J. Grempler ; J. R. Thyrian ; H.-J. Rumpf ; U. John ; U. HapkeSource :
- Journal of Health Psychology [ 1359-1053 ] ; 2008-05.
Abstract
The aim of the study was to test the effectiveness of a postpartum smoking cessation and relapse prevention intervention. Structural equation modeling techniques were applied to evaluate the impact of the intervention on smoking behavior and on non-behavioral variables derived from the Transtheoretical Model (TTM). Women were randomized to an intervention (I) and control group (C). Smoking status, TTM-variables, and control variables were assessed four weeks, six and 12 months postpartum. Membership in the intervention group significantly predicted non-smoking and higher self-efficacy six months, but not one year postpartum, after controlling for demographic, smoking, and postpartum risk variables.
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DOI: 10.1177/1359105308088528
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Postpartum Smoking Cessation and Relapse Prevention Intervention</title><author wicri:is="90%"><name sortKey="Roske, K" sort="Roske, K" uniqKey="Roske K" first="K." last="Röske">K. Röske</name><affiliation><mods:affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany,</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: roeske@uni-greifswald.de</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Schumann, A" sort="Schumann, A" uniqKey="Schumann A" first="A." last="Schumann">A. Schumann</name><affiliation><mods:affiliation>Cambridge Health Alliance, Boston, MA, USA</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Hannover, W" sort="Hannover, W" uniqKey="Hannover W" first="W." last="Hannöver">W. Hannöver</name><affiliation><mods:affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Grempler, J" sort="Grempler, J" uniqKey="Grempler J" first="J." last="Grempler">J. Grempler</name><affiliation><mods:affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Thyrian, J R" sort="Thyrian, J R" uniqKey="Thyrian J" first="J. R." last="Thyrian">J. R. Thyrian</name><affiliation><mods:affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Rumpf, H J" sort="Rumpf, H J" uniqKey="Rumpf H" first="H.-J." last="Rumpf">H.-J. Rumpf</name><affiliation><mods:affiliation>University of Lübeck, Germany</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="John, U" sort="John, U" uniqKey="John U" first="U." last="John">U. John</name><affiliation><mods:affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Hapke, U" sort="Hapke, U" uniqKey="Hapke U" first="U." last="Hapke">U. Hapke</name><affiliation><mods:affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:EBB0D4167D34D0B2A726264268E4268CB7116C6D</idno><date when="2008" year="2008">2008</date><idno type="doi">10.1177/1359105308088528</idno><idno type="url">https://api.istex.fr/document/EBB0D4167D34D0B2A726264268E4268CB7116C6D/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001191</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001191</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Postpartum Smoking Cessation and Relapse Prevention Intervention</title><author wicri:is="90%"><name sortKey="Roske, K" sort="Roske, K" uniqKey="Roske K" first="K." last="Röske">K. Röske</name><affiliation><mods:affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany,</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: roeske@uni-greifswald.de</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Schumann, A" sort="Schumann, A" uniqKey="Schumann A" first="A." last="Schumann">A. Schumann</name><affiliation><mods:affiliation>Cambridge Health Alliance, Boston, MA, USA</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Hannover, W" sort="Hannover, W" uniqKey="Hannover W" first="W." last="Hannöver">W. Hannöver</name><affiliation><mods:affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Grempler, J" sort="Grempler, J" uniqKey="Grempler J" first="J." last="Grempler">J. Grempler</name><affiliation><mods:affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Thyrian, J R" sort="Thyrian, J R" uniqKey="Thyrian J" first="J. R." last="Thyrian">J. R. Thyrian</name><affiliation><mods:affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Rumpf, H J" sort="Rumpf, H J" uniqKey="Rumpf H" first="H.-J." last="Rumpf">H.-J. Rumpf</name><affiliation><mods:affiliation>University of Lübeck, Germany</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="John, U" sort="John, U" uniqKey="John U" first="U." last="John">U. John</name><affiliation><mods:affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Hapke, U" sort="Hapke, U" uniqKey="Hapke U" first="U." last="Hapke">U. Hapke</name><affiliation><mods:affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Health Psychology</title><idno type="ISSN">1359-1053</idno><idno type="eISSN">1461-7277</idno><imprint><publisher>SAGE Publications</publisher><pubPlace>Sage UK: London, England</pubPlace><date type="published" when="2008-05">2008-05</date><biblScope unit="volume">13</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="556">556</biblScope><biblScope unit="page" to="568">568</biblScope></imprint><idno type="ISSN">1359-1053</idno></series><idno type="istex">EBB0D4167D34D0B2A726264268E4268CB7116C6D</idno><idno type="DOI">10.1177/1359105308088528</idno><idno type="ArticleID">10.1177_1359105308088528</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1359-1053</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim of the study was to test the effectiveness of a postpartum smoking cessation and relapse prevention intervention. Structural equation modeling techniques were applied to evaluate the impact of the intervention on smoking behavior and on non-behavioral variables derived from the Transtheoretical Model (TTM). Women were randomized to an intervention (I) and control group (C). Smoking status, TTM-variables, and control variables were assessed four weeks, six and 12 months postpartum. Membership in the intervention group significantly predicted non-smoking and higher self-efficacy six months, but not one year postpartum, after controlling for demographic, smoking, and postpartum risk variables.</div></front></TEI><istex><corpusName>sage</corpusName><author><json:item><name>K. Röske</name><affiliations><json:string>Ernst-Moritz-Arndt-University Greifswald, Germany,</json:string><json:string>E-mail: roeske@uni-greifswald.de</json:string></affiliations></json:item><json:item><name>A. Schumann</name><affiliations><json:string>Cambridge Health Alliance, Boston, MA, USA</json:string></affiliations></json:item><json:item><name>W. Hannöver</name><affiliations><json:string>Ernst-Moritz-Arndt-University Greifswald, Germany</json:string></affiliations></json:item><json:item><name>J. Grempler</name><affiliations><json:string>Ernst-Moritz-Arndt-University Greifswald, Germany</json:string></affiliations></json:item><json:item><name>J.R. Thyrian</name><affiliations><json:string>Ernst-Moritz-Arndt-University Greifswald, Germany</json:string></affiliations></json:item><json:item><name>H.-J. Rumpf</name><affiliations><json:string>University of Lübeck, Germany</json:string></affiliations></json:item><json:item><name>U. John</name><affiliations><json:string>Ernst-Moritz-Arndt-University Greifswald, Germany</json:string></affiliations></json:item><json:item><name>U. Hapke</name><affiliations><json:string>Ernst-Moritz-Arndt-University Greifswald, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>cessation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>intervention</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>postpartum</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>RCT</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>relapse</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>smoking</value></json:item></subject><articleId><json:string>10.1177_1359105308088528</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>The aim of the study was to test the effectiveness of a postpartum smoking cessation and relapse prevention intervention. Structural equation modeling techniques were applied to evaluate the impact of the intervention on smoking behavior and on non-behavioral variables derived from the Transtheoretical Model (TTM). Women were randomized to an intervention (I) and control group (C). Smoking status, TTM-variables, and control variables were assessed four weeks, six and 12 months postpartum. Membership in the intervention group significantly predicted non-smoking and higher self-efficacy six months, but not one year postpartum, after controlling for demographic, smoking, and postpartum risk variables.</abstract><qualityIndicators><score>6.176</score><pdfVersion>1.3</pdfVersion><pdfPageSize>481.89 x 685.984 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>707</abstractCharCount><pdfWordCount>6159</pdfWordCount><pdfCharCount>41109</pdfCharCount><pdfPageCount>13</pdfPageCount><abstractWordCount>98</abstractWordCount></qualityIndicators><title>Postpartum Smoking Cessation and Relapse Prevention Intervention</title><refBibs><json:item><host><author></author><title>EQS 6 Structural equations program manual</title></host></json:item><json:item><author><json:item><name>P.M. Bentler</name></json:item><json:item><name>P. Dudgeon</name></json:item></author><host><volume>47</volume><pages><last>592</last><first>563</first></pages><author></author><title>Annual Review of Psychology</title></host><title>Covariance structure analysis: Statistical practice, theory, and directions</title></json:item><json:item><host><author></author><title>Structural equations with latent variables</title></host></json:item><json:item><author><json:item><name>H. Brenner</name></json:item><json:item><name>A. Mielck</name></json:item></author><host><volume>22</volume><pages><last>236</last><first>225</first></pages><issue>2</issue><author></author><title>Preventive Medicine</title></host><title>The role of childbirth in smoking cessation</title></json:item><json:item><author><json:item><name>C.-P. Chou</name></json:item><json:item><name>P.M. Bentler</name></json:item></author><host><volume>25</volume><pages><last>136</last><first>115</first></pages><author></author><title>Multivariate Behavioral Research</title></host><title>Model modification in covariance structure modeling: A comparison among likelihood ratio, Lagrange Multiplier, & Wald tests</title></json:item><json:item><author><json:item><name>G.-J. Colman</name></json:item><json:item><name>T. Joyce</name></json:item></author><host><volume>24</volume><pages><last>35</last><first>29</first></pages><issue>1</issue><author></author><title>American Journal of Preventive Medicine</title></host><title>Trends in smoking before, during, and after pregnancy in ten states</title></json:item><json:item><author><json:item><name>D.G. Cook</name></json:item><json:item><name>D.P. Strachan</name></json:item></author><host><volume>54</volume><pages><last>366</last><first>357</first></pages><issue>4</issue><author></author><title>Thorax</title></host><title>Health effects of passive smoking-10: Summary of effects of parental smoking on the respiratory health of children and implications for research</title></json:item><json:item><author><json:item><name>G.F. Cope</name></json:item><json:item><name>P. Nayyar</name></json:item><json:item><name>R. Holder</name></json:item></author><host><volume>40</volume><pages><last>679</last><first>674</first></pages><issue>6</issue><author></author><title>Annals of Clinical Biochemistry</title></host><title>Feedback from a point-of-care test for nicotine intake to reduce smoking during pregnancy</title></json:item><json:item><author><json:item><name>C.C. DiClemente</name></json:item><json:item><name>P. Dolan-Mullen</name></json:item><json:item><name>R.A. Windsor</name></json:item></author><host><volume>9</volume><issue>3</issue><author></author><title>Tobacco Control</title></host><title>The process of pregnancy smoking cessation: Implications for interventions</title></json:item><json:item><author><json:item><name>P. Dolan-Mullen</name></json:item></author><host><volume>6</volume><pages><last>238</last><first>217</first></pages><issue>2</issue><author></author><title>Nicotine & Tobacco Research</title></host><title>How can more smoking suspension during pregnancy become lifelong abstinence? Lessons learned about predictors, interventions, and gaps in our accumulated knowledge</title></json:item><json:item><author><json:item><name>P. Dolan-Mullen</name></json:item><json:item><name>M.A. Richardson</name></json:item><json:item><name>V.P. Quinn</name></json:item><json:item><name>D.H. Ershoff</name></json:item></author><host><volume>11</volume><pages><last>330</last><first>323</first></pages><issue>5</issue><author></author><title>American Journal of Health Promotion</title></host><title>Postpartum return to smoking: Who is at risk and when</title></json:item><json:item><author><json:item><name>N. Edwards</name></json:item><json:item><name>N. Sims-Jones</name></json:item></author><host><volume>25</volume><pages><last>100</last><first>94</first></pages><issue>2</issue><author></author><title>Birth</title></host><title>Smoking and smoking relapse during pregnancy and postpartum: Results of a qualitative study</title></json:item><json:item><author><json:item><name>L.A. Fingerhut</name></json:item><json:item><name>J.C. Kleinman</name></json:item><json:item><name>J.S. Kendrick</name></json:item></author><host><volume>80</volume><pages><last>544</last><first>541</first></pages><issue>5</issue><author></author><title>American Journal of Public Health</title></host><title>Smoking before, during, and after pregnancy</title></json:item><json:item><host><pages><last>61</last><first>59</first></pages><author></author><title>Smoking cessation and relapse prevention in women postpartum: Results from a randomized controlled trial</title></host></json:item><json:item><host><author></author><title>Smoking cessation and relapse prevention for women post partum: Results from a randomized controlled trial after 6 and 12 months</title></host></json:item><json:item><author><json:item><name>T.F. Heatherton</name></json:item><json:item><name>L.T. Kozlowski</name></json:item><json:item><name>R.C. Frecker</name></json:item><json:item><name>K.O. Fagerström</name></json:item></author><host><volume>86</volume><pages><last>1127</last><first>1119</first></pages><issue>9</issue><author></author><title>British Journal of Addiction</title></host><title>The Fagerström Test for Nicotine Dependence: A revision of the Fagerström Tolerance Questionnaire</title></json:item><json:item><author><json:item><name>L.-T. Hu</name></json:item><json:item><name>P.M. Bentler</name></json:item></author><host><volume>6</volume><pages><last>55</last><first>1</first></pages><author></author><title>Structural Equation Modeling</title></host><title>Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives</title></json:item><json:item><author><json:item><name>C. Jäkle</name></json:item><json:item><name>S. Keller</name></json:item><json:item><name>E. Baum</name></json:item><json:item><name>H.-D. Basler</name></json:item></author><host><volume>45</volume><pages><last>146</last><first>138</first></pages><issue>3</issue><author></author><title>Diagnostica</title></host><title>Skalen zur selbstwirksamkeit und entscheidungsbalance im prozess der verhaltensänderung von rauchern [Scales for the measurement of self-efficacy and decisional balance in the process of behavioral change in smokers]</title></json:item><json:item><author><json:item><name>M. Jamshidian</name></json:item><json:item><name>P.M. Bentler</name></json:item></author><host><volume>24</volume><pages><last>41</last><first>21</first></pages><author></author><title>Journal of Educational and Behavioral Statistics</title></host><title>ML estimation of mean and covariance structures with missing data using complete data routines</title></json:item><json:item><author><json:item><name>J.L. Johnson</name></json:item><json:item><name>P.A. Ratner</name></json:item><json:item><name>J.L. Bottorff</name></json:item><json:item><name>W. Hall</name></json:item><json:item><name>S. Dahinten</name></json:item></author><host><volume>49</volume><pages><last>52</last><first>44</first></pages><issue>1</issue><author></author><title>Nursing Research</title></host><title>Preventing smoking relapse in postpartum women</title></json:item><json:item><author><json:item><name>N. Kolble</name></json:item><json:item><name>T. Hummel</name></json:item><json:item><name>R. von Mering</name></json:item><json:item><name>A. Huch</name></json:item><json:item><name>R. Huch</name></json:item></author><host><volume>99</volume><pages><last>183</last><first>179</first></pages><issue>2</issue><author></author><title>European Journal of Obstetrics, Gynecology, and Reproductive Biology</title></host><title>Gustatory and olfactory function in the first trimester of pregnancy</title></json:item><json:item><host><author></author><title>Community intervention programme to promote non-smoking in pregnant women</title></host></json:item><json:item><author><json:item><name>C.M. McBride</name></json:item><json:item><name>S.J. Curry</name></json:item><json:item><name>H.A. Lando</name></json:item><json:item><name>P.L. Pirie</name></json:item><json:item><name>L.C. Grothaus</name></json:item><json:item><name>J.C. Nelson</name></json:item></author><host><volume>89</volume><pages><last>711</last><first>706</first></pages><issue>5</issue><author></author><title>American Journal of Public Health</title></host><title>Prevention of relapse in women who quit smoking during pregnancy</title></json:item><json:item><author><json:item><name>C.M. McBride</name></json:item><json:item><name>K.M. Emmons</name></json:item><json:item><name>I.M. Lipkus</name></json:item></author><host><volume>18</volume><pages><last>170</last><first>156</first></pages><issue>2</issue><author></author><title>Health Education Research</title></host><title>Understanding the potential of teachable moments: The case of smoking cessation</title></json:item><json:item><author><json:item><name>D. McLeod</name></json:item><json:item><name>S. Pullon</name></json:item><json:item><name>T. Cookson</name></json:item></author><host><volume>116</volume><pages><first>418</first></pages><issue>1173</issue><author></author><title>New Zealand Medical Journal</title></host><title>Factors that influence changes in smoking behaviour during pregnancy</title></json:item><json:item><host><author></author><title>Motivational interviewing: Preparing people to change addictive behavior</title></host></json:item><json:item><host><pages><last>477</last><first>453</first></pages><author></author><title>Theory and context in Project PANDA: A program to help postpartum women stay off cigarettes</title></host></json:item><json:item><author><json:item><name>P. O'Campo</name></json:item><json:item><name>R.R. Faden</name></json:item><json:item><name>H. Brown</name></json:item><json:item><name>A.C. Gielen</name></json:item></author><host><volume>8</volume><pages><last>13</last><first>8</first></pages><issue>1</issue><author></author><title>American Journal of Preventive Medicine</title></host><title>The impact of pregnancy on women's prenatal and postpartum smoking behavior</title></json:item><json:item><author><json:item><name>J.O. Prochaska</name></json:item><json:item><name>W.F. Velicer</name></json:item></author><host><volume>12</volume><pages><last>48</last><first>38</first></pages><issue>1</issue><author></author><title>American Journal of Health Promotion</title></host><title>The transtheoretical model of health behavior change</title></json:item><json:item><author><json:item><name>P.A. Ratner</name></json:item><json:item><name>J.L. Johnson</name></json:item><json:item><name>J.L. Bottorff</name></json:item><json:item><name>S. Dahinten</name></json:item><json:item><name>W. Hall</name></json:item></author><host><volume>25</volume><pages><last>92</last><first>81</first></pages><issue>1</issue><author></author><title>Addictive Behaviors</title></host><title>Twelve-month follow-up of a smoking relapse prevention intervention for postpartum women</title></json:item><json:item><author><json:item><name>K. Röske</name></json:item><json:item><name>W. Hannöver</name></json:item><json:item><name>J. Grempler</name></json:item><json:item><name>J.R. Thyrian</name></json:item><json:item><name>H.J. Rumpf</name></json:item><json:item><name>U. John</name></json:item></author><host><volume>21</volume><pages><last>392</last><first>386</first></pages><issue>3</issue><author></author><title>Health Education Research</title></host><title>Post-partum intention to resume smoking</title></json:item><json:item><author><json:item><name>K. Röske</name></json:item><json:item><name>W. Hannöver</name></json:item><json:item><name>J. Kelbsch</name></json:item><json:item><name>J.R. Thyrian</name></json:item><json:item><name>U. John</name></json:item><json:item><name>U. Hapke</name></json:item></author><host><volume>66</volume><pages><last>702</last><first>697</first></pages><issue>10</issue><author></author><title>Gesundheitswesen</title></host><title>Bereitschaft von frauen, nach der geburt ihres kindes an einer individuellen beratung zum rauchen teilzunehmen [The readiness of women postpartum to participate in smoking cessation counselling]</title></json:item><json:item><author><json:item><name>H.H. Severson</name></json:item><json:item><name>J.A. Andrews</name></json:item><json:item><name>E. Lichtenstein</name></json:item><json:item><name>M. Wall</name></json:item><json:item><name>L. Akers</name></json:item></author><host><volume>26</volume><pages><last>130</last><first>120</first></pages><issue>1</issue><author></author><title>Preventive Medicine</title></host><title>Reducing maternal smoking and relapse: Long-term evaluation of a pediatric intervention</title></json:item><json:item><author><json:item><name>A.L. Stotts</name></json:item><json:item><name>C.C. DiClemente</name></json:item><json:item><name>J.P. Carbonari</name></json:item><json:item><name>P. Dolan-Mullen</name></json:item></author><host><volume>21</volume><pages><last>471</last><first>459</first></pages><issue>4</issue><author></author><title>Addictive Behaviors</title></host><title>Pregnancy smoking cessation: A case of mistaken identity</title></json:item><json:item><author><json:item><name>J.R. Thyrian</name></json:item><json:item><name>W. Hannöver</name></json:item><json:item><name>J. Grempler</name></json:item><json:item><name>K. Röske</name></json:item><json:item><name>U. John</name></json:item><json:item><name>U. Hapke</name></json:item></author><host><volume>51</volume><pages><last>50</last><first>45</first></pages><issue>1</issue><author></author><title>Journal of Midwifery and Women's Health</title></host><title>An intervention to support postpartum women to quit smoking or remain smoke-free</title></json:item><json:item><author><json:item><name>J.R. Thyrian</name></json:item><json:item><name>W. Hannöver</name></json:item><json:item><name>K. Röske</name></json:item><json:item><name>U. John</name></json:item><json:item><name>U. Hapke</name></json:item></author><host><volume>65</volume><pages><last>689</last><first>687</first></pages><author></author><title>Geburtshilfe und Frauenheilkunde</title></host><title>Rauchen vor, während und nach der geburt: Längsschnittliche daten einer bevölkerungsstichprobe [Smoking before, during and after pregnancy: Longitudinal data from a population based sample]</title></json:item><json:item><host><author></author><title>Women and smoking: A report of the Surgeon General</title></host></json:item><json:item><author><json:item><name>B. Valanis</name></json:item><json:item><name>E. Lichtenstein</name></json:item><json:item><name>J.P. Mullooly</name></json:item><json:item><name>K. Labuhn</name></json:item><json:item><name>K. Brody</name></json:item><json:item><name>H.H. Severson</name></json:item></author><host><volume>20</volume><pages><last>8</last><first>1</first></pages><issue>1</issue><author></author><title>American Journal of Preventive Medicine</title></host><title>Maternal smoking cessation and relapse prevention during health care visits</title></json:item><json:item><author><json:item><name>S.M. Van't Hof</name></json:item><json:item><name>M.A. Wall</name></json:item><json:item><name>D.W. Dowler</name></json:item><json:item><name>M.J. Stark</name></json:item></author><host><volume>9</volume><issue>3</issue><author></author><title>Tobacco Control</title></host><title>Randomised controlled trial of a postpartum relapse prevention intervention</title></json:item><json:item><author><json:item><name>W.F. Velicer</name></json:item><json:item><name>C.C. DiClemente</name></json:item><json:item><name>J.S. Rossi</name></json:item><json:item><name>J.O. Prochaska</name></json:item></author><host><volume>15</volume><pages><last>283</last><first>271</first></pages><author></author><title>Addictive Behaviors</title></host><title>Relapse situations and self-efficacy: An integrative model</title></json:item><json:item><author><json:item><name>W.F. Velicer</name></json:item><json:item><name>J.O. Prochaska</name></json:item><json:item><name>J.L. Fava</name></json:item><json:item><name>G.J. Norman</name></json:item><json:item><name>C.A. Redding</name></json:item></author><host><volume>38</volume><pages><last>233</last><first>216</first></pages><issue>5</issue><author></author><title>Homeostasis</title></host><title>Smoking cessation and stress management: Applications of the transtheoretical model of behavior change</title></json:item><json:item><author><json:item><name>W.F. Velicer</name></json:item><json:item><name>J.S. Rossi</name></json:item><json:item><name>C.C. DiClemente</name></json:item><json:item><name>J.O. Prochaska</name></json:item></author><host><volume>21</volume><pages><last>584</last><first>555</first></pages><issue>5</issue><author></author><title>Addictive Behaviors</title></host><title>A criterion measurement model for health behavior change</title></json:item><json:item><author><json:item><name>M.A. Wall</name></json:item><json:item><name>H.H. Severson</name></json:item><json:item><name>J.A. Andrews</name></json:item><json:item><name>E. Lichtenstein</name></json:item><json:item><name>L. Zoref</name></json:item></author><host><volume>96</volume><pages><last>628</last><first>622</first></pages><issue>4</issue><author></author><title>Pediatrics</title></host><title>Pediatric office-based smoking intervention: Impact on maternal smoking and relapse</title></json:item></refBibs><genre><json:string>research-article</json:string></genre><host><volume>13</volume><publisherId><json:string>HPQ</json:string></publisherId><pages><last>568</last><first>556</first></pages><issn><json:string>1359-1053</json:string></issn><issue>4</issue><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1461-7277</json:string></eissn><title>Journal of Health Psychology</title></host><categories><wos><json:string>social science</json:string><json:string>psychology, clinical</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>public health & health services</json:string><json:string>public health</json:string></scienceMetrix></categories><publicationDate>2008</publicationDate><copyrightDate>2008</copyrightDate><doi><json:string>10.1177/1359105308088528</json:string></doi><id>EBB0D4167D34D0B2A726264268E4268CB7116C6D</id><score>0.019350655</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/EBB0D4167D34D0B2A726264268E4268CB7116C6D/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/EBB0D4167D34D0B2A726264268E4268CB7116C6D/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/EBB0D4167D34D0B2A726264268E4268CB7116C6D/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Postpartum Smoking Cessation and Relapse Prevention Intervention</title><title level="a" type="sub" xml:lang="en">A Structural Equation Modeling Application to Behavioral and Non-behavioral Outcomes of a Randomized Controlled Trial</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>SAGE Publications</publisher><pubPlace>Sage UK: London, England</pubPlace><availability><p>SAGE</p></availability><date>2008</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Postpartum Smoking Cessation and Relapse Prevention Intervention</title><title level="a" type="sub" xml:lang="en">A Structural Equation Modeling Application to Behavioral and Non-behavioral Outcomes of a Randomized Controlled Trial</title><author xml:id="author-1"><persName><forename type="first">K.</forename><surname>Röske</surname></persName><email>roeske@uni-greifswald.de</email><affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany,</affiliation></author><author xml:id="author-2"><persName><forename type="first">A.</forename><surname>Schumann</surname></persName><affiliation>Cambridge Health Alliance, Boston, MA, USA</affiliation></author><author xml:id="author-3"><persName><forename type="first">W.</forename><surname>Hannöver</surname></persName><affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</affiliation></author><author xml:id="author-4"><persName><forename type="first">J.</forename><surname>Grempler</surname></persName><affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</affiliation></author><author xml:id="author-5"><persName><forename type="first">J.R.</forename><surname>Thyrian</surname></persName><affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</affiliation></author><author xml:id="author-6"><persName><forename type="first">H.-J.</forename><surname>Rumpf</surname></persName><affiliation>University of Lübeck, Germany</affiliation></author><author xml:id="author-7"><persName><forename type="first">U.</forename><surname>John</surname></persName><affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</affiliation></author><author xml:id="author-8"><persName><forename type="first">U.</forename><surname>Hapke</surname></persName><affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</affiliation></author></analytic><monogr><title level="j">Journal of Health Psychology</title><idno type="pISSN">1359-1053</idno><idno type="eISSN">1461-7277</idno><imprint><publisher>SAGE Publications</publisher><pubPlace>Sage UK: London, England</pubPlace><date type="published" when="2008-05"></date><biblScope unit="volume">13</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="556">556</biblScope><biblScope unit="page" to="568">568</biblScope></imprint></monogr><idno type="istex">EBB0D4167D34D0B2A726264268E4268CB7116C6D</idno><idno type="DOI">10.1177/1359105308088528</idno><idno type="ArticleID">10.1177_1359105308088528</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2008</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>The aim of the study was to test the effectiveness of a postpartum smoking cessation and relapse prevention intervention. Structural equation modeling techniques were applied to evaluate the impact of the intervention on smoking behavior and on non-behavioral variables derived from the Transtheoretical Model (TTM). Women were randomized to an intervention (I) and control group (C). Smoking status, TTM-variables, and control variables were assessed four weeks, six and 12 months postpartum. Membership in the intervention group significantly predicted non-smoking and higher self-efficacy six months, but not one year postpartum, after controlling for demographic, smoking, and postpartum risk variables.</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>cessation</term></item><item><term>intervention</term></item><item><term>postpartum</term></item><item><term>RCT</term></item><item><term>relapse</term></item><item><term>smoking</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2008-05">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/EBB0D4167D34D0B2A726264268E4268CB7116C6D/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus sage not found" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article" dtd-version="2.3" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">sphpq</journal-id><journal-id journal-id-type="publisher-id">HPQ</journal-id><journal-title>Journal of Health Psychology</journal-title><issn pub-type="ppub">1359-1053</issn><publisher><publisher-name>SAGE Publications</publisher-name><publisher-loc>Sage UK: London, England</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1177/1359105308088528</article-id><article-id pub-id-type="publisher-id">10.1177_1359105308088528</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>Postpartum Smoking Cessation and Relapse Prevention Intervention</article-title><subtitle>A Structural Equation Modeling Application to Behavioral and Non-behavioral Outcomes of a Randomized Controlled Trial</subtitle></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Röske</surname><given-names>K.</given-names></name><aff>Ernst-Moritz-Arndt-University Greifswald, Germany, <email xlink:type="simple">roeske@uni-greifswald.de</email></aff></contrib></contrib-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Schumann</surname><given-names>A.</given-names></name><aff>Cambridge Health Alliance, Boston, MA, USA</aff></contrib></contrib-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Hannöver</surname><given-names>W.</given-names></name><aff>Ernst-Moritz-Arndt-University Greifswald, Germany</aff></contrib></contrib-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Grempler</surname><given-names>J.</given-names></name><aff>Ernst-Moritz-Arndt-University Greifswald, Germany</aff></contrib></contrib-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Thyrian</surname><given-names>J.R.</given-names></name><aff>Ernst-Moritz-Arndt-University Greifswald, Germany</aff></contrib></contrib-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Rumpf</surname><given-names>H.-J.</given-names></name><aff>University of Lübeck, Germany</aff></contrib></contrib-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>John</surname><given-names>U.</given-names></name><aff>Ernst-Moritz-Arndt-University Greifswald, Germany</aff></contrib></contrib-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Hapke</surname><given-names>U.</given-names></name><aff>Ernst-Moritz-Arndt-University Greifswald, Germany</aff></contrib></contrib-group><pub-date pub-type="ppub"><month>05</month><year>2008</year></pub-date><volume>13</volume><issue>4</issue><fpage>556</fpage><lpage>568</lpage><abstract><p>The aim of the study was to test the effectiveness of a postpartum smoking cessation and relapse prevention intervention. Structural equation modeling techniques were applied to evaluate the impact of the intervention on smoking behavior and on non-behavioral variables derived from the Transtheoretical Model (TTM). Women were randomized to an intervention (I) and control group (C). Smoking status, TTM-variables, and control variables were assessed four weeks, six and 12 months postpartum. Membership in the intervention group significantly predicted non-smoking and higher self-efficacy six months, but not one year postpartum, after controlling for demographic, smoking, and postpartum risk variables.</p></abstract><kwd-group><kwd>cessation</kwd><kwd>intervention</kwd><kwd>postpartum</kwd><kwd>RCT</kwd><kwd>relapse</kwd><kwd>smoking</kwd></kwd-group><custom-meta-wrap><custom-meta xlink:type="simple"><meta-name>sagemeta-type</meta-name><meta-value>Journal Article</meta-value></custom-meta><custom-meta xlink:type="simple"><meta-name>search-text</meta-name><meta-value>556 Postpartum Smoking Cessation and Relapse Prevention InterventionA Structural Equation Modeling Application to Behavioral and Non-behavioral Outcomes of a Randomized Controlled Trial SAGE Publications, Inc.200810.1177/1359105308088528 K.Röske Ernst-Moritz-Arndt-University Greifswald, Germany, roeske@uni-greifswald.de A.Schumann Cambridge Health Alliance, Boston, MA, USA W.Hannöver Ernst-Moritz-Arndt-University Greifswald, Germany J.Grempler Ernst-Moritz-Arndt-University Greifswald, Germany J.R.Thyrian Ernst-Moritz-Arndt-University Greifswald, Germany H.-J.Rumpf University of Lübeck, Germany U.John Ernst-Moritz-Arndt-University Greifswald, Germany U.Hapke Ernst-Moritz-Arndt-University Greifswald, Germany Abstract The aim of the study was to test the effectiveness of a postpartum smoking cessation and relapse prevention intervention. Structural equation modeling techniques were applied to evaluate the impact of the intervention on smoking behavior and on non-behavioral variables derived from the Transtheoretical Model (TTM). Women were randomized to an intervention (I) and control group (C). Smoking status, TTM-variables, and control variables were assessed four weeks, six and 12 months postpartum. Membership in the intervention group significantly predicted non-smoking and higher self-efficacy six months, but not one year postpartum, after controlling for demographic, smoking, and postpartum risk variables. cessation intervention postpartum RCT relapse smoking Keywords ACKNOWLEDGMENTS. The study, as part of the Research Collaboration in Early Substance Use Intervention (EARLINT), has been funded by the German Federal Ministry of Education and Research (grant no. 01EB0120), the Social Ministry of the State of Mecklenburg-West Pomerania (grant no. IX311a 406.68.43.05), and the Krupp von Bohlen and Halbach-Foundation. COMPETING INTERESTS: None declared. ADDRESS. Correspondence should be directed to: KATHRIN RÖSKE, Dipl.-Psych., University of Greifswald, Institute of Epidemiology and Social Medicine, Walther-Rathenau-Str. 48, 17489 Greifswald, Germany. [Tel. +49 3834 86 5698; Fax +49 3834 86 5698; email: roeske@uni-greifswald.de] 557 Introduction SMOKING after pregnancy imposes health risks for both the mother and the newborn child. The risks of smoking for women are well documented (US Department of Health and Human Services, 2001). The exposure of infants to environmental tobacco smoke (ETS) is associated with higher risks for res- piratory diseases, otitis media and sudden infant death syndrome (Cook & Strachan, 1999). In Germany 35 to 41 percent of women smoke before pregnancy, estimates about quit rates during pregnancy range from 49 to 60 percent (Lang, Brüggemann, Licht, Herman, & Greiser, 1999; Thyrian, Hannöver, Röske, John, & Hapke, 2005). Changes in smoking behavior during pregnancy mainly result from the care for the baby and social pressure not to smoke when pregnant (Edwards & Sims-Jones, 1998; O'Campo, Faden, Brown, & Gielen, 1992). Smoking cessation is also linked to pregnancy nausea and loss of taste for tobacco (Kolble, Hummel, von Mering, Huch, & Huch, 2001; McLeod, Pullon, & Cookson, 2003). These external motivational factors result in a suspension of smoking behavior rather than in continuous abstinence (Stotts, DiClemente, Carbonari, & Dolan-Mullen, 1996). About half of the women who quit during pregnancy resume smoking within six months after delivery. Relapse rates rise up to 80 percent within 12 months (Colman & Joyce, 2003; Fingerhut, Kleinman, & Kendrick, 1990; Thyrian et al., 2005). In Germany about half of the children up to five years are exposed to ETS due to smoking parents (Brenner & Mielck, 1993). Evidence on the effects of postnatal interven- tions for smoking cessation and relapse prevention to date is scarce (Johnson, Ratner, Bottorff, Hall, & Dahinten, 2000; McBride et al., 1999; Mullen, DiClemente, & Bartholomew, 2000; Valanis et al., 2001; Van't Hof, Wall, Dowler, & Stark, 2000; Wall, Severson, Andrews, Lichtenstein, & Zoref, 1995). Fewer studies still employed outcome vari- ables beyond behavioral criteria (such as absti- nence rates, quit rates, or relapse rates), which may provide information about progress in the motivation to stop smoking or maintain absti- nence. Such non-behavioral characteristics have been shown to be relevant as outcome criteria of approaches that focus on fostering the intention to stop smoking (Velicer, Prochaska, Fava, Norman, & Redding, 1998; Velicer, Rossi, DiClemente, & Prochaska, 1996). Under non-behavioral intervention outcome vari- ables attitudes, knowledge, self-efficacy or personal arguments for or against behavior change may be subsumed. In the Vancouver smoking relapse preven- tion program (Johnson et al., 2000), the in-hospital intervention provided by nurses significantly increased the proportion of women who remained abstinent six months postpartum. Beyond smoking behavior smoking cessation self-efficacy was exam- ined but failed to show a significant difference between intervention and control condition. The pro- ject 'Modification of Maternal Smoking' (MOMS) (Wall et al., 1995), revealed significant differences in quit rates and in relapse rates at six months postpar- tum for an intervention delivered by pediatricians during well care visits. Wall et al. found more favor- able attitudes and knowledge regarding passive smoking due to the intervention. The intervention effects in both studies were not sustained at 12 months postpartum (Ratner, Johnson, Bottorff, Dahinten, & Hall, 2000; Severson, Andrews, Lichtenstein, Wall, & Akers, 1997). The current study reports data from a randomized trial comparing usual care with a smoking cessation and relapse prevention intervention for women four weeks postpartum. The intervention was based on the Transtheoretical Model of Behavior Change (TTM; Prochaska & Velicer, 1997; Velicer et al., 1998). We found statistically significant differences between the intervention and control condition at six months postpartum but not at 12 months. Intention to treat analyses for the six months fol- low-up revealed that 9.7 percent of the women who smoked four weeks after delivery had stopped in the intervention group compared to 2.7 percent in the control group, and 58.9 percent of the women who did not smoke four weeks postpartum had main- tained abstinence in the intervention group vs 46.7 percent in the control group. Results are reported in detail elsewhere (Hannöver et al., 2004, submitted). Here, we examined whether the effects of the TTM-based intervention on smoking status as behav- ioral outcome variable translate to non-behavioral outcome variables derived from the TTM. Those variables are smoking cessation self-efficacy and the decisional balance between the pros and cons of non- smoking which are conceptualized as dependent variables in the TTM framework (Velicer et al., 1996, 1998). As mentioned earlier, the protection of the infant has to be taken into account as a strong external motivator for changes in smoking behavior of women postpartum. Therefore we distinguish 558 between internal smoking cessation self-efficacy and self-efficacy not to smoke for the baby's sake on the one hand and between internal decisional balance and decisional balance for the baby on the other. We evaluate the impact of the intervention on both behavioral and non-behavioral outcome variables by employing structural equation modeling techniques (SEM). SEM allows assessing changes in smoking status, decisional balance, and self-efficacy associ- ated with the intervention, while controlling for the initial behavioral and motivational situation, for the stability of the variables between baseline and sub- sequent follow-ups, and for various confounding variables. We hypothesize that the participation in the intervention would be associated with non- smoking and improvements in the TTM outcome variables at the six and 12 months follow-up. Method Study design and participants The study 'Smoking cessation and relapse preven- tion in women postpartum' was a prospective ran- domized controlled trial. Between May 2002 and March 2003, 3343 women gave birth on the mater- nity wards of six hospitals in Mecklenburg West- Pomerania, a rural area in the northeast of Germany. Of these 2790 women were screened at the time of giving birth and retrospectively asked about their smoking behavior before pregnancy. The inclusion criteria for our study were having smoked before pregnancy and speaking German. Of the screened women, 1574 did not smoke before pregnancy, 88 did not speak German and were excluded, 1128 women indicated that they had smoked before preg- nancy. Of these, 871 gave informed consent to par- ticipate in the randomized controlled trial. These women were randomized by an alternating assign- ment to either the intervention (n = 438) or control group (n = 433) according to their entry into the study protocol. Four weeks after giving birth 644 women partic- ipated in the baseline assessment (Time 0). Of these, 299 women received the intervention, 345 were in the control condition, for two women of the intervention group data were lost because of techni- cal problems. Six months after pregnancy 566 women were successfully contacted for the first fol- low-up (Time 1), that is, 256 women in the inter- vention group and 310 women in the control group. Reasons for loss were refusal of further participa- tion (n = 26), no contact within the time frame of three months (n = 46) and technical problems (n = 6). For the second follow-up 12 months after giving birth (Time 2) data were available for 529 women, 248 in the intervention group and 281 in the control group. Participants were lost because of refusal of further participation (n = 12), no contact within the time frame of three months (n = 70) and technical problems (n = 2). The study procedure was approved by the ethics review board of the University of Greifswald. Intervention Women in the intervention condition received a home counseling session four to six weeks after giv- ing birth and two telephone counseling sessions four and 12 weeks later. The counseling was conducted by four trained study co-workers. It was based on the principles of Motivational Interviewing (Miller & Rollnick, 2002) and tailored to the motivational stage of change of the women. The intervention con- cept is described elsewhere in detail (Thyrian et al., 2006). Furthermore the women in both the interven- tion and control condition received: (a) a self-help manual addressing maternal smoking, smoking ces- sation, and relapse prevention; and (b) a manual addressing the partner of the participating women, in order to initiate a tobacco smoke free environment for mothers and newborns. Women in the control condition were assessed at Time 0, Time 1, and Time 2, but received no intervention between measure- ment occasions. Measures The variables of interest in this study were derived from the baseline assessment and two follow-up outcome assessments. Smoking status as the behav- ioral outcome variable, and several control variables were single-item variables. The TTM variables self- efficacy and decisional balance as non-behavioral outcome variables were conceptualized as multiple- indicator latent variables. Latent variables are error- free constructs that represent a superior order of abstraction than measured indicators and that explain the shared variance among multiple mea- sured indicators (Bollen, 1989). The assessments contained the same questions at baseline and fol- low-up. Therefore, the multiple-indicator latent variables and the single-item variables are identical at Time 0, Time 1, and Time 2. Intervention conditions were coded 1 for the smoking counseling intervention condition and 0 for the assessment-only control condition. 559 Non-smoking was assessed by a single-item vari- able at all three time points with the question 'Are you currently a smoker?' Current smokers were coded 0 and current non-smokers were coded 1. An alternative question employed in this study was 'Have you smoked in the last four weeks?', coded 0 for current smokers and 1 for current non-smokers. Identical results were revealed for both variables, and only findings for the first variable are reported here. The pros of non-smoking and the cons of non- smoking were assessed with a scale for the mea- surement of decisional balance in smokers. In this instrument, women were asked to indicate on a five- point rating scale how important each of six pros of non-smoking and six cons of non-smoking was with respect to their decision not to smoke (with (1) not at all important and (5) very important). The instru- ment included a previously published 10-item scale (Jäkle, Keller, Baum, & Basler, 1999) and two addi- tional items. An exploratory factor analysis revealed the pros and the cons as two sub-factors, internal consistency was α = .83 for the pros and α = .75 for the cons. Three indicators were created for each of the two latent variables by pair wise combining two items of the pros and the cons, respectively. Baby-related pros of non-smoking were indicated by two items: 'When I don't smoke I do not smell of smoke for my baby'; 'When I don't smoke the risk of health problems for my baby will be lower.' These statements were rated as the regular pros and cons of non-smoking mentioned above. Internal consistency among the two items was α = .66. Smoking cessation self-efficacy was assessed using the scale for the measurement of self-efficacy in smokers (Jäkle et al., 1999), a German translation based on the original self-efficacy scale (Velicer, DiClemente, Rossi, & Prochaska, 1990). Women were asked to assess their confidence not to smoke on a five-point rating scale with (1) being not at all confident and (5) being very confident, across nine situations. An exploratory factor analysis revealed a single factor solution (eigenvalue = 4.58), internal consistency among the nine items was α = .90. To create the latent variable, items were combined into three indicators of three items each. Self-efficacy not to smoke for the baby's sake was measured with seven items similar to the self-effi- cacy scale mentioned above. Items specifically referred to situations with the newborn baby as a reason for confidence not to smoke. Examples are 'How confident are you not to smoke when you have a hard day with your baby?' and 'How confi- dent are you not to smoke when you are outdoors with your baby?' The exploratory factor analysis showed a single factor solution (eigenvalue = 3.07), internal consistency among the seven items was α = .84. For the three latent variable indicators, the three items with the lowest factor loadings were com- bined to one indicator, and the remaining four items were pair wise combined into two indicators of two items each. Control variables were single-item variables. We selected demographic variables, smoking behavior variables, and risk variables associated with the spe- cific situation of smoking or ex-smoking postpar- tum women as potential covariates (Dolan-Mullen, 2004). Age was asked in years. Education was cate- gorized as (1) /= 12 years of schooling, reflecting the German education system. Smoking behavior variables were the age at onset of regular smoking, and the sever- ity of nicotine dependence assessed with the Fagerström Test for Nicotine Dependence (FTND, Heatherton, Kozlowski, Frecker, & Fagerström, 1991) retrospectively for the time before pregnancy. The FTND comprises six items stressing physical aspects of nicotine dependence yielding a sum score between 0 (low dependence) and 10 (high depen- dence). Women were asked which percentage of the time per day they were exposed to second-hand smoke. Responses were dichotomized to reflect exposure vs no exposure to second-hand smoke. Having a partner who smokes and having other chil- dren besides the newborn were assessed as risk vari- ables. Women were asked whether they were breastfeeding the newborn. Further, women were asked whether they felt awkward or unpleasant about having gained weight since their pregnancy. Responses were assessed on a five-point rating scale from (1) not at all unpleasant, to (5) very unpleasant. Women without weight gain were assigned response category 1. The scale was dichotomized collapsing the response categories 1 and 2 vs 3, 4, and 5. Finally, the baby's height in cm and weight in grams at the time of birth was obtained. All covariates were assessed at Time 0, except for the baby's height and weight, which were assessed at Time 1. Analyses We performed structural equation modeling (SEM) using the EQS 6 software for Windows (Bentler, 2005). SEM compares a proposed hypothetical model with empirical data using maximum likeli- 560 hood estimation. The closeness of the hypothetical model to the empirical data is evaluated through various goodness-of-fit indexes. We report the Satorra-Bentler χ2 statistic (S-B χ2, Bentler & Dudgeon, 1996), the adjusted robust comparative fit index (RCFI, Bentler & Dudgeon, 1996), and the root-mean-square error of approximation (RMSEA, Hu & Bentler, 1999). The S-B χ2 examines differ- ences between the sample covariance matrix and the fitted covariance matrix. It is preferable to maxi- mum-likelihood χ2 statistics when the data are mul- tivariately kurtose, as was the case in the present study. The RCFI compares the improvement of fit of the hypothesized model to a model of indepen- dence among the measured variables while adjust- ing for sample size and non-normality. It ranges from 0 to 1 with values above .95 indicating good model fit. The RMSEA evaluates model fit based on the size of the residuals. Values of less than .06 indi- cate a relatively good fit between the hypothesized model and the observed data. The analyses involved the following step approach: first, confirmatory factor analyses were performed to test the sufficiency of the measure- ment model and the adequacy of the associations among the latent and measured variables. Across the three time points, each latent variable was pre- dicted by its manifest indicators, and all latent vari- ables and single-item variables were correlated without inferring prediction paths. Since baseline and follow-up measures were the same, correlated errors were included between corresponding mani- fest indicators. The same measurement model was estimated separately for the intervention group and control group at Time 0, Time 1, and Time 2, and the invariance of these measurement models was then tested across groups and across times by imposing equality constraints. Second, the structural model of associations among independent and dependent latent and single- item variables was fitted. Experimental group status was positioned to predict the outcome variables at Time 1 and Time 2, while controlling for associa- tions with the same variables measured at baseline. All baseline variables were correlated, and the resid- uals of the outcome variables were also correlated. Third, to control for confounding, 11 potential covariates (age, education, age at onset of smoking, severity of nicotine dependence, exposure to second- hand smoke, having a smoking partner, having other children, breastfeeding, awkwardness of weight gain, baby's height, baby's weight) were added to the models. Predictive paths were specified from each covariate to each outcome variable in the model. Covariances among the baseline variables including those among the covariates were also modeled. Model building was performed with 511 women who provided data at the Time 0, Time 1, and Time 2 assessments. There were single missing values in the data set, reducing the complete cases sample size to 490 women in the measurement and struc- tural model analyses. When covariates were added to the model, the complete cases sample size was further reduced to 396 women. To deal with the missing data problem, we used the EM-type proce- dure provided by the EQS software to impute miss- ing data (Jamshidian & Bentler, 1999). All analyses were run for complete cases, deleting cases with any missing values, and for the complete data set with imputed missing data. Results were highly similar, therefore only results obtained in the com- plete case analysis are reported below. Results Sample description Summary statistics for all study variables are pro- vided in Table 1. Outcome and control variables are also compared between the intervention and control group to obtain a randomization check, and no sig- nificant differences were found. Step 1: Testing the measurement model All separate measurement models fit well (all RCFI ≥ .98). Equivalence of the measurement model in the intervention and control group (all Δ S-B χ2 ≤ 45.78, Δ d.f. = 44, p > .05) as well as across Time 0, Time 1, and Time 2 (Δ S-B χ2 = 34.92, Δ d.f. = 28, p > .05) was confirmed. The overall measurement model met the standards for excellent model fit: S-B χ2 (780, N = 490) = 997.06, RCFI = .98, RMSEA = 0.024. All factor loadings of the manifest indicators were sig- nificant (p < .001), and were between .57 and .91. The Lagrange Multiplier test (Chou & Bentler, 1990) was inspected to determine if any supplementary paths were needed in the model and if certain mani- fest indicators cross-loaded on non-hypothesized latent variables. No additional paths were indicated. Of particular interest in the measurement model were correlations between variables. The interven- tion condition was significantly associated with non- 561 ~ CII) Of) Of) and weight, measured >•. ... 562 Table 2. Fact i:i 'T=! 'i3 01) 'i3 " o s >. S1 C5 iJ:Q!1 u °"d 563 Figure 1. Structural model for primary and secondary outcome variables of a postpartum smoking cessation and relapse prevention intervention. Note: The figure does not show direct prediction paths for the same variable over time. With two exceptions, all direct pre- diction paths from Time 0 to Time 1, from Time 1 to Time 2, and from Time 0 to Time 2 were significant (p < .05), the excep- tions being the path from Non-smoking Time 0 to Non-smoking Time 2 and the path from Baby-related pros Time 0 to Baby-related pros Time 2 (see Table 3). Manifest indicators of latent variables and correlations among residuals of variables at Time 1 and Time 2 are also omitted. Fit statistics: S-B χ2 (869, N = 490) = 1173.53, RCFI = .98, RMSEA = 0.027 Table 3. Regression coefficients of direct prediction paths for the same variable over time in the final structural model Note: Dash in cell indicates non-significant paths. All remaining paths p < .05 smoking at Time 1, smoking cessation self-efficacy at Time 1 and self-efficacy not to smoke for the baby's sake at Time 1. No significant associations were found between intervention condition and baseline variables, indicating that randomization resulted in equal balance of the study variables. Almost all other correlations among the baseline and follow-up latent and single-item variables were found to be significant. Table 2 presents the factor loadings and correlations in the measurement model. 564 Step 2: Testing the structural model We specified a fully predictive structural model with each Time 0 variable predicting each Time 1 variable and each Time 1 variable predicting each Time 2 vari- able. The model was trimmed gradually by removing non-significant paths. Once the model was estab- lished, direct paths from each Time 0 variable to each Time 2 variable were modeled. Figure 1 depicts the final structural model across the three time points. Fit statistics were S-B χ2 (869, N = 490) = 1173.53, RCFI = .98, RMSEA = 0.027. Intervention significantly predicted non-smoking at Time 1, higher smoking cessation self-efficacy at Time 1, and higher self-effi- cacy not to smoke for the baby's sake at Time 1, while controlling for smoking status and TTM variables at Time 0. Direct effects from intervention to variables at Time 2 were not significant. Significant prediction paths were identified from smoking cessation self- efficacy at Time 0 to non-smoking at Time 1, from cons of non-smoking at Time 0 to smoking cessation self-efficacy at Time 1, and likewise from non-smok- ing at Time 0 to smoking cessation self-efficacy at Time 1. Non-smoking at Time 1 predicted smoking cessation self-efficacy at Time 2 and self-efficacy not to smoke for the baby's sake at Time 2. Pros of non- smoking at Time 1 predicted cons of non-smoking at Time 2 and baby-related pros of non-smoking at Time 1 predicted pros of non-smoking at Time 2. In addi- tion, stability of the same variables over time was sub- stantial. All but two direct prediction paths were found to be significant, the exceptions being the path from Non-Smoking Time 0 to Time 2, and the path from Baby-related pros Time 0 to Baby-related pros Time 2. Table 3 reports the regression coefficients of direct prediction paths for the final model. Step 3: Adding control variables All relationships of interest in the model held when potential covariates were added. Inclusion of the control variables did not impede the predictive paths between group membership and outcome variables. Coefficients were somewhat smaller in size compared to the model without covariates. Most paths from control variables to outcome vari- ables were not significant. The only significant rela- tionships were paths from having other children to smoking cessation self-efficacy (standardized path coefficient β = –.07, p < .05) and from exposure to second-hand smoke to smoking cessation self-effi- cacy (β = –.07, p < .05). The control variables did not enhance model fit, which was S-B χ2 (1297, N = 396) = 1764.10, RCFI = .96, RMSEA = .030. Discussion The most important finding of our study is that the postpartum smoking cessation and relapse preven- tion intervention impacted smoking behavior and self-efficacy. Women in the intervention group were significantly more likely to be non-smokers six months after the intervention, which is in line with results of earlier intervention studies (Johnson et al., 2000; Wall et al., 1995). Contrary to the findings of Johnson et al. (2000) the intervention in the present study enhanced the level of self-efficacy (e.g. the confidence not to smoke in different challenging sit- uations and the confidence not to smoke for the baby's sake). According to the regression coeffi- cients, the influence of the intervention on self- efficacy is not very strong. Self-efficacy increased due to the intervention at six months postpartum, but self-efficacy in turn did not influence smoking behavior at 12 months postpartum. The intervention had no effect on the decisional balance variables, that is, the pros and cons of non-smoking. As our study, a number of previous studies also failed to achieve long-term changes as a result of the intervention (Ratner et al., 2000; Severson et al., 1997). The short term effects occurring consistently in our study and the studies mentioned above under- line the notion that the postpartum period is a teach- able moment (DiClemente, Dolan-Mullen, & Windsor, 2000; McBride, Emmons, & Lipkus, 2003). Interventions seem to be effective in sup- porting change during this sensitive period for a rel- atively short time but the effects fade away without further efforts to influence the behavior or maintain the achieved behavior changes. Our intervention program consisted of a limited number of three contacts in the postpartum period, two of which were telephone contacts. An adapta- tion to routine health care for women postpartum in Germany and most other developed countries would implicate a higher number of contacts. Professionals such as midwives, gynecologists, or pediatricians have regular personal and more fre- quent contacts over the course of preventive med- ical checkups or well-baby visits than could be examined in our study protocol. Furthermore they have a longer existing and more trustful relationship with the women than study staff. Therefore higher effectiveness might be expected by an implementa- tion of smoking cessation and relapse prevention intervention into routine care by these profession- als. But at least in Germany the financial incentives 565 are lacking to motivate practitioners or midwives to engage in smoking cessation and relapse prevention counselling for both pregnant women and women postpartum. Furthermore new approaches to enhance the intervention effects and support coun- sellors should be considered. Inclusion of immedi- ate biochemical feedback of nicotine metabolites in urine samples in a motivational intervention revealed promising results in reducing smoking during pregnancy (Cope, Nayyar, & Holder, 2003). However it is still unknown what the feedback might add to the effect of counselling alone. We revealed certain relations between the behav- ioral and non-behavioral variables. From Time 0 to Time 1, non-smoking predicted higher self-efficacy, and self-efficacy also predicted non-smoking. For women postpartum, this reciprocal relation reflects the special motivational and experiential situation of these women. Women who quit smoking during pregnancy and are non-smokers postpartum have experienced that they are able to maintain non- smoking for a lengthy period of time, which may increase and consolidate the confidence not to smoke in the future. About half of the women smoked during pregnancy. These women may be expected to have low levels of self-efficacy because of unsuccessful reduction attempts, quit attempts or relapses, which decreases the likelihood of non- smoking in the future. Still little is known about reasons or triggers of relapses after a period of many months of absti- nence during pregnancy and early postpartum period. One plausible explanation is that smoking cessation during pregnancy is only a suspended behavior rather than permanent change. This assumption is supported by results of the study reported here. We found that 13 percent of women indicate an intention to resume smoking after delivery (Röske et al., 2006). Until now some fac- tors associated with a higher rate of relapse were identified, such as a smoking partner or smoking friends (Dolan-Mullen, Richardson, Quinn, & Ershoff, 1997). The structural equation modeling techniques enabled control for potentially con- founding variables in our analysis. We included a number of variables that are well known to impede intervention effects, such as demographic characteristics, smoking behavior variables, and risk variables associated with the specific situa- tion of smoking or ex-smoking postpartum women (Dolan-Mullen, 2004). Findings con- firmed that improvements in the outcome vari- ables were due to the intervention, but cannot be explained by the control variables. The lack of influence of these variables on outcome variables might be due to our approach of modeling the main variables of interest first and adding confounders to the model later. A strength of the present study is that the sample was composed of both smoking and non-smoking women at baseline. This adequately reflects the tar- get population of our intervention, that is, women postpartum. The high ecological validity of the study helps to translate the findings into routine care. For internal validity, we considered perform- ing a multiple-group analysis for smoking and non- smoking women as an alternative analytic strategy, but stratified sample sizes were not adequate for such complex modeling techniques. Instead we decided to use a one-group analytic strategy, which preserved the statistical power of the whole sample size while accounting for baseline differences in smoking status. Limitations Some limitations of the present analysis should be mentioned: first, assessments of smoking status rely solely on self-reports. Thus non-disclosure of smok- ing cannot be excluded, but the smoking rates in this study are in line with results from other epi- demiological studies, and counsellors and inter- viewers were not the same persons. On the other hand, the high external validity of the study (few and 'soft' inclusion criteria, large sample size, high retention rates, and a sample representative for an entire region in Germany) speaks in favour of the study. Second, a potential bias to the effect of the treatment is that apart from the usual care, women in the control group received state-of-the-art self- help material. Self-help brochures have shown effectiveness in a number of RCTs and might have attenuated the differences between the experimental groups. Third, of the 1128 women who were screened and judged eligible to participate, 871 gave informed consent. A comparison of these women with non-responders according to sociode- mographic characteristics revealed that the propor- tion of women with school education of more than 10 years was higher in consenting women (18,0% vs 8,6%; Röske et al., 2004). For baseline assess- ment four weeks after screening on maternity wards 227 women could not be reached and no informa- tion about a possible selection bias due to the attri- tion is available. 566 Conclusion We conclude from our study that smoking cessation and relapse prevention interventions can success- fully add to non-smoking and the self-efficacy not to smoke among mothers with newborn children. These results provide a basis for further activities in both research for and implementation of advanced strategies to achieve life-long abstinence of mothers and to create a smoke-free childhood and smoke- free families. References Bentler, P.M. (2005). EQS 6 Structural equations program manual. Encino, CA: Multivariate Software. Bentler, P.M., & Dudgeon, P. (1996). Covariance structure analysis: Statistical practice, theory, and directions. Annual Review of Psychology, 47, 563-592. Bollen, K.A. (1989). Structural equations with latent variables. New York: Wiley. Brenner, H., & Mielck, A. (1993). The role of childbirth in smoking cessation. Preventive Medicine, 22(2), 225-236. Chou, C.-P., & Bentler, P.M. (1990). Model modification in covariance structure modeling: A comparison among likelihood ratio, Lagrange Multiplier, & Wald tests . Multivariate Behavioral Research, 25, 115-136. Colman, G.-J., & Joyce, T. (2003). Trends in smoking before, during, and after pregnancy in ten states. American Journal of Preventive Medicine, 24(1), 29-35. Cook, D.G., & Strachan, D.P. (1999). Health effects of passive smoking-10: Summary of effects of parental smoking on the respiratory health of children and implications for research. Thorax, 54(4), 357-366. Cope, G.F., Nayyar, P., & Holder, R. (2003). Feedback from a point-of-care test for nicotine intake to reduce smoking during pregnancy. Annals of Clinical Biochemistry, 40(Pt 6), 674-679. DiClemente, C.C., Dolan-Mullen, P., & Windsor, R.A. (2000). The process of pregnancy smoking cessation: Implications for interventions. Tobacco Control, 9(Suppl. 3), 11116-21. Dolan-Mullen, P. (2004). How can more smoking suspension during pregnancy become lifelong abstinence? Lessons learned about predictors, interventions, and gaps in our accumulated knowledge. Nicotine & Tobacco Research, 6(2), 217-238. Dolan-Mullen, P., Richardson, M.A., Quinn, V.P., & Ershoff, D.H. (1997). Postpartum return to smoking: Who is at risk and when. American Journal of Health Promotion, 11(5), 323-330. Edwards, N., & Sims-Jones, N. (1998). Smoking and smoking relapse during pregnancy and postpartum: Results of a qualitative study. Birth, 25(2), 94-100. Fingerhut, L.A., Kleinman, J.C., & Kendrick, J.S. (1990). Smoking before, during, and after pregnancy. American Journal of Public Health, 80(5), 541-544. Hannöver, W., Kelbsch, J., Röske, K., Thyrian, J.R., John, U., & Hapke, U. (2004). Smoking cessation and relapse prevention in women postpartum: Results from a randomized controlled trial. In W. F. Velicer & S. Keller (Eds.), Research on the transtheoretical model: Where are we now, where are we going? (pp. 59-61). Lengerich: Pabst Science Publishers. Hannöver, W., Thyrian, J.R., Röske, K., Grempler, J., Rumpf, H.J., John, U. et al. (submitted). Smoking cessation and relapse prevention for women post partum: Results from a randomized controlled trial after 6 and 12 months . Heatherton, T.F., Kozlowski, L.T., Frecker, R.C., & Fagerström, K.O. (1991). The Fagerström Test for Nicotine Dependence: A revision of the Fagerström Tolerance Questionnaire . British Journal of Addiction, 86(9), 1119-1127. Hu, L.-T., & Bentler, P.M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1-55. Jäkle, C., Keller, S., Baum, E., & Basler, H.-D. (1999). Skalen zur selbstwirksamkeit und entscheidungsbalance im prozess der verhaltensänderung von rauchern [Scales for the measurement of self-efficacy and decisional balance in the process of behavioral change in smokers]. Diagnostica, 45(3), 138-146. Jamshidian, M., & Bentler, P.M. (1999). ML estimation of mean and covariance structures with missing data using complete data routines. Journal of Educational and Behavioral Statistics, 24, 21-41. Johnson, J.L., Ratner, P.A., Bottorff, J.L., Hall, W., & Dahinten, S. (2000). Preventing smoking relapse in postpartum women . Nursing Research, 49(1), 44-52. Kolble, N., Hummel, T., von Mering, R., Huch, A., & Huch, R. (2001). Gustatory and olfactory function in the first trimester of pregnancy. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 99(2), 179-183. Lang, P., Brüggemann, M., Licht, S., Herman, B., & Greiser, E. (1999). Community intervention programme to promote non-smoking in pregnant women. In P. Lang & E. Greiser (Eds.), European symposium on smoking in pregnancy: Taking the chance for action. Bremen, May 25-27, 1998. Bremen: Bremen Institute for Prevention Research and Social Medicine (BIPS). McBride, C.M., Curry, S.J., Lando, H.A., Pirie, P.L., Grothaus, L.C., & Nelson, J.C. (1999). Prevention of relapse in women who quit smoking during pregnancy. American Journal of Public Health, 89(5), 706-711. McBride, C.M., Emmons, K.M., & Lipkus, I.M. (2003). Understanding the potential of teachable moments: The case of smoking cessation. Health Education Research, 18(2), 156-170. 567 McLeod, D., Pullon, S., & Cookson, T. (2003). Factors that influence changes in smoking behaviour during pregnancy. New Zealand Medical Journal, 116(1173), U418. Miller, W.R., & Rollnick, S. (2002). Motivational interviewing: Preparing people to change addictive behavior, 2nd edn. New York: Guilford Press. Mullen, P.D., DiClemente, C.C., & Bartholomew, L.K. (2000). Theory and context in Project PANDA: A program to help postpartum women stay off cigarettes. In L. K. Bartholomew, G. S. Parcel, G. Kok, & N. H. Gottlieb (Eds.), Intervention mapping: Designing theory-and evidence-based health promotion programs (pp. 453-477). Mountain View, CA: Mayfield Publishers. O'Campo, P., Faden, R.R., Brown, H., & Gielen, A.C. (1992). The impact of pregnancy on women's prenatal and postpartum smoking behavior. American Journal of Preventive Medicine, 8(1), 8-13. Prochaska, J.O., & Velicer, W.F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12(1), 38-48. Ratner, P.A., Johnson, J.L., Bottorff, J.L., Dahinten, S., & Hall, W. (2000). Twelve-month follow-up of a smoking relapse prevention intervention for postpartum women. Addictive Behaviors, 25(1), 81-92. Röske, K., Hannöver, W., Grempler, J., Thyrian, J.R., Rumpf, H.J., John, U. et al. (2006). Post-partum intention to resume smoking . Health Education Research, 21(3), 386-392. Röske, K., Hannöver, W., Kelbsch, J., Thyrian, J.R., John, U., & Hapke, U. (2004). Bereitschaft von frauen, nach der geburt ihres kindes an einer individuellen beratung zum rauchen teilzunehmen [The readiness of women postpartum to participate in smoking cessation counselling]. Gesundheitswesen, 66(10), 697-702. Severson, H.H., Andrews, J.A., Lichtenstein, E., Wall, M., & Akers, L. (1997). Reducing maternal smoking and relapse: Long-term evaluation of a pediatric intervention. Preventive Medicine , 26(1), 120-130. Stotts, A.L., DiClemente, C.C., Carbonari, J.P., & Dolan-Mullen, P. (1996). Pregnancy smoking cessation: A case of mistaken identity. Addictive Behaviors, 21(4), 459-471. Thyrian, J.R., Hannöver, W., Grempler, J., Röske, K., John, U., & Hapke, U. (2006). An intervention to support postpartum women to quit smoking or remain smoke-free. Journal of Midwifery and Women's Health, 51(1), 45-50. Thyrian, J.R., Hannöver, W., Röske, K., John, U., & Hapke, U. (2005). Rauchen vor, während und nach der geburt: Längsschnittliche daten einer bevölkerungsstichprobe [Smoking before, during and after pregnancy: Longitudinal data from a population based sample]. Geburtshilfe und Frauenheilkunde, 65, 687-689. US Department of Health and Human Services. ( 2001). Women and smoking: A report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Valanis, B., Lichtenstein, E., Mullooly, J.P., Labuhn, K., Brody, K., Severson, H.H. et al. (2001). Maternal smoking cessation and relapse prevention during health care visits. American Journal of Preventive Medicine, 20(1), 1-8. Van't Hof, S.M., Wall, M.A., Dowler, D.W., & Stark, M.J. (2000). Randomised controlled trial of a postpartum relapse prevention intervention. Tobacco Control, 9(Suppl. 3), 11164-66. Velicer, W.F., DiClemente, C.C., Rossi, J.S., & Prochaska, J.O. (1990). Relapse situations and self-efficacy: An integrative model. Addictive Behaviors, 15, 271-283. Velicer, W.F., Prochaska, J.O., Fava, J.L., Norman, G.J., & Redding, C.A. (1998). Smoking cessation and stress management: Applications of the transtheoretical model of behavior change. Homeostasis , 38(5-6), 216-233. Velicer, W.F., Rossi, J.S., DiClemente, C.C., & Prochaska, J.O. (1996). A criterion measurement model for health behavior change. Addictive Behaviors, 21(5), 555-584. Wall, M.A., Severson, H.H., Andrews, J.A., Lichtenstein, E., & Zoref, L. (1995). Pediatric office-based smoking intervention: Impact on maternal smoking and relapse. Pediatrics, 96(4 Pt 1), 622-628. 568 Author biographies KATHRIN RÖSKE is a psychologist and received her PhD in 2007 with her research about smoking cessation and relapse prevention in women postpartum. ANJA SCHUMANN is a psychologist and an expert in structural equation modeling techniques. She has broad international research experience and has stayed in the USA several times. WOLFGANG HANNÖVER, Dipl.-Psych. 1996, degree in Psychology at the University of Trier. He received his doctoral degree in 2001 at the Friedrich-Schiller-University of Jena and is a Member of the Motivational Interviewing Network of Trainers. JULIA GREMPLER is a psychologist. She works as project staff investigating psychological disorders in a multicenter trial. RENÉ THYRIAN is a psychologist. His main research interest is examining the TTM for multiple behaviors, developing and delivering interventions in special target groups like women postpartum and teenagers. DR HANS-JÜRGEN RUMPF is a psychologist. He is head of the research group S:TEP (Substance Abuse: Treatment, Epidemiology and Prevention) at the University of Lübeck and collaborating part- ner in EARLINT. U. JOHN is the director of the Institute of Epidemiology and Social Medicine in Greifswald. He is the head of the Research Collaboration in Early substance use Intervention (EARLINT). U. HAPKE had his professional training in social work as well as psychology. He was the principal investigator of the study 'Smoking cessation and relapse prevention in women postpartum'.</meta-value></custom-meta></custom-meta-wrap></article-meta></front><back><ref-list><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Bentler, P.M.</surname></name> (<year>2005</year>). <source>EQS 6 Structural equations program manual</source>. <publisher-loc>Encino, CA</publisher-loc>: <publisher-name>Multivariate Software</publisher-name>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Bentler, P.M.</surname></name>, & <name name-style="western"><surname>Dudgeon, P.</surname></name> (<year>1996</year>). <article-title>Covariance structure analysis: Statistical practice, theory, and directions</article-title>. <source>Annual Review of Psychology</source>, <volume>47</volume>, <fpage>563</fpage>-<lpage>592</lpage>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Bollen, K.A.</surname></name> (<year>1989</year>). <source>Structural equations with latent variables</source>. <publisher-loc>New York</publisher-loc>: <publisher-name>Wiley</publisher-name>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Brenner, H.</surname></name>, & <name name-style="western"><surname>Mielck, A.</surname></name> (<year>1993</year>). <article-title>The role of childbirth in smoking cessation</article-title>. <source>Preventive Medicine</source>, <volume>22</volume>(<issue>2</issue>), <fpage>225</fpage>-<lpage>236</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Chou, C.-P.</surname></name>, & <name name-style="western"><surname>Bentler, P.M.</surname></name> (<year>1990</year>). <article-title>Model modification in covariance structure modeling: A comparison among likelihood ratio, Lagrange Multiplier, & Wald tests</article-title> . <source>Multivariate Behavioral Research</source>, <volume>25</volume>, <fpage>115</fpage>-<lpage>136</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Colman, G.-J.</surname></name>, & <name name-style="western"><surname>Joyce, T.</surname></name> (<year>2003</year>). <article-title>Trends in smoking before, during, and after pregnancy in ten states</article-title>. <source>American Journal of Preventive Medicine</source>, <volume>24</volume>(<issue>1</issue>), <fpage>29</fpage>-<lpage>35</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Cook, D.G.</surname></name>, & <name name-style="western"><surname>Strachan, D.P.</surname></name> (<year>1999</year>). <article-title>Health effects of passive smoking-10: Summary of effects of parental smoking on the respiratory health of children and implications for research</article-title>. <source>Thorax</source>, <volume>54</volume>(<issue>4</issue>), <fpage>357</fpage>-<lpage>366</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Cope, G.F.</surname></name>, <name name-style="western"><surname>Nayyar, P.</surname></name>, & <name name-style="western"><surname>Holder, R.</surname></name> (<year>2003</year>). <article-title>Feedback from a point-of-care test for nicotine intake to reduce smoking during pregnancy</article-title>. <source>Annals of Clinical Biochemistry</source>, <volume>40</volume>(Pt <issue>6</issue>), <fpage>674</fpage>-<lpage>679</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>DiClemente, C.C.</surname></name>, <name name-style="western"><surname>Dolan-Mullen, P.</surname></name>, & <name name-style="western"><surname>Windsor, R.A.</surname></name> (<year>2000</year>). <article-title>The process of pregnancy smoking cessation: Implications for interventions</article-title>. <source>Tobacco Control</source>, <volume>9</volume>(Suppl. <issue>3</issue>), <fpage>11116</fpage>-<lpage>21</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Dolan-Mullen, P.</surname></name> (<year>2004</year>). <article-title>How can more smoking suspension during pregnancy become lifelong abstinence? Lessons learned about predictors, interventions, and gaps in our accumulated knowledge</article-title>. <source>Nicotine & Tobacco Research</source>, <volume>6</volume>(<issue>2</issue>), <fpage>217</fpage>-<lpage>238</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Dolan-Mullen, P.</surname></name>, <name name-style="western"><surname>Richardson, M.A.</surname></name>, <name name-style="western"><surname>Quinn, V.P.</surname></name>, & <name name-style="western"><surname>Ershoff, D.H.</surname></name> (<year>1997</year>). <article-title>Postpartum return to smoking: Who is at risk and when</article-title>. <source>American Journal of Health Promotion</source>, <volume>11</volume>(<issue>5</issue>), <fpage>323</fpage>-<lpage>330</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Edwards, N.</surname></name>, & <name name-style="western"><surname>Sims-Jones, N.</surname></name> (<year>1998</year>). <article-title>Smoking and smoking relapse during pregnancy and postpartum: Results of a qualitative study</article-title>. <source>Birth</source>, <volume>25</volume>(<issue>2</issue>), <fpage>94</fpage>-<lpage>100</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Fingerhut, L.A.</surname></name>, <name name-style="western"><surname>Kleinman, J.C.</surname></name>, & <name name-style="western"><surname>Kendrick, J.S.</surname></name> (<year>1990</year>). <article-title>Smoking before, during, and after pregnancy</article-title>. <source>American Journal of Public Health</source>, <volume>80</volume>(<issue>5</issue>), <fpage>541</fpage>-<lpage>544</lpage>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Hannöver, W.</surname></name>, <name name-style="western"><surname>Kelbsch, J.</surname></name>, <name name-style="western"><surname>Röske, K.</surname></name>, <name name-style="western"><surname>Thyrian, J.R.</surname></name>, <name name-style="western"><surname>John, U.</surname></name>, & <name name-style="western"><surname>Hapke, U.</surname></name> (<year>2004</year>). <source>Smoking cessation and relapse prevention in women postpartum: Results from a randomized controlled trial</source>. In <name name-style="western"><surname>W. F. Velicer</surname></name> & <name name-style="western"><surname>S. Keller</surname></name> (Eds.), <source>Research on the transtheoretical model: Where are we now, where are we going?</source> (pp. <fpage>59</fpage>-<lpage>61</lpage>). <publisher-loc>Lengerich</publisher-loc>: <publisher-name>Pabst Science Publishers</publisher-name>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Hannöver, W.</surname></name>, <name name-style="western"><surname>Thyrian, J.R.</surname></name>, <name name-style="western"><surname>Röske, K.</surname></name>, <name name-style="western"><surname>Grempler, J.</surname></name>, <name name-style="western"><surname>Rumpf, H.J.</surname></name>, <name name-style="western"><surname>John, U.</surname></name> et al. (submitted). <source>Smoking cessation and relapse prevention for women post partum: Results from a randomized controlled trial after 6 and 12 months</source> .</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Heatherton, T.F.</surname></name>, <name name-style="western"><surname>Kozlowski, L.T.</surname></name>, <name name-style="western"><surname>Frecker, R.C.</surname></name>, & <name name-style="western"><surname>Fagerström, K.O.</surname></name> (<year>1991</year>). <article-title>The Fagerström Test for Nicotine Dependence: A revision of the Fagerström Tolerance Questionnaire</article-title> . <source>British Journal of Addiction</source>, <volume>86</volume>(<issue>9</issue>), <fpage>1119</fpage>-<lpage>1127</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Hu, L.-T.</surname></name>, & <name name-style="western"><surname>Bentler, P.M.</surname></name> (<year>1999</year>). <article-title>Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives</article-title>. <source>Structural Equation Modeling</source>, <volume>6</volume>, <fpage>1</fpage>-<lpage>55</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Jäkle, C.</surname></name>, <name name-style="western"><surname>Keller, S.</surname></name>, <name name-style="western"><surname>Baum, E.</surname></name>, & <name name-style="western"><surname>Basler, H.-D.</surname></name> (<year>1999</year>). <article-title>Skalen zur selbstwirksamkeit und entscheidungsbalance im prozess der verhaltensänderung von rauchern [Scales for the measurement of self-efficacy and decisional balance in the process of behavioral change in smokers]</article-title>. <source>Diagnostica</source>, <volume>45</volume>(<issue>3</issue>), <fpage>138</fpage>-<lpage>146</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Jamshidian, M.</surname></name>, & <name name-style="western"><surname>Bentler, P.M.</surname></name> (<year>1999</year>). <article-title>ML estimation of mean and covariance structures with missing data using complete data routines</article-title>. <source>Journal of Educational and Behavioral Statistics</source>, <volume>24</volume>, <fpage>21</fpage>-<lpage>41</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Johnson, J.L.</surname></name>, <name name-style="western"><surname>Ratner, P.A.</surname></name>, <name name-style="western"><surname>Bottorff, J.L.</surname></name>, <name name-style="western"><surname>Hall, W.</surname></name>, & <name name-style="western"><surname>Dahinten, S.</surname></name> (<year>2000</year>). <article-title>Preventing smoking relapse in postpartum women</article-title> . <source>Nursing Research</source>, <volume>49</volume>(<issue>1</issue>), <fpage>44</fpage>-<lpage>52</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Kolble, N.</surname></name>, <name name-style="western"><surname>Hummel, T.</surname></name>, <name name-style="western"><surname>von Mering, R.</surname></name>, <name name-style="western"><surname>Huch, A.</surname></name>, & <name name-style="western"><surname>Huch, R.</surname></name> (<year>2001</year>). <article-title>Gustatory and olfactory function in the first trimester of pregnancy</article-title>. <source>European Journal of Obstetrics, Gynecology, and Reproductive Biology</source>, <volume>99</volume>(<issue>2</issue>), <fpage>179</fpage>-<lpage>183</lpage>.</citation></ref><ref><citation citation-type="confproc" xlink:type="simple"><name name-style="western"><surname>Lang, P.</surname></name>, <name name-style="western"><surname>Brüggemann, M.</surname></name>, <name name-style="western"><surname>Licht, S.</surname></name>, <name name-style="western"><surname>Herman, B.</surname></name>, & <name name-style="western"><surname>Greiser, E.</surname></name> (<conf-date>1999</conf-date>). <article-title>Community intervention programme to promote non-smoking in pregnant women</article-title>. In P. Lang & E. Greiser (Eds.), <conf-name>European symposium on smoking in pregnancy: Taking the chance for action</conf-name>. <conf-loc>Bremen</conf-loc>, May 25-27, <conf-date>1998</conf-date>. <conf-loc>Bremen: Bremen Institute for Prevention Research and Social Medicine (BIPS)</conf-loc>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>McBride, C.M.</surname></name>, <name name-style="western"><surname>Curry, S.J.</surname></name>, <name name-style="western"><surname>Lando, H.A.</surname></name>, <name name-style="western"><surname>Pirie, P.L.</surname></name>, <name name-style="western"><surname>Grothaus, L.C.</surname></name>, & <name name-style="western"><surname>Nelson, J.C.</surname></name> (<year>1999</year>). <article-title>Prevention of relapse in women who quit smoking during pregnancy</article-title>. <source>American Journal of Public Health</source>, <volume>89</volume>(<issue>5</issue>), <fpage>706</fpage>-<lpage>711</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>McBride, C.M.</surname></name>, <name name-style="western"><surname>Emmons, K.M.</surname></name>, & <name name-style="western"><surname>Lipkus, I.M.</surname></name> (<year>2003</year>). <article-title>Understanding the potential of teachable moments: The case of smoking cessation</article-title>. <source>Health Education Research</source>, <volume>18</volume>(<issue>2</issue>), <fpage>156</fpage>-<lpage>170</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>McLeod, D.</surname></name>, <name name-style="western"><surname>Pullon, S.</surname></name>, & <name name-style="western"><surname>Cookson, T.</surname></name> (<year>2003</year>). <article-title>Factors that influence changes in smoking behaviour during pregnancy</article-title>. <source>New Zealand Medical Journal</source>, <volume>116</volume>(<issue>1173</issue>), <fpage>U418</fpage>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Miller, W.R.</surname></name>, & <name name-style="western"><surname>Rollnick, S.</surname></name> (<year>2002</year>). <source>Motivational interviewing: Preparing people to change addictive behavior</source>, <edition>2</edition>nd edn. <publisher-loc>New York</publisher-loc>: <publisher-name>Guilford Press</publisher-name>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Mullen, P.D.</surname></name>, <name name-style="western"><surname>DiClemente, C.C.</surname></name>, & <name name-style="western"><surname>Bartholomew, L.K.</surname></name> (<year>2000</year>). <source>Theory and context in Project PANDA: A program to help postpartum women stay off cigarettes</source>. In <name name-style="western"><surname>L. K. Bartholomew</surname></name>, <name name-style="western"><surname>G. S. Parcel</surname></name>, <name name-style="western"><surname>G. Kok</surname></name>, & <name name-style="western"><surname>N. H. Gottlieb</surname></name> (Eds.), <source>Intervention mapping: Designing theory-and evidence-based health promotion programs</source> (pp. <fpage>453</fpage>-<lpage>477</lpage>). <publisher-loc>Mountain View, CA</publisher-loc>: <publisher-name>Mayfield Publishers</publisher-name>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>O'Campo, P.</surname></name>, <name name-style="western"><surname>Faden, R.R.</surname></name>, <name name-style="western"><surname>Brown, H.</surname></name>, & <name name-style="western"><surname>Gielen, A.C.</surname></name> (<year>1992</year>). <article-title>The impact of pregnancy on women's prenatal and postpartum smoking behavior</article-title>. <source>American Journal of Preventive Medicine</source>, <volume>8</volume>(<issue>1</issue>), <fpage>8</fpage>-<lpage>13</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Prochaska, J.O.</surname></name>, & <name name-style="western"><surname>Velicer, W.F.</surname></name> (<year>1997</year>). <article-title>The transtheoretical model of health behavior change</article-title>. <source>American Journal of Health Promotion</source>, <volume>12</volume>(<issue>1</issue>), <fpage>38</fpage>-<lpage>48</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Ratner, P.A.</surname></name>, <name name-style="western"><surname>Johnson, J.L.</surname></name>, <name name-style="western"><surname>Bottorff, J.L.</surname></name>, <name name-style="western"><surname>Dahinten, S.</surname></name>, & <name name-style="western"><surname>Hall, W.</surname></name> (<year>2000</year>). <article-title>Twelve-month follow-up of a smoking relapse prevention intervention for postpartum women</article-title>. <source>Addictive Behaviors</source>, <volume>25</volume>(<issue>1</issue>), <fpage>81</fpage>-<lpage>92</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Röske, K.</surname></name>, <name name-style="western"><surname>Hannöver, W.</surname></name>, <name name-style="western"><surname>Grempler, J.</surname></name>, <name name-style="western"><surname>Thyrian, J.R.</surname></name>, <name name-style="western"><surname>Rumpf, H.J.</surname></name>, <name name-style="western"><surname>John, U.</surname></name> et al. (<year>2006</year>). <article-title>Post-partum intention to resume smoking</article-title> . <source>Health Education Research</source>, <volume>21</volume>(<issue>3</issue>), <fpage>386</fpage>-<lpage>392</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Röske, K.</surname></name>, <name name-style="western"><surname>Hannöver, W.</surname></name>, <name name-style="western"><surname>Kelbsch, J.</surname></name>, <name name-style="western"><surname>Thyrian, J.R.</surname></name>, <name name-style="western"><surname>John, U.</surname></name>, & <name name-style="western"><surname>Hapke, U.</surname></name> (<year>2004</year>). <article-title>Bereitschaft von frauen, nach der geburt ihres kindes an einer individuellen beratung zum rauchen teilzunehmen [The readiness of women postpartum to participate in smoking cessation counselling]</article-title>. <source>Gesundheitswesen</source>, <volume>66</volume>(<issue>10</issue>), <fpage>697</fpage>-<lpage>702</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Severson, H.H.</surname></name>, <name name-style="western"><surname>Andrews, J.A.</surname></name>, <name name-style="western"><surname>Lichtenstein, E.</surname></name>, <name name-style="western"><surname>Wall, M.</surname></name>, & <name name-style="western"><surname>Akers, L.</surname></name> (<year>1997</year>). <article-title>Reducing maternal smoking and relapse: Long-term evaluation of a pediatric intervention</article-title>. <source>Preventive Medicine</source> , <volume>26</volume>(<issue>1</issue>), <fpage>120</fpage>-<lpage>130</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Stotts, A.L.</surname></name>, <name name-style="western"><surname>DiClemente, C.C.</surname></name>, <name name-style="western"><surname>Carbonari, J.P.</surname></name>, & <name name-style="western"><surname>Dolan-Mullen, P.</surname></name> (<year>1996</year>). <article-title>Pregnancy smoking cessation: A case of mistaken identity</article-title>. <source>Addictive Behaviors</source>, <volume>21</volume>(<issue>4</issue>), <fpage>459</fpage>-<lpage>471</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Thyrian, J.R.</surname></name>, <name name-style="western"><surname>Hannöver, W.</surname></name>, <name name-style="western"><surname>Grempler, J.</surname></name>, <name name-style="western"><surname>Röske, K.</surname></name>, <name name-style="western"><surname>John, U.</surname></name>, & <name name-style="western"><surname>Hapke, U.</surname></name> (<year>2006</year>). <article-title>An intervention to support postpartum women to quit smoking or remain smoke-free</article-title>. <source>Journal of Midwifery and Women's Health</source>, <volume>51</volume>(<issue>1</issue>), <fpage>45</fpage>-<lpage>50</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Thyrian, J.R.</surname></name>, <name name-style="western"><surname>Hannöver, W.</surname></name>, <name name-style="western"><surname>Röske, K.</surname></name>, <name name-style="western"><surname>John, U.</surname></name>, & <name name-style="western"><surname>Hapke, U.</surname></name> (<year>2005</year>). <article-title>Rauchen vor, während und nach der geburt: Längsschnittliche daten einer bevölkerungsstichprobe [Smoking before, during and after pregnancy: Longitudinal data from a population based sample]</article-title>. <source>Geburtshilfe und Frauenheilkunde</source>, <volume>65</volume>, <fpage>687</fpage>-<lpage>689</lpage>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>US Department of Health and Human Services.</surname></name> ( <year>2001</year>). <source>Women and smoking: A report of the Surgeon General</source>. <publisher-loc>Atlanta, GA</publisher-loc>: <publisher-name>US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health</publisher-name>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Valanis, B.</surname></name>, <name name-style="western"><surname>Lichtenstein, E.</surname></name>, <name name-style="western"><surname>Mullooly, J.P.</surname></name>, <name name-style="western"><surname>Labuhn, K.</surname></name>, <name name-style="western"><surname>Brody, K.</surname></name>, <name name-style="western"><surname>Severson, H.H.</surname></name> et al. (<year>2001</year>). <article-title>Maternal smoking cessation and relapse prevention during health care visits</article-title>. <source>American Journal of Preventive Medicine</source>, <volume>20</volume>(<issue>1</issue>), <fpage>1</fpage>-<lpage>8</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Van't Hof, S.M.</surname></name>, <name name-style="western"><surname>Wall, M.A.</surname></name>, <name name-style="western"><surname>Dowler, D.W.</surname></name>, & <name name-style="western"><surname>Stark, M.J.</surname></name> (<year>2000</year>). <article-title>Randomised controlled trial of a postpartum relapse prevention intervention</article-title>. <source>Tobacco Control</source>, <volume>9</volume>(Suppl. <issue>3</issue>), <fpage>11164</fpage>-<lpage>66</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Velicer, W.F.</surname></name>, <name name-style="western"><surname>DiClemente, C.C.</surname></name>, <name name-style="western"><surname>Rossi, J.S.</surname></name>, & <name name-style="western"><surname>Prochaska, J.O.</surname></name> (<year>1990</year>). <article-title>Relapse situations and self-efficacy: An integrative model</article-title>. <source>Addictive Behaviors</source>, <volume>15</volume>, <fpage>271</fpage>-<lpage>283</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Velicer, W.F.</surname></name>, <name name-style="western"><surname>Prochaska, J.O.</surname></name>, <name name-style="western"><surname>Fava, J.L.</surname></name>, <name name-style="western"><surname>Norman, G.J.</surname></name>, & <name name-style="western"><surname>Redding, C.A.</surname></name> (<year>1998</year>). <article-title>Smoking cessation and stress management: Applications of the transtheoretical model of behavior change</article-title>. <source>Homeostasis</source> , <volume>38</volume>(<issue>5</issue>-<issue>6</issue>), <fpage>216</fpage>-<lpage>233</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Velicer, W.F.</surname></name>, <name name-style="western"><surname>Rossi, J.S.</surname></name>, <name name-style="western"><surname>DiClemente, C.C.</surname></name>, & <name name-style="western"><surname>Prochaska, J.O.</surname></name> (<year>1996</year>). <article-title>A criterion measurement model for health behavior change</article-title>. <source>Addictive Behaviors</source>, <volume>21</volume>(<issue>5</issue>), <fpage>555</fpage>-<lpage>584</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Wall, M.A.</surname></name>, <name name-style="western"><surname>Severson, H.H.</surname></name>, <name name-style="western"><surname>Andrews, J.A.</surname></name>, <name name-style="western"><surname>Lichtenstein, E.</surname></name>, & <name name-style="western"><surname>Zoref, L.</surname></name> (<year>1995</year>). <article-title>Pediatric office-based smoking intervention: Impact on maternal smoking and relapse</article-title>. <source>Pediatrics</source>, <volume>96</volume>(<issue>4</issue> Pt <issue>1</issue>), <fpage>622</fpage>-<lpage>628</lpage>.</citation></ref></ref-list></back></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Postpartum Smoking Cessation and Relapse Prevention Intervention</title><subTitle>A Structural Equation Modeling Application to Behavioral and Non-behavioral Outcomes of a Randomized Controlled Trial</subTitle></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Postpartum Smoking Cessation and Relapse Prevention Intervention</title><subTitle>A Structural Equation Modeling Application to Behavioral and Non-behavioral Outcomes of a Randomized Controlled Trial</subTitle></titleInfo><name type="personal"><namePart type="given">K.</namePart><namePart type="family">Röske</namePart><affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany,</affiliation><affiliation>E-mail: roeske@uni-greifswald.de</affiliation></name><name type="personal"><namePart type="given">A.</namePart><namePart type="family">Schumann</namePart><affiliation>Cambridge Health Alliance, Boston, MA, USA</affiliation></name><name type="personal"><namePart type="given">W.</namePart><namePart type="family">Hannöver</namePart><affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</affiliation></name><name type="personal"><namePart type="given">J.</namePart><namePart type="family">Grempler</namePart><affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</affiliation></name><name type="personal"><namePart type="given">J.R.</namePart><namePart type="family">Thyrian</namePart><affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</affiliation></name><name type="personal"><namePart type="given">H.-J.</namePart><namePart type="family">Rumpf</namePart><affiliation>University of Lübeck, Germany</affiliation></name><name type="personal"><namePart type="given">U.</namePart><namePart type="family">John</namePart><affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</affiliation></name><name type="personal"><namePart type="given">U.</namePart><namePart type="family">Hapke</namePart><affiliation>Ernst-Moritz-Arndt-University Greifswald, Germany</affiliation></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>SAGE Publications</publisher><place><placeTerm type="text">Sage UK: London, England</placeTerm></place><dateIssued encoding="w3cdtf">2008-05</dateIssued><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">The aim of the study was to test the effectiveness of a postpartum smoking cessation and relapse prevention intervention. Structural equation modeling techniques were applied to evaluate the impact of the intervention on smoking behavior and on non-behavioral variables derived from the Transtheoretical Model (TTM). Women were randomized to an intervention (I) and control group (C). Smoking status, TTM-variables, and control variables were assessed four weeks, six and 12 months postpartum. Membership in the intervention group significantly predicted non-smoking and higher self-efficacy six months, but not one year postpartum, after controlling for demographic, smoking, and postpartum risk variables.</abstract><subject><genre>keywords</genre><topic>cessation</topic><topic>intervention</topic><topic>postpartum</topic><topic>RCT</topic><topic>relapse</topic><topic>smoking</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Health Psychology</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">1359-1053</identifier><identifier type="eISSN">1461-7277</identifier><identifier type="PublisherID">HPQ</identifier><identifier type="PublisherID-hwp">sphpq</identifier><part><date>2008</date><detail type="volume"><caption>vol.</caption><number>13</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>556</start><end>568</end></extent></part></relatedItem><identifier type="istex">EBB0D4167D34D0B2A726264268E4268CB7116C6D</identifier><identifier type="DOI">10.1177/1359105308088528</identifier><identifier type="ArticleID">10.1177_1359105308088528</identifier><recordInfo><recordContentSource>SAGE</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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