Abstract
This study aimed to identify the factors associated with prenatal smoking cessation interventions based on the 5As model among public health nurses (PHNs) in Japan. A nationwide cross-sectional study was conducted from December 2019 to February 2020 via a self-administered questionnaire. The study subjects were 1988 PHNs working in 431 health centers of municipalities and special wards across the country. Of the 1988 questionnaires mailed, 521 responses (26.2%) were included in the analysis. Of the 521 responses, most of the respondents were female (98.1%) and the mean age was 37.5 years. There were statistically significant differences on age, work regions, experience years working as a PHN and smoking cessation training after becoming a PHN in implementing the 5As. Self-efficacy, professional development competency, research utilization competency, age and experience years working as a PHN were positively associated with the 5As. Social nicotine dependence was negatively associated with the 5As. Furthermore, self-efficacy mediated the relationship between the 5As and professional development competency, research utilization competency, social nicotine dependence, age and experience years working as a PHN. In the future, smoking cessation intervention training should be widely implemented to improve self-efficacy and prenatal smoking cessation interventions among Japanese PHNs.
Highlights
Maternal smoking and second-hand smoke exposure during pregnancy are two modifiable risk factors for maternal and fetal health [1]
Self-efficacy, professional development competency, research utilization competency, age and experience years working as a public health nurses (PHNs) were positively associated with the 5As
Self-efficacy mediated the relationship between the 5As and professional development competency, research utilization competency, social nicotine dependence, age and experience years working as a PHN
Summary
Maternal smoking and second-hand smoke exposure during pregnancy are two modifiable risk factors for maternal and fetal health [1]. Many studies have reported that maternal smoking during pregnancy was associated with increased risks for ectopic pregnancy, preterm premature rupture of the membrane, placenta previa, abruption placenta, miscarriage, stillbirth, preterm birth (less than 37 weeks gestation), low birth weight (less than 2500 g), small for gestational age and congenital anomalies such as cleft lip [2,3,4,5,6,7,8,9,10]. Maternal exposure to second-hand smoke during pregnancy has been reported to be associated with spontaneous abortion, stillbirth, preterm birth, small for gestational age, low birth weight, neonatal asphyxia and neural tube defects [13,14,15,16,17,18]. In high-income countries such as the USA, Denmark and Sweden, the prevalence of maternal smoking
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