Health Education Research, Vol. 15, No. 4, 491-502,
August 2000
© 2000 Oxford University Press
A pilot study to establish a randomized trial methodology to test the efficacy of a behavioural intervention
1 Scottish Cot Death Trust, and
2 Paediatric Epidemiology and Community Health (PEACH) Unit, Department of Child Health, Royal Hospital for Sick Children, Yorkhill, Glasgow University, Glasgow G3 8SJ, UK,
3 Department of Obstetrics and Gynaecology, and
4 Haematology Department, Yorkhill NHS Trust, Yorkhill, Glasgow University, Glasgow G3 8SJ, UK,
5 No Smoking Day, Unit 203, 16 Baldwins Gardens, London EC1N 7RJ, UK,
6 Department of Public Health, Glasgow University, Glasgow G12 8QQ, UK,
7 Family Education Services, Christchurch, New Zealand and
8 Health Promotion Department, Greater Glasgow Health Board, Dalian House, PO Box 15328, 350 St Vincent Street, Glasgow G3 8YY, UK
How can pregnant women be helped to stop smoking? This was a pilot study of midwife home-based motivational interviewing. Clients were 100 consecutive self-reported smokers booking at clinics in Glasgow from March to May 1997. Smoking guidance is routinely given at booking. In addition, intervention clients received a median of four home-based motivational interviewing sessions from one specially trained midwife. All sessions (n = 171) were audio-taped and interviews (n = 49) from 13 randomly selected clients were transcribed for content analysis. Three `experts' assessed intervention quality using a recognized rating scale. Cotinine measurement on routine blood samples confirmed self-reported smoking change from late pregnancy telephone interview. Postnatal telephone questionnaire measured client satisfaction. Focus groups of routine midwives explored acceptability, problems and disruption of normal care. Fisher exact, 
2 and Mann–Whitney tests compared enrolment characteristics. Two-sample t-tests assessed outcome between groups. Motivational interviewing was satisfactory in more than 75% of transcribed interviews. In this pilot study, self-reported smoking at booking (100 of 100 available) corroborated by cotinine (93 of 100) compared with late pregnancy self-reports (intervention 47 of 48; control 49 of 49) and cotinine (intervention 46 of 48; control 47 of 49) showed no significant difference between groups. Tools have been developed to answer the question: `Can proactive opportunistic home-based motivational interviewing help pregnant smokers reduce their habit?'.
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