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Tennessee Intervention for Pregnant Smokers

East Tennessee State University

Current Project

Tennessee Intervention for Pregnant Smokers


Providing education and support to eliminate pregnancy smoking in Northeast Tennessee

No Smoking Sign

In January of 2007, funding of over $1.2 million was awarded to the TIPS (Tennessee Intervention for Pregnant Smokers) program. The objective of this four year initiative, which was designed and is directed by Dr. Beth Bailey, Assistant Professor of Family Medicine, is to improve birth and infant outcomes in Northeast Tennessee by improving the overall health status of pregnant women in this region. Specifically, this multifaceted program involves the implementation and evaluation of interventions that focus on reducing pregnancy and postpartum smoking and smoke exposure while addressing associated health and lifestyle factors that impact pregnancy outcomes. All pregnant smokers in the six-county area of Northeast Tennessee (approximately 4200 women over the project period) have the potential to benefit from this program.

The principle component of the TIPS program is a Brief Intervention (BI) incorporated into prenatal care that targets smoking cessation. This intervention is based on the 5 As, an approach consistent with strategies developed by the National Cancer Institute, the American Medical Association, and adapted for pregnant women by ACOG. Training in implementing the BI is offered to all prenatal health care providers and health department WIC/HUGS staff in the 6-county target region. Following training, each provider integrates the BI into the routine prenatal care of every smoke-exposed pregnancy, offers smoking cessation self-help guides and secondhand smoke resource information to all applicable women, and documents each session. To maximize the utilization of the BI by regional prenatal health care providers, TIPS also assesses providers perceptions and use of the 5As method of smoking cessation with pregnant smokers. In addition to training current health care providers, TIPS also conducts trainings with students completing nursing and medical degrees at ETSU. This will allow for the acceptance and continuation of brief smoking cessation counseling in the context of prenatal care in the region for years to come.

In addition to the provision of training and support for incorporating brief interventions into the prenatal care of all smokers, TIPS also provides intensive prenatal care case management services in high-risk practices and inpatient hospital settings to high-risk and postpartum women. The case managers provide additional encouragement in smoking cessation and limiting secondhand smoke exposure, assist the women in finding additional community resources, and arrange additional support and education for interested patients. The vital role of the case manager is to provide support and referral assistance, as many of the women face multiple challenges that interfere with pregnancy health in general, and smoking cessation specifically.

To further facilitate the improvement of birth and infant outcomes in Northeast Tennessee, TIPS directs many other regional pregnancy smoking cessation efforts. A culturally sensitive smoking cessation self-help manual has been developed and is being disseminated to all pregnant women in Northeast Tennessee. TIPS staff members frequently conduct presentations for health care professionals and community groups to explain the program and provide resources for pregnancy smoking cessation efforts. Community-based pregnancy smoking cessation and education workshops were designed by TIPS for groups of prenatal patients, both as stand-alone sessions and sessions incorporated into general prenatal education classes. Additional smoking cessation and pregnancy health related resources are also available to both providers and pregnant women on the TIPS website.

The above-mentioned service provision components of TIPS are partnered with comprehensive evaluation efforts. Data collection associated with each phase of the program, including the collection of regional baseline and ongoing birth data, will enable a through assessment of program effectiveness, and provide information about future improvements and applications of the TIPS program.

East Tennessee State University
Box 70621 Johnson City, TN  37614
Office: (423) 439- 6705      Fax: (423) 439-2440

Beth Bailey, Ph.D., Principal Investigator and Program Director:

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