PSYCHOSOCIAL RISK FACTORS FOR SMOKING IN PREGNANT WOMEN IN RURAL APPALACHIA

1. PSYCHOSOCIAL RISK FACTORS FOR SMOKING IN PREGNANT WOMEN IN RURAL APPALACHIA Jessica H. Turner, M.A.1, Jennifer a. Correll, M.A. 1, Kristen Carlosh1, Beth Bailey Ph.D.2, & William T. Dalton III, Ph.D.1 Department of Psychology1 & Department of Family Medicine2 East Tennessee State University, Johnson City, TN Introduction RESULTS CONCLUSIONS • Smoking is one of the most preventable causes of death (CDC, 2006), and Tennessee has one of the highest smoking rates (26%) as compared to the national average (20%; CDC, 2011). More concerning, smoking rates during pregnancy are as high as 39% in some areas (Bailey, 2006). • Pregnant women who smoke are at increased risk for spontaneous abortion in addition to placental problems and hemorrhage during childbirth (CDC, 2011). Infants exposed to smoking in utero have lower birth weight, small gestational size, and are more likelyto be preterm (Jaddoe et al., 2008; Orr et al., 2007). Later in life, these children have higher rates of attention deficit disorders, learning disabilities, impulsivity, and conduct disorders (Cornelius & Day, 2009). • Research has found numerous psychosocial concerns contributing to smoking. Some of these risk factors are mental illness including ADHD (Fu et al., 2007; Sousa et al., in press), high stress levels (Krueger & Chang, 2008), engaging in other unhealthy behaviors (Kaleta & Jegier, 2007; O’Riordan et al., 2006), and the presence of weight concerns (Pomerleau & Saules, 2007). • In the current sample, more than half of the women admitted to having smoked at some point during their pregnancy. • Several psychosocial factors were found to be significantly different for pregnant women who smoked as compared to those who did not. • When predicting smoking status based on the psychosocial factors which were found to be different, only stress and support from others had predictive value. • Stress was the strongest predictor followed by support from others. implications • Illustrates the importance of screening for stress levels and perceived social support in medical setting. • Of the psychosocial risk factors under consideration, stress is probably the most amenable to change. • Importance of teaching stress reduction strategies to pregnant women to decrease the likelihood of smoking during pregnancy. • Future research should assess the effectiveness of various stress reduction strategies in smoking cessation efforts for pregnant women in rural Appalachia. • Based on t-test results, the following variables were entered in the stepwise logistic regression: • Weight Concern • Attention Difficulties • Depression • Stress • Partner Support • Other Support • Self-Esteem Objective The goal of this study was to explore the predictive power of psychosocial risk factors for smoking during pregnancy of women in rural Southern Appalachia. Methods References • Participants • 191 pregnant women enrolled in the Tennessee Intervention for Pregnant Smokers (TIPS) study • Measures • Smoking Questionnaire • Demographic Questionnaire • Weight Concern Scale (WCS) [Weight Concern] • Body Image Concern Inventory (BICI) [Body Image] • Eating Attitudes Test-26 (EAT-26) [Diet, Bulimic Food Preoccupation, Oral Control] • Current Symptoms Scale (CSS) [Attention Difficulties] • Center for Epidemiologic Studies Short Depression Scale (CESD-10) [Depression] • Prenatal Psychosocial Profile (PPP) [Stress, Support, Self-Esteem] • III. Procedure • Participants were recruited through health care and doctor visits • Assessments were completed at first and third trimester. • IV. Analysis Plan • T-tests for mean differences in smokers and non-smokers • Stepwise logistic regression Available upon request. Funding Credit Funding for TIPS Project provided by: Governor Phil Bredesen &The Governors Office of Children’s Care Coordination • Stress entered the equation at step one suggesting it is the strongest predictor of smoking in this sample of pregnant women in rural Appalachia. • Stress alone accounted for approximately 17% of the variance in smoking status. • Support from others entered the equation at step two as the second strongest predictor of smoking. • Together, stress and support from others accounts for nearly 20% of the variance in smoking status.