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Provider survey of attitudes and practices about smoking cessation during pregnancy in the Bronx
Provider Survey of Attitudes and Practices About Smoking Cessation During Pregnancy in the Bronx
METHODS: One hundred two charts of sexually active women (40 black, median age 26.0 years, and 62 Hispanic, median age 25.0 years) admitted to an inner city emergency room with a diagnosis of spontaneous abortion were reviewed. Of these 102 subjects, 61 had prior spontaneous/elective abortions, 90 were not using any form of birth control methods, and 22 were smokers.
Jonelle M. Bingham, MD
RESULTS: Increased maternal age was significantly (P ⫽ .05) associated with recurrent spontaneous abortion among minority women after controlling for gravidity, previous abortions, smoking, and STDs. In comparison with younger women (younger than 20 years), the risk for abortion was increased for older women (over 20; P ⫽ .000, by Kruskal-Wallis test). The maximum occurrence (76%) of spontaneous abortion in minority women was between the 6 –12 weeks’ gestations. The risk of recurrent spontaneous abortion was highly correlated with gravidity (r ⫽ .486; P ⫽ .001, by Spearman rank correlation test). Current smokers had 35% increased risk of spontaneous abortion, and no association emerged with STDs or the use of contraceptives.
Bronx Lebanon Hospital, Bronx, NY
Karla Damus, PhD, and Magdy Mikhail, MD About 13% of US pregnant women smoke despite known adverse fetal and maternal effects. Brief interventions using the 5As have been shown to be effective; other surveys report the need for more provider training. Little is reported from minority communities. OBJECTIVE: To survey the attitude, knowledge, and practices related to smoking cessation in pregnant women of obstetric providers working in a major inner city hospital in the South Bronx, providing baseline data to inform and evaluate a planned follow-up interventional initiative. METHODS: A 17-question anonymous survey was piloted and administered to obstetric providers caring for pregnant women in a South Bronx teaching hospital. Purposive sampling at grand rounds resulted in 70 completed surveys, which were then analyzed using NCSS 97. RESULTS: 76% of respondents were female; average years practiced were 16.2. 94% asked about smoking, 96% thought it was very important to quit, 92% encouraged smoking pregnant patients to stop, and the majority felt that provider support and counseling was very important. A third identified gradual cessation as a method they use, and 4.3% knew about the 5As. Coping (77%), addiction (70%), and peer pressure (67%) were rated as very important factors affecting women quitting. 7% rarely or never encourage their smoking, nonpregnant patients to quit. CONCLUSIONS: The surveyed providers need additional training and resources to take advantage of the window of opportunity of pregnancy to implement the 5As with every smoking pregnant patient seen in the South Bronx.
Recurrence of Spontaneous Abortion in Minority Women Danny W. Shaban, MD Bronx-Lebanon Hospital Center/Albert Einstein College of Medicine, Bronx, NY
Prabhudas Palan, PhD, Angela Woodall, MD, and Magdy Mikhail, MD OBJECTIVE: To evaluate risk factors for recurrent spontaneous abortions in minority women.
VOL. 101, NO. 4 (SUPPLEMENT), APRIL 2003
CONCLUSIONS: Increased maternal age was significantly associated with recurrence of spontaneous abortion in minority women, and there were no significant ethnic differences. Educational programs aimed at minority women focused on spontaneous and voluntary abortions may reduce the rate of voluntary termination of pregnancy and ectopic pregnancy and may have a positive impact on future abortions and fertility.
Teaching Operative Dictations in U.S. Residency Programs Amy C. Eichholz, MD University of Iowa Hospitals and Clinics, Iowa City, IA
Anil K. Sood, MD, Brad L. VanVoorhis, MD, Joel I. Sorosky, MD, and Brian Smith, PhD OBJECTIVE: 1) To determine the extent of formal education regarding operative dictations in US obstetrics-gynecology residency programs. 2) To prospectively evaluate the effectiveness of formal teaching. METHODS: A one-page questionnaire was mailed to all US obstetrics-gynecology residency program directors. The operative dictations of all obstetrics-gynecology residents at the University of Iowa before and after a 30-minute formal teaching session were evaluated and scored based on the presence or absence of eight key elements. RESULTS: A 73% response rate was obtained from the surveys. The results from the survey demonstrated that fewer than 20% of programs have any formal teaching in place; however, 84% of the residency program directors feel that it is important to teach. All obstetrics-gynecology residents at the University of Iowa attended the 30-minute teaching session. The mean scores for all residents improved from 9.63 to 18.63 after a formal teaching session (P ⬍ 0.001). The preteaching
MONDAY POSTERS
23S
METHODS: One hundred two charts of sexually active women (40 black, median age 26.0 years, and 62 Hispanic, median age 25.0 years) admitted to an inner city emergency room with a diagnosis of spontaneous abortion were reviewed. Of these 102 subjects, 61 had prior spontaneous/elective abortions, 90 were not using any form of birth control methods, and 22 were smokers.
Jonelle M. Bingham, MD
RESULTS: Increased maternal age was significantly (P ⫽ .05) associated with recurrent spontaneous abortion among minority women after controlling for gravidity, previous abortions, smoking, and STDs. In comparison with younger women (younger than 20 years), the risk for abortion was increased for older women (over 20; P ⫽ .000, by Kruskal-Wallis test). The maximum occurrence (76%) of spontaneous abortion in minority women was between the 6 –12 weeks’ gestations. The risk of recurrent spontaneous abortion was highly correlated with gravidity (r ⫽ .486; P ⫽ .001, by Spearman rank correlation test). Current smokers had 35% increased risk of spontaneous abortion, and no association emerged with STDs or the use of contraceptives.
Bronx Lebanon Hospital, Bronx, NY
Karla Damus, PhD, and Magdy Mikhail, MD About 13% of US pregnant women smoke despite known adverse fetal and maternal effects. Brief interventions using the 5As have been shown to be effective; other surveys report the need for more provider training. Little is reported from minority communities. OBJECTIVE: To survey the attitude, knowledge, and practices related to smoking cessation in pregnant women of obstetric providers working in a major inner city hospital in the South Bronx, providing baseline data to inform and evaluate a planned follow-up interventional initiative. METHODS: A 17-question anonymous survey was piloted and administered to obstetric providers caring for pregnant women in a South Bronx teaching hospital. Purposive sampling at grand rounds resulted in 70 completed surveys, which were then analyzed using NCSS 97. RESULTS: 76% of respondents were female; average years practiced were 16.2. 94% asked about smoking, 96% thought it was very important to quit, 92% encouraged smoking pregnant patients to stop, and the majority felt that provider support and counseling was very important. A third identified gradual cessation as a method they use, and 4.3% knew about the 5As. Coping (77%), addiction (70%), and peer pressure (67%) were rated as very important factors affecting women quitting. 7% rarely or never encourage their smoking, nonpregnant patients to quit. CONCLUSIONS: The surveyed providers need additional training and resources to take advantage of the window of opportunity of pregnancy to implement the 5As with every smoking pregnant patient seen in the South Bronx.
Recurrence of Spontaneous Abortion in Minority Women Danny W. Shaban, MD Bronx-Lebanon Hospital Center/Albert Einstein College of Medicine, Bronx, NY
Prabhudas Palan, PhD, Angela Woodall, MD, and Magdy Mikhail, MD OBJECTIVE: To evaluate risk factors for recurrent spontaneous abortions in minority women.
VOL. 101, NO. 4 (SUPPLEMENT), APRIL 2003
CONCLUSIONS: Increased maternal age was significantly associated with recurrence of spontaneous abortion in minority women, and there were no significant ethnic differences. Educational programs aimed at minority women focused on spontaneous and voluntary abortions may reduce the rate of voluntary termination of pregnancy and ectopic pregnancy and may have a positive impact on future abortions and fertility.
Teaching Operative Dictations in U.S. Residency Programs Amy C. Eichholz, MD University of Iowa Hospitals and Clinics, Iowa City, IA
Anil K. Sood, MD, Brad L. VanVoorhis, MD, Joel I. Sorosky, MD, and Brian Smith, PhD OBJECTIVE: 1) To determine the extent of formal education regarding operative dictations in US obstetrics-gynecology residency programs. 2) To prospectively evaluate the effectiveness of formal teaching. METHODS: A one-page questionnaire was mailed to all US obstetrics-gynecology residency program directors. The operative dictations of all obstetrics-gynecology residents at the University of Iowa before and after a 30-minute formal teaching session were evaluated and scored based on the presence or absence of eight key elements. RESULTS: A 73% response rate was obtained from the surveys. The results from the survey demonstrated that fewer than 20% of programs have any formal teaching in place; however, 84% of the residency program directors feel that it is important to teach. All obstetrics-gynecology residents at the University of Iowa attended the 30-minute teaching session. The mean scores for all residents improved from 9.63 to 18.63 after a formal teaching session (P ⬍ 0.001). The preteaching
MONDAY POSTERS
23S