Study to analyze smoking among pregnant women

The IU School of Public Health has received a $900,000 grant from the Indiana State Department of Health in order to conduct a study to help pregnant women in Indiana quit smoking.

Smoking during pregnancy has proved to be a major contributor to one of Indiana’s biggest problems: infant mortality.

In 2010, Indiana’s infant mortality rate was sixth in the nation.

At the beginning of 2011, it was projected that 7.7 out of every 1000 children in Indiana would die within the first year of life.

It is among the Department of Health’s top priorities to improve these rates, IU researchers said.

With help from the state, public health researchers at IU will conduct a study to attempt to get this problem under control.

“It’s a great opportunity to try an innovative strategy to hopefully help solve a major problem among pregnant women,” said Jon Macy, principal investigator and assistant professor in the School of Public Health.

The basis of this study is testing the effect of financial incentives on reducing smoking among pregnant women. 

It will be a collaborative effort of researchers from both IU Bloomington and IUPUI.
They will recruit 600 women from several prenatal care units in central and south-central Indiana. 

Subjects will be selected from six locations, including three Wishard Health Services units, two St. Francis units and one IU Health unit.

Randomly selected subjects will be placed into either the high incentive, low incentive or control group, with 200 women per group. Each woman’s smoking habits will be tracked throughout her pregnancy.

Each woman will receive a financial reward each time she visits the doctor for a prenatal care appointment with improved smoking habits.

If, when they arrive at the doctor for their first prenatal care visit, they have not smoked, subjects will receive financial incentives.

Members of the high incentive group will receive $50 for not smoking, those in the low incentive group will receive $25 and control group members will not receive any financial incentive.

This reward is given at each of the women’s ten visits, depending on how they have improved up to that point.

The researchers have confidence in this method of study, as it has proven successful in other studies of pregnant women.

“Based on Indiana rates of infant mortality, there is a need for more effective programs,” project manager Rachel Dowty said. “This has been effective in other areas.”

At the end of the experiment, researchers will compare the three groups to seek any differences in smoking rates throughout the pregnancy due to incentives. Researchers will also look at birth outcomes in terms of the baby’s weight and whether they were early or full term.

Macy said they will make a cost-benefit analysis at the conclusion of the study.
“The state wanted to explore new and innovative ways to approach this problem,” he said. “We hope to learn whether or not it’s a cost-effective approach.”

In addition, the women will be tracked up to six months after the study in order to determine if this intervention has a lasting effect.

“It’s common to quit while pregnant, but as soon as the baby is born, they go right back to smoking,” Macy said.

The research team is in the planning stages. It is developing relationships with the recruiting sites and keeping the state Department of Health updated on progress.

“They deserve a lot of credit,” Dowty said. “This has the potential to be very beneficial for the state.”

Once it launches in the spring, the study is set to last up to three years. Macy said they have high hopes for its long-term benefits.

“This will help us learn more about how we can deal with this public health problem,” Macy said.learn more about how we can deal with this public health problem,” Macy said.