Many worksite health-promotion projects only evaluate a program by documenting employee program utilization or by determining what behaviors have or have not been changed. The failure of a program may be due to its implementation rather than to the science of the intervention. Often, program implementation problems are overlooked. Many managers do not set up an implementation monitoring program to assess problems prior to breakdowns. This article describes how to monitor program implementation through the establishment of a Quality Assurance System in a worksite health-promotion program. A case study approach for a quit-smoking program administered to a large corporation will be used to demonstrate this method.

Evaluation Studies as Topic↗

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Evaluation of the impact of dissemination of smoking cessation methods on the low birthweight rate and on health care costs: achieving year 2000 objectives for the nation.

Nationwide dissemination of efficacious and cost-effective smoking cessation methods during the 1990s represents an important part of the solution to reducing the low birthweight (LBW) rate and associated health care costs. A minimum of 250,000 LBW births must be prevented during the 1990s to achieve the year 2000 LBW rate objective of 5% of total births. Annually 1,500 to 6,000 LBW births might be prevented between 1991 and 2000, and cumulatively 29,000 to 44,000, by dissemination of tested smoking cessation methods. Twelve to eighteen percent of the objective might be accomplished by dissemination. LBW births attributable to smoking might be reduced from the current 20% to 26% rate to a rate of 9% to 12% if the overall maternal smoking prevalence rate is reduced to 10% as projected in the Year 2000 Objectives. Smoking-attributable health care cost savings from dissemination would range from $22 million to $59 million.

Birth Rate↗

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Guidelines for conducting smoking cessation programs.

Explore the source record for details and available documents.

Counseling↗

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The impact on infant birth weight and gestational age of cotinine-validated smoking reduction during pregnancy.

OBJECTIVE: To evaluate the impact of cotinine-confirmed smoking reduction during pregnancy on infant birth weight and gestational age at birth. DESIGN: Group analyses from a prospective, randomized smoking-cessation intervention trial using cotinine levels to assess smoking cessation and reduction. SETTING: Four maternity clinics of Jefferson County Health Department in Birmingham, Ala. PATIENTS: A total of 803 pregnant smokers and 474 never smokers with a fetal gestational age of 32 weeks or less at the first prenatal visit to a clinic. MAIN OUTCOME MEASURES: Infant birth weight and gestational age at birth. RESULTS: Infants who were born to women who quit smoking (quitters) had the highest mean birth weight (3371 +/- 581 g), followed by infants who were born to women who did not change smoking behavior (no changers) (3043 +/- 587 g). The mean infant birth weight of infants born to the quitters, adjusted by mother's age, race, height, weight at baseline, and gestational age at delivery was 241 g heavier than that among the no changers (P = .0008) and 167 g heavier than the reducers (P = .04). The adjusted mean infant birth weight of infants born to the reducers was 92 g heavier than that among the no changers (P = .08). White reducers with baseline cotinine levels greater than 100 ng/mL had infants who were 241 g heavier than did white no changers. A 220-g difference was also seen in black reducers with a baseline cotinine level of 100 ng/mL or less. Although smoking cessation increased infant gestational age at delivery by 1 week, smoking reduction had little effect. CONCLUSION: Cotinine-validated smoking reduction rates were positively associated with an increase in infant birth weight. While smoking cessation must continue to be the primary objective for pregnant smokers, specific intervention methods should also be directed toward smoking reduction for women who cannot quit.

Biomarkers↗