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R A Windsor

Publications and source records attributed to R A Windsor.

58 records · Page 4Linked to original sources

A cost-effectiveness analysis of self-help smoking cessation methods for pregnant women.

Estimates of the cost effectiveness and cost benefit of health promotion-health education methods for pregnant smokers designed to increase birth weight are not available. This paper presents the results of a cost-effectiveness analysis from a recently completed randomized trial to evaluate the effectiveness of self-help smoking cessation methods for pregnant women in public health maternity clinics. The study population--309 pregnant smokers from 3 prenatal clinics--were randomly assigned, during their first clinic visit, to 1 of 3 groups: (a) group 1 received the standard clinic information and advice to quit smoking, (b) group 2 received the standard clinic information and advice to quit plus the manual "Freedom From Smoking in 20 Days" by the American Lung Association, and (c) group 3 received the standard clinic information and advice to quit plus the pregnancy-specific manual "A Pregnant Woman's Self-Help Guide to Quit Smoking." The quit rates by the end of pregnancy were 2 percent for group 1, 6 percent for group 2, and 14 percent for group 3. Analyses also indicated that the method used for group 3 was the most cost effective: group 3 achieved smoking cessation at less than half the cost experienced by the other two groups. Although additional studies are needed concerning the behavioral impact, cost effectiveness, and cost benefit of self-help health education methods for smoking cessation, the methods tested in this trial are promising as solutions to part of the problem of low birth weight among infants of smoking mothers in the United States.

Cost-Benefit Analysis↗

Personal health practices of urban adults in Alabama: Davis Avenue Community Study.

The need to establish baseline data on and monitor the personal health practices and beliefs of adults in a community served by health care facilities is well documented. The purpose of the survey was to determine health care practices, personal health behaviors, and health services use of the adults living in the Davis Avenue Community (DAC), a six-census tract area located in Mobile, AL. The DAC's population is approximately 95 percent black. Using methods developed by the National Center for Health Statistics, 402 adults between the ages of 20 and 69 years were interviewed by telephone by trained personnel to ascertain the health-related characteristics of residents in this health services area. Information collected in this survey provided the staff of the Franklin Memorial Primary Health Center, who provide primary health care in the area, with an empirical base on which to plan and market health promotion and education programs for the health services area.

Adult↗

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↗