Pregnancy Clinical Trial
Official title:
Evaluation of a Tailored Text Message Intervention for Pregnant Smokers (MiQuit): a Pilot Trial
The overall aim of the study is to estimate the likely impact of the MiQuit text message
based smoking cessation service for pregnant smokers and to establish robust estimates for
the key factors which would be required in order to design a larger definitive trial of this
intervention(MiQuit).
These key factors include: the range of recruitment rates in different centres; quit rates
amongst participants; feasibility of assessing smoking status of participants in later
pregnancy; and the likely effect of MiQuit when women are offered this in National Health
Service (NHS) settings.
Epidemiological evidence indicates that smoking during pregnancy increases the risk of many
pregnancy related complications and is associated with many adverse postnatal problems.
Around 15% of women still smoke throughout their pregnancy; younger women and those from more
deprived backgrounds are much more likely to smoke. Behavioural support, available through
NHS Stop Smoking Services, is effective but only accessed by a minority of smokers with most
trying to quit alone. For this large group, self-help interventions may be an effective
alternative.
MiQuit is a 12 week tailored, self-help, text-message intervention developed for pregnant
smokers. A pilot study found this was feasible and acceptable for recipients, thus if MiQuit
could have such an impact in routine NHS care, its low cost would make it highly
cost-effective.
Before MiQuit could be used in routine care, a definitive randomised controlled trial (RCT)
would be needed but currently there is insufficient information to justify conducting this.
This pilot trial will investigate whether it is possible to evaluate MiQuit in a multi-centre
RCT located within the NHS, using research network resources. This study will recruit 400
pregnant smokers who will be randomly allocated to either MiQuit or control, and will provide
estimates for the parameters required for determining the necessary resources for a
definitive trial. These include: the range of recruitment rates in different centres; quit
rates amongst participants; feasibility of assessing smoking status of trial participants in
later pregnancy and ascertainment rates obtained; and the likely effect of MiQuit when women
are offered this in NHS settings.
Secondary objectives include; To estimate and model the likely effectiveness and cost
effectiveness of MiQuit compared with usual care including a generic smoking cessation
information leaflet; To document participants' use of MiQuit interactive features and of NHS
cessation support; To assess the effect of MiQuit on social cognitive determinants of
quitting smoking and; To explore participant views and experiences of using MiQuit.
The participants will be recruited before 25 weeks gestation when they attend NHS hospital
clinics for routine antenatal ultrasound scans. Recruitment will take place in around 12
United Kingdom (UK) centres over a 12 month period. Follow-up will be via telephone at 1
month after randomization and again at week 36 gestation. The follow-up is over a 9 month
period. If a participant reports they have stopped smoking, this "quit" will be validated
with a exhaled Carbon Monoxide (CO) measurement and/or salivary cotinine measurement.
A small number of semi-structured telephone interviews will be carried out with a selection
of participants from the MiQuit arm to explore their views and experience of the
intervention.
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