Healthy Pregnancies Project: Cluster Randomized Controlled Trial of a Community Intervention to Reduce Tobacco Use among Alaska Native Women.
Christi A Patten, Harry A Lando, Chris A Desnoyers, Martha J Bock, Lucinda Alexie, Paul A Decker, Christine A Hughes, Kenneth Resnicow, Linda Burhansstipanov, Rahnia Boyer, Joseph Klejka
Author Information
Christi A Patten: Department of Psychiatry and Psychology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
Harry A Lando: School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, 1300 2nd St, Ste 200, Minneapolis, MN 55454, USA.
Chris A Desnoyers: Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA.
Martha J Bock: Department of Psychiatry and Psychology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. ORCID
Lucinda Alexie: Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA.
Paul A Decker: Department of Health Sciences Research, Mayo Clinic, Harwick 7, 200 First Street SW, Rochester, MN 55905, USA.
Christine A Hughes: Department of Psychiatry and Psychology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
Kenneth Resnicow: School of Public Health, University of Michigan, 109 S. Observatory, 3867 SPH1, Ann Arbor, MI 48109, USA.
Linda Burhansstipanov: Native American Cancer Initiatives, Inc., 3022 South Nova Road, Pine, CO 80470, USA.
Rahnia Boyer: Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA.
Joseph Klejka: Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA.
Substantial gaps remain in the evidence base for prenatal tobacco Use interventions among Indigenous women. Using a cluster randomized controlled trial (RCT), the Healthy Pregnancies Project evaluated a community-level intervention for Alaska Native (AN) women in rural western Alaska. Sixteen villages were randomly assigned to usual care (control, = 8 villages) or usual care plus a community-level intervention delivered by local AN "Native Sisters" ( = 8 villages). Outcomes were tobacco Use rate at delivery and at 2 and 6 months postpartum, with biochemical confirmation obtained at 6 months. The program had high reach, enrolling 73% of all eligible women screened. Of the 352 participants, 67% used tobacco at baseline. No significant differences emerged between study groups on follow-up in tobacco Use rates. More intervention than control participants made a quit attempt at 2 months postpartum (70% vs. 51%, respectively, = 0.012). Participants in both study groups reported the program helped to raise awareness of healthy pregnancies in the study villages. This trial supports the reach of a community-level intervention, but not its efficacy for reducing tobacco Use during pregnancy or postpartum. Efforts to sustain early quit attempts appear warranted. The community involvement, and reported impact on raising awareness of the importance of healthy pregnancies, supports the value of the research program in this community.
