Smoking Cessation Counselling for Pregnant and Postpartum Women among Midwives, Gynaecologists and Paediatricians in Germany

The incorporation of guidelines for the treatment of tobacco smoking into routine care requires positive attitudes, counselling skills and knowledge about additional help available for smokers. The study assesses performance of smoking cessation intervention, attitudes, training status and knowledge about additional help for smokers in the care for pregnant and parenting women by midwives, gynaecologists and paediatricians. A survey of all midwives, gynaecologists and paediatricians registered for primary medical care in the federal state Saarland, Germany, was conducted. Participation in the postal questionnaires was 85 %. Depending on profession, 90 % to 100 % see smoking cessation counselling as their assignment, 17 % to 80 % screen for, 48 % to 90 % document smoking status, and 55 % to 76 % offer brief or extensive counselling. 61 % to 87 % consider training to enhance their knowledge and/or counselling skills necessary. The compliance of providers with the necessity to give support in smoking cessation is very high. However, the current status of cessation counselling does not sufficiently correspond to the evidence based requirements. Reports in medical press and advanced training courses should support health care providers and establish smoking as an inherent topic of the anamnesis and treatment of current and former pregnant or parenting smokers

Interobserver agreement of the German translation of the Motivational Interviewing Sequential Code for Observing Process Exchanges

The aim of this study is to assess the interobserver agreement of the German translation of the MI-SCOPE. We applied it to transcribed counseling sessions on smoking cessation and relapse prevention with women postpartum. The MI-SCOPE is an instrument to assess and quantify MI-specific processes. Twenty percent random samples for parsing and coding each were drawn from 162 transcripts of MI sessions from the treatment arm of an RCT to assess interobserver agreement. Whole transcripts were coded. Each transcript was randomly assigned to two of three raters who parsed and coded the transcripts separately. Cohen’s κ was computed to assess interobserver agreement. Concordance about parses ranged between κ = .702 and κ = .955 (25th percentile−median−75th percentile: .896−.918−.936). The kappas did not differ significantly between the three combinations of raters (H = 2.648; df = 2, p = .266). Concordance about codes for all 46 categories ranged between κ = .590 and κ = .822 (25th percentile−median−75th percentile: .680−.718−.748). The kappas did not differ significantly between the three combinations of raters (H = 4.095; df = 2, p = .129). The German translation of the MI-SCOPE yielded good to excellent κ for parsing as well as for coding. This indicates that MI as an intervention can be taught, learned, and adherence to MI as an intervention may be objectively observed and assessed