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Abstract
Objectives Explore Aboriginal women’s responses to an adapted Risk Behaviour Diagnosis (RBD) Scale about smoking in pregnancy.
Methods and design An Aboriginal researcher interviewed women and completed a cross-sectional survey including 20 Likert scales.
Setting Aboriginal Community Controlled Health Services, community groups and playgroups and Aboriginal Maternity Services in regional New South Wales, Australia.
Participants Aboriginal women (n=20) who were pregnant or gave birth in the preceding 18 months; included if they had experiences of smoking or quitting during pregnancy.
Primary and secondary outcome measures Primary outcomes: RBD constructs of perceived threat and perceived efficacy, dichotomised into high versus low. Women who had quit smoking, answered retrospectively. Secondary outcome measures: smoking status, intentions to quit smoking (danger control), protection responses (to babies/others) and fear control responses (denial/refutation). Scales were assessed for internal consistency. A chart plotted responses from low to high efficacy and low to high threat.
Results RBD Scales had moderate-to-good consistency (0.67–0.89 Cronbach’s alpha). Nine women had quit and 11 were smoking; 6 currently pregnant and 14 recently pregnant. Mean efficacy level 3.9 (SD=0.7); mean threat 4.3 (SD=0.7). On inspection, a scatter plot revealed a cluster of 12 women in the high efficacy-high threat quadrant—of these 11 had quit or had a high intention of quitting. Conversely, a group with low threat-low efficacy (5 women) were all smokers and had high fear control responses: of these, 4 had low protection responses. Pregnant women had a non-significant trend for higher threat and lower efficacy, than those previously pregnant.
Conclusion Findings were consistent with a previously validated RBD Scale showing Aboriginal smokers with high efficacy-high threat had greater intentions to quit smoking. The RBD Scale could have diagnostic potential to tailor health messages. Longitudinal research required with a larger sample to explore associations with the RBD Scale and quitting.
- Indigenous populations
- maternal smoking
- tobacco smoking
- risk assessment
- risk behaviour
- pregnancy
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Footnotes
Contributors GG conceived the study, designed the survey and the methods, prepared the data, contributed to the analysis and data interpretation and wrote the paper.
MB conducted the data collection, and contributed to the cultural interpretation of findings and final paper.
SC conducted the statistical analysis and wrote the preliminary findings.
BB oversaw the study, contributed to the interpretation and critically reviewed the final paper.
CO oversaw the statistical analysis, interpretation and writing of the results, and contributed to the final paper.
Competing interests None declared.
Ethics approval University of Newcastle HREC and Aboriginal Health and Medical Research Council HREC.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Indigenous protocols may limit the sharing of data for this paper.