Prevalence and Correlates of Tobacco Smoking During the Perinatal Period Among Women Enrolled in a Midwestern WIC Program.

BACKGROUND: Perinatal tobacco smoking remains a public health concern and is associated with smoking related morbidity and mortality. This study aims to report the prevalence and correlates of smoking during pregnancy among low-income women. METHODS: The study sample comprised 729 pregnant women who were enrolled in a perinatal depression registry in a public health WIC program between 2013 and 2015. Smoking risks were obtained from the clinical USDA Risk Assessment. STATA 14.2 was used for analyses. RESULTS: 15.1% of women reported smoking during pregnancy. Compared to White women, Black women were less likely to smoke odds ratio (OR 0.45 [95% CI 0.25-0.81]). Foreign-born women and women living in non-smoking homes remained at a lower risk for smoking during pregnancy. IMPLICATIONS: Smoking during pregnancy is prevalent among low-income women. In addition to prenatal education on smoking cessation, supportive measures to help deliver smoking cessation interventions should be provided to household members.

Perinatal depression screening in a Women, Infants, and Children (WIC) program: perception of feasibility and acceptability among a multidisciplinary staff.

OBJECTIVE: Best practices for addressing women's mental health and screening for depression in public health clinics are not available. Clinic staff are often responsible for screening for depression; however, few studies examine staff perceptions on feasibility and acceptability of using perinatal screening for mood disorders in ethnically diverse public health clinics. METHODS: During December 2012, we conducted four focus groups using a semistructured interview guide with public health clinic staff of varying disciplines (n=25) in a Special Supplemental Nutrition Program for Women, Infants, and Children. All interviews were audio recorded and analyzed using thematic analysis. RESULTS: We found five descriptive themes related to acceptability and feasibility of screening for perinatal depression in a public health clinic. The main themes include (1) literacy barriers, (2) need for referrals and follow-up with outside services, (3) training and capacity needs, (4) stigma of depression, and (5) location and privacy of screening. Although multiple barriers to universal depression screening in a public health clinic were identified, participants found value in practice of screening low-income women for depression. CONCLUSION: Factors for facilitating implementation of systematic depression screening in a public health clinic have been identified. Implications discuss how policy makers and public health clinic administrators can improve the universal depression screening process.