The effectiveness of an educational video intervention delivering specified health-related information in helping Chinese smoking expectant fathers to quit : a pragmatic randomized controlled trial

Abstract

Background: Secondhand smoke exposure during pregnancy remains a significant problem in China, which can lead to adverse pregnant outcomes. It has been reported that 36% of the expectant fathers were current smokers and this rate even increased to 44% during postpartum. Despite 80% of these smokers were aware of smoking hazards, 53% of them failed to point out the diseases that can be caused by smoking. Besides, only 11% of them believed that SHS can negatively affect fetus’ health. Providing specified health-related information may motivate these smokers to quit. However, there is a paucity of smoking-related education or counselling services in China. Hence, an innovative intervention that clearly convey the specified health-related information focusing on the health of pregnant women and children should be developed. Video has been proven as an effective method in delivering health education. However, the effectiveness of combining the video and specified health-related educational information to help the expectant fathers quit smoking is underexplored. Aim: To examine the effectiveness of an educational video intervention delivering specified health-related information in helping smoking expectant fathers quit smoking. Methods: Before the interventional study, the factors contributing to the abstinence of expectant fathers were explored. The interventional video-set was developed by rigorous design and promoted after testing the feasibility and acceptability though a pilot study. A three-arm RCT was conducted in three tertiary hospitals in China with 1023 expectant fathers who were confirmed as smokers verified by an exhaled carbon monoxide level of 4 parts per million (ppm) or above and had smartphones for receiving interventions and follow-up, were invited to participate in the study. After receiving a smoking cessation leaflet and brief smoking cessation advice at baseline, all participants were randomly allocated into different groups. Among all participants, 333 in the video intervention group received four videos showing the smoking hazards specific to pregnant women and the fetus at 1-, 3-, 5-, and 7-week, 322 in the text-message intervention group received four text-messages containing the same information with the videos, and 368 in the control group received no further intervention. Subjects in the three groups were required to report their abstinence, stage of readiness to quit and smoking self-efficacy at baseline, 1-week, 1-, 3-, and 6-month follow-up. Results: Statistically significantly higher biochemical validated abstinence and self-reported 7-day point prevalence of abstinence, and more proportion of movement from the pre-contemplation stage to action stage were reported for subjects in video group than those in the text-message and control groups at 6-month follow-up. Conclusion: this study showed that the educational video intervention delivering specified health-related information was effective in promoting smoking cessation among smoking expectant fathers. Further studies should be carried out to examine its intervention effectiveness in long-term. Significance and implications: This study bridged the gap in existing literature by showing the effectiveness of an educational video intervention delivering specified health-related information in helping smoking expectant fathers quit. The results can be used to guide the development of smoking cessation interventions, particularly using the video to effectively deliver to smokers.