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This randomized controlled trial aims to determine the effect of motivational interviewing-based, digital game-supported counseling on postpartum smoking relapse among pregnant women who quit smoking spontaneously during pregnancy. Women who smoked at least one cigarette per day before pregnancy and quit smoking during pregnancy will be included. Participants will be randomly assigned to two groups: in the intervention group, online motivational interviewing sessions will be delivered once each during the third and fourth prenatal follow-ups by the researcher, and a digital game assignment will be provided after each session; the control group will receive routine health counseling delivered during prenatal follow-ups. The primary outcome measure is the rate of smoking relapse at three months postpartum. Secondary outcome measures include the postpartum slip rate, craving to smoke, and motivation to remain abstinent.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention Group | Experimental | Participants will receive counseling supported by motivational interviewing and a digital game. |
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| Control Group | Active Comparator | Participants receive routine antenatal care |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Motivational Interviewing and Digital Game-Supported Counseling | Behavioral | Collaborative, autonomy-supportive counseling delivered in two structured sessions using motivational interviewing techniques, scheduled during the 3rd and 4th routine antenatal visits. The counseling focuses on sustaining abstinence, coping with cues, relapse prevention, and managing partner/household exposure. Each session follows a manualized protocol, with a session checklist completed at every visit. After each session, participants are assigned a digital game-based task designed to reinforce key counseling themes and support behavior maintenance. |
| Measure | Description | Time Frame |
|---|---|---|
| Point prevalence abstinence | 7-day point prevalence abstinence at 3 months postpartum | At 3 months postpartum |
| Continuous abstinence | Continuous abstinence rate at 3 months postpartum | At 3 months postpartum |
| Measure | Description | Time Frame |
|---|---|---|
| Motivation for smoking abstinence | Assessed using the Turkish version of the Abstinence-Related Motivational Engagement (ARME) Scale, which evaluates participants' motivation to maintain smoking abstinence through total scale scores. | At baseline, and at 1, 2, and 3 months postpartum |
| Level of cigarette craving |
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Inclusion Criteria:
Exclusion Criteria:
Withdrawal Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Nurbanu ODACI | Contact | +905444083222 | nur_banu_odaci@hotmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Bilge KALANLAR | Hacettepe Üniversitesi | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lokman Hekim Universty | Recruiting | Ankara | Ankara | Turkey (Türkiye) |
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A randomized controlled experimental study with pre-test post-test parallel design
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| Routine Antenatal Care | Behavioral | Routine antenatal care is provided at the study hospital according to the Ministry of Health's pregnancy follow-up program, which includes visits at ≤14 weeks, 18-24 weeks, 28-32 weeks, and 36-38 weeks of gestation. |
|
Measured using a self-reported 0-10 rating scale for cigarette craving (0 = no craving, 10 = extreme craving). |
| At baseline, and at 1, 2, and 3 months postpartum |
| Prevalence of slips | Prevalence of slips | At 1, 2, and 3 months postpartum |
| ID | Term |
|---|---|
| D062405 | Motivational Interviewing |
| ID | Term |
|---|---|
| D037001 | Directive Counseling |
| D003376 | Counseling |
| D008605 | Mental Health Services |
| D004191 | Behavioral Disciplines and Activities |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
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