Concerns regarding potential distress caused by these procedures were alleviated in the initial pilot study of 30 women in which an anxiety self-report measure, the State-Trait Anxiety Inventory (Spielberger, Gorsuch, & Lushene, 1970), indicated no significant increase in anxiety postultrasound. In fact, there was a slight selleck chem Wortmannin nonsignificant decrease in state anxiety immediately following the ultrasound (Groff et al., 2005). Investigators also met with a subset of these women and observed no significant distress postultrasound. Relief that their babies were healthy was most commonly noted. MI intervention. The MI intervention consisted of one 45- to 50-min, face-to-face, individual counseling session conducted immediately after the ultrasound; one personalized feedback letter mailed 1 week later; and one follow-up counseling session conducted via telephone 2 weeks subsequent to the initial session.

Spacing was based, in part, on observations that typical 1-month intervals (corresponding to regularly scheduled prenatal visits) between intervention points may be too lengthy to have maximum impact (Secker-Walker, Solomon, Flynn, Skelly, & Mead, 1998). Master��s-level counselors were trained to deliver the MI intervention designed to promote diminished smoking during pregnancy, emphasizing cessation. The intervention was based on a specific therapeutic style of MI (W. Miller & Rollnick, 1991), originally evaluated on individuals with alcohol problems (W. Miller et al., 1992) and extended to other problem behaviors (Colby et al., 1998; Saunders, Wilkinson, & Phillips, 1995).

Elements of the Transtheoretical Model were also employed in this intervention (Prochaska, DiClemente, Velicer, & Rossi, 1993; Stotts et al., 2002). More specifically, the first MI counseling session (face-to-face) consisted of the following components: (a) building rapport and gathering information, (b) assessing current motivation, (c) discussing attempts to quit smoking and the importance of doing so, (d) identifying barriers to change, and (e) eliciting a change goal. The second session was conducted by telephone and was 20�C30 min in length. Session 2 focused primarily on the personalized feedback letter mailed to the woman within the previous 2 weeks. Feedback was delivered in a nonjudgmental objective manner consistent with an MI style.

Women reviewed the feedback letter with the counselor, and reactions and comments were elicited. Reviewing progress and renegotiating the change plan also occurred in Session 2. Personalized nonphysiological data based on the intake questionnaire were compiled for the feedback letter, including stage of change, pros and cons of quitting Carfilzomib (decisional balance), cognitive/behavioral change strategies (processes of change), temptations to smoke, and confidence to abstain. Smoking in the household and social networks were also addressed.