Perceptions of Aboriginal Women towards Smoking During Pregnancy
The harmful consequences of smoking during pregnancy have been widely documented. It is also known that during this period, mothers are more likely to reduce or stop smoking. Despite the information provided on the consequences of smoking, some women maintain this habit during pregnancy and this situation is more common among mothers from socio-economically disadvantaged backgrounds (Jamal et al. 2016). The significance that women give to smoking during pregnancy, whether they are smokers or not, has, however, been little studied. Small, Porr, Swab & Murray, (2018) conducted an extensive systematic review of qualitative evidence and managed to identify some of the possible factors that influence smoking during pregnancy. However, the study by Small, Porr, Swab & Murray, (2018) focus on general factors. The findings from such study cannot be applied in policy amendment because they are descriptive. It is because of this that the current study intends to establish aboriginal women from lower socioeconomic background in New South Wales about prominence of smoking cessation. The purpose of this research was to identify the perceptions of women from less advantaged socioeconomic backgrounds in New South Wales about prominence of smoking cessation.
At the origin of the study presented here, I found the conviction that it would important to complete and verify the knowledge acquired in order to understand how pregnant women in less advantaged socioeconomic backgrounds from New South Wales differ from women from high socioeconomic background in their perceptions towards smoking during pregnancy and how they perceive the messages that are transmitted to them about the use of tobacco. On the other hand, we considered that, at the time of pregnancy, women are more likely to be interested in the information that is transmitted and the content of the messages and to be permeable to them; Pregnancy is thus a time when they can acquire more knowledge and develop a motivation to integrate them into their behavior.
The study with utilize phenomenological design of qualitative research. This means that lived experience of the less advantaged women from New South Wales would be used to create themes. The use of a phenomenological design of qualitative approach would be appropriate for such exploratory research as it allowed the identification of their representations from the discourse of the first concerned. The women would be interviewed through semi-directed interviews during which they would be free to express themselves. The context of maternity supervision would be also addressed through group interviews with caregivers working with prenatal clients. Although such an approach has no claim to statistical representativeness, it does offer key elements for understanding a problem such as smoking during pregnancy.
Identification of Factors Inhibiting Inability to Stop Smoking During Pregnancy
The study will focus on all socioeconomic variables such as the level of income, the level of education, the relationship status of the participants and also the age. The need to study these variables is attributable to the fact that most of these variables could be the underlying causes of stress, which forces pregnant aboriginal mothers from New South Wales to engage in smoking during pregnancy as a way of alleviating stress (Ingall & Cropley 2010). The social and economic environment has a recognized influence on the development of representations and behaviors regarding tobacco and alcohol. This is why the sample would be constructed in such a way as to allow some exemplarity in this sense (Hauck, Ronchi , Lourey & Lewis 2013). It is also because of this that the two groups of women would targeted: pregnant aboriginal women from less advantaged socioeconomic backgrounds in New South Wales and pregnant women of medium to high socio-economic status. Family Affluence Scale (FAS) would help in determining the kind of questions to answer. The scale is important because it gives an idea about the socioeconomic status of the respondent. The variables would also be based on self-efficacy scale. The scale was developed based on a study by Condiotte & Lichtenstein (1981). It contain 36 items that captures the social and emotional situations in which people are likely to smoke.
The research participants would be selected by taking into account the diversity of their living environments (Johnston & Thomas 2008). The sample would be constructed in such a way as to allow some exemplarity in this sense. Two groups of women would be targeted: pregnant aboriginal women from less advantaged socioeconomic backgrounds in New South Wales and pregnant women of medium to high socio-economic status. Health and social services centers located in the study area would be requested to facilitate the recruitment of the participants through different services they offer. Aboriginal women from less affluent backgrounds from New South Wales were recruited through the program specifically designed for them. Women from better-off backgrounds were contacted through prenatal classes offered in the selected health and social service centers. Convenience sampling would be used. Eligible women would be asked for their consent before they are interviewed.
One of the instruments I plan to use is family affluence scale and self-efficacy scale. As mentioned earlier, Family Affluence Scale (FAS) would help in determining the kind of questions such as the socioeconomic situation of the participants (Johnston & Thomas 2008). The scale is important because it gives an idea about the socioeconomic status of the respondent. The variables would also be based on self-efficacy scale. The scale was developed based on a study by Lawrance (1989). It contains 36 items that captures the social and emotional situations in which people are likely to smoke.
Views of Aboriginal Women concerning Socioeconomic Conditions and Stress Levels
Questions would be asked about the environment and pregnancy monitoring to identify significant people. Other questions would be related to their sources of information. A short questionnaire would also be administered to collect additional socio-economic data.
Context
The study is set in suburb community of New South Wales where aboriginal women from different socioeconomic backgrounds resides.
Researcher role
The researcher’s role would be to design the appropriate questionnaires based on the scales selected, administer the interviews based on the questionnaires created and then analyze the interview responses.
At the origin of this research, we would rely on the premise, widely quoted in the scientific literature, that pregnancy is a special time in the adoption of better lifestyle habits, particularly the abandonment of smoking (Briggs, Lindorff & Ivers 2003). Smoking is one of the lifestyle habits most often cited as having serious consequences for maternal and fetal health, so the pressure on pregnant women to quit is particularly strong (Ino 2010). It is now established that smoking is the main modifiable risk factor for the morbidity and mortality associated with pregnancy in developed countries (Liu, Rao, Hu, Sun & Mao 2006). Despite this, some aboriginal women still smoke even when they are pregnant. The study would therefore be based on the believe that beyond the knowledge conveyed and integrated on the harmful aspects of smoking during pregnancy, it is much more the social identity and its foundations which will determine the perception of the risk and hence the smoking behavior. , but also, the dominant social representation of smoking during pregnancy (Einarson & Riordan 2009). The influence of the environment, particularly that of the partner and the immediate family, is highly likely to determine whether a pregnant woman will smoke or not (Wigginton & Lee 2013). This should be a pathway in the development of messages and programs for pregnant women. This study intends to demonstrate the multiple challenges faced by smokers, especially those from disadvantaged backgrounds (Borland, Babayan, Irfan & Schwartz 2013).
Once the data is obtained, qualitative analysis would be carried out in order to determine the major themes that can differentiate pregnant women from less privileged setting from the women from high socioeconomic status in regard to smoking during pregnancy. Thematic analysis would be conducted in order to ascertain key themes from each group of participants. The themes would then be compared to ascertain whether different socioeconomic statuses influence the smoking habits during pregnancy. The results would be presented in such a way as to highlight the differences and convergences noted in women’s discourse according to their socio-economic background.
Phenomenological Design of Qualitative Research to Identify Themes
One of the strengths of the research is that the instruments that would be used have been tested for validity. This means that if the right questions are used, the chances of getting valid results would be high. Another strength is that the use of a phenomenological design of qualitative approach would be appropriate for such exploratory research as it allowed the identification of their representations from the discourse of the first concerned. Nevertheless, the study is likely to be limited by bias from the researchers. In addition, the study sample may not be big enough to allow generalization of the findings.
Strict measures would be put in place to ensure the anonymity of the participants and the confidentiality of the data collected. The research would begin after the team received a certificate of ethical approval registered university within the setting.
References
Borland T., Babayan A., Irfan S. & Schwartz R. (2013). Exploring the adequacy of smoking cessation support for pregnant and postpartum women. BMC Public Health 2013;13(1):472
Briggs V. L., Lindorff K.J., Ivers R. G. (2003). Aboriginal and Torres Strait Islander Australians and tobacco. Tob Control 2003; 12(Suppl 2):ii5–8
Einarson A. & Riordan S. (2009). Smoking in pregnancy and lactation: a review of risks and cessation strategies. Eur J Clin Pharmacol 2009;65(4):325–30.
Hauck Y., Ronchi F., Lourey B. & Lewis L. (2013). Challenges and enablers to smoking cessation for young pregnant Australian women: a qualitative study. Birth 2013;40(3):202–8.
Horta B. L., Kramer M. S. & Platt R.W. (2001). Maternal smoking and the risk of early weaning: a meta-analysis. Am J Public Health 2001;91(2):304–7.
Ingall G. & Cropley M. (2010). Exploring the barriers of quitting smoking during pregnancy: a systematic review of qualitative studies. Women Birth 2010;23(2):45–52
Ino T. (2010). Maternal smoking during pregnancy and offspring obesity: meta-analysis. Pediatr Int 2010;52(1):94–9.
Jamal A., King B. A., Neff L. J., Whitmill J., Babb S. D., & Graffunder C. M. (2016). Current cigarette smoking among adults – United States, 2005–2015. MMWR Morb Mortal Wkly Rep 2016;65(44):1205–11
Johnston V. & Thomas D. P. (2008). Smoking behaviours in a remote Australian Indigenous community: the influence of family and other factors. Soc Sci Med 2008;67(11):1708–16
Lawrance, L. (1989). Validation of a self-efficacy scale to predict adolescent smoking. Health Education Research Theory and Practice, 4, 351-360.
Liu Y., Rao K., Hu T.W., Sun Q., & Mao Z. (2006). Cigarette smoking and poverty in China. Soc Sci Med 63(11):2784–90.
Small, S., Porr, C., Swab, M., Murray, C. (2018). Experiences and cessation needs of Indigenous women who smoke during pregnancy: a systematic review of qualitative evidence. JBI Database System Rev Implement Rep 2018; 16(2):385–452.
Wigginton B. & Lee C. (2013). A story of stigma: Australian women’s accounts of smoking during pregnancy. Crit Public Health 2013;23(4):466–81.
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