Knowledge about the deleterious effects of smoking and its relationship to smoking cessation among pregnant adolescents.

Smoking cessation among pregnant adolescents remains a complex and unresolved issue. The purpose of this study was to examine adolescents' knowledge of the detrimental effects of smoking on pregnant women and fetuses and its relationship to efforts to quit smoking. The sample consisted of 71 pregnant adolescents, and a three-group randomized intervention design-Teen FreshStart (TFS), Teen FreshStart with buddy (TFSB), and usual care control (UCC)-was used. Instruments included a demographic questionnaire, a smoking history questionnaire, and an 11-item scale measuring knowledge of the effects of smoking during pregnancy. For the entire sample, knowledge scores increased significantly (p = .000) from T1 (preintervention) to T2 (postintervention), and the adolescents who quit smoking had significantly higher knowledge at T2 (p = .028) and greater increases (T1 to T2) in their knowledge (p = .019) than did those who did not quit. Together, the TFS and TFSB groups had significantly higher knowledge at T2 (p = .017) and a significantly greater increase in knowledge from T1 to T2 (p = .005) than did the UCC group. This also held true when the TFS and TFSB groups were examined individually. Each had significantly higher knowledge at T2 (TFS, p = .029; TFSB, p = .008) and a significantly greater increase in knowledge from T1 to T2 (TFS, p = .007; TFSB, p = .009) than did the UCC group. Furthermore, despite the small sample sizes, within-group comparisons showed (a) no significant differences between quitters and nonquitters in the UCC group, (b) significantly higher knowledge at T2 (p = .052) and a trend indicating greater increases in knowledge from T1 to T2 (p = .092) for the quitters compared with the nonquitters in the TFS group, and (c) a trend for adolescents in the TFSB group who quit smoking to have greater increases in knowledge compared with those who did not quit (p = .158). These results indicate the need for continued inquiry into the relationship between pregnant teenagers' health knowledge and decisions to stop smoking.

Attitudes and knowledge about drinking: relationships with drinking behavior among pregnant teenagers.

Data were collected on the drinking behavior of 415 pregnant adolescents from 1990 to 1994. The relationships between knowledge and attitudes about drinking and drinking behavior were examined. Knowledge about drinking was not related to average daily volume of alcohol before or during pregnancy. Those with specific knowledge about fetal alcohol effects drank less before pregnancy, and in the first trimester, and were also less likely to drink to intoxication. Among drinkers, general knowledge about drinking was significantly related to a decrease in drinking between pre-pregnancy and first trimester, as well as between first and third trimesters. Those with more intolerant attitudes about drinking drank less before and during pregnancy. They had fewer episodes of binge drinking, intoxication, negative consequences, and problem drinking during pregnancy. They were more likely to decrease drinking from the first to third trimesters. These relationships are relevant to developing effective education programs for the high-risk group of pregnant teenagers who drink.

Adaptation of children of parents suffering from cancer: A preliminary study of a new field for primary prevention research.

An important new field for primary prevention research is proposed: the adaptation of normal children to the stress of normal parents who suffer from cancer. A pilot retrospective investigation of adolescent daughters of mothers who has mastectomy for breast cancer revealed a high level of motivation to participate in the study. Most girls were significantly upset and felt inadequately supported during periods of peak stress in their mothers caused by the illness and its treatment. Prospective studies are proposed that will develop and evaluate methods to ameliorate suffering and to lower the risk of psychopathology in children of parents with cancer.

Patterns of cooperation of child psychiatry with other departments in hospitals.

Four patterns of child psychiatrist cooperation which have implications for prevention are described: Autonomous Psychiatric Unit; Consultation; Collaboration; and Executive Partnership. These represent a gradient of increasing participation of psychiatrists inside the other department in the treatment of patients, in case responsibility, and in administrative authority over the service system.