{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:10:24Z","timestamp":1791486624429,"version":"4.3.4"},"reference-count":74,"publisher":"BMJ","issue":"8","funder":[{"DOI":"10.13039\/100013026","name":"Hunter Cancer Research Alliance","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100013026","id-type":"DOI","asserted-by":"crossref"}]},{"name":"NSW Ministry of Health"},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,4,28]]},"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Indigenous women have the highest smoking prevalence during pregnancy (47%) in Australia. Health professionals report lack of knowledge, skills and confidence to effectively manage smoking among pregnant women in general. We developed a behaviour change intervention aimed to improve health professionals\u2019 management of smoking in Indigenous pregnant women\u2014the Indigenous Counselling And Nicotine (ICAN) QUIT in Pregnancy. This intervention includes webinar training for health professionals, an educational resources package for health professionals and pregnant women, free oral nicotine replacement therapy (NRT) for pregnant women, and audit and feedback on health professionals' performance.<\/jats:p>\n                    <jats:p>The aim of this study is to test the feasibility and acceptability of the ICAN QUIT in Pregnancy intervention to improve health professionals' provision of evidence-based culturally responsive smoking cessation care to Australian Indigenous pregnant smokers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This protocol describes the design of a step-wedge cluster randomised pilot study. Six Aboriginal Medical Services (AMSs) are randomised into three clusters. Clusters receive the intervention staggered by 1\u2009month. Health professionals report on their knowledge and skills pretraining and post-training and at the end of the study. Pregnant women are recruited and followed up for 3\u2009months. The primary outcome is the recruitment rate of pregnant women. Secondary outcomes include feasibility of recruitment and follow-up of participating women, and webinar training of health professionals, measured using a designated log; and measures of effectiveness outcomes, including quit rates and NRT prescription rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>In accordance with the Aboriginal Health and Medical Research Council guidelines, this study has been developed in collaboration with a Stakeholder and Consumer Aboriginal Advisory Panel (SCAAP). The SCAAP provides cultural consultation, advice and direction to ensure that implementation is acceptable and respectful to the Aboriginal communities involved. Results will be disseminated to AMSs, Aboriginal communities and national Aboriginal bodies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration details<\/jats:title>\n                    <jats:p>This protocol (version 4, 14 October 2016) is registered with the Australian and New Zealand Clinical Trials Registry (Ref #: ACTRN 12616001603404).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-016095","type":"journal-article","created":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T12:45:21Z","timestamp":1659098721000},"page":"e016095","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["The Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy Pilot Study protocol: a feasibility step-wedge cluster randomised trial to improve health providers' management of smoking during pregnancy"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1916-836X","authenticated-orcid":false,"given":"Yael","family":"Bar-Zeev","sequence":"first","affiliation":[{"name":"The University of Newcastle, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Billie","family":"Bonevski","sequence":"additional","affiliation":[{"name":"The University of Newcastle, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Bovill","sequence":"additional","affiliation":[{"name":"The University of Newcastle, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maree","family":"Gruppetta","sequence":"additional","affiliation":[{"name":"The University of Newcastle, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Oldmeadow","sequence":"additional","affiliation":[{"name":"Hunter Medical Research Institute, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerrin","family":"Palazzi","sequence":"additional","affiliation":[{"name":"Hunter Medical Research Institute, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lou","family":"Atkins","sequence":"additional","affiliation":[{"name":"Centre for Behaviour Change, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Reath","sequence":"additional","affiliation":[{"name":"Western Sydney University, Penrith, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian S","family":"Gould","sequence":"additional","affiliation":[{"name":"The University of Newcastle, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,8,4]]},"reference":[{"key":"2025121515275408000_7.8.e016095.1","unstructured":"Australian Institute of Health and Welfare. Australia's mothers and babies 2013\u2014in brief. Canberra: AIHW, 2015."},{"key":"2025121515275408000_7.8.e016095.2","unstructured":"Australian Institute of Health and Welfare. Australian burden of disease study: impact and causes of illness and death in Aboriginal and Torres Strait Islander people, 2011. Canberra: AIHW, 2016."},{"key":"2025121515275408000_7.8.e016095.3","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1375\/jsc.6.1.33","article-title":"Jumping the Hurdles for Smoking Cessation in Pregnant Aboriginal and Torres Strait Islander Women in Australia","volume":"6","author":"Gould","year":"2011","journal-title":"The Journal of Smoking Cessation\u00a0"},{"key":"2025121515275408000_7.8.e016095.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2013.08.006"},{"key":"2025121515275408000_7.8.e016095.5","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/nts211"},{"key":"2025121515275408000_7.8.e016095.6","first-page":"31","article-title":"Exploring the barriers and enablers to smoking cessation in Pregnant Aboriginal and Torres Strait Islander women with the behaviour change wheel","volume":"21","author":"Gould","year":"2014","journal-title":"Australasian Epidemiologist"},{"key":"2025121515275408000_7.8.e016095.7","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2012-050436"},{"key":"2025121515275408000_7.8.e016095.8","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-12-165","article-title":"Knowledge, attitudes and other factors associated with assessment of tobacco smoking among pregnant aboriginal women by health care providers: a cross-sectional survey","volume":"12","author":"Passey","year":"2012","journal-title":"BMC Public Health"},{"key":"2025121515275408000_7.8.e016095.9","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1093\/ntr\/ntw331","article-title":"Opportunities Missed: A Cross-Sectional Survey of the Provision of Smoking Cessation Care to Pregnant Women by Australian General Practitioners and Obstetricians","volume":"19","author":"Zeev","year":"2017","journal-title":"Nicotine Tob Res"},{"key":"2025121515275408000_7.8.e016095.10","doi-asserted-by":"crossref","unstructured":"Gould GS . Here's how to close the gap on indigenous women smoking during pregnancy. The Conversation (Iss. July 21). 2016. https:\/\/theconversation.com\/heres-how-to-close-the-gap-on-indigenous-women-smoking-during-pregnancy-62347","DOI":"10.64628\/AA.6w7ha3a4q"},{"key":"2025121515275408000_7.8.e016095.11","unstructured":"Fiore MC . Treating tobacco use and dependence: 2008 update. U.S. Department of Health and Human Services. Public Health Service."},{"key":"2025121515275408000_7.8.e016095.12","first-page":"CD001055","article-title":"Psychosocial interventions for supporting women to stop smoking in pregnancy","volume":"10","author":"Chamberlain","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121515275408000_7.8.e016095.13","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-013-9486-6"},{"key":"2025121515275408000_7.8.e016095.14","doi-asserted-by":"publisher","DOI":"10.3310\/hta19880"},{"key":"2025121515275408000_7.8.e016095.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2010.11.016"},{"key":"2025121515275408000_7.8.e016095.16","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntr324"},{"key":"2025121515275408000_7.8.e016095.17","first-page":"CD010078","article-title":"Pharmacological interventions for promoting smoking cessation during pregnancy","volume":"12","author":"Coleman","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121515275408000_7.8.e016095.18","doi-asserted-by":"crossref","unstructured":"Stead LF , Perera R , Bullen C , et al . Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev\u00a0 2012.","DOI":"10.1002\/14651858.CD000146.pub4"},{"key":"2025121515275408000_7.8.e016095.19","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.301.2.594"},{"key":"2025121515275408000_7.8.e016095.20","first-page":"46","article-title":"Management of smoking in pregnant women","volume":"43","author":"Mendelsohn","year":"2014","journal-title":"Aust Fam Physician"},{"key":"2025121515275408000_7.8.e016095.21","unstructured":"Zwar N , Richmond R , Borland R , et al . Supporting smoking cessation: a guide for health professionals. Melbourne, 2011. (updated July 2014)."},{"key":"2025121515275408000_7.8.e016095.22","unstructured":"NICE. Smoking: stopping in pregnancy and after childbirth, 2010."},{"key":"2025121515275408000_7.8.e016095.23","first-page":"57","article-title":"New Zealand smoking cessation guidelines","volume":"121","author":"McRobbie","year":"2008","journal-title":"N Z Med J"},{"key":"2025121515275408000_7.8.e016095.24","unstructured":"Canadian Action Network for the Advancement, Dissemination and Adoption of Practice-informed Tobacco Treatment. Canadian smoking cessation clinical practice guideline. Toronto, Canada, 2011."},{"key":"2025121515275408000_7.8.e016095.25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6909.2009.01084.x"},{"key":"2025121515275408000_7.8.e016095.26","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03530400058039"},{"key":"2025121515275408000_7.8.e016095.27","doi-asserted-by":"publisher","DOI":"10.4278\/ajhp.110624-QUAL-265"},{"key":"2025121515275408000_7.8.e016095.28","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-005-9009-x"},{"key":"2025121515275408000_7.8.e016095.29","first-page":"53","article-title":"Supporting pregnant women to quit smoking: postal survey of New Zealand general practitioners and midwives' smoking cessation knowledge and practices","volume":"121","author":"Glover","year":"2008","journal-title":"N Z Med J"},{"key":"2025121515275408000_7.8.e016095.30","doi-asserted-by":"publisher","DOI":"10.1080\/09595239800186981"},{"key":"2025121515275408000_7.8.e016095.31","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.midw.2004.12.011","article-title":"The attitude of maternity staff to, and smoking cessation interventions with, childbearing women in London","volume":"21","author":"Condliffe","year":"2005","journal-title":"Midwifery"},{"key":"2025121515275408000_7.8.e016095.32","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-200103000-00006"},{"key":"2025121515275408000_7.8.e016095.33","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000280572.18234.96"},{"key":"2025121515275408000_7.8.e016095.34","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.3.1.39"},{"key":"2025121515275408000_7.8.e016095.35","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2006.15.400"},{"key":"2025121515275408000_7.8.e016095.36","doi-asserted-by":"publisher","DOI":"10.1080\/1462220031000094150"},{"key":"2025121515275408000_7.8.e016095.37","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-536x.1998.00025.x"},{"key":"2025121515275408000_7.8.e016095.38","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.jmwh.2005.12.003","article-title":"Perceptions and use of smoking cessation in nurse-midwives' practice","volume":"51","author":"Price","year":"2006","journal-title":"J Midwifery Womens Health"},{"key":"2025121515275408000_7.8.e016095.39","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/ADM.0000000000000000","article-title":"Smoking cessation during pregnancy and postpartum: practice patterns among obstetrician-gynecologists","volume":"8","author":"Coleman-Cowger","year":"2014","journal-title":"J Addict Med"},{"key":"2025121515275408000_7.8.e016095.40","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000165.pub4"},{"key":"2025121515275408000_7.8.e016095.41","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2014-007020","article-title":"Predictors of intentions to quit smoking in aboriginal tobacco smokers of reproductive age in regional New South Wales (NSW), Australia: quantitative and qualitative findings of a cross-sectional survey","volume":"5","author":"Gould","year":"2015","journal-title":"BMJ Open"},{"key":"2025121515275408000_7.8.e016095.42","first-page":"CD000214","article-title":"Training health professionals in smoking cessation","volume":"5","author":"Carson","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121515275408000_7.8.e016095.43","first-page":"47","article-title":"Methodological challenges and options for addressing them in Aboriginal and Torres Strait Islander health research","volume":"21","author":"Smith","year":"2014","journal-title":"Australasian Epidemiologist"},{"key":"2025121515275408000_7.8.e016095.44","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-14-250","article-title":"Developing anti-tobacco messages for australian aboriginal and Torres Strait Islander peoples: evidence from a national cross-sectional survey","volume":"14","author":"Gould","year":"2014","journal-title":"BMC Public Health"},{"key":"2025121515275408000_7.8.e016095.45","doi-asserted-by":"publisher","DOI":"10.5694\/mja11.10858"},{"key":"2025121515275408000_7.8.e016095.46","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntp180"},{"key":"2025121515275408000_7.8.e016095.47","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1017\/jsc.2014.3","article-title":"A Pragmatic Guide for Smoking Cessation Counselling and the Initiation of Nicotine Replacement Therapy for Pregnant Aboriginal and Torres Strait Islander Smokers","volume":"10","author":"Gould","year":"2015","journal-title":"J Smok Cessat"},{"key":"2025121515275408000_7.8.e016095.48","unstructured":"NSW Ministry of Health. quit for new life NRT Protocol. Centre for Population Health 2013."},{"key":"2025121515275408000_7.8.e016095.49","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-7-37"},{"key":"2025121515275408000_7.8.e016095.50","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-1"},{"key":"2025121515275408000_7.8.e016095.51","doi-asserted-by":"crossref","unstructured":"Bovill M , Bar-Zeev Y , Gruppetta M , et al . Collective and negotiated design for a clinical trial addressing smoking cessation supports for Aboriginal and Torres Strait Islander mothers in NSW, SA and Qld ? developing a pilot study. Aust J Prim Health 2017. published online 31 March 2017.doi:10.1071\/PY16140","DOI":"10.1071\/PY16140"},{"key":"2025121515275408000_7.8.e016095.52","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h391"},{"key":"2025121515275408000_7.8.e016095.53","unstructured":"Australian Institute of Health and Welfare. Healthy Futures\u2014Aboriginal Community Controlled Health Services: Report Card 2016. Canberra, 2016."},{"key":"2025121515275408000_7.8.e016095.54","article-title":"Assessing and validating an Educational Resource Package for the management of Smoking Cessation in Indigenous Pregnant Women","volume":"12","author":"Bar-Zeev","year":"2016","journal-title":"Asia-Pacific J Clin Oncol"},{"key":"2025121515275408000_7.8.e016095.55","unstructured":"The Health Consequences of Smoking-50 years of Progress: a Report of the Surgeon General. Atlanta, 2014."},{"key":"2025121515275408000_7.8.e016095.56","doi-asserted-by":"publisher","DOI":"10.1080\/14622200410001669169"},{"key":"2025121515275408000_7.8.e016095.57","unstructured":"Gould G , Clarke M , Cadet-James M , et al . Our smoking and smoke-free stories\u201d by Aboriginal women: a qualitative study. GP16 Conference, Perth, WA. 2016."},{"key":"2025121515275408000_7.8.e016095.58","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1991.tb01879.x"},{"key":"2025121515275408000_7.8.e016095.59","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntt127"},{"key":"2025121515275408000_7.8.e016095.60","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2010.03226.x"},{"key":"2025121515275408000_7.8.e016095.61","doi-asserted-by":"publisher","DOI":"10.1111\/add.13395"},{"key":"2025121515275408000_7.8.e016095.62","doi-asserted-by":"publisher","DOI":"10.3109\/00016347109157292"},{"key":"2025121515275408000_7.8.e016095.63","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.pmedr.2014.10.004","article-title":"Using the risk behaviour diagnosis scale to understand australian aboriginal smoking - A cross-sectional validation survey in regional New South Wales","volume":"2","author":"Gould","year":"2015","journal-title":"Prev Med Rep"},{"key":"2025121515275408000_7.8.e016095.64","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2004.00995.x"},{"key":"2025121515275408000_7.8.e016095.65","doi-asserted-by":"publisher","DOI":"10.3109\/00048674.2010.482919"},{"key":"2025121515275408000_7.8.e016095.66","unstructured":"Haswell M , Blignault I , Fitzpatrick S , et al . The Social and Emotional Wellbeing of Indigenous Youth: reviewing and extending the evidence and examining its implications for policy and practice, 2013."},{"key":"2025121515275408000_7.8.e016095.67","doi-asserted-by":"crossref","first-page":"S115","DOI":"10.1111\/1753-6405.12448","article-title":"Improving health service access and wellbeing of young aboriginal parents in an urban setting: mixed methods evaluation of an arts-based program","volume":"40","author":"Jersky","year":"2016","journal-title":"Aust N Z J Public Health"},{"key":"2025121515275408000_7.8.e016095.68","doi-asserted-by":"publisher","DOI":"10.1186\/1478-7954-8-2"},{"key":"2025121515275408000_7.8.e016095.69","first-page":"521","article-title":"The Delete-a-Group Jackknife","volume":"17","author":"Kott","year":"2001","journal-title":"J off stat"},{"key":"2025121515275408000_7.8.e016095.70","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-117"},{"key":"2025121515275408000_7.8.e016095.71","unstructured":"NHMRC. Values and ethics: guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research. Canberra, ACT: Commonwealth of Australia, 2003."},{"key":"2025121515275408000_7.8.e016095.72","doi-asserted-by":"crossref","first-page":"24","DOI":"10.5694\/mja14.00581","article-title":"Facilitators and barriers to implementation of a pragmatic clinical trial in aboriginal health services","volume":"203","author":"Liu","year":"2015","journal-title":"Med J Aust"},{"key":"2025121515275408000_7.8.e016095.73","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-14-579","article-title":"Clinical trials in a remote aboriginal setting: lessons from the BOABS smoking cessation study","volume":"14","author":"Marley","year":"2014","journal-title":"BMC Public Health"},{"key":"2025121515275408000_7.8.e016095.74","unstructured":"West R . Assessing smoking cessation performance in NHS Stop Smoking Services: the Russell Standard (Clinical)- Version 2, 2005."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-016095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T23:28:11Z","timestamp":1765841291000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-016095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8]]},"references-count":74,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2017,8,4]]},"published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1136\/bmjopen-2017-016095"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-016095","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8]]}}}