STudy on E-Cigarettes and Pregnancy (STEP) – Study Protocol of a Mixed Methods Study on Risk Perception of E-Cigarette Use During Pregnancy and Sample Description

 

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Abstract

Introduction During pregnancy, the motherʼs healthy lifestyle is crucial for the health of the fetus. Potential risk factors for maternal and child health should therefore be identified and reduced as early as possible. The consumption of e-cigarettes represents one of these potential risk factors. Exploring risk perceptions about e-cigarette use during pregnancy can provide early indications of possible user motives. Therefore, our mixed methods STudy on E-cigarettes and Pregnancy (STEP) aimed to comprehensively analyze risk perceptions about e-cigarette use during pregnancy based on an Integrated Health Belief Model (IHBM). This paper describes the study design, methods, sample population and limitations of STEP.

Methods Our sequential mixed methods study combined qualitative and quantitative approaches. In the qualitative section of the study which preceded the quantitative part of the study, we aimed to characterize risk perceptions about e-cigarette use during pregnancy. We used a netnographic research approach which analyzed discussion threads in online forums dealing with e-cigarette use during pregnancy. The analysis was based on an IHBM. Identified themes were incorporated in the questionnaire which was developed for the quantitative part of the study. The quantitative section aimed to quantify, among other things, perceived threats, barriers and benefits and to explore differences in risk perception according to sociodemographic characteristics and tobacco and e-cigarette usage.

Results In the qualitative section, 1552 posts in 25 online discussion threads dealing, inter alia, with e-cigarette use during pregnancy were identified. The quantitative part looked at the responses in the questionnaires handed in by 575 pregnant women who attended a hospital in Hamburg (Germany) from April 2018 to January 2019 (response rate: 27.5%).

Conclusion Data collection was successful for both the qualitative and quantitative parts of the study. When interpreting the results of STEP, different limitations should be taken into account. The results of STEP provide starting points for the development of tailored preventive measures for pregnant women.

Zusammenfassung

Einleitung Während der Schwangerschaft ist ein gesunder Lebensstil der Mutter entscheidend für die Gesundheit des Fetus. Potenzielle Risikofaktoren für die Gesundheit von Mutter und Kind sollten daher frühestmöglich identifiziert und reduziert werden. Die Nutzung von E-Zigaretten stellt einen dieser potenziellen Risikofaktoren dar. Die Erforschung der Risikowahrnehmung der E-Zigarettennutzung in der Schwangerschaft kann frühzeitige Hinweise zu möglichen Nutzungsmotiven liefern. Unsere Mixed-Methods-Studie zu E-Zigaretten und Schwangerschaft (STEP) zielte daher auf die umfassende Analyse der Risikowahrnehmung der E-Zigarette in der Schwangerschaft basierend auf einem Integrierten Health Belief Model (IHBM). Das vorliegende Manuskript zielt auf die Beschreibung des Studiendesigns, der Methodik, der Stichprobe und der Limitationen von STEP.

Methoden Unsere sequenzielle Mixed-Methods-Studie kombinierte qualitative und quantitative Ansätze. Innerhalb des qualitativen Studienteils, welcher dem quantitativen Studienteil vorausging, zielten wir auf die Charakterisierung der Risikowahrnehmung der E-Zigarettennutzung in der Schwangerschaft. Basierend auf einem netnografischen Forschungsansatz analysierten wir Diskussionsstränge in Onlineforen, die sich mit der E-Zigarettennutzung in der Schwangerschaft beschäftigen. Die Analyse erfolgte in Anlehnung an das IHBM. Die identifizierten Themen dienten der Fragebogenentwicklung für den quantitativen Studienteil. Der quantitative Studienteil zielte auf die Quantifizierung der u. a. wahrgenommenen Risiken, Barrieren und Vorteile sowie der Untersuchung der Unterschiede in der Risikowahrnehmung abhängig von soziodemografischen Eigenschaften und dem Nutzungsverhalten von Tabak- und E-Zigaretten.

Ergebnisse Im qualitativen Studienteil wurden 1552 Beiträge in 25 Onlinediskussionssträngen, die sich u. a. mit der E-Zigarettennutzung in der Schwangerschaft beschäftigen, identifiziert. Im quantitativen Studienteil beantworteten insgesamt 575 Schwangere in einem Krankenhaus in Hamburg (Deutschland) den Fragebogen (Response: 27,5%) von April 2018 bis Januar 2019.

Schlussfolgerung Die Datensammlung im qualitativen und quantitativen Studienteil verlief erfolgreich. Bei der Interpretation der Ergebnisse von STEP müssen unterschiedliche Limitationen berücksichtigt werden. Die Ergebnisse von STEP liefern Ansatzpunkte für die Entwicklung von gezielten Präventionsmaßnahmen für Schwangere.

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