The Effect of Motivational Interviewing and Digital Game-Supported Counseling on Postpartum Relapse

N/ARecruitingNCT07271953

Lokman Hekim University72 enrolled

Overview

This randomized controlled trial aims to determine the effect of motivational interviewing-based, digital game-supported counseling on postpartum smoking relapse among pregnant women who quit smoking spontaneously during pregnancy. Women who smoked at least one cigarette per day before pregnancy and quit smoking during pregnancy will be included. Participants will be randomly assigned to two groups: in the intervention group, online motivational interviewing sessions will be delivered once each during the third and fourth prenatal follow-ups by the researcher, and a digital game assignment will be provided after each session; the control group will receive routine health counseling delivered during prenatal follow-ups. The primary outcome measure is the rate of smoking relapse at three months postpartum. Secondary outcome measures include the postpartum slip rate, craving to smoke, and motivation to remain abstinent.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

Conditions

Postpartum Period Smoking Relapse Behavior

Interventions

Motivational Interviewing and Digital Game-Supported CounselingBEHAVIORAL

Collaborative, autonomy-supportive counseling delivered in two structured sessions using motivational interviewing techniques, scheduled during the 3rd and 4th routine antenatal visits. The counseling focuses on sustaining abstinence, coping with cues, relapse prevention, and managing partner/household exposure. Each session follows a manualized protocol, with a session checklist completed at every visit. After each session, participants are assigned a digital game-based task designed to reinforce key counseling themes and support behavior maintenance.

Routine Antenatal CareBEHAVIORAL

Routine antenatal care is provided at the study hospital according to the Ministry of Health's pregnancy follow-up program, which includes visits at ≤14 weeks, 18-24 weeks, 28-32 weeks, and 36-38 weeks of gestation.

Eligibility

Sex: FEMALEMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Aged ≥18 years * Being in the second trimester of pregnancy * Smoked at least one cigarette per day before pregnancy and quit smoking during the first trimester of pregnancy * Have internet access * Own a device capable of playing the digital game (e.g., smart phone, tablet, or computer) * Native Turkish speakers Exclusion Criteria: * Having a diagnosis of any psychiatric disorder * Currently using another pharmacological or behavioral smoking cessation method * Having a high-risk pregnancy Withdrawal Criteria: * Experience pregnancy termination for any reason * Do not participate in any stage of the counseling sessions * Are diagnosed with postpartum depression during the postpartum period * Resume smoking during pregnancy

Outcomes

Primary Outcomes

Point prevalence abstinence

7-day point prevalence abstinence at 3 months postpartum

Time frame: At 3 months postpartum

Continuous abstinence

Continuous abstinence rate at 3 months postpartum

Time frame: At 3 months postpartum

Secondary Outcomes

Motivation for smoking abstinence

Assessed using the Turkish version of the Abstinence-Related Motivational Engagement (ARME) Scale, which evaluates participants' motivation to maintain smoking abstinence through total scale scores.

Time frame: At baseline, and at 1, 2, and 3 months postpartum

Level of cigarette craving

Measured using a self-reported 0-10 rating scale for cigarette craving (0 = no craving, 10 = extreme craving).

Time frame: At baseline, and at 1, 2, and 3 months postpartum

Prevalence of slips

Time frame: At 1, 2, and 3 months postpartum