Pathways from socioeconomic status to prenatal smoking: A test of the reserve capacity model

Irene Yang, Lynne A. Hall, Kristin Ashford, Sudeshna Paul, Barbara Polivka, S. Lee Ridner

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: Low-income, unemployed women with low levels of education aremore likely to smoke during pregnancy compared to their higher-income, employed, and well-educated counterparts. The reserve capacity model (RCM) offers a theoretical framework to explain how psychosocial factors may serve as pathways connecting socioeconomic status (SES) to health behaviors. Research supports the link between prenatal smoking and several psychosocial variables such as chronic stressors, depressive symptoms, and social support. How these variables interrelate to explain the predominance of prenatal smoking in lower socioeconomic groups of pregnant women has not been fully elucidated. Objective: The aim of this study was to test the RCM to evaluate the roles of early pregnancy levels of chronic stress, quality of the primary intimate relationship, and depressive symptoms in explaining the relationship between SES and persistent prenatal smoking. Methods: A secondary analysis of data from 370 pregnant nonsmokers, spontaneous quitters, and persistent prenatal smokers was conducted. On the basis of the RCM, chronic stressors, depressive symptoms, and the quality of the primary intimate relationship were evaluated as potential mediating variables linking SES with persistent prenatal smoking using path analysis. Results: Path analyses indicated that a simple model with all three psychosocial variables as mediators of the relationship between SES and persistent prenatal smoking provided the best fit. Discussion: Findings indicated that chronic stressors, depressive symptoms, and the quality of the primary intimate relationship play important roles in the pathway from SES to prenatal smoking status. This knowledge can assist in the development of prevention and intervention strategies to target these variables and ultimately reduce prenatal smoking.

Original languageEnglish
Pages (from-to)2-11
Number of pages10
JournalNursing Research
Volume66
Issue number1
DOIs
StatePublished - 2017

Bibliographical note

Funding Information:
The authors acknowledge that this project was supported by Grant 1P30 GM110788-01 from the National Institute of General Medical Sciences, Grant T32 NR01275 from the National Institute of Nursing Research, and a Dissertation Completion Award from the University of Louisville School of Interdisciplinary and Graduate Studies. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of General Medical Sciences, the National Institute of Nursing Research, or the National Institutes of Health.

Publisher Copyright:
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • Pregnant women
  • Psychosocial aspects
  • Smoking
  • Socioeconomic status

ASJC Scopus subject areas

  • Nursing (all)

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