, 2009a). Although several decades of research have focused on interventions for pregnant smokers, interventions developed and evaluated among AI/AN pregnant women do not exist (Melvin & Gaffney, 2004; U.S. Department of Health and Human Services, 2001). The updated Clinical Practice Guideline (Fiore et al., 2008) highlighted the need for development of selleck products effective interventions and delivery strategies for pregnant tobacco users generally and especially populations that carry a disproportionate burden from tobacco such as Alaska Native women. In addition, no previous work has evaluated interventions for women who use ST during pregnancy. To enhance acceptability and feasibility, the updated Clinical Practice Guideline emphasized that new techniques and treatment delivery strategies may be required to address the needs of AI/AN pregnant tobacco users (Fiore et al.

). The current pilot study assessed the feasibility and acceptability of a targeted cessation intervention for pregnant Alaska Native women. Information learned from this study could be useful in developing cessation interventions for pregnant women in other AI/AN communities. Methods This study was approved by the Alaska Area Institutional Review Board (IRB), the Yukon-Kuskokwim Health Corporation (YKHC), the Alaska Native Tribal Health Consortium, and the Mayo Clinic IRB. Study setting The Y-K Delta region is located in Western Alaska with a total population of 25,000. Bethel (population 5,000) is the hub of the 56 villages comprising this region. The geography and climate of the Y-K Delta region pose severe transportation limitations.

There is no road system connecting the villages and people travel by small airplane, boat, or snow machine. Approximately 94% of the population outside of Bethel are of Alaska Native ethnicity (Yup��ik or Cup��ik) and are homogenous with respect to language and culture. Few Alaska Natives are employed and most engage in subsistence living (Alaska Humanities Forum, 2003). About 99% of women receive prenatal care at the Y-K Delta Regional Hospital (YKDRH) in Bethel. In addition to the first prenatal visit at the YKDRH, nearly all women are seen at about Week 36 of gestation. At this time, high-risk pregnancies are triaged to the Alaska Native Medical Center in Anchorage. The remaining women stay at the Bethel prematernal home until delivery. There was an average of 600 Y-K Delta births per year from 2000 to 2007. The YKDRH clinical cessation program has provided nicotine dependence Brefeldin_A treatment services to patients and employees of YKHC since 1999. This program provides nicotine dependence treatment and counseling services to all patients of the hospital through referrals from the medical staff.