Exploring the Impact of Missing Data on Maternal Tobacco Program Results: An Analysis of Self-Efficacy on Smoking Cessation

Exploring the Impact of Missing Data on Maternal Tobacco Program Results: An Analysis of Self-Efficacy on Smoking Cessation | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Exploring the Impact of Missing Data on Maternal Tobacco Program Results: An Analysis of Self-Efficacy on Smoking Cessation Mengting Zhao, Benjamin Langworthy This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4573036/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 3 You are reading this latest preprint version Abstract Background: Tobacco use is a major contributor to chronic illnesses worldwide, leading to significant morbidity and mortality. Effective tobacco cessation programs are crucial in reducing the health risks associated with smoking. This study aims to investigate the relationship between confidence scores, indicating individuals’ confidence in quitting smoking on a scale of 0 to 10, and carbon monoxide (CO) levels over time among participants in the North Dakota State Department of Health Maternal Tobacco Program. Methods: We analyzed data from 226 participants using linear mixed-effects models and accounted for missing data using complete case analysis, multiple imputation under a missing at random (MAR) assumption, and multiple imputation under a missing not at random (MNAR) assumption with various delta-adjustment values. This MNAR assumption is considered because we believe patients who resume smoking may be less likely to return for follow-up visits. Results: The findings suggest that higher confidence scores at the first prenatal visit were associated with lower CO levels, and this effect attenuated over time. This indicates that participants with higher confidence scores were less likely to smoke. Our results remained consistent under different missing data assumptions for prenatal visits, including MAR and MNAR mechanisms. The postpartum dataset yielded similar results. Conclusion: Our study highlights the importance of evaluating participants’ self-assessed confidence during their initial baseline visit. The findings indicate that patients with lower confidence scores are at an increased risk of discontinuing their participation in the program. Tobacco cessation Missing Not at Random Multiple Imputation Full Text Additional Declarations Competing interest reported. Mengting Zhao is an employee of Professional Data Analysts (PDA), which helps to support the North Dakota State Department of Health and Human Services, Tobacco Prevention and Control Program. Supplementary Files supplementarymaterial.pdf Cite Share Download PDF Status: Under Review Version 1 posted Editor assigned by journal 17 Jun, 2024 Submission checks completed at journal 17 Jun, 2024 First submitted to journal 12 Jun, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4573036","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":315570722,"identity":"58967ec6-cc01-42d9-9848-b2dfef7554b6","order_by":0,"name":"Mengting Zhao","email":"","orcid":"","institution":"University of Minnesota","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Mengting","middleName":"","lastName":"Zhao","suffix":""},{"id":315570723,"identity":"6e5af2f5-7c78-43a5-bde7-9bdaac1db343","order_by":1,"name":"Benjamin Langworthy","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAvklEQVRIiWNgGAWjYBACPjBpICHHD+EzE9bCBiYrLIwlG0jTcqYiccMBorWwnz38mrdNInHzjey0BwwV1okNBLXw5KVZA7UYb7uRu92A4Uw6EVoYcsyMc9skZIFatkkwth0mQgv/G7AWxs0zQFr+EaNFIsf4cc4ZCcUNEiAtDURpeWPG/KdCwljizNttEgnH0o0JauHnzzH+OMOgTo6/HWjLhxprWYJawBbBmQlEKAcB5g9EKhwFo2AUjIKRCgAehzrLS8xKWwAAAABJRU5ErkJggg==","orcid":"","institution":"University of Minnesota","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Benjamin","middleName":"","lastName":"Langworthy","suffix":""}],"badges":[],"createdAt":"2024-06-13 02:26:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4573036/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4573036/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":59544266,"identity":"3bde4a1d-9b73-47f3-a639-87eef2f65033","added_by":"auto","created_at":"2024-07-03 04:43:30","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":261017,"visible":true,"origin":"","legend":"","description":"","filename":"ExploringtheImpactofSelfEfficacyonSmokingCessation.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4573036/v1_covered_5102f571-96b5-4c6c-9a9f-166edccaa197.pdf"},{"id":59543459,"identity":"94ae4895-a741-432d-b0f4-8684d1577831","added_by":"auto","created_at":"2024-07-03 04:35:29","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":195637,"visible":true,"origin":"","legend":"","description":"","filename":"supplementarymaterial.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4573036/v1/2350ae9773b0be08107b2580.pdf"}],"financialInterests":"Competing interest reported. 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Effective tobacco cessation programs are crucial in reducing the health risks associated with smoking. This study aims to investigate the relationship between confidence scores, indicating individuals’ confidence in quitting smoking on a scale of 0 to 10, and carbon monoxide (CO) levels over time among participants in the North Dakota State Department of Health Maternal Tobacco Program.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods: We analyzed data from 226 participants using linear mixed-effects models and accounted for missing data using complete case analysis, multiple imputation under a missing at random (MAR) assumption, and multiple imputation under a missing not at random (MNAR) assumption with various delta-adjustment values. This MNAR assumption is considered because we believe patients who resume smoking may be less likely to return for follow-up visits.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: The findings suggest that higher confidence scores at the first prenatal visit were associated with lower CO levels, and this effect attenuated over time. This indicates that participants with higher confidence scores were less likely to smoke. Our results remained consistent under different missing data assumptions for prenatal visits, including MAR and MNAR mechanisms. The postpartum dataset yielded similar results.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusion: Our study highlights the importance of evaluating participants’ self-assessed confidence during their initial baseline visit. 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