Pediatrician Advice, Family Counseling & SHS Reduction for Underserved Children
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Second Hand Tobacco Smoke
- Sponsor
- Temple University
- Enrollment
- 327
- Locations
- 4
- Primary Endpoint
- Child Urine Cotinine
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
The study's primary aim is to test the hypothesis that an intervention integrating pediatric clinic-level quality improvement with home-level behavioral counseling (CQI+BC) will result in greater reductions in child cotinine (a biomarker of secondhand smoke exposure) and reported cigarettes exposed/day than a clinic-level quality improvement plus attention control intervention (CQI+A). A secondary aim is to test the hypothesis that relative to CQI+A, CQI+BC will result in higher cotinine-verified, 7-day point prevalence quit rate among parents.
Detailed Description
Child secondhand smoke exposure (SHSe) is a significant public health problem that has been linked to asthma, acute respiratory illnesses, otitis, and SIDS, and is associated with increased risk of cancers, cardiovascular disease, and behavior problems. This project will test the effectiveness of a comprehensive multilevel intervention to reduce young children's SHSe in minority and medically underserved communities known to have the highest SHSe-related morbidity and mortality risk. First, we will provide a clinic-level quality improvement (CQI) intervention to improve the care of pediatric patients with SHSe in four pediatric clinics in North and West Philadelphia. We will then randomize eligible parents visiting the CQI clinics into either a home-level behavioral counseling intervention (CQI+BC) or a home-level attention control intervention (CQI+A). In addition to clinic-level intervention, CQI+BC provides personalized, behavioral counseling with intensive skills training and support where SHSe occurs (in the home), as well as systems navigation to facilitate access to and effective use of reimbursable nicotine replacement therapy and smoking cessation medication. Participants will complete assessments at pre-treatment, 3-month end of treatment, and 12-month follow-up.
Investigators
Eligibility Criteria
Inclusion Criteria
- •at least 18 years of age
- •English-speaking
- •parent or legal guardian of child under 11 years old who lives with him/her
- •daily smoker
Exclusion Criteria
- •non-nicotine drug dependence
- •psychiatric disturbance (bipolar, schizophrenia, psychosis)
- •inadequate health literacy
Outcomes
Primary Outcomes
Child Urine Cotinine
Time Frame: up to 12 months
Child urine cotinine is a biomarker for assessing second-hand smoke exposure. We anticipate the CQI+BC treatment group will experience a greater reduction in child urine cotinine over time than the CQI+A control group.
Parent-reported Second-hand Smoke Exposure in Cigarettes Per Day From All Sources
Time Frame: up to 12 months
Parental report of cigarettes child is exposed to each day in the home and car by all sources during the 7 days prior to assessment. We anticipate the CQI+BC treatment group will report greater reductions in second-hand smoke exposure over time than the CQI+A control group.
Secondary Outcomes
- Parent-reported Cotinine-verified 7-day Point Prevalence Abstinence(up to 12 months)