Enhancing Equity in Smoke-free Housing

Not Applicable

• Conditions: Tobacco Use Cessation; Tobacco Smoking; Tobacco Use; Second Hand Tobacco Smoke; Tobacco Use Disorder
• Interventions: Behavioral: Smokefree Implementation Framework and Toolkit

• Registration Number: NCT06042361
• Lead Sponsor: Harvard School of Public Health (HSPH)

Brief Summary

The goal of this clinical trial is to learn about the acceptability, feasibility, and effectiveness of smoke-free housing policy implementation in Permanent Supportive Housing communities. The main objective of this study is to identify and refine adaptations for a smoke-free housing implementation framework that incorporates behavioral health support and meets the needs of residents living in Permanent Supportive Housing.

Detailed Description

The study aims are:

Aim 1): Identify adaptations for a smokefree housing implementation framework and identify opportunities to integrate these adaptations with ongoing behavioral health support, to meet the needs of residents living in Permanent Supportive Housing (PSH) (Phase 1).

Aim 2): The research team will pilot test the adapted implementation framework, including an implementation toolkit, to assess the acceptability, feasibility and effectiveness of the primary intervention provided to Property Managers (Phase 2).

Aim 3): Based on a synthesis of qualitative and quantitative evidence, the research team will further refine the smokefree implementation framework and toolkit, comprising modified versions of the "Implementation Guide", "Action Plan" and "Implementation Checklist", to support future needs of Permanent Supportive Housing communities (Phase 3).

The research team seeks to use the opportunity provided by smokefree housing implementation to minimize indoor smoking and encourage smoking cessation, and thus help move communities with a history of profound health disparities towards a more equitable, tobacco-free future. The impact of this project will be evident not only among smokers, but also non-smokers, children and the elderly who share residential communities with people supported by PSH programs.

If successful, the results of this work will be used to promote broader and more effective use of the smokefree PSH implementation framework in federally-assisted public and affordable housing communities nationally.

Study Timeline

• Study First Submitted: 2023-07-27
• Study Start: 2023-09-01
• Study First Submitted QC: 2023-09-13
• Study First Posted: 2023-09-18
• Status Verified: 2024-10
• Last Update Submitted: 2024-10-17
• Last Update Posted: 2024-10-18
• Primary Completion: 2025-09-01
• Study Completion: 2025-12-31

Recruitment & Eligibility

• Status: ENROLLING_BY_INVITATION
• Sex: All
• Target Recruitment: 480

Inclusion Criteria

• Adult residents of the six affordable housing communities who smoke or do not smoke tobacco, who receive or do not receive Permanent Supportive Housing services, and can complete a survey in English or Spanish.
• Adult residents of the six affordable housing communities who smoke or do not smoke tobacco, who receive or do not receive Permanent Supportive Housing services, and can participate in a focus group discussion in English.
• Property Managers (or their designated appointees) of the six affordable housing communities where the research will be conducted and able to receive the intervention and participate in the qualitative interviews in English.
• Caseworkers who are dedicated health workers who provide behavioral health support (mental health and substance use support interventions) to residents at each of the six properties and who can receive the intervention and participate in the qualitative interviews in English.

Exclusion Criteria

• Those unable to speak English or Spanish.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Intervention	Smokefree Implementation Framework and Toolkit	All participants will receive the intervention of the Smokefree Implementation Framework and Toolkit

Primary Outcome Measures

Name	Time	Method
Acceptability of Intervention Measure (AIM)	Pre-intervention through 6 months post intervention	The Smokefree Implementation Framework and Toolkit is acceptable to implement in Permanent Supportive Housing communities. Measured using 4-items from the AIM.
Feasibility of Intervention Measure (FIM)	Pre-intervention through 6 months post intervention	The Smokefree Implementation Framework and Toolkit is feasible to implement in Permanent Supportive Housing communities. Measured using 4-items from the FIM.

Secondary Outcome Measures

Name	Time	Method
Behavior of residents who smoke	Pre-intervention through 6 months post intervention	Self-reported behavior of smoking (cigarettes/day in the past 30 days) of residents who smoke
Residents' self-reported exposure to secondhand smoke	Pre-intervention through 6 months post intervention	Self-reported exposure to secondhand smoke (smell or sight) in the home or around the property, will be assessed with two questions in survey form.
Ambient second-hand smoke in common indoor areas	Pre-intervention through 6 months post intervention	Monitored using passive nicotine dosimetry monitors placed in common areas

Trial Locations

Locations (1)

Harvard TH Chan School of Public Health; 🇺🇸 Boston, Massachusetts, United States