SHS Treatment for Postpartum African American Smokers

针对产后非裔美国吸烟者的二手烟治疗

• 批准号: 7266361
• 负责人: BRADLEY N COLLINS
• 金额: $ 47.1万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-16 至 2009-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7266361
• 关键词: 2 year old; Abstinence; Address; Affect; African American; American; Asthma; Behavior; Behavioral; Benefits and Risks; Binding; Caring; Cessation of life; Characteristics; Child; Childhood; Chronic Bronchitis; Cigarette; Clinic; Clinical; Combined Modality Therapy; Communities; Community Health; Condition; Control Groups; Cotinine; Counseling; DNA; Daily; Effectiveness; Environmental Tobacco Smoke; Family; Fostering; Frequencies; Future; Genetic; Goals; Healthcare; Healthy People 2010; Home environment; Infant; Intervention; Intervention Studies; Knowledge; Life; Link; Lung; Mails; Manuals; Maternal and Child Health; Measurement; Measures; Mediating; Mental Depression; Moods; Morbidity - disease rate; Mothers; Outcome; Outcome Measure; Outsourcing; Participant; Patient Self-Report; Pediatric Hospitals; Pennsylvania; Philadelphia; Population; Postpartum Period; Prevalence; Primary Health Care; Program Development; Psychology; Psychosocial Factor; Public Health; Randomized; Rate; Recruitment Activity; Risk; Saliva; Shapes; Smoke; Smoker; Smoking Behavior; Social support; Standards of Weights and Measures; Support System; Telephone; Testing; Time; Tobacco; Tobacco use; Transdisciplinary Tobacco Research Center; Treatment outcome; Unintentional Childhood Injury; Universities; Urine; Week; Weight; Weight Gain; Withholding Treatment; Woman; base; behavior change; concept; day; depressive symptoms; design; disorder later incidence prevention; falls; follow-up; improved; maternal cigarette smoking; mortality; pediatrician; programs; psychosocial; response; self help; smoking cessation; success; week trial

DESCRIPTION (provided by applicant): More than 19 million children in the U.S. are exposed to second-hand smoke (SHS) on a daily basis. Infants are the most susceptible to SHS harm, and for children under five, SHS exposure causes more deaths than all unintentional childhood injuries combined. In response to Healthy People 2010 goals and NCI priorities, this trial aims to reduce infant SHS exposure in an under-served urban African American (AA) population while simultaneously promoting smoking cessation among the postpartum (Pp) mothers. The proposed 16-week trial, "Philadelphia FRESH (Family Rules for Establishing Smoke-free Homes)," will randomize 450 Pp mothers of children up to two years old into two treatment groups. Mothers randomized to the multimodal, individualized treatment (MIT) will receive 1.) pediatrician advice, 2.) two intensive, family-centered, in-home behavioral counseling sessions, 3.) a culturally-sensitive treatment manual mailed in four sections, biweekly starting week 1, and 4.) seven follow-up phone counseling sessions. Mothers in the standard care control (SCC) group will receive pediatrician assessment, advice, and one comprehensive self-help manual with information on SHS and its reduction, smoking cessation, and relapse prevention. We predict that through 12-month follow-up, the MIT group will demonstrate better infant SHS exposure and maternal smoking outcomes (measured by self-report, infant urine cotinine, and maternal saliva cotinine) than the SCC group. Our trial will also test the mediating influence of social support, perceived infant vulnerability to SHS, and negative affect on smoking outcomes by incorporating treatment components to boost and sustain natural maternal support systems, increase knowledge of SHS risks and benefits of SHS reduction, and improve mood management. We hypothesize that improvements in these variables will positively impact treatment outcome. Finally, our trial will test the moderating effects of baseline weight concerns and depression symptoms. We hypothesize a main effect for baseline weight concerns and depression on outcomes, as well as an interaction: moms with greater baseline weight concern and depression will have better outcomes in MIT compared to SCC. We will use GEE analysis to test hypothesized smoking behavior changes across baseline, 8-week, 16-week (EOT), 3-mo and 12-month follow-up time points and explore the influence of moderating variables. Path analysis will test mediating variables' influence on outcomes.

描述（由申请人提供）：美国有超过1900万儿童每天暴露于二手烟（SHS）。婴儿最容易受到SHS伤害，对于五岁以下的儿童，与所有无意的儿童伤害相比，SHS暴露会导致更多的死亡。为了应对健康人的2010年目标和NCI的优先事项，该试验旨在减少在服务不足的城市非裔美国人（AA）人口中的婴儿SHS暴露，同时促进产后（PP）母亲中的戒烟。拟议的16周审判“费城新鲜（建立无烟房屋的家庭规则）”将使450 pp的儿童母亲最多两岁，分为两个治疗组。母亲随机地接受多模式的个性化治疗（MIT）。每两周开始第一周，第4周。）七个后续电话咨询会议。标准护理控制中的母亲（SCC）小组将获得儿科评估，建议以及一份全面的自助手册，其中包含有关SHS及其减少，戒烟和预防复发的信息。我们预测，通过12个月的随访，麻省理工学院组将表现出比SCC组更好的婴儿SHS暴露和孕产妇吸烟结果（通过自我报告，婴儿尿cotinine和母体唾液Cotinine衡量）。我们的试验还将通过合并治疗成分来增强和维持自然产妇支持系统，增加SHS风险和减少SHS的益处，并改善SHS的知识，并改善SHS的知识，并改善社会支持，感知到婴儿对SHS的脆弱性以及对吸烟结果的负面影响以及对吸烟结果的负面影响以及对吸烟结果的负面影响的中介影响，并情绪管理。我们假设这些变量的改善将对治疗结果产生积极影响。最后，我们的试验将测试基线体重问题和抑郁症状的调节作用。我们假设对基线体重的关注和抑郁症对结果的主要影响以及一种相互作用：与SCC相比，基线体重更大，抑郁症的妈妈在麻省理工学院的结果将更好。我们将使用GEE分析来测试基线，8周，16周（EOT），3-MO和12个月的随访时间点的假设吸烟行为的变化，并探索调节变量的影响。路径分析将测试中介变量对结果的影响。