A+ Head Start Intervention for Smoke Free Homes

无烟家庭的领先干预措施

• 批准号: 7895764
• 负责人: CYNTHIA S RAND
• 金额: $ 62.86万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7895764
• 关键词: Age; Air; Asthma; Awareness; Baltimore; Behavior Therapy; Behavioral; Bronchitis; Caregivers; Characteristics; Child; Child health care; Childhood Asthma; Chronic; Chronic Bronchitis; Cities; Communities; Cotinine; Education; Education Projects; Educational Background; Effectiveness; Enrollment; Environmental Tobacco Smoke; Expectancy; Exposure to; Family; Head Start Program; Health; Health Knowledge, Attitudes, Practice; Home environment; Household; Intervention; Link; Low Literacy Population; Low income; Measures; Mediator of activation protein; Medical; Mental Depression; Minority; Morbidity - disease rate; Motivation; Nicotine; Otitis Media; Outcome; Outcome Measure; Patient Self-Report; Population; Poverty; Preschool Child; Prevalence; Public Health; Randomized Clinical Trials; Relative (related person); Reporting; Research; Respiratory Tract Infections; Risk; Role; Salivary; Schools; Self Efficacy; Severities; Smoke; Smoker; Smoking; Stress; Structure; Students; Surveys; Symptoms; Testing; Tobacco; United States Environmental Protection Agency; Wheezing; Work; aged; base; demographics; experience; follow-up; health care service utilization; high risk; improved; indexing; motivational enhancement therapy; programs; psychosocial; respiratory; secondary outcome; smoking cessation; smoking intervention; social; successful intervention; urinary

DESCRIPTION (provided by applicant): Environmental tobacco smoke (ETS) exposure has been identified as a significant threat to children's respiratory health and has been clearly linked to increased risk of asthma, bronchitis, wheeze and otitis media. ETS exposure is higher in households at or below poverty level and this same population has also been found to be at significantly increased risk for asthma morbidity, as well as other respiratory infections. Studies have reported that between 30-70% of low-income children with asthma enrolled in Head Start programs report a smoker in the home. Because of the increased health risks experienced by their students, Head Start programs have a mandate to help high-risk families improve the health of their preschool children. Further, in 2007 the Environmental Protection Agency (EPA) and the Office of Head Start announced a new initiative to promote smoke-free homes for Head Start Children. For these reasons, Head Start programs offer a timely and important venue for reaching high-risk, low-income pre-school children and intervening to reduce these children's exposure to ETS. We therefore propose to draw on our established health and research partnership with Head Start programs in Baltimore City to test the effectiveness of an ETS reduction intervention with demonstrated efficacy, when delivered in the context of an overall EPA-based Head Start ETS reduction education program. Specifically, we will conduct a randomized clinical trial of a home-delivered, motivational interviewing-based ETS reduction intervention combined with a HS-level EPA/ETS education program in reducing children's ETS exposure, compared to a HS-level EPA/ETS education program alone. We will enroll 350 HS students aged 2-5 years with a caregiver-reported smoker in the home from all 17 Baltimore City HS programs. The primary study outcome measure will be household ETS levels, as measured by home air nicotine levels at six month follow-up. Secondary outcomes include caregiver-reported home and car smoking bans, child's salivary cotinine levels, children's respiratory symptoms, caregiver smoking cessation, school absences, and health care utilization measures. In addition, at the HS level we will evaluate the degree of implementation of the HS-level EPA/ETS education program, change in the proportion of families who report smoking in home for all HS students, and change in HS staff knowledge, attitudes and practices related to ETS exposure and reduction. If successful, this demonstration and education project could have significant public health implications for school and community-based strategies to improve children's long-term respiratory health. Environmental tobacco smoke (ETS) exposure has been identified as a significant threat to children's respiratory health and has been clearly linked to increased risk of asthma, bronchitis, wheeze and otitis media. Low-income and minority children are more likely to be exposed to second-hand smoke and to suffer respiratory illnesses, such as asthma. The current study will test a behavioral intervention to reduce ETS exposure among low-income preschool children enrolled in Head Start and if successful, this project could have significant public health implications for school and community-based strategies to improve children's long-term respiratory health.

描述（由申请人提供）： 环境烟草烟雾（ETS）暴露已被确定为对儿童呼吸健康健康的重大威胁，并且显然与增加哮喘，支气管炎，喘息和中耳炎的风险增加有关。在贫困水平或低于贫困水平的家庭中，ETS的暴露率更高，也发现同一人群显着增加了哮喘发病率以及其他呼吸道感染的风险。研究报道说，有30-70％的低收入儿童参加了头开始计划，报告了家中吸烟者。由于学生的健康风险增加，因此头开始计划具有帮助高风险家庭改善其学龄前儿童的健康的任务。此外，在2007年，环境保护署（EPA）和Head Start办公室宣布了一项新计划，以促进Head Start儿童的无烟房屋。由于这些原因，Head Start计划提供了一个及时，重要的场所，以吸引高风险，低收入的学龄前儿童和干预以减少这些孩子对ETS的接触。因此，我们建议在巴尔的摩市与Head Start计划建立的健康和研究合作伙伴关系，以测试ETS减少干预措施的有效性，并在总体基于EPA的Head Start START START DICETS减少教育计划的背景下提供了功效。具体而言，与仅HS级EPA/ETS教育计划相比，我们将对基于HS级的EPA/ETS教育计划进行一项家庭提供的，基于动机的ETS减少干预措施的随机临床试验。我们将在所有17个巴尔的摩市HS计划中的家庭中，在家庭中招募350名2-5岁的HS学生。主要的研究结果指标将是家庭ETS水平，如六个月随访时由家庭空气尼古丁水平衡量。次要结果包括护理人员报告的家庭和汽车吸烟禁令，儿童唾液可替宁水平，儿童呼吸症状，护理人员戒烟，学校缺勤和医疗保健利用措施。此外，在HS级别，我们将评估HS级EPA/ETS教育计划的实施程度，改变为所有HS学生报告在家中吸烟的家庭的比例，以及HS员工知识，态度和与ETS暴露和减少有关的HS员工知识，态度和实践。如果成功的话，这个演示和教育项目可能会对改善儿童长期呼吸健康健康的学校和社区策略产生重大的公共卫生影响。环境烟草烟雾（ETS）暴露已被确定为对儿童呼吸健康健康的重大威胁，并且显然与增加哮喘，支气管炎，喘息和中耳炎的风险增加有关。低收入和少数民族儿童更有可能暴露于二手烟雾并遭受呼吸道疾病（例如哮喘）。当前的研究将测试行为干预措施，以减少入学开始的低收入学龄前儿童中的ETS暴露，如果成功，该项目可能对改善儿童长期呼吸道健康的学校和社区策略具有重大的公共卫生影响。