A+ Head Start Intervention for Smoke Free Homes

无烟家庭的领先干预措施

基本信息

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
项目类别：
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

项目摘要

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）：环境中的烟草烟雾 (ETS) 暴露已被确定为对儿童呼吸系统健康的重大威胁，并且与哮喘、支气管炎、喘息和中耳炎的风险增加明显相关。贫困线或贫困线以下的家庭接触 ETS 的比例较高，而且这些人群患哮喘和其他呼吸道感染的风险也显着增加。研究报告称，参加 Head Start 计划的低收入哮喘儿童中有 30-70% 报告家中有吸烟者。由于学生面临的健康风险增加，启蒙计划的任务是帮助高风险家庭改善学龄前儿童的健康。此外，2007 年，环境保护署 (EPA) 和 Head Start 办公室宣布了一项新举措，旨在为 Head Start 儿童推广无烟家庭。出于这些原因，启蒙计划为接触高风险、低收入学前儿童并进行干预以减少这些儿童接触 ETS 提供了一个及时且重要的场所。因此，我们建议利用我们与巴尔的摩市 Head Start 计划建立的健康和研究伙伴关系，在基于 EPA 的 Head Start ETS 减少教育计划的背景下，测试 ETS 减少干预措施的有效性，并证明其效果。具体来说，我们将开展一项随机临床试验，对家庭实施的、基于动机访谈的 ETS 减少干预措施与 HS 级 EPA/ETS 教育计划相结合，与 HS 级 EPA/ETS 教育计划相比，减少儿童的 ETS 暴露独自的。我们将从所有 17 个巴尔的摩市高中项目中招收 350 名 2-5 岁的高中学生，家里有一名照料者报告吸烟者。主要研究结果衡量标准是家庭 ETS 水平，通过六个月随访时家庭空气中的尼古丁水平进行测量。次要结果包括看护者报告的家庭和汽车吸烟禁令、儿童唾液可替宁水平、儿童呼吸道症状、看护者戒烟、缺课和医疗保健利用措施。此外，在HS层面，我们将评估HS层面EPA/ETS教育计划的实施程度，所有HS学生报告在家吸烟的家庭比例的变化，以及HS员工知识、态度和行为的变化。与 ETS 暴露和减少相关的实践。如果成功，这一示范和教育项目可能会对学校和社区改善儿童长期呼吸健康的战略产生重大的公共卫生影响。环境中的烟草烟雾 (ETS) 暴露已被确定为对儿童呼吸系统健康的重大威胁，并且与哮喘、支气管炎、喘息和中耳炎的风险增加明显相关。低收入和少数民族儿童更有可能接触二手烟并患哮喘等呼吸道疾病。目前的研究将测试一种行为干预措施，以减少参加 Head Start 的低收入学龄前儿童的 ETS 暴露，如果成功，该项目可能会对学校和社区改善儿童长期呼吸健康的策略产生重大的公共卫生影响。