Intervening with Smoking Parents of Inpatients to Reduce Exposure

对住院患者的吸烟父母进行干预以减少接触

• 批准号: 9001324
• 负责人: Karen M. Wilson
• 金额: $ 45.99万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-08 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9001324
• 关键词: Abstinence; Acute bronchitis; Address; Admission activity; Adult; Asthma; Biological; Biological Markers; Bronchiolitis; Child; Childhood; Chronic; Clinical; Complex; Consult; Control Groups; Cotinine; Counseling; Coupled; Diagnosis; Disease; Education; Effectiveness; Environmental Tobacco Smoke; Exposure to; Family; Floor; Future; Goals; Grant; Guidelines; Health; Health Care Costs; Home environment; Hospitalization; Hospitalized Child; Hospitals; Influenza; Inpatients; Institution; Intervention; Lead; Lower Respiratory Tract Infection; Maintenance; Morbidity - disease rate; Outpatients; Parents; Pediatric Research; Pneumonia; Population; Prevalence; Prevention; Process Measure; Professional counselor; Provider; Randomized Controlled Trials; Readiness; Reporting; Risk; Role; Screening procedure; Services; Site; Smoke; Smoke-free home; Smoker; Smoking; Smoking Cessation Intervention; System; Testing; Time; Tobacco; Tobacco Dependence; Tobacco Use Cessation; Tobacco smoke; Tobacco use; Training; Treatment Efficacy; United States Public Health Service; Validation; dissemination trial; effective intervention; efficacy testing; environmental tobacco smoke exposure; evidence base; follow-up; group intervention; health related quality of life; home smoking ban; implementation trial; improved; member; mortality; motivational enhancement therapy; nicotine replacement; programs; quitline; screening; smoking cessation; success; tobacco control; tobacco exposure

DESCRIPTION (provided by applicant): Secondhand tobacco smoke (SHS) exposure is an important cause of morbidity and mortality among children; it is related to multiple diseases and increases the risk of hospitalization. Effective interventions exist for smoking cessation. In addition to the need for effective cessation interventions, there is an important role for counseling on exposure reduction, especially as evidence suggests that families with home smoking bans are more likely to quit smoking over time. Several studies have studied effective ways to provide cessation and exposure reduction counseling to parents of children in the outpatient setting and for adult inpatient smokers, including the Clinical Effort Against Secondhand Smoke (CEASE) project. The inpatient stay presents different challenges and opportunities from outpatient practice in the treatment of children's smoke exposure. The hospitalization of a child may present a teachable moment for parents who smoke. Several small studies of parents of hospitalized children have found modest success with inpatient interventions involving counseling, and QuitLine referral or nicotine replacement therapy. Our intervention uses the evidence-based US Public Health Service Treating Tobacco Use and Dependence guidelines coupled with the best evidence specific to using the child's inpatient stay to help parents quit smoking and reduce their children's exposure. We will use the RE-AIM framework to evaluate and maximize our institution's readiness to change, as well as intervention implementation and maintenance. We are proposing a randomized controlled trial to test the efficacy of our intervention bundle. The specific aims of the study are: Aim 1) To assess the efficacy of the intervention in increasing parent report of having smoke-free homes and cars 6 months after hospitalization; Aim 2) To demonstrate whether children whose parents receive the intervention bundle have greater decreases in cotinine levels 6 months post-hospitalization; Aim 3) To assess the efficacy of the intervention in increasing parent quit rates months after hospitalization; Aim 4) To use implementation process measures from the RE-AIM framework to assess the extent that our intervention results in hospital-wide systems change, including automatic screening for tobacco smoke exposure and delivery of tobacco control services. To achieve these aims, we are proposing a randomized controlled trial of our intervention bundle, which is evidence-based, effective in outpatient settings, and pilot-tested within our institution. We will follow both the control and intervention groups for 6 months, and use biological markers of exposure to assess exposure reduction and parent cessation. Understanding whether traditional smoking cessation interventions can help parents of hospitalized children will give inpatient providers an effective toolkit for providing a comprehensive intervention for tobacco cessation and exposure reduction.

描述（由申请人提供）：二手烟草烟雾（SHS）暴露是儿童发病率和死亡率的重要原因；它与多种疾病有关，并增加了住院的风险。存在有效的戒烟干预措施。除了需要有效的停止干预措施外，还在减少暴露的咨询方面还有重要作用，尤其是在证据表明，有家庭吸烟禁令的家庭更有可能随着时间的流逝而戒烟。几项研究研究了在门诊环境中为儿童的父母和成人的住院吸烟者（包括针对二手烟雾（CEASE）项目的临床努力）提供停止和减少暴露咨询的有效方法。住院住宿在治疗儿童的烟雾暴露方面带来了不同的挑战和机会。儿童的住院治疗可能会给抽烟的父母提供一个可教的时刻。对住院子女的父母的几项小型研究发现了涉及咨询的住院干预措施以及Quitline转诊或尼古丁替代疗法的成功成功。我们的干预使用基于证据的美国公共卫生服务，以治疗烟草使用和依赖指南，并提供特定于使用孩子住院住院的最佳证据，以帮助父母戒烟并减少孩子的暴露。我们将使用RE-AIM框架来评估和最大化机构准备改变以及干预实施和维护。我们提出了一项随机对照试验，以测试干预捆绑包的功效。该研究的具体目的是：目标1）评估干预措施在住院后6个月内有无烟房屋和汽车的父母报告的疗效；目标2）证明父母接受干预捆绑的孩子是否在院后6个月的可替氨酸水平降低了；目标3）评估干预措施在增加住院几个月后增加父母退出率的功效；目标4）使用RE-AIM框架中的实施过程指标，以评估我们的干预导致医院范围内的系统变化的程度，包括自动筛查烟草烟雾曝光和提供烟草控制服务的交付。为了实现这些目标，我们提出了对干预捆绑的随机对照试验，该试验是基于证据的，有效的门诊环境，并在我们的机构内进行了试点测试。我们将遵循6个月的对照组和干预组，并使用暴露的生物学标记来评估暴露量减少和父母戒烟。了解传统的戒烟干预措施是否可以帮助住院子女的父母为住院提供者提供有效的工具包，以提供全面的干预措施，以减少烟草戒烟和暴露。