Reducing Tobacco Smoke Exposures among Low Income Children and Women Caregivers in the Arkansas Delta Region

减少阿肯色三角洲地区低收入儿童和妇女护理人员的烟草烟雾暴露

基本信息

批准号：
9484515
负责人：
Pebbles Fagan
金额：
$ 29.63万
依托单位：
UNIV OF ARKANSAS FOR MED SCIS
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/9484515
关键词：
Abstinence Adopted Adoption African American Arkansas Attitude Awareness Belief Biofeedback Caregivers Child Chronic Chronic Disease Cigar Cigarette Communication Communities Community Health Aides Control Groups Counseling County Cues Data Development Diffusion Diffusion of Innovation Disadvantaged Distress Educational Materials Electronic cigarette Ethnic group Exposure to Face Feedback Focus Groups Goals Hand Health Health Personnel Home environment Improve Access Intervention Interview Knowledge Link Liquid substance Longitudinal Studies Low income Malignant neoplasm of lung Measures Mediating Medical Methods Modeling Morbidity - disease rate Motivation Outcome Outcome Study Persons Play Policies Poverty Prevalence Preventive care Preventive healthcare Process Provider Research Research Infrastructure Risk Role Rural Rural Community Science Severities Smoke Smoke-free home Smoker Smoking Structure Testing Tobacco Tobacco smoke Tobacco use Treatment Efficacy Universities Woman Women&apos s Group acute toxicity aged cigarette smoking comparative efficacy design environmental tobacco smoke exposure evidence base group intervention health belief health disparity hookah innovation insight mortality primary outcome prototype public policy on tobacco racial and ethnic randomized trial risk perception rural area rural counties rural health network safety practice secondary outcome smoke-free policy smoking cessation smoking prevalence social social norm theories tobacco exposure

项目摘要

PROJECT SUMMARY/ABSTRACT Consistent with the theme of the ARCHD, the long-term goal of this study is to reduce the burden of multiple tobacco exposures, improve access to preventive care, and reduce the risk for chronic diseases among socially disadvantaged African American women and children. Cigarette smoking prevalence among African American (AA) Arkansan women is nearly double the overall smoking prevalence for AA women in the US and rates are increasing within this group in AR. Health disparities are often systematically linked to social disadvantage, with socially disadvantaged AA women and children having poorer access to preventive health care, disproportionately higher rates of secondhand smoke exposure, and lower exposure to smoke-free policies in the home compared to advantaged groups. There are enormous health care provider and infrastructure deficits in rural counties in the AR Delta region, yet providers play an important role in motivating women to implement smoke-free policies in the home to protect their children. Community health workers, who are from the community, could have a powerful influence on women's adoption processes by increasing the awareness of the innovation—i.e., smoke-free policies—and persuading them to consider, adopt, and sustain the innovation. Women caregivers often establish rules for smoking in the home, but the diffusion of evidence- based tobacco control policies in rural communities has been slow. This mixed-methods study will apply an implementation framework using the Diffusion of Innovation Theory, Health Belief Model, and Theory of Reasoned Action to guide the development and implementation of an intervention that aims to increase the adoption of comprehensive smoke-free policies (ban on cigarettes, cigars, electronic cigarettes, and hookah and safekeeping products from children) in the homes of socially disadvantaged AA women caregivers aged 18-50 years who live in the AR Delta region. Our transdisciplinary team, the Coalition for a Tobacco Free Arkansas, Tri-County Rural Health Network, and the University of Arkansas for Medical Sciences, will implement a small-scale randomized trial that tests the feasibility and compares outcomes for the intervention group (community health worker + risk communication materials + brief motivational counseling + tobacco exposure feedback on the child) to those for the control group (risk communication materials) on the primary outcome, implementation of smoke-free policy in the home, and the secondary outcomes, quitting and smoking reduction at 3, 6, and 12 months. Our aims are to 1) conduct semi-structured interviews among AA women caregivers (n = 30) and community health workers (n = 15) to understand multi-level and -domain factors that influence tobacco use and policy practices; 2) use the interview data to develop, adapt, and pilot test the intervention prototypes using 6 focus groups of women caregivers (n = 48) and feedback from our Stakeholder Partnership Board; and 3) assess the influence of the intervention on the study's outcomes (n = 206).

项目摘要/摘要与ACHD的主题一致，这项研究的长期目标是减少多重的燃烧烟草暴露，改善获得预防保健的机会，并降低慢性病的风险在社会上处于弱势群体的非裔美国妇女和儿童。非洲人吸烟的患病率美国（AA）阿肯色妇女几乎是美国AA妇女的整体吸烟率的两倍，在AR中，该组中的价格正在上升。健康差异通常与社会有系统地联系在一起劣势，社会上处于弱势的AA妇女和儿童无法获得预防健康护理，二手烟暴露的比例不成比例，无烟较低与优越的群体相比，家庭中的政策。有巨大的医疗保健提供者和基础设施在AR Delta地区的粗糙县定义，但提供商在激励方面发挥了重要作用妇女在家中实施无烟政策以保护自己的孩子。社区卫生工作者，谁来自社区，可以通过增加妇女的收养过程有强大的影响意识到创新（即无烟政策），并说服他们考虑，采用和维持创新。妇女照顾者经常在家庭中制定吸烟规则，但证据的扩散 - 根据农村社区的烟草控制政策，速度很慢。这项混合方法研究将适用使用创新理论的扩散，健康信念模型和理论的实施框架指导开发和实施干预措施的合理行动，旨在增加采用全面的无烟政策（禁止香烟，雪茄，电子香烟和水烟和儿童的保管产品）在社会不利的AA女子照料者的家中 18至50年的人居住在AR Delta地区。我们的跨学科团队，免费烟草联盟阿肯色州，三县农村健康网络和阿肯色大学医学科学大学将实施一个小规模的随机试验，该试验测试可行性并比较干预的结果小组（社区卫生工作者 +风险交流材料 +简短的动机咨询 +烟草对儿童的暴露反馈）给对照组（风险通信材料）的孩子的暴露反馈结果，在家中实施无烟政策以及次要结果，安静和吸烟减少3、6和12个月。我们的目标是1）AA妇女进行半结构化访谈护理人员（n = 30）和社区卫生工作者（n = 15）了解多层次和 - 域因因素影响烟草使用和政策实践； 2）使用访谈数据来开发，适应和试点测试干预原型使用6个焦点女性护理人员（n = 48）和我们的利益相关者的反馈合伙委员会； 3）评估干预对研究结果的影响（n = 206）。