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

• 批准号: 9926738
• 负责人: Pebbles Fagan
• 金额: $ 37.7万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 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/9926738
• 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; Distress; Educational Materials; Electronic cigarette; Ethnic group; Exposure to; Face; Feedback; Focus Groups; Goals; Hand; Health; Health Personnel; Home environment; Improve Access; Infrastructure; Intervention; Interview; Knowledge; Link; 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; 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' s Group; acute toxicity; aged; cigarette smoking; cigarillos; comparative efficacy; design; electronic liquid; 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 culture; social disadvantage; social norm; theories; tobacco exposure; tobacco products; tobacco-free

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).

项目概要/摘要 与ARCHD的主题一致，本研究的长期目标是减轻多重负担 烟草暴露，改善获得预防性护理的机会，并降低慢性病的风险 非洲裔美国妇女和儿童的社会弱势群体吸烟率。 美国 (AA) 阿肯色州女性的总体吸烟率几乎是美国 AA 女性总体吸烟率的两倍 AR 群体中的患病率不断增加。健康差异通常与社会有系统的联系。 劣势，社会弱势群体的妇女和儿童获得预防性保健的机会较差 护理、二手烟暴露率不成比例地较高以及无烟暴露率较低 与优势群体相比，家庭政策有大量的医疗保健提供者和群体。 三角洲地区农村县的基础设施存在缺陷，但供应商在激励方面发挥着重要作用 妇女在家中实施无烟政策以保护其子女 社区卫生工作者。 来自社区，可以通过增加 对创新（即无烟政策）的认识，并说服他们考虑、采用和维持 女性护理人员经常制定在家吸烟的规则，但证据的传播- 农村社区的烟草控制政策进展缓慢。这项混合方法研究将应用一种方法。 使用创新扩散理论、健康信念模型和健康理论的实施框架 合理的行动指导旨在提高干预措施的制定和实施 采取全面的无烟政策（禁止香烟、雪茄、电子烟和水烟） 以及保管儿童的产品）在社会弱势 AA 老年女性护理人员的家中 居住在 AR 三角洲地区的 18-50 岁人士 我们的跨学科团队，无烟联盟。 阿肯色州、三县农村卫生网络和阿肯色医学大学将 实施一项小规模随机试验，测试可行性并比较干预结果 小组（社区卫生工作者+风险沟通材料+简短的动机咨询+烟草 儿童的暴露反馈）到对照组的暴露反馈（风险沟通材料） 结果，在家中实施无烟政策，以及次要结果，戒烟和吸烟 在 3、6 和 12 个月时减少。我们的目标是 1) 对 AA 女性进行半结构化访谈。 护理人员（n = 30）和社区卫生工作者（n = 15）了解多层次和领域因素 影响烟草使用和政策实践；2) 使用访谈数据来制定、调整和试点测试 使用 6 个女性护理人员焦点小组 (n = 48) 和利益相关者的反馈制定干预原型 合作伙伴委员会；3) 评估干预措施对研究结果的影响（n = 206）。