Parents Awareness Reducing Exposure to Nicotine and Tobacco (PARENT)

家长减少接触尼古丁和烟草的意识（家长）

• 批准号: 7547017
• 负责人: MYRA L. MURAMOTO
• 金额: $ 16.99万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-01-01 至 2010-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7547017
• 关键词: Address; Adult; Attitude; Awareness; Behavior; Caregivers; Caring; Cessation of life; Characteristics; Child; Child Care; Child health care; Cigarette; Clinical; Communities; Cotinine; Counseling; Data; Databases; Development; Dietary Intervention; Disease; Economically Deprived Population; Education; Educational Intervention; Environment; Environmental Health; Environmental Tobacco Smoke; Exposure to; Family; Feasibility Studies; Funding; Health; Health Knowledge, Attitudes, Practice; Health Personnel; Health Promotion; Health Services Accessibility; Home environment; Household; Intervention; Intervention Studies; Life; Link; Measures; Mediating; Medical; Modeling; Nicotine; Outcome; Outcome Measure; Parents; Patient Self-Report; Phase; Physical activity; Pilot Projects; Population; Positioning Attribute; Preparation; Prevalence; Prevalence Study; Public Health; Randomized; Reporting; Research; Research Design; Risk; Salivary; Screening procedure; Site; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Staging; Surveys; System; Testing; Tobacco; Tobacco Use Cessation; Tobacco use; Training; United States; Work; base; brief intervention; design; efficacy trial; experience; fight against; instrument; intervention effect; member; parent project; parental influence; population based; primary outcome; programs; response; smoking cessation; smoking prevalence; therapy design; therapy development; tobacco screening

DESCRIPTION (provided by applicant): Parents' Awareness Reducing Exposure to Nicotine and Tobacco (PARENT) Second hand smoke (SHS) exposure in children is a major public health problem. As many as 43% or more than 15 million U.S. children live with a smoker. In more than 70% of homes with both adult smokers and children, smoking is allowed within the home. Childcare centers (CCCs) are an underutilized venue for child health promotion and have a potentially significant influence on parental smoking behavior. Nearly 60% of preschoolers receive non-parental care on a daily basis. Thus, the potential to reach a large number of children and parents is substantial. Training child care workers (CCWs) to conduct brief tobacco interventions (BI) for smoking cessation/SHS reduction, will prepare CCWs to more effectively influence parental tobacco use behavior. Thus we propose a developmental feasibility study to develop and pilot test a system intervention to reduce SHS exposure in children attending six childcare centers, entitled Parents Awareness Reducing Exposure to Nicotine and Tobacco (PARENT). The PARENT system intervention targets two populations: 1) CCWs and 2) children and their parents/caregivers (P/Cs). It is designed to promote family-centered approaches to creating smoke-free environments for the whole family through a combination of a) brief tobacco cessation/SHS reduction intervention training of CCWs, b) implementation of routine SHS screening to identify children at risk, c) adding education on tobacco cessation/SHS exposure reduction to the center's environment and parent involvement activities. The proposed project has four stages: Stage I - formative research and intervention development. Stage II- smoking prevalence study to estimate children's SHS exposure; document parental knowledge, attitudes, and behaviors with regards to SHS and smoking (n~650); and identify SHS- exposed children who are eligible for the pilot intervention study. Stage III - pilot intervention feasibility study. Six CCCs will be randomized to the PARENT intervention or a comparison intervention (nutrition/physical activity inservice) (3 CCCs in each study condition, n=120 parent/child pairs, 20 pairs/center). Primary outcome measures are: 1) children's' SHS exposure as measured by salivary cotinine and 2) changes in self-reported P/C behaviors related to smoking and SHS exposure. Secondary measures include 1) CCW reports of tobacco interventions with P/Cs, 2) P/C reports of interventions received from CCWs, and 3) rates of SHS exposure screening and implementation of tobacco education at CCCs (measures of system change). The hypotheses underlying these measures are that systemic changes in the childcare center will be reflected in lower cotinine levels among the children in the intervention sites, and that this shift will be mediated by positive changes in parent/caregiver behaviors related to smoking and SHS exposure. Stage IV - repeat the prevalence survey, analyze data, and based on effect sizes and feasibility results from the pilot intervention study, refine the PARENT intervention, instruments and study design features in preparation to seek funding for a fully-powered Phase III randomized controlled efficacy trial. Tobacco use and the resulting death and disease continue to be the single greatest threat to public health in the United States today. Most tobacco users are smokers. The threat to the public health from cigarette second hand smoke (SHS) has been well-documented. Children are especially vulnerable to SHS. Because SHS is an acknowledged threat to public health, population-based strategies to change smoking behavior and reduce SHS are highly relevant.

描述（由申请人提供）：父母的意识降低了对儿童的尼古丁和烟草（父母）二手烟（SHS）的暴露是一个主要的公共卫生问题。多达43％或超过1500万美国儿童与吸烟者一起生活。在拥有成年吸烟者和儿童的70％以上的房屋中，家庭内允许吸烟。育儿中心（CCC）是未充分利用儿童健康促进的场所，对父母的吸烟行为有潜在的重要影响。每天，近60％的学龄前儿童接受非父母护理。因此，接触大量儿童和父母的潜力是巨大的。培训托儿工人（CCWS）进行简短的烟草干预措施（BI），以减少戒烟/SHS，将准备CCWS以更有效地影响父母的烟草使用行为。因此，我们提出了一项开发可行性研究，以开发和试点测试系统干预措施，以减少参加六个托儿中心的儿童的SHS暴露，有资格的父母意识降低暴露于尼古丁和烟草（父母）。 父系统干预针对两个人群：1）CCW和2）儿童及其父母/护理人员（P/CS）。它旨在促进以家庭为中心的方法来通过a）组合为全家人创造无烟环境，a）简短的烟草戒烟/减少CCWS的SHS干预培训，b）实施常规SHS筛查以识别有风险的儿童，c）在中心的环境中增加烟草敞口的教育，以减少中心的环境和父母的涉及活动。拟议的项目有四个阶段：第一阶段 - 形成性研究和干预开发。第二期吸烟流行研究，以估计儿童sh的暴露；关于SHS和吸烟的父母知识，态度和行为（n〜650）；并确定有资格参加试点干预研究的SHS暴露儿童。第三阶段 - 飞行员干预可行性研究。六个CCC将被随机分配给父母干预或比较干预措施（营养/身体活动不服务）（每个研究条件下有3个CCC，n = 120个父/子对，20对/中心）。主要结果指标是：1）通过唾液可替宁测量的儿童SHS暴露和2）与吸烟和SHS暴露有关的自我报告的P/C行为的变化。次要措施包括1）CCW报告中有P/CS的烟草干预措施，2）P/C报告从CCWS获得的干预措施，以及3）SHS暴露率筛查和CCCS烟草教育的实施（系统变更的衡量）。这些措施的基本假设是，育儿中心的全身变化将反映在干预地点的儿童中的较低的可替宁水平中，并且这种转变将由与吸烟和SHS暴露有关的父母/照顾者行为的积极变化介导。第四阶段 - 重复患病率调查，分析数据以及基于效果大小和可行性的结果，从试点干预研究结果，完善父母干预，工具和研究设计特征，以准备寻求资金为完全动力的III期随机对照效能试验。 烟草使用以及导致的死亡和疾病仍然是当今美国对公共卫生的最大威胁。大多数烟草使用者都是吸烟者。有充分记录在香烟二手烟（SHS）对公共卫生的威胁。儿童特别容易受到sh的影响。由于SHS是对公共卫生的公认威胁，因此基于人群的改变吸烟行为和减少SHS的策略非常相关。