Healthy families: study protocol for a randomized controlled trial of a screening, brief intervention, and referral to treatment intervention for caregivers to reduce secondhand smoke exposure among pediatric emergency patients
Healthy families: study protocol for a randomized controlled trial of a screening, brief intervention, and referral to treatment intervention for caregivers to reduce secondhand smoke exposure among pediatric emergency patients
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DOI：
10.1186/s12889-017-4278-8
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发表时间：
2017-05-02
影响因子：
4.5
通讯作者：
Gordon, Judith S.
中科院分区：
文献类型：
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作者：
Mahabee-Gittens, E. Melinda;Ammerman, Robert T.;Gordon, Judith S.
背景资料：非自愿暴露于二手烟（SHSe）是导致儿童急诊科（PED）和紧急护理（UC）发病的重要原因。在PED和UC中提供的SHSe干预措施将使吸烟者和儿童受益，但目前还没有大型试验测试这些干预措施的有效性。健康家庭计划是第一个随机对照试验，以测试是否筛选，简短的干预，并转介到治疗（SBIRT）干预交付的PED和UC将有效地减少SHSe在儿童和增加戒烟的smokers.Methods/design：本试验采用随机，两组设计，其中儿童0-17岁的吸烟者从PED和UC招募。符合条件的吸烟者被随机分为：1）SBIRT条件，面对面，量身定制的咨询，重点是儿童的疾病，减少儿童SHSe的重要性，护理人员戒烟，以及接受尼古丁替代疗法的选择;或2）健康习惯控制条件，包括面对面，量身定制的注意力控制“5-2-1-0”咨询，重点是改善孩子的健康。在基线时亲自进行二元评估，并在6周和6个月时通过电子邮件、电话或亲自进行评估。主要结果是生化验证，7天点患病率和长期戒烟。次要结果是每周吸烟，24小时戒烟尝试，和生化验证的儿童SHSe在每个时间点。这种干预的成本也将analysed.Discussion：本研究将测试一种创新的，多层次的干预，旨在减少儿童SHSe和增加戒烟的照顾者。如果有效和常规使用，这种SBIRT模式每年可以在美国达到至少100万吸烟者，从而显著降低了看护者的烟草使用、与SHSe相关的儿科疾病以及该儿童群体的医疗保健费用。
Background: Involuntary exposure to secondhand smoke (SHSe) is an important cause of morbidity in children who present to the pediatric emergency department (PED) and urgent care (UC). SHSe interventions delivered in the PED and UC would benefit both the smoker and child, but there have been no large trials testing the efficacy of such interventions. The Healthy Families program is the first randomized controlled trial to test whether a screening, brief intervention, and referral to treatment (SBIRT) intervention delivered in the PED and UC will be effective in decreasing SHSe in children and increasing cessation in smokers.Methods/design: This trial uses a randomized, two-group design in which caregiver-smokers of children 0-17 years old are recruited from the PED and UC. Eligible caregiver-smokers are randomized to either the: 1) SBIRT Condition with face-to-face, tailored counseling that focuses on the child's illness, the importance of reducing child SHSe, caregiver smoking cessation, and the option to receive nicotine replacement therapy; or 2) Healthy Habits Control Condition which includes face-to-face, tailored attention control "5-2-1-0" counseling that focuses on improving the child's health. Dyadic assessments are conducted in-person at baseline, and via email, phone, or in-person at 6-weeks and 6-months. The primary outcomes are biochemically-verified, 7-day point prevalence and prolonged smoking abstinence. Secondary outcomes are cigarettes smoked per week, 24 h quit attempts, and biochemically validated child SHSe at each time point. The costs of this intervention will also be analyzed.Discussion: This study will test an innovative, multilevel intervention designed to reduce child SHSe and increase smoking cessation in caregivers. If effective and routinely used, this SBIRT model could reach at least one million smokers a year in the U.S., resulting in significant reductions in caregivers' tobacco use, SHSe-related pediatric illness, and healthcare costs in this population of children.