A randomized trial to reduce passive smoke exposure in low-income households with young children
A randomized trial to reduce passive smoke exposure in low-income households with young children
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DOI：
10.1542/peds.108.1.18
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发表时间：
2001-07-01
期刊：
影响因子：
8
通讯作者：
Monroe, AD
中科院分区：
文献类型：
--
作者：
Emmons, KM;Hammond, SK;Monroe, AD
客观的。在美国，儿童被动吸烟的情况很普遍；据估计，近 40% 的 5 岁以下儿童与吸烟者生活在一起。关于减少儿童被动吸烟暴露的随机研究很少，而且已评估的干预措施的影响也很有限。本研究的目的是确定对幼儿吸烟父母的动机干预是否会减少家庭被动吸烟暴露。方法。 KISS 项目（让婴儿远离烟雾）是一项理论驱动的减少暴露干预措施，针对有幼儿的低收入家庭，它是一项随机对照研究，参与者（有 3 岁以下孩子的吸烟父母/照顾者 (N = 291)，通过初级保健机构招募）被随机分配到动机干预 (MI) 或自助 (SH) 比较条件。 3个月和6个月时进行后续评估。 MI 条件包括在参与者家中与经过培训的健康教育者进行 30 至 45 分钟的动机访谈以及 4 次后续电话咨询。作为干预措施的一部分，提供了家庭空气尼古丁基线评估和参与者一氧化碳水平评估的反馈。 SH 组的参与者收到了一份戒烟手册、被动吸烟提示表和邮件中的资源指南。通过被动扩散监测仪测量家庭尼古丁水平。结果。 MI 家庭 6 个月的尼古丁水平明显较低。跨基线、3个月和6个月时间点的重复测量方差分析显示出显着的治疗时间交互作用，其中MI组的尼古丁水平显着下降，SH组的尼古丁水平增加，但与基线没有显着差异。结论。这项研究针对的是大量种族和民族不同的低收入家庭样本，在这些家庭中，暴露和疾病负担可能都很严重。据我们所知，这是第一项有效减少有健康儿童的家庭被动吸烟暴露的客观指标的研究。这些发现对儿科医疗保健提供者具有重要意义，他们在与家长合作保护儿童健康方面发挥着重要作用。提供者可以通过激励策略帮助父母努力减少家庭被动吸烟暴露，并提供一系列方法，无论父母是否准备好戒烟。
Objective. Passive smoke exposure among children is widespread in the United States; estimates suggest that almost 40% of children who are younger than 5 years live with a smoker. Few randomized studies of passive smoke exposure reduction among children have been conducted, and the impact of interventions that have been evaluated has been limited. The objective of this study was to determine whether a motivational intervention for smoking parents of young children will lead to reduced household passive smoke exposure.Methods. Project KISS (Keeping Infants Safe From Smoke), a theory-driven exposure reduction intervention targeting low-income families with young children, was a randomized controlled study in which participants-smoking parents/caregivers (N = 291) who had children who were younger than 3 years and who were recruited through primary care settings-were randomly assigned to either the motivational intervention (MI) or a self-help (SH) comparison condition was used. Follow-up assessments were conducted at 3 and 6 months. The MI condition consisted of a 30- to 45-minute motivational interviewing session at the participant's home with a trained health educator and 4 follow-up telephone counseling calls. Feedback from baseline household air nicotine assessments and assessment of the participant's carbon monoxide level was provided as part of the intervention. Participants in the SH group received a copy of the smoking cessation manual, the passive smoke reduction tip sheet, and the resource guide in the mail. Household nicotine levels were measured by a passive diffusion monitor.Results. The 6-month nicotine levels were significantly lower in MI households. Repeated measures analysis of variance across baseline, 3-month, and 6-month time points showed a significant time-by-treatment interaction, whereby nicotine levels for the MI group decreased significantly and nicotine levels for the SH group increased but were not significantly different from baseline.Conclusions. This study targeted a large sample of racially and ethnically diverse low-income families, in whom both exposure and disease burden is likely to be significant. This is the first study to our knowledge that has been effective in reducing objective measures of passive smoke exposure in households with healthy children. These findings have important implications for pediatric health care providers, who play an important role in working with parents to protect children's health. Providers can help parents work toward reducing household passive smoke exposure using motivational strategies and providing a menu of approaches regardless of whether the parents are ready to quit.