Reducing Underserved Children's Exposure to Tobacco Smoke: A Randomized Counseling Trial With Maternal Smokers.
Reducing Underserved Children's Exposure to Tobacco Smoke: A Randomized Counseling Trial With Maternal Smokers.
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DOI：
10.1016/j.amepre.2015.03.008
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发表时间：
2015-10
影响因子：
5.5
通讯作者：
Audrain-McGovern J
中科院分区：
文献类型：
--
作者：
Collins BN;Nair US;Hovell MF;DiSantis KI;Jaffe K;Tolley NM;Wileyto EP;Audrain-McGovern J
解决母亲吸烟和儿童二手烟暴露问题是公共卫生的优先事项。帮助父母减少儿童接触二手烟的标准护理建议和自助材料不足以促进服务不足人口的变化。我们测试了行为咨询方法对服务不足的母亲吸烟者减少婴儿和学龄前儿童二手烟暴露的有效性。一项两组随机试验：实验性行为咨询与强化标准护理（对照）。评估工作人员设盲。从低收入城市社区随机招募了300名产妇吸烟者。参与者有一个年龄<4岁的孩子在基线时暴露于两支或更多的母亲香烟/天。费城建立无烟家庭的家庭规则（FRESH）包括16周的咨询。在个性化的认知行为治疗框架内使用行为塑造方法，咨询加强了采取越来越具有挑战性的二手烟吸烟保护行为的努力，最终目标是建立一个无烟家庭。主要结局是治疗结束时儿童可替宁和报告的二手烟暴露（母亲吸烟/暴露日）。次要结局是治疗结束时、7天时点患病率、自我报告的吸烟/天和生物等效戒烟状态。参与FRESH行为咨询与治疗结束时较低的儿童可替宁（β=-0.18，p=0.03）和二手烟暴露（β=-0.57，p=0.03）相关。行为咨询组的母亲吸烟量明显低于对照组（β=-1.84，P =0.03），戒烟率明显高于对照组（13.8%vs1.9%，χ2=10.56，P<0.01）。住在家里的其他吸烟者没有调节作用。FRESH行为咨询减少了儿童二手烟暴露，并提高了高度贫困和脆弱人群的戒烟率。
Addressing maternal smoking and child secondhand smoke exposure is a public health priority. Standard care advice and self-help materials to help parents reduce child secondhand smoke exposure is not sufficient to promote change in underserved populations. We tested the efficacy of a behavioral counseling approach with underserved maternal smokers to reduce infant’s and preschooler’s secondhand smoke exposure. A two-arm randomized trial: experimental behavior counseling versus enhanced standard care (control). Assessment staff members were blinded. Three hundred randomized maternal smokers were recruited from low-income urban communities. Participants had a child aged <4 years exposed to two or more maternal cigarettes/day at baseline. Philadelphia Family Rules for Establishing Smokefree Homes (FRESH) included 16 weeks of counseling. Using a behavioral shaping approach within an individualized cognitive–behavioral therapy framework, counseling reinforced efforts to adopt increasingly challenging secondhand smoke exposure–protective behaviors with the eventual goal of establishing a smokefree home. Primary outcomes were end-of-treatment child cotinine and reported secondhand smoke exposure (maternal cigarettes/day exposed). Secondary outcomes were end-of-treatment 7-day point-prevalence self-reported cigarettes smoked/day and bioverified quit status. Participation in FRESH behavioral counseling was associated with lower child cotinine (β= −0.18, p=0.03) and secondhand smoke exposure (β= −0.57, p=0.03) at end of treatment. Mothers in behavioral counseling smoked fewer cigarettes/day (β= –1.84, p=0.03) and had higher bioverified quit rates compared with controls (13.8% vs 1.9%, χ2=10.56, p<0.01). There was no moderating effect of other smokers living at home. FRESH behavioral counseling reduces child secondhand smoke exposure and promotes smoking quit rates in a highly distressed and vulnerable population.
DOI：
10.1016/j.otohns.2008.05.002
发表时间：
2008-09
期刊：
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
影响因子：
--
作者：
Mueller DT;Collins BN
通讯作者：
Collins BN
影响因子：
2.1
作者：
Collins BN;Ibrahim JK;Hovell M;Tolley NM;Nair US;Jaffe K;Zanis D;Audrain-McGovern J
通讯作者：
Audrain-McGovern J