Motivating parents of kids with asthma to quit smoking: the effect of the teachable moment and increasing intervention intensity using a longitudinal randomized trial design
Motivating parents of kids with asthma to quit smoking: the effect of the teachable moment and increasing intervention intensity using a longitudinal randomized trial design
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DOI：
10.1111/add.13389
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发表时间：
2016-09-01
期刊：
影响因子：
6
通讯作者：
Dunsiger, Shira
中科院分区：
文献类型：
--
作者：
Borrelli, Belinda;McQuaid, Elizabeth L.;Dunsiger, Shira
我们测试了两个目标：（1）可教时刻（TM）：与健康儿童（HC）的父母相比，二手烟暴露（SHSe）反馈是否会促使哮喘儿童的父母戒烟;（2）更大的干预强度[加强预防采纳模型（PAM）]是否会比先前测试的干预（PAM）产生更大的戒烟效果。设计和干预目标1：两次家访（哮喘教育或儿童健康），并使用动机访谈和SHSe反馈进行戒烟诱导。目标二：家访后，哮喘儿童的父母被随机分配到PAM组（n=171; 6次哮喘教育电话）或增强型PAM（n=170; 6次哮喘教育/戒烟电话+重复SHSe反馈）。设置Rhode Island，USA。哮喘儿童（n=341）或健康儿童（n=219）的父母，他们不需要戒烟来登记。测量在基线，2，4，6和12个月。禁欲是生物性的。结果是7天和30天的点患病率、戒烟率（ppa）、SHSe（原发性）和哮喘发病率目标1：技术备忘录得到以下方面的支持：哮喘儿童的父母达到30天[比值比（OR）=2.60，95%置信区间（CI）=1.22-5.54]和7天ppa的可能性是哮喘儿童父母的两倍多。（OR=2.26，95%CI =1.13-4.51），且SHSe水平低于HC。治疗强度越大，TM效应越强（OR=3.60; 95%CI =1.72-7.55）。目标二：增强PAM是更有可能实现30天的PPA在主要终点，4个月（OR=2.12，95%CI 1.09-4.12）和改善哮喘的结果与PAM。ConclusionsSmoking caution interviewing（动机访谈加生物标志物反馈）似乎激励戒烟更强烈的哮喘儿童的父母比健康儿童的父母。增加干预强度可使哮喘儿童的父母更好地戒烟，并改善哮喘预后。
AimsWe tested two aims: (1) the teachable moment (TM): whether second-hand smoke exposure (SHSe) feedback motivates cessation in parents of children with asthma versus parents of healthy children (HC); and (2) whether greater intervention intensity [enhanced-precaution adoption model (PAM)] produces greater cessation than a previously tested intervention (PAM).Design and interventionsAim 1: two home visits (asthma education or child wellness), and cessation induction using motivational interviewing and SHSe feedback. Aim 2: post-home-visits, parents with asthmatic children were randomized to PAM (n=171; six asthma education calls) or enhanced-PAM (n=170; six asthma education/smoking cessation calls+repeat SHSe feedback).SettingRhode Island, USA.ParticipantsParents of asthmatic (n=341) or healthy (n=219) children who did not have to want to quit smoking to enroll.MeasurementsMeasurements were given at baseline, 2, 4, 6 and 12months. Abstinence was bioverified. Outcomes were 7-day and 30-day point prevalence abstinence (ppa) and SHSe (primary) and asthma morbidity (secondary).FindingsAim 1: the TM was supported: parents of asthmatic children were more than twice as likely to achieve 30-day [odds ratio (OR)=2.60, 95% confidence interval (CI)=1.22-5.54] and 7-day ppa (OR=2.26, 95% CI=1.13-4.51) at 2months (primary end-point) and have non-detectable levels of SHSe than HCs. Greater treatment intensity yielded stronger TM effects (OR=3.60; 95% CI=1.72-7.55). Aim 2: enhanced-PAM was more likely to achieve 30-day ppa at the primary end-point, 4months (OR=2.12, 95% CI 1.09-4.12) and improved asthma outcomes versus PAM.ConclusionsSmoking cessation intervention (Motivational Interviewing plus biomarker feedback) appear to motivate smoking cessation more strongly among parents of asthmatic children than among parents of healthy children. Increased intervention intensity yields greater smoking cessation among parents of asthmatic children and better asthma outcomes.