Intergrating a Smoke-Free Home Intervention into the 5As to Support Cessation

摘要 建立无烟家庭可能是支持甚至催化吸烟的一个很有前途的方法 停止。外出的不便，再加上吸烟环境线索的减少 在家里，可能会导致吸烟的减少和戒烟努力的增加。然而，还没有严格的研究来测试 在保护儿童远离二手烟的背景下，创建无烟家庭对戒烟的影响 暴露在烟雾中。我们开发了一种简短的无烟家庭干预措施，“有些事情是好的 此外，这对于促进低收入家庭全面禁烟非常有效。AS 作为NCI州和社区烟草控制研究计划的一部分，我们进行了一项有效性试验，并 有效性试验、概括性试验和传播试验，每个阶段都有积极的结果 研究。汇集了我们三个随机对照试验的数据，结合了一项全国传播研究的结果， 记录支持戒烟的干预措施的潜力。我们建议与两家大型联邦政府合作 南乔治亚州农村合格的健康中心(FQHC)严格测试疗效和潜在的可扩展性 将无烟家庭干预纳入5A(询问、建议、评估、协助、安排)方法 美国预防服务工作组建议的戒烟措施。口岸健康中心充当安全网 美国弱势人群的初级保健。大多数FQHC患者是社会经济学的 处于不利地位，代表着戒烟的高度优先事项。开发和测试一种集成方法 从一开始就对FQHC进行干预，如果得到证实，应该会增加干预的潜在使用 有效。我们的第一个目标是调整干预措施，使之融入戒烟5A，其次是 一项随机对照试验，以测试将无烟家庭干预纳入5A吸烟方法的有效性 在FQHC患者中停止使用。这种方法可能会比目前的方法具有更广泛的影响范围 吸引那些还没有准备好戒烟的人，以及提供一个社会和物质的个人环境， 支持更多的退出尝试和成功停止。我们还计划进行一个多组件 检查实施结果、成本和可伸缩性潜力的流程评估。建议数 研究将首先严格评估是否整合了强有力的无烟家庭干预措施 加入5A可以鼓励低收入患者持续戒烟。

SUMMARY Establishing smoke-free homes may be a promising approach to support, and perhaps catalyze, smoking cessation. The inconvenience of going outside, combined with a reduction of environmental cues to smoke in the home, may result in less smoking and increased efforts to quit. Yet, no rigorous studies have tested the impact of creating smoke-free homes on cessation outside the context of protecting children from secondhand smoke exposure. We have developed a brief smoke-free homes intervention, “Some Things are Better Outside”, that is very effective in promoting the adoption of total smoking bans in low-income households. As part of NCI’s State and Community Tobacco Control research initiative, we conducted an efficacy trial, an effectiveness trial, a generalizability trial and a dissemination trial with positive outcomes in each phase of the research. Pooled data from our three RCTs, combined with results from a national dissemination study, document the potential of the intervention to support cessation. We propose to partner with two large federally qualified health centers (FQHCs) in rural south Georgia to rigorously test the efficacy and potential scalability of integrating a smoke-free homes intervention into the 5A (Ask, Advise, Assess, Assist, Arrange) approach for tobacco cessation recommended by the U.S. Preventive Services Task Force. FQHCs serve as the safety net of primary care for vulnerable populations in the U.S. Most FQHC patients are socioeconomically disadvantaged and represent a high priority for cessation. Developing and testing an approach for integrating the intervention into FQHCs from the outset should increase potential use of the intervention if proven effective. Our first aim is to adapt the intervention for integration into the 5As for tobacco cessation, followed by an RCT to test the efficacy of integrating the smoke-free homes intervention into the 5A approach for smoking cessation among FQHC patients. This approach may have broader reach than current approaches as it may appeal to those not yet ready to quit, as well as provide a social and physical personal environment that supports increased quit attempts and successful cessation. We also plan to conduct a multi-component process evaluation that examines implementation outcomes, cost and scalability potential. The proposed research will be the first to rigorously assess whether the integration of a strong smoke-free homes intervention into the 5As can encourage sustained smoking cessation in low-income patients.