Reducing Secondhand Smoke Exposure Among Pediatric Patients in the Emergency Department Setting

项目摘要 物质使用障碍不成比例地影响在急诊室寻求治疗的个人 （ED）。尼古丁成瘾是艾德人群中常见的物质使用障碍， 成年人直接吸烟和他们的孩子通过二手烟暴露（SHSe）。ED具有独特的定位， 向高危成人和儿童人群提供烟草使用障碍的预防性干预措施， 获得预防性护理。虽然ED可以扩大医疗保健，包括对健康的关注， 尽管对儿童及其照料者的宣传和疾病预防工作取得了进展，但这方面的努力很少得到落实。 通常报告的障碍包括公共卫生干预的时间、资源和技能。因此， 培养能够领导多学科研究的科学家，将ED的临床使命扩展到 包括促进健康和预防疾病工作。然而，很少有人注意到量化 儿童健康教育对儿童艾德（P艾德）利用贡献及如何有效实施的探讨 在这个有利的环境中进行减少SHSe的干预。因此，本项目的具体目标是：1） 确定儿童SHSe对SHS暴露的医疗保健利用和相关费用的贡献 与未暴露儿童相比，接受PED治疗的儿童; 2）选择两个现有儿童中的一个， 以证据为基础的SHSe减少干预措施，并确定适应和成功实施 通过对医生、护士、社会工作者和 3）制定实施计划和相应的程序手册 用于将来的R01 SHSe减少干预，该干预将适用于PED设置。成功 完成拟议的项目将导致确定儿童SHSe的健康和经济负担 关于PED，并创建实施计划，以减少在未来R01试验中测试的SHSe。博士 阿什利湖候选人Merianos是辛辛那提大学的助理教授。国家 卫生指导研究科学家发展奖（K01）的研究所将为候选人提供 混合方法学和预防干预方面的基础研究和职业培训， 落实建议的工作。Merianos博士的长期职业目标是成为一名健康服务研究员， 在开发，适应和实施基于证据的物质行为干预方面的专业知识 在急性医疗环境中影响儿童的使用障碍。通过拟议的K01工作，她计划 关注PED中的儿童SHSe，以获得纳入健康促进和疾病所需的新技能 将预防纳入急性医疗环境。

PROJECT SUMMARY Substance use disorders disproportionately affect individuals seeking treatment in Emergency Departments (EDs). Nicotine addiction is a commonly reported substance use disorder in ED populations that impacts adults directly and their children through secondhand smoke exposure (SHSe). EDs are uniquely positioned to deliver preventive intervention for tobacco use disorders to at-risk adult and child populations with limited access to sources of preventive care. While EDs could expand medical care to include a focus on health promotion and disease prevention for children and their caregivers, implementation of such efforts is rare. Commonly reported barriers include time, resources, and skill in public health intervention. Thus, there is a call to train scientists capable of leading multi-disciplinary research that extends the clinical mission of EDs to include health promotion and disease prevention efforts. However, little attention has been given to quantifying the contribution child SHSe has on pediatric ED (PED) utilization and exploring how to effectively implement SHSe reduction interventions into this opportune setting. Therefore, the specific aims of this project are: 1) To determine the contribution that child SHSe has on healthcare utilization and related costs in SHS-exposed children who present to the PED compared with unexposed children; 2) To select one of two existing, evidence-based SHSe reduction interventions, and identify ways to adapt and successfully implement the intervention in the PED setting by conducting focused interviews with physicians, nurses, social workers, and healthcare administrators; and 3) To develop an implementation plan and corresponding manual of procedures for use in a future R01 SHSe reduction intervention that will be adapted for the PED setting. The successful completion of the proposed project will result in identification of the health and economic burden of child SHSe on the PED and creation of an implementation plan to reduce SHSe to be tested in a future R01 trial. Dr. Ashley L. Merianos, the candidate, is an Assistant Professor at the University of Cincinnati. The National Institutes of Health Mentored Research Scientist Development Award (K01) will provide the candidate with fundamental research and career training in mixed-methods methodology and preventive intervention to implement the proposed work. Dr. Merianos’ long-term career goal is to be a health services researcher with expertise in developing, adapting, and implementing evidence-based behavioral interventions for substance use disorders affecting children in the acute healthcare setting. Through the proposed K01 work, she plans to focus on child SHSe in the PED to acquire new skills needed to incorporate health promotion and disease prevention into the acute healthcare setting.