Establishing smoke-free homes with families involved in child protective services: An effectiveness-implementation trial of an integrated program

项目摘要 儿童接触二手烟(SHS)与多种形式的癌症有关 寿命。生活在低社会经济地位家庭的幼儿患癌症的风险增加 暴露于SHS。被证实参与儿童保护制度的家庭 虐待儿童是SHS的一个特别高风险群体，因为这些家庭经常生活在 贫困和报告的高每日吸烟率。重要的是，虐待儿童的受害者也 增加癌症和癌症过早死亡的风险，与父母吸烟无关 行为。确定向这些人广泛传播有效的SHS预防计划的方法 高危家庭是减少癌症差异的重要战略。我们提出了一个 有效性-实施混合试验类型1，以检查将两者整合的影响 循证计划，有些事情在外面更好(SHS预防计划)和 SafeCare®(防止虐待儿童计划)，关于建立无烟家庭和 关于执行进程成果的报告。目标1侧重于标准化的提炼 将这两个项目整合(系统地编织)为“无烟安全护理(SFSC)”。目标 2和3专注于杂交试验。将招募50名经过认证的SafeCare提供商，并 随机分配以提供SFSC或标准安全护理。服务提供者将分别为10名 符合纳入标准的研究家庭(N=500)(母亲或居住在 在家里抽烟)。主要的结果，无烟家庭状况，将被衡量 通过4个时间点(基准、8周、20周和1年)的自我报告，并通过AIR进行验证 尼古丁监测8周和1岁(目标2)。将收集过程措施进行审查 编织干预如何影响提供商的保真度、交付时间和成本等 流程措施(目标3)。如果有效，SFSC可以有效地传播，广泛传播 由国家安全护理培训和研究中心向100多名经认证的人采用 美国和世界各地的SafeCare机构为参与 儿童保护服务，减少癌症风险和高危人群的差异。

Project Abstract Child exposure to secondhand smoke (SHS) is linked to multiple forms of cancer throughout the lifespan. Young children living in low-socioeconomic status households are at increased risk for SHS exposure. Families involved with the child protection system as the result of substantiated child maltreatment are an especially high-risk group for SHS, as these families are often living in poverty and report high daily smoking rates. Importantly, child maltreatment victimization also increases risk of cancer and premature death from cancer, independent of parent smoking behavior. Identifying ways to broadly disseminate effective SHS prevention programs to these high-risk families is an important strategy for reducing cancer disparities. We propose an effectiveness-implementation hybrid trial type 1 to examine the impact of integrating two evidence-based programs, Some Things are Better Outside (SHS prevention program) and SafeCare® (Child Maltreatment Prevention Program), on establishing a smoke-free home and on implementation process outcomes. Aim 1 focuses on the refinement of the standardized integration (systematic braiding) of the two programs into “Smoke-Free SafeCare (SFSC).” Aims 2 and 3 focus on the hybrid trial. Fifty certified SafeCare Providers will be recruited and randomly assigned to deliver either SFSC or Standard SafeCare. Providers will each serve ten research families (N = 500) who meet the inclusion criteria (Mother or another person residing in the home smokes at home). The primary outcome, smoke-free home status, will be measured via self-report at 4-timepoints (baseline, 8-weeks, 20-weeks, and 1-year), and validated via air nicotine monitor at 8 weeks and 1-year (Aim 2). Process measures will be collected to examine how the braided intervention impacts provider fidelity, delivery time and costs, and other process measures (Aim 3). If effective, SFSC can be efficiently disseminated for widespread adoption by the National SafeCare Training and Research Center to the over 100 accredited SafeCare agencies across the United States and worldwide that serve parents involved with child protection services, reducing cancer risk and disparities for a high-risk population.