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

项目摘要 儿童暴露于二手烟（SHS）与多种形式的癌症有关， 寿命生活在社会经济地位低的家庭中的幼儿面临更大的风险， SHS暴露。由于得到证实的暴力行为而卷入儿童保护系统的家庭 虐待儿童是SHS的特别高风险群体，因为这些家庭通常生活在 贫困和报告的高每日吸烟率。重要的是，儿童虐待受害者还 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一项重要战略。我们提出了一个 有效性-实施混合试验类型1，以检查整合两种 SHS预防计划（SHS Prevention Program） SafeCare®（儿童虐待预防方案），关于建立无烟家庭， 执行过程的结果。目标1侧重于对标准化 将这两个计划整合（系统编织）为“无烟安全护理”。旨在 2和3集中在混合试验。将招募50名经过认证的安全护理提供者， 随机分配，提供SFSC或标准SafeCare。供应商将每人提供10个 符合入选标准的研究家庭（N = 500）（母亲或居住在 在家里抽烟）。主要结果，无烟家庭状况，将被衡量 通过4个时间点（基线、8周、20周和1年）的自我报告，并通过空中验证 8周和1年时的尼古丁监测（目标2）。将收集过程测量结果， 编织干预如何影响提供者的保真度、交付时间和成本，以及其他 过程措施（目标3）。如果有效，SFSC可以有效地传播， 国家安全护理培训和研究中心通过了100多个认证 美国和世界各地的SafeCare机构为参与儿童健康的父母提供服务， 儿童保护服务，减少癌症风险和高风险人群的差异。

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.