Web-Based Respiratory Education About Tobacco and Health

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DESCRIPTION (provided by applicant): We propose to develop an interactive Internet-based program (WeBREATHe: Web-Based Respiratory Education About Tobacco and Health) to train pediatric respiratory therapists and nurses to provide brief, hospital-based tobacco cessation interventions to parents of hospitalized pediatric patients. During Phase I, we designed and evaluated a prototype program, based on an empirically validated tobacco cessation intervention, specifically aimed at respiratory therapists and nurses specializing in the care of children with respiratory illnesses at a large children's hospital. The results of the evaluation were very promising, with participants reporting a significant change in their knowledge, attitudes, perceived barriers, and self-efficacy towards providing tobacco cessation interventions to their patients' parents. During Phase II, activities will include: 1) refinement of the existing website; 2) completion of current modules (e.g., video vignettes); 3) development of additional modules to target different nursing settings and patient modalities (i.e., outpatient); 4) development of tobacco cessation modules for pediatric patients and for smokeless tobacco users; 5) development of tobacco use prevention modules aimed at pediatric patients; 6) conducting a randomized clinical trial with 150 respiratory therapists and nurses from three hospitals across the United States (Florida, Ohio, and Oregon). The Specific aims for Phase II are: Aim 1. Refine the existing components of the program, populate all video role models and vignettes, and add new components to target outpatient pediatric respiratory therapists and nurses. Modules on tobacco cessation for pediatric patients and smokeless tobacco users, and prevention of tobacco use aimed at pediatric patients will also be developed. Aim 2. Evaluate the program for use in children's hospital settings in a randomized trial in which 150 respiratory therapists and nurses from three hospitals will be randomly assigned within hospital to either the Training Condition (WeBREATHe program), or to a Delayed Training Control condition. Participants' tobacco cessation behaviors, attitudes, knowledge, perceived barriers, and self-efficacy regarding delivery of a tobacco cessation intervention will be measured at baseline, immediately post- training, and at three months post-training. User satisfaction measures will also be collected post- training. Aim 3. Develop a final version of the interactive training program and create manuals and packaging for a marketable product. PROJECT NARRATIVE The use of tobacco represents a significant public health problem both in mortality and morbidity. The specific effects of environmental tobacco smoke (ETS) exposure on children's respiratory health provide the respiratory therapist (RT) and nurse (RN) a clinical opportunity to encourage tobacco-using parents of patients to quit. There is a strong need for disseminable tobacco cessation training programs for RTs and RNs that are based on empirically validated programs. The WeBREATHe program aims to teach RTs and RNs how to help their patients' parents quit smoking. Reducing children's exposure to ETS will lead to improved health and reduce the economic burden on the pediatric healthcare system.