Innovation for Smoke-Free Homes: Real-Time Feedback

无烟家庭的创新：实时反馈

• 批准号: 8188261
• 负责人: Melbourne F Hovell
• 金额: $ 87.17万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-11 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8188261
• 关键词: Adult; Age-Years; Behavior; Behavioral; Biological Assay; California; Caucasians; Caucasoid Race; Child; Child health care; Clinic; Clinical; Clinical Services; Consumer Preferences; Control Groups; Cotinine; Counseling; Data; Dose; Effectiveness; Environment; Environmental Tobacco Smoke; Ethnic group; Event; Excision; Exposure to; Family; Feedback; Frequencies; Future; Health; Health Hazards; Home environment; Household; Income; Individual; Infant; Instruction; Intervention; Latino; Lead; Learning; Light; Location; Low income; Lung diseases; Measures; Mechanics; Mediator of activation protein; Minority Groups; Monitor; Motivation; Nature; Nicotine; Parents; Pattern; Phase; Pilot Projects; Procedures; Process; Professional counselor; Psychological reinforcement; Randomized; Records; Recruitment Activity; Reporting; Research; Research Personnel; Resources; Risk; Sampling; Shapes; Smoke; Smoking; Social Environment; Social Interaction; Social Reinforcement; Study Section; Sudden infant death syndrome; Suggestion; Technology; Telemetry; Testing; Time; Tobacco use; Urine; Woman; base; brief advice; clinically significant; effective intervention; efficacy testing; group intervention; high risk; innovation; new technology; non-smoker; particle; preadolescence; programs; racial and ethnic; response; smoking cessation; social; sound; theories; tobacco control; treatment as usual

DESCRIPTION (provided by applicant): Secondhand smoke exposure (SHSe) is a significant health risk, especially to young children. More than 50 percent of children's SHSe occurs at home and children in low-income households are more likely to be exposed to SHS. Thus, home-based interventions are needed to protect children from SHSe. This is the first efficacy study to test whether children's home SHSe can be reduced by using innovative SHS particle monitors to provide real-time feedback to household residents plus brief advice/praise. This study will test the efficacy of immediate feedback and brief advice/praise on low-income families' ability to reduce children's exposure to nicotine, as measured by cotinine assays, reduce smoking in the home, and establish home smoking bans. Learning theory and pilot data suggest that real-time feedback from the monitor plus brief advice will prompt and reinforce SHSe reduction behaviors. Four hundred families from Women, Infants, and Children (WIC) programs in San Diego, California will be recruited. Households will be randomly assigned to an experimental group that receives continuous real-time feedback from a SHS particle monitor plus feedback-related brief advice/praise to reduce their child's exposure, or to a usual care control group where the particle monitor delivers no feedback. During the intervention phase, monitors in households of the experimental group will produce warning lights and beeps when SHS is detected. The primary specific aims are to: 1) Determine the differential group change in SHSe levels, as measured by child cotinine assays, due to real-time monitor feedback and brief advice; 2) Determine the differential group change in the establishment of home smoking bans; and 3) Validate differential change in particle measures of SHSe using nicotine dosimeters and child urine cotinine assays. The exploratory aims are to: determine theoretical moderators (e.g., child's health) of the effect of brief advice plus feedback; assess the effects of theoretical mediators (e.g., establishment of home smoking bans and other social contingencies) of change in SHSe; explore the dynamic nature of SHSe by examining the continuous particle monitor records over months to identify social contexts and micro- environments in the home as precise targets for intervention (e.g., smoking location, nonsmoker locations, and social interactions while smoking); assess the differential changes in tobacco use and SHSe by racial/ethnic group and by single v two-parent families to increase understanding of disparities for tobacco control; and obtain suggestions from families to enhance future use of the monitors. This is also the first large-scale test of a new technology in residential tobacco control, where real-time and telemetry feedback to investigators will both enable immediate feedback from light and sound alerts to families and inform investigators of smoking events or reduction in smoking events that warrant advice or praise. Thus, this application opens a new direction for future innovative studies using novel technology to advance reduction of SHSe in a range of micro-environments. PUBLIC HEALTH RELEVANCE: Secondhand smoke exposure (SHSe) is a significant health hazard for adults and children, especially the medically vulnerable. There is no risk-free level of SHSe and cumulative exposure can lead to pulmonary diseases and Sudden Infant Death Syndrome (SIDS). Millions of U.S. children are exposed at home. This is the first study to test an innovative particle monitor to provide real-time feedback (lights/sounds) to encourage parents to reduce young children's SHSe in their home.

描述（由申请人提供）：二手烟暴露（SHSe）是重大的健康风险，特别是对幼儿。超过50%的儿童发生在家中，低收入家庭的儿童更有可能接触到严重的健康问题。因此，需要以家庭为基础的干预措施来保护儿童免受SHSe的侵害。这是第一个测试使用创新的SHS粒子监测器向住户提供实时反馈以及简短的建议/赞扬是否可以降低儿童家庭SHSe的功效研究。本研究将测试即时反馈和简短建议/表扬对低收入家庭减少儿童接触尼古丁的能力的有效性，通过可替宁测定，减少家庭吸烟，并建立家庭禁烟令。学习理论和试点数据表明，来自监测器的实时反馈加上简短的建议将促进和加强降低SHSe的行为。来自加州圣地亚哥妇女、婴儿和儿童（WIC）项目的400个家庭将被招募。家庭将被随机分配到实验组，实验组接收来自SHS颗粒监测仪的连续实时反馈，并提供与反馈相关的简短建议/表扬，以减少他们孩子的接触，或者被分配到常规护理对照组，颗粒监测仪不提供反馈。在干预阶段，当检测到SHS时，实验组家庭中的监测器将发出警示灯和蜂鸣声。主要的具体目标是：1)根据实时监测反馈和简短建议，通过儿童可替宁测定，确定SHSe水平的差异组变化；2)确定家庭禁烟制度建立的差异群体变化；3)使用尼古丁剂量计和儿童尿可替宁测定验证SHSe颗粒测量的差异变化。探索性目标是：确定简短建议加反馈效果的理论调节因子（例如，儿童健康）；评估理论中介（例如，建立家庭禁烟令和其他社会突发事件）对SHSe变化的影响；通过检查连续数月的颗粒监测记录，探索SHSe的动态性质，以确定社会背景和家庭微环境作为干预的精确目标（例如，吸烟地点、非吸烟者地点和吸烟时的社会互动）；评估不同种族/族裔群体以及单亲和双亲家庭在烟草使用和重度吸烟方面的差异变化，以增加对烟草控制差异的了解；并从家庭中获取建议，以提高未来监视器的使用。这也是住宅烟草控制新技术的第一次大规模测试，向调查人员提供实时和遥测反馈，既可以从灯光和声音警报向家庭提供即时反馈，又可以向调查人员通报吸烟事件或吸烟事件的减少，这些事件值得建议或赞扬。因此，这一应用为未来的创新研究开辟了一个新的方向，利用新技术来推进一系列微环境中SHSe的降低。