Linking Cessation & Prevention to Stop Intergenerational Transmission of Smoking

描述：(申请人提供)。多代人的研究为吸烟行为从父母传给孩子提供了确凿的证据。这项拟议的研究将测试防止吸烟代际传播的策略。在吸烟的父母开始使用循证电话(Quitline)戒烟服务时，将向吸烟的父母传播一项针对儿童吸烟预防的循证育儿计划。一项两组随机对照试验将测试基于证据的儿童吸烟预防育儿计划-无烟儿童-与州戒烟热线以证据为基础的成人戒烟服务相结合的效果。无烟儿童是一个以家庭为基础的、自我指导的项目，旨在让吸烟的父母参与儿童的反吸烟社交活动。该项目推荐的所有反吸烟社交活动对于尝试戒烟的父母来说都是同样重要的。这项试验将检查项目对儿童开始吸烟和父母戒烟的影响。总结。符合条件的儿童将是来自任何种族/民族的单亲或双亲家庭的最年长的男性或女性儿童，他们的基线年龄为7岁至9岁，处于吸烟开始前阶段，并与与孩子住在一起的父母、继父母或其他监护人一起登记，并已开始使用Quitline戒烟服务。与州戒烟热线合作，将使用滚动招募来招收1,294名符合条件的儿童及其父母。参与者将在州内被随机分配到治疗组(成人戒烟服务加儿童吸烟预防计划)或对照组(仅限成人戒烟服务)。参与者将在随机分配和最终随访之间遵循为期36个月的方案。家长将在干预后1个月和6个月完成基线评估和后续访谈，此后每年进行一次；此外，治疗组家长将完成计划实施情况调查。儿童将在干预后1个月和6个月完成基线评估，并在干预后6个月和此后每年进行后续访谈；他们将在最后一次随访时年龄在10岁至12岁之间。研究假设假设降低了儿童开始吸烟的几率(第一次吸香烟)，降低了儿童吸烟的敏感性，并增加了父母保持戒烟的可能性。生存分析将测试干预对儿童开始吸烟和父母戒烟的影响。比例优势模型将测试干预对不开始吸烟的儿童吸烟易感性的影响。将使用回归分析和潜在变量建模来确定干预效果的中介变量和调节变量。此外，亦会进行成本效益分析。 与公共健康相关：拟议的项目将测试一种创新的公共卫生干预策略，既可以防止儿童开始吸烟，又可以提高父母戒烟的几率。如果有效，拟议的儿童预防和成人戒烟服务的联系可以通过将无烟儿童计划纳入全美提供的以证据为基础的Quitline服务组合来传播。

DESCRIPTION: (provided by applicant). Multi-generational studies provide conclusive evidence for the transmission of smoking behavior from parent to child. The proposed study will test a strategy for preventing intergenerational transmission of smoking. An evidence-based parenting program for child smoking prevention will be disseminated to parents who smoke as they initiate use of evidence-based telephone (Quitline) smoking cessation services. A two-group, randomized controlled trial will test the effects of combining the evidence-based parenting program for child smoking prevention, called Smoke-free Kids, with the evidence-based adult smoking cessation services of state Quitlines. Smoke-free Kids is a home-based, self-directed program that engages parents who smoke in anti-smoking socialization of children. All of the anti-smoking socialization activities recommended by this program are equally relevant to parents who are making a quit attempt. The trial will examine program effects on child initiation of smoking and on parent maintenance of smoking cessation. Summary. Eligible children will be eldest male or female children from single- or two-parent households, of any race/ethnicity, who will be ages 7 to 9 at baseline, in the pre-initiation stage of smoking, and enrolled with a parent, stepparent, or other guardian who lives with the child and who has begun using Quitline cessation services. In partnership with state Quitlines, rolling recruitment will be used to enroll 1,294 eligible children and their parents. Participants will be assigned randomly within states to either the treatment (adult cessation services plus child smoking prevention program), or control (adult cessation services only) group. Participants will follow a 36-month protocol between random assignment and final follow-up. Parents will complete baseline assessments plus follow-up interviews 1 and 6 months post-intervention and annually thereafter; in addition, treatment group parents will complete program implementation surveys. Children will complete baseline assessments plus follow-up interviews 1 and 6 months post-intervention and annually thereafter; they will be ages 10 to 12 at final follow-up. The study hypotheses posit reduced odds of child initiation of smoking (first instance of puffing on a cigarette), lower child susceptibility to smoking, and increased likelihood that parents will maintain smoking cessation. Survival analysis will test the effects of the intervention on initiation of smoking among children and on maintenance of cessation among parents. A proportional odds model will test the effects of the intervention on susceptibility to smoking among children who do not initiate smoking. Regression analyses and latent variable modeling will be used to identify mediators and moderators of intervention effects. Cost-effectiveness analyses will also be conducted. PUBLIC HEALTH RELEVANCE: The proposed project will test an innovative public health intervention strategy that could both prevent children from starting to smoke and improve the odds that parents will quit smoking. If effective, the proposed linkage of child prevention and adult cessation services could be disseminated by incorporating the Smoke-free Kids program into the portfolio of evidence-based Quitline services offered throughout the United States.