Linking Cessation & Prevention to Stop Intergenerational Transmission of Smoking

描述：（由申请人提供）。多代研究为吸烟行为从父母传给子女提供了确凿的证据。这项拟议的研究将测试一项防止吸烟代际传播的战略。将向吸烟的父母传播预防儿童吸烟的循证育儿计划，因为他们开始使用循证电话（戒烟热线）戒烟服务。一项两组随机对照试验将测试将以证据为基础的预防儿童吸烟的养育计划（称为无烟儿童）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计划，让吸烟的父母参与儿童的反吸烟社会化。该计划推荐的所有反吸烟社会化活动对正在尝试戒烟的父母同样重要。该试验将检查项目对儿童开始吸烟和父母维持戒烟的影响。摘要符合条件的儿童将是来自单亲或双亲家庭的年龄最大的男性或女性儿童，任何种族/民族，基线时年龄为7至9岁，处于开始吸烟前阶段，与父母、继父母或其他监护人一起登记，与儿童一起生活，并已开始使用Quitline戒烟服务。与州Quitlines合作，滚动招募将用于招募1，294名符合条件的儿童及其父母。参与者将在各州内随机分配到治疗组（成人戒烟服务加儿童吸烟预防计划）或对照组（仅成人戒烟服务）。参与者将在随机分配和最终随访之间遵循36个月的方案。父母将在干预后1个月和6个月以及此后每年完成基线评估和随访访谈;此外，治疗组父母将完成项目实施调查。儿童将在干预后1个月和6个月以及此后每年完成基线评估和随访访谈;他们在最终随访时年龄为10至12岁。研究假设：降低儿童开始吸烟（第一次吸烟）的几率，降低儿童对吸烟的易感性，增加父母保持戒烟的可能性。生存分析将测试干预措施对儿童开始吸烟和父母保持戒烟的影响。比例优势模型将测试干预措施对未开始吸烟的儿童吸烟易感性的影响。回归分析和潜在变量建模将用于确定干预效果的中介和调节因素。还将进行成本效益分析。 公共卫生相关性：拟议的项目将测试一种创新的公共卫生干预战略，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，建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美国各地提供的循证戒烟服务组合来传播。

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.