Innovation for Smoke-Free Homes: Real-Time Feedback

无烟家庭的创新：实时反馈

• 批准号: 8661242
• 负责人: Melbourne F Hovell
• 金额: $ 127.59万
• 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/8661242
• 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.

描述（由申请人提供）：二手烟暴露（SHSe）是一个重大的健康风险，特别是对幼儿。超过50%的儿童的SHSe发生在家里，低收入家庭的儿童更有可能暴露于SHS。因此，需要以家庭为基础的干预措施，以保护儿童从SHSe。这是第一项功效研究，旨在测试是否可以通过使用创新的SHS颗粒监测器向家庭居民提供实时反馈以及简短的建议/表扬来减少儿童家中的SHSe。这项研究将测试即时反馈和简短的建议/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，实时反馈的监测加上简短的建议，将提示和加强SHSe减少行为。将招募来自加州圣地亚哥妇女、婴儿和儿童（WIC）项目的400个家庭。家庭将被随机分配到一个实验组，接受来自SHS颗粒监测器的连续实时反馈，加上与反馈相关的简短建议/表扬，以减少他们孩子的暴露，或者到一个常规护理控制组，其中颗粒监测器没有提供反馈。在干预阶段，当检测到SHS时，实验组家庭中的监视器将发出警告灯和蜂鸣声。主要的具体目标是：1）确定由于实时监测反馈和简要建议，通过儿童可替宁测定法测量的SHSe水平的差异组变化; 2）确定家庭禁烟规定中的差异组变化;和3）使用尼古丁剂量计和儿童尿可替宁测定法测量SHSe颗粒的差异变化。探索性的目的是：确定理论调节因子（例如，儿童的健康）的简短建议加反馈的影响;评估理论调解人的影响（例如，建立家庭吸烟禁令和其他社会突发事件）;通过检查数月的连续颗粒监测器记录来探索SHSe的动态性质，以将家庭中的社会背景和微环境识别为干预的精确目标（例如，吸烟地点、非吸烟地点和吸烟时的社会互动）;评估不同种族/民族和单亲家庭与双亲家庭的烟草使用和SHSe的差异变化，以增加对烟草控制差异的理解;并从家庭获得建议，以加强未来使用监测器。这也是住宅烟草控制新技术的第一次大规模测试，其中向调查人员提供的实时和遥测反馈将使家庭能够立即从灯光和声音警报中获得反馈，并向调查人员通报值得建议或表扬的吸烟事件或减少吸烟事件。因此，该应用为未来的创新研究开辟了一个新的方向，使用新技术在一系列微环境中减少SHSe。