Promoting Smoke-free Homes in Lakota Communities.

在拉科塔社区推广无烟家庭。

• 批准号: 9273127
• 负责人: Patricia Nez Henderson
• 金额: $ 47.38万
• 依托单位: BLACK HILLS CTR/AMERICAN INDIAN HEALTH
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9273127
• 关键词: 18 year old; Adoption; Adult; Advocacy; Air; American Indians; Area; Asthma; Attitude; Back; Belief; Biological Markers; Biological Tumor Markers; Carcinogens; Cessation of life; Child; Childhood Asthma; Cigarette; Cities; Communities; Control Groups; Coronary heart disease; Cotinine; Data; Decision Making; Development; Diabetes Mellitus; Elderly; Environmental Tobacco Smoke; Experimental Designs; Exposure to; Feedback; Focus Groups; Health; Health Benefit; High Prevalence; Home environment; Household; Individual; Intervention; Intervention Studies; Interview; Knowledge; Laws; Malignant neoplasm of lung; Measures; Methods; Monitor; Morbidity - disease rate; Myocardial Infarction; Nicotine; Nitrosamines; Northern Plains Tribe; Participant; Patient Self-Report; Pilot Projects; Policies; Population; Privatization; Public Health; Randomized; Randomized Controlled Trials; Research; Reservations; Risk; Rivers; Sampling; Serum; Severities; Sioux Indians; Smoke-free home; Smoker; Smoking; South Dakota; Statutes and Laws; Sudden infant death syndrome; Testing; Teton Sioux Indian; Tobacco; Training; Tribes; Urine; Weight; Work; Workplace; arm; base; community based participatory research; environmental tobacco smoke exposure; experience; functional status; health related quality of life; improved; informant; intervention effect; member; mortality; non-smoker; non-smoking; post intervention; premature; primary outcome; promoter; restricting smoking; smoking prevalence; smoking restriction; standardize measure; study population; tribal member; urinary

Secondhand smoke (SHS) is recognized as a class A carcinogen and has no safe level of exposure. SHS is estimated to contribute to over 3,000 lung cancer deaths in non-smokers annually. With widespread legislation restricting smoking in workplaces and other public venues, most of the U.S. public now live in states with laws to protect against SHS exposure. Yet, the primary place in which involuntary exposure to SHS still occurs is now in homes. Nonsmokers from the Cheyenne River Sioux Tribe, a Lakota tribe from South Dakota, disproportionately share the burden of SHS, especially in their homes. Our own recent findings show that Cheyenne River Sioux adult nonsmokers have cotinine levels equal to those regularly seen in active smokers. With smoking prevalence as high as 50% among this population, the consequences of SHS already manifest in this Tribe, including high prevalences of childhood asthma and sudden infant death syndrome. Further complicating matters, the expanded use of commercial tobacco products for ceremonial and cultural practices is creating challenges not typically seen in non-American Indian communities. Therefore, eliminating SHS exposure in a culturally appropriate manner is a fundamental step in decreasing morbidity and mortality among Cheyenne River Sioux Tribe and other Northern Plains Tribes. Our primary study objective is to test a culturally tailored intervention to encourage adoption of home smoking restrictions in Cheyenne River Sioux Tribal households where nonsmokers are present. We propose to conduct a randomized, controlled trial to develop, implement and evaluate a culturally tailored SHS advocacy training both with and without urinary biomarker feedback. Biomarker feedback is an intervention method that provides highly personalized feedback including, in this instance, levels of urinary tobacco-specific pro-carcinogen markers that further characterize evidence of the negative sequelae of smoking in homes Our Specific Aims are to 1) Assess knowledge, attitudes and beliefs about secondhand smoke exposure and perceived barriers to adoption of smoking restrictions in tribal member households on the Cheyenne River Sioux Tribe Reservation. Based on our prior work we expect that few participants know about the dangers associated with SHS exposure. We expect that few have smoke-free homes; 2) Augment, implement, and evaluate a nonsmokers’ urinary cotinine and carcinogen biomarker feedback intervention on the adoption of household smoking restrictions. We expect that the nonsmoker adults who receive advocacy training with urinary biomarker feedback will be more likely to affirm that smoking restrictions are needed within their households than those just receiving advocacy training only, and; 3) Determine the effect of the intervention on health-related quality of life 6 months after implementation of advocacy and biomarker feedback intervention. We hypothesize that the intervention will be associated with improved health-related quality of life, beyond any improvement experienced by advocacy training-only control group.

二手烟（SHS）被认为是a类致癌物，没有安全暴露水平。