Reducing Secondhand Smoke Exposure Among Pediatric Patients in the Emergency Department Setting

项目概要 药物使用障碍对在急诊科寻求治疗的个人影响尤为严重 （ED）。尼古丁成瘾是 ED 人群中常见的一种物质使用障碍，影响 成人及其子女直接接触二手烟 (SHSe)。 ED 的独特定位是 向高危成人和儿童群体提供烟草使用障碍的预防性干预措施 获得预防性护理的来源。虽然急诊室可以扩大医疗保健范围以包括对健康的关注 对于儿童及其照顾者的促进和疾病预防，实施此类努力是罕见的。 常见的障碍包括公共卫生干预方面的时间、资源和技能。因此，有一个调用 培养能够领导多学科研究的科学家，将 ED 的临床使命扩展到 包括健康促进和疾病预防工作。然而，很少有人关注量化 儿童SHSe对儿科ED（PED）利用的贡献及探索如何有效实施 SHSe 减少干预措施就是在这个适当的环境中进行的。因此，本项目的具体目标是： 1） 确定儿童 SHSe 对暴露于 SHS 的医疗保健利用率和相关成本的贡献 向 PED 报告的儿童与未接触过的儿童进行比较； 2）选择两个现有的之一， 基于证据的 SHSe 减少干预措施，并确定适应和成功实施的方法 通过对医生、护士、社会工作者和社会工作者进行重点访谈，对 PED 环境进行干预 医疗保健管理人员； 3) 制定实施计划和相应的程序手册 用于未来 R01 SHSe 减少干预措施，该干预措施将适应 PED 设置。成功者 拟议项目的完成将导致确定儿童 SHSe 的健康和经济负担 关于 PED 并制定减少 SHSe 的实施计划，以在未来的 R01 试验中进行测试。博士。 候选人 Ashley L. Merianos 是辛辛那提大学的助理教授。国家报 卫生研究院指导研究科学家发展奖（K01）将为候选人提供 混合方法论和预防性干预的基础研究和职业培训 实施拟议的工作。 Merianos 博士的长期职业目标是成为一名健康服务研究员 开发、调整和实施基于证据的行为干预措施的专业知识 在紧急医疗保健环境中使用影响儿童的疾病。通过拟议的 K01 工作，她计划 在 PED 中重点关注儿童 SHSe，以获得将健康促进和疾病纳入其中所需的新技能 预防进入急性医疗保健环境。

PROJECT SUMMARY Substance use disorders disproportionately affect individuals seeking treatment in Emergency Departments (EDs). Nicotine addiction is a commonly reported substance use disorder in ED populations that impacts adults directly and their children through secondhand smoke exposure (SHSe). EDs are uniquely positioned to deliver preventive intervention for tobacco use disorders to at-risk adult and child populations with limited access to sources of preventive care. While EDs could expand medical care to include a focus on health promotion and disease prevention for children and their caregivers, implementation of such efforts is rare. Commonly reported barriers include time, resources, and skill in public health intervention. Thus, there is a call to train scientists capable of leading multi-disciplinary research that extends the clinical mission of EDs to include health promotion and disease prevention efforts. However, little attention has been given to quantifying the contribution child SHSe has on pediatric ED (PED) utilization and exploring how to effectively implement SHSe reduction interventions into this opportune setting. Therefore, the specific aims of this project are: 1) To determine the contribution that child SHSe has on healthcare utilization and related costs in SHS-exposed children who present to the PED compared with unexposed children; 2) To select one of two existing, evidence-based SHSe reduction interventions, and identify ways to adapt and successfully implement the intervention in the PED setting by conducting focused interviews with physicians, nurses, social workers, and healthcare administrators; and 3) To develop an implementation plan and corresponding manual of procedures for use in a future R01 SHSe reduction intervention that will be adapted for the PED setting. The successful completion of the proposed project will result in identification of the health and economic burden of child SHSe on the PED and creation of an implementation plan to reduce SHSe to be tested in a future R01 trial. Dr. Ashley L. Merianos, the candidate, is an Assistant Professor at the University of Cincinnati. The National Institutes of Health Mentored Research Scientist Development Award (K01) will provide the candidate with fundamental research and career training in mixed-methods methodology and preventive intervention to implement the proposed work. Dr. Merianos’ long-term career goal is to be a health services researcher with expertise in developing, adapting, and implementing evidence-based behavioral interventions for substance use disorders affecting children in the acute healthcare setting. Through the proposed K01 work, she plans to focus on child SHSe in the PED to acquire new skills needed to incorporate health promotion and disease prevention into the acute healthcare setting.