MassCONECT 4 Kids: Promoting Smoke-Free Homes

描述(由申请人提供)：家庭中非自愿二手烟(SHS)暴露是一种完全可以预防的公共健康威胁，对社会经济地位较低的社区的幼儿造成不成比例的负担。我们由NCI资助的社区网络计划MassCONECT先前证明了动机干预(ML)的有效性，以保护易受SHS影响的儿童。我们现在提出一项基于社区的参与性研究(CBPR)倡议，通过让父母自愿采用无烟家庭政策来保护儿童免受SHS的影响，来评估ML与通常的最佳实践(UBP)的有效性。ML将与社区合作伙伴一起开发，纳入卫生部门赞助的针对高危儿童的家访计划，并由训练有素的社区卫生工作者提供。目标1)：在马萨诸塞州的波士顿、伍斯特和劳伦斯三个城市，为高危儿童(0-3岁)制定并整合一项促进无烟家庭的干预措施，将其纳入现有的早期干预(EL)家访计划。EL计划由马萨诸塞州公共卫生部赞助，促进家庭与儿童的互动，以达到适当的发展里程碑。对于符合条件的家庭，即父母/主要照顾者(或配偶/重要的另一半)吸烟且不存在无烟家庭政策，UBP由关于SHS和无烟家庭、戒烟热线和其他公共戒烟服务的书面材料组成。ML将由训练有素的社区卫生工作者提供，使用专门为客户量身定做的文化和语言信息。目的2：评估UBP和ML在减少高危儿童SHS暴露方面的有效性：我们将在三个城市招募500个符合条件的El家庭，并随机将他们分配到UBP或ML。我们假设，与UBP相比，ML将导致以下主要结果：i)显著提高无烟家庭政策的采用率，ii)显著减少在家中吸烟的香烟数量，iii)显著降低家庭SHS，以及iv)显著降低儿童SHS暴露。这一干预措施是学术界-社区-卫生部门强有力合作的产物，严格执行CBPR原则，为社区建设能力，通过与现有国家资助资源的伙伴关系最大限度地发挥可持续发展的潜力，并为保护弱势儿童和减少差距提供了一个创新的场所。 这项研究鼓励采取无烟家庭政策，以保护高危儿童不受二手烟的影响。通过将这种社区努力整合到卫生部门赞助的家访计划中，这项研究提供了一种促进儿童健康的创新战略。

DESCRIPTION (provided by applicant): Involuntary secondhand smoke (SHS) exposure in homes is an entirely preventable public health threat that disproportionately burdens young children in communities of low socioeconomic position. Our NCI-funded Community Networks Program MassCONECT previously demonstrated the efficacy of motivational intervention (Ml) to protect vulnerable children from SHS. We now propose a community-based participatory research (CBPR) initiative to evaluate the effectiveness of Ml compared with usual best practices (UBP) by having parents voluntarily adopt smoke-free home policies to protect children from SHS. Ml will be developed in conjunction with community partners, integrated into a health department-sponsored home visiting program for high-risk children, and delivered by trained community health workers. Aim 1): Develop and integrate an intervention to promote smoke-free homes into existing Early Intervention (El) home visiting programs for high-risk children (ages 0-3 years) in three Massachusetts cities: Boston, Worcester, and Lawrence. El programs, sponsored by the Massachusetts Department of Public Health, facilitate family interactions with children to meet appropriate developmental milestones. For eligible El households, ie where either the parent/primary caregiver (or the spouse/significant other) smokes and no smoke-free home policy exists, UBP consists of written materials about SHS and smoke-free homes, quitlines and other publicly available cessation services. Ml will be delivered by a trained community health worker, using specifically developed messages culturally and linguistically tailored to the client. Aim 2: Assess the effectiveness of UBP vs. Ml to reduce SHS exposure for at-risk children: We will enroll 500 eligible El households in the three cities and randomize them to UBP or Ml. We hypothesize that compared to UBP, Ml will result in the primary outcomes of: i) significantly higher rates of adoption of a smoke-free household policy, ii) significantly lower numbers of cigarettes smoked inside the home, iii) significantly lower domestic SHS, and iv) significantly lower child SHS exposure. This intervention, a product of a strong academic-community-health department collaboration, rigorously applies CBPR principles, builds capacity for communities, maximizes the potential for sustainability through partnership with existing state-funded resources, and offers an innovative venue to protect vulnerable children and reduce disparities. This study encourages the adoption of smoke-free home policies to protect at-risk children from involuntary exposure to secondhand smoke. By integrating such community efforts into home visiting programs sponsored by health departments, the study offers an innovative strategy to promote the health of kids.