TOBACCO PREVENTION WITH PARENTS AND CHILDREN IN AN HMO

描述：(申请人描述) 建议的研究重点是预防青少年开始吸烟。 登记在两个管理型医疗机构的人。父母和孩子都有一个 与医疗保健系统的直接、持续的关系，可能会有 在父母和保健部门之间建立伙伴关系方面的协同作用 在防止吸烟的努力中提供帮助。研究的目的是： (1)进行随机试验以评估吸烟的影响 为家长和儿童(10-12岁)提供的预防干预方案 是通过两个大型管理保健组织提供的。干预措施 包括：(A)邮寄父母预防吸烟工具包；(B)外联 健康教育者给家长的跟进电话(S)；(C)邮寄 儿童防烟工具包；(D)提供者认可和支持 通过放置在医疗表中的线索向父母和孩子传递信息 父母和子女；和(E)推广通讯邮寄和健康教育者 一年后打来电话。这种干预将被比作通常的护理 对照组进行双臂研究。主端点将是 24个月随访时的吸烟易感性。实验： 香烟，每月吸烟也将被评估为次要的 结果。(2)对吸烟情况进行前瞻性、纵向分析 发病过程。从社会学习理论的角度出发，我们 将：(A)评估父母和子女在烟草问题上的相关性 态度、信念、行为和营销曝光率，横向和 随着时间的推移；(B)确定易感性的预测因素，试验 吸烟和每月吸烟，以及(C)确定儿童和父母的因素 这就改变了干预的效果。的方法论目标 研究的目的是：(1)确定以人口为基础的家庭样本 10-12岁儿童(N=10,000)；(2)随机选择同意的家庭(N=5,000) 干预或常规护理；(3)确定375个家庭的亚样本 干预组和对照组(总分N=750)作为 纵向评估子队列。进行电话健康行为 随机选择父母的调查(在有两个父母参加的家庭中 (4)进行6个月、12个月和24个月的随访 对评估分组中的父母和儿童进行调查和(5)进行 对所有研究家庭的儿童进行24个月的跟踪调查 后随机化。

DESCRIPTION: (Applicant's Description) The proposed study focuses on prevention of smoking initiation among youth enrollees in two managed care organizations. Parents and children have a direct, ongoing relationship with the health care system, and there may be synergy in establishing a partnership between the parent and the health care provider in efforts to prevent smoking initiation. The study aims are to: (1) Conduct a randomized trial to evaluate the impact of a smoking prevention intervention package for parents and children (ages 10-12) that is provided through two large managed care organizations. The intervention includes: (a) mailed parental smoking prevention kit; (b) outreach follow-up phone call(s) to the parent by a health educator; (c) mailed child's smoking prevention kit; (d) provider endorsement and supportive message for parents and children via cues placed in medical chart of the parents and children; and (e) booster newsletter mailing and health educator call at one year. This intervention will be compared to a usual care control group in a two-arm study. The primary endpoint will be susceptibility to smoking at a 24-month followup. Experimentation with cigarettes, and monthly smoking will also be evaluated as secondary outcomes. (2) Conduct a prospective, longitudinal analysis of the smoking onset process. Building from a social-learning theoretical perspective, we will: (a) Assess the correlation between parent and child regarding tobacco attitudes, beliefs, behavior, and marketing exposure, cross-sectionally and over time; (b) Identify predictors of susceptibility, experimentation with smoking, and monthly smoking, and (c) Identify child and parent factors which modify the effect of the intervention. The methodological aims of the study are to: (1) Identify a population-based sample of families with children ages 10-1 2 (N=l0,000); (2) Randomize consenting families (N=5000) to intervention or usual care; (3) Identify a subsample of 375 families in the intervention and control groups (total N = 750) to serve as a longitudinal assessment subcohort. Conduct telephone health behavior surveys with randomly selected parent (in families with 2 parents enrolled in GHC & KPNW) and index child; (4) Conduct 6, 12 and 24 month follow-up surveys of parents and children in the assessment subcohorts and (5) Conduct follow-up surveys with children in all study families 24 months post-randomization.