Sustaining Cessation in Smokers With Kids With Asthma

描述（由申请人提供）：此申请是我们先前NHLBI资助的更新，“激励哮喘儿童的父母戒烟”。本研究比较了接受哮喘治疗儿童的低收入照顾者的两种由护士提供的基于家庭的戒烟干预措施；一个侧重于通过提供动机性访谈和生物标志物反馈（PAM）来增强风险感知，另一个侧重于使用AHRQ指南（BAM）来建立自我效能感。在2个月的随访中，PAM的戒烟率明显高于BAM，但两组在6个月时的复发率都很高。当前研究的第一个目的是利用我们先前证明的戒烟干预（PAM）来检查假设的认知、情感和行为过程，这些过程是导致孩子最近哮喘发作的吸烟者与健康孩子的吸烟者之间的教育时刻的基础。很少有研究，如果有的话，对可教时刻背后的假设结构进行了系统的评估，也没有包括没有经历可教时刻的个人的适当比较组。

DESCRIPTION (provided by applicant): This application is a renewal of our prior NHLBI grant, "Motivating the Parents of Kids with Asthma to Quit Smoking." This study compared two nurse-delivered home-based smoking cessation interventions for low income caregivers of children receiving asthma treatment; one that focused on augmenting risk perception through the provision of Motivational Interviewing and biomarker feedback (PAM), and one that focused on building self-efficacy using AHRQ guidelines (BAM). PAM achieved significantly greater quit rates than BAM at a 2 month follow-up, but both groups had high relapse rates by 6-months. The first aim of the current study is to utilize our previously demonstrated smoking cessation intervention (PAM) to examine the cognitive, affective, and behavioral processes hypothesized to underlie the Teachable Moment in smokers with kids who had a recent asthma exacerbation vs. smokers with healthy kids. Few, if any studies, have conducted a systematic evaluation of the constructs hypothesized to underlie the Teachable Moment, nor have they included the appropriate comparison groups of individuals not experiencing a teachable moment. Our second aim attempts to sustain the excellent short-term quit rates we found in our first study by testing whether supplementing PAM with a telephone-based intervention improves and sustains quitting more than PAM plus contact control among parents of kids with asthma. The telephone counseling will be theory based, targeting the constructs associated with quitting in our first study (perceived risk, precaution effectiveness, self-efficacy). To our knowledge, no studies have utilized telephone counseling to motivate smoking cessation in the parents of kids with asthma. Our primary outcomes: point prevalence abstinence, relapse, ETS reduction, asthma morbidity, and health care utilization. We will also examine mediators and moderators. Our study has public health significance because it will be conducted in the "real world," during the course of the child's asthma treatment, proactively reaching smokers who may not otherwise quit.