Computer-Delivered Interventions for Secondhand Smoke Exposure

描述（由申请人提供）：近40%的美国儿童在家中暴露于二手烟草烟雾（SHS），高达50%的儿童在汽车中暴露于二手烟草烟雾，危及数百万儿童的健康和生命。需要更有效、更廉价和更容易获得的干预措施，以影响父母和照顾者制定吸烟限制的意愿和能力。我们建议开发一种创新的计算机模拟干预，SHS- sims，使护理人员能够看到他们或他人吸烟使儿童暴露于SHS的程度，暴露的潜在负面健康影响，以及不同的行动如何减少暴露。干预的核心是一个交互式屏幕，描绘了SHS暴露的模拟，具有吸引人的图形、动画、声音和英语和西班牙语的音频交流。在拟议的第一阶段STTR中，我们将通过在妇女，婴儿和儿童（WIC）诊所招募总共约80名参与者来测试干预的可行性和潜在优点，这些参与者允许在车内吸烟，并将随机分配到SHS-Sims干预组或静态教育对照组（每组约40人）。计算机干预将涉及通过模拟界面探索不同的现实生活场景。参与者将获得有关暴露和健康影响的用户友好指导和解释。在干预结束时，受试者将接受采访，了解他们所学到的知识，以及他们改变行为的意图。我们将通过以下能力来判断第一阶段干预是否成功：(1)增加对SHS暴露和减少暴露策略的认识和理解；(2)增加启动缓解战略的意愿；(3)被临床工作人员接受。第一阶段的数据将用于确定开发更广泛的基于模拟的干预措施的实用性和适当性，该干预措施侧重于其他常见的SHS暴露途径，包括家庭和户外。所提出的干预技术可能具有重大的公共卫生意义，因为它可以在诊所、医院或医疗实践的候诊室广泛而廉价地部署给父母。

DESCRIPTION (provided by applicant): Close to 40% of US children are exposed to secondhand tobacco smoke (SHS) in homes and up to 50% in cars, compromising the health and lives of millions of children. More effective, inexpensive, and accessible interventions are needed that impact parents' and caregivers' willingness and ability to institute smoking restrictions. We propose the development of an innovative, computerized simulation intervention, SHS-Sims, that allows caregivers to see the extent to which their or others' smoking exposes children to SHS, the potential negative health impacts of the exposure, and how different actions can reduce the exposure. The heart of the intervention is an interactive screen depicting the simulation of SHS exposure, with appealing graphics, animation, sound, and audio communication in English and Spanish. In the proposed Phase I STTR, we will test the feasibility and potential merit of the intervention by recruiting a total of approximately 80 participants in Women, Infant, and Children (WIC) clinics, who allow smoking in their car and who will be randomly assigned to the SHS-Sims intervention or static educational control groups (~40 in each group). The computer intervention will involve the exploration of different real life scenarios with the simulation interface. Participants will be provided with user-friendly direction and explanation of exposures and health effects. At the end of the intervention, the subjects will be interviewed about what they learned, and about their intentions to change behavior. We will judge the success of the Phase I intervention by its ability to: (1) increase knowledge and understanding regarding SHS exposure and strategies to reduce exposure; (2) increase intentions to initiate mitigation strategies; and (3) be accepted by clinic staff. Data from Phase I will be used to determine the utility and appropriateness of developing a more extensive simulation-based intervention that focuses on other common avenues of SHS exposure, including the home and the outdoors. The proposed intervention technology has the potential to be of great public health significance in that it could be deployed widely and inexpensively to parents in waiting rooms of clinics, hospitals, or medical practices.