Improving Parent/Adolescent Communication about Tobacco

描述（由申请人提供）：低社会经济地位的市中心儿童在青春期开始吸烟并在整个成年期继续使用烟草的风险很高。青少年对非紧急健康问题的急性护理服务的高利用率表明，急诊科（ED）为预防烟草使用提供了一个有前途和创新的环境。此外，由于寻求紧急护理的青少年患者通常由父母陪同，因此在急诊科提供的干预措施可以同时到达儿童和父母。儿童/父母同时干预的基本原理源于青少年吸烟与父母对吸烟的宽容之间的强烈联系。K23奖将为候选人提供时间、资源和指导，将她对烟草预防的研究兴趣与她在急诊医学的临床经验结合起来。她的长期目标是制定量身定制的干预措施，帮助父母防止青少年子女开始吸烟和使用烟草。为奖励期提出的研究计划的重点是对题为“改善父母/青少年关于烟草的沟通”的预防烟草战略进行试点测试、修订、实施和评价。该策略是由研究团队开发的，基于计划行为理论。干预措施包括：父母可向11-14岁的青少年儿童传达有关烟草使用的文化上适当的口头和书面信息；一盘模拟父母与青少年对这些信息进行有效讨论的录像带；一种测试干预效果的调查工具。对IMPACT的重点访谈、定量评估和专家评审将导致对材料的修订，随后使用六个月的纵向随机设计评估IMPACT的效果。本研究旨在探讨IMPACT对青少年吸烟意向和意愿的影响，以及影响的潜在中介和调节因子。假设的中介因素包括青少年对烟草风险的了解；青少年对父母态度、社会接受程度和烟草使用流行程度的看法；而自我效能感的青少年要避免，父母要防止，使用。假设的调节因素包括青少年种族/民族、青少年性别和父母吸烟行为。为奖励期提出的职业发展计划包括先进的定性和定量方法、健康行为理论、青少年成瘾的课程，以及对现有烟草预防计划的实地观察。在奖励期结束时，候选人希望提交一份R01资助申请，用于一项纵向研究，旨在评估IMPACT对青少年实验、开始和持续使用烟草的影响。

DESCRIPTION (provided by applicant): Inner-city children of low socioeconomic status are at high risk for initiating tobacco use during adolescence and continuing its use throughout adulthood. The high utilization of acute-care services for non-emergent health problems by adolescents suggests that the emergency department (ED) offers a promising and innovative setting for the prevention of tobacco use. Furthermore, because adolescent patients seeking urgent care typically are accompanied by parents, an intervention delivered in the ED can reach child and parent simultaneously. The rationale for coincident child/parent intervention derives from the strong association of adolescent smoking with perceived parental leniency toward smoking. The K23 award will provide the time, resources, and mentorship for the Candidate to integrate her research interest in tobacco prevention with her clinical experience in emergency medicine. Her long-term goal is to develop tailored interventions that will help parents prevent tobacco initiation and use by their adolescent children. The research plan proposed for the Award period centers on the pilot testing, revision, implementation, and evaluation of a tobacco prevention strategy entitled Improving Parent/Adolescent Communication about Tobacco (IMPACT). The strategy was developed by the research team and is based on the Theory of Planned Behavior. The intervention consists of: culturally appropriate verbal and written messages about tobacco use that can be conveyed by parents to their adolescent children aged 11-14 years; a videotape that models effective parent-adolescent discussion of these messages, and; a survey instrument to test the effectiveness of the intervention. Focused interviews, quantitative evaluation, and expert review of IMPACT will result in revision of the materials, followed by evaluation of the effects of IMPACT using a six-month longitudinal, randomized design. The proposed research seeks to explore the effect of IMPACT on validated measures of adolescent intention and willingness to smoke, as well as potential mediators and moderators of the effect. Hypothesized mediators include adolescent knowledge of tobacco risk; adolescent perceptions of parental attitudes, social acceptance, and prevalence of tobacco use; and the self-efficacy of adolescents to avoid, and parents to prevent, use. Hypothesized moderators include adolescent race/ethnicity, adolescent gender, and parent smoking behavior. The career development plan proposed for the Award period incorporates coursework in advanced qualitative and quantitative methods, health behavior theory, adolescent addiction, as well as field observation of existing tobacco prevention programs. By the end of the Award period, the Candidate expects to submit an R01 grant application for a longitudinal study designed to assess the effect of IMPACT on adolescent experimentation, initiation, and ongoing use of tobacco.