Journal article
Kids Safe and Smokefree (KiSS) Multilevel Intervention to Reduce Child Tobacco Smoke Exposure: Long-Term Results of a Randomized Controlled Trial
International journal of environmental research and public health, v 15(6), p1239
12 Jun 2018
PMID: 29895740
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Pediatricians following clinical practice guidelines for tobacco intervention (Ask, Advise, and Refer [AAR]) can motivate parents to reduce child tobacco smoke exposure (TSE). However, brief clinic interventions are unable to provide the more intensive, evidence-based behavioral treatments that facilitate the knowledge, skills, and confidence that parents need to both reduce child TSE and quit smoking. We hypothesized that a multilevel treatment model integrating pediatric clinic-level AAR with individual-level, telephone counseling would promote greater long-term (12-month) child TSE reduction and parent smoking cessation than clinic-level AAR alone. Methods: Pediatricians were trained to implement AAR with parents during clinic visits and reminded via prompts embedded in electronic health records. Following AAR, parents were randomized to intervention (AAR + counseling) or nutrition education attention control (AAR + control). Child TSE and parent quit status were bioverified. Results: Participants (n = 327) were 83% female, 83% African American, and 79% below the poverty level. Child TSE (urine cotinine) declined significantly in both conditions from baseline to 12 months (p = 0.001), with no between-group differences. The intervention had a statistically significant effect on 12-month bioverified quit status (p = 0.029): those in the intervention group were 2.47 times more likely to quit smoking than those in the control. Child age was negatively associated with 12-month log-cotinine (p = 0.01), whereas nicotine dependence was positively associated with 12-month log-cotinine levels (p = 0.001) and negatively associated with bioverified quit status (p = 0.006). Conclusions: Pediatrician advice alone may be sufficient to increase parent protections of children from TSE. Integrating clinic-level intervention with more intensive individual-level smoking intervention is necessary to promote parent cessation.
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Details
- Title
- Kids Safe and Smokefree (KiSS) Multilevel Intervention to Reduce Child Tobacco Smoke Exposure: Long-Term Results of a Randomized Controlled Trial
- Creators
- Stephen J. Lepore - Temple UniversityBradley N. Collins - Temple UniversityDonna L. Coffman - Temple UniversityJonathan P. Winickoff - Massachusetts General HospitalUma S. Nair - Temple UniversityBeth Moughan - Temple UniversityTyra Bryant-Stephens - Children's Hospital of PhiladelphiaDaniel Taylor - St Christophers Hosp Children, Dept Pediat, Philadelphia, PA 19134 USADavid Fleece - Temple UniversityMelissa Godfrey - Temple University
- Publication Details
- International journal of environmental research and public health, v 15(6), p1239
- Publisher
- Mdpi
- Number of pages
- 16
- Grant note
- R01 CA158361 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000436496900190
- Scopus ID
- 2-s2.0-85048608426
- Other Identifier
- 991021838581304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Environmental Sciences
- Public, Environmental & Occupational Health