REFERENCE: Zakarian J.M., Hovell M.F., Matt G.E., Sandweiss R.D., Micik S.H., Anders B. Behavioral counseling for reducing babies' ETS exposure: Implementation in community clinics. Presented at the Center for Disease Control and Prevention's 13th National Conference on Chronic Disease Prevention and Control in Atlanta, GA, December, 1998.

Objective: To test the effectiveness of a behavioral-counseling program, as delivered by community clinic staff as part of well-baby care services, for reducing babies' exposure to environmental tobacco smoke (ETS).

Setting: Eight community clinics in San Diego County.

Intervention: Staff were trained to deliver a seven-session program consisting of behavioral contracting, shaping, and problem-solving. Counseling sessions are conducted in-person and on the telephone. The program will be offered to approximately 75 low-income smoking mothers of children age three and younger and outcomes will be compared to approximately 75 controls assigned at random.

Outcomes: This paper reports the initial outcomes for clinic delivery of a new prevention service. Frequency of counseling sessions, continuity of sessions, staff turn-over, and other system difficulties will be presented.

Conclusions: Implementation of preventive care in under-funded community clinics presents many challenges. Recommendations regarding systems changes will be offered.


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