CBEACH

BEST FOR BABY PROJECT

PROMOTING ENVIRONMENTAL TOBACCO SMOKE EXPOSURE REDUCTION:

A PEDIATRIC EFFECTIVENESS TRIAL

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Behavioral Ecological Model

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An estimated 20 million U.S. children are exposed to secondhand tobacco smoke (SHS). Pediatric care provides a key opportunity to address the medical implications of young children's exposure to SHS. Best for Baby Project, supported by The American Heart Association, furthers the work at CBEACH focused on behavioral methods to intervene in reducing children's exposure from SHS. The primary aim of this randomized trial is to determine the effectiveness of prompting physicians to deliver brief counseling to help patient families protect their children from SHS exposure with the aid of children's urine cotinine feedback provided by project staff. P Mothers with children under five years old exposed to SHS in the home were recruited (n=102) through multiple Women's, Infants and Children's Nutrition Program (WIC) sites and assigned at random to a 2-group design: Control Group: usual medical care versus Experimental Group: referral to a behavioral counseling service provided in the home by project staff. Physicians listed by study families were mailed training material and results of cotinine lab values with guidelines on interpreting study children's SHS exposure levels. Mothers were given the lab results also and incentives to communicate about the implications of these findings with their child's physician. All parents are being interviewed regarding their smoking patterns and their child's SHS exposure at Baseline, Month 6 Post-Test and Month 12 Follow-Up. In addition, biological samples from which cotinine, biomarkers for nicotine, were obtained from each child and from parents who report smoking cessation. Repeated measures analyses and multivariate statistical modeling will be employed to determine the differential reduction in SHS and/or smoking cessation between the two conditions. A pilot survey to explore level of interest of physicians in providing SHS counseling is being conducted also. Results of overall study will inform the effectiveness of similar services in routine pediatric care. Melbourne F. Hovell, Ph.D., M.P.H. serves as Principle Investigator, Susan Meltzer, M.P.H., as Coordinator and Dr Meltzer serves as medical consultant for the project.

Principal Investigator: Mel Hovell, PhD, MPH

Co-Principal Investigator: Susan Meltzer, MPH

Funded 2002-2004

Source: American Heart Association

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