Can a Minimal Intervention Reduce Secondhand Smoke Exposure Among Children with Asthma from Low Income Minority Families? Results of a Randomized Trial
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We report on the results of a low-intensity behavioral intervention to reduce second hand smoke (SHS) exposure of children with asthma from low income minority households in Los Angeles, California. In this study, 242 child/adult dyads were randomized to a behavioral intervention (video, workbook, minimal counseling) or control condition (brochure). Main outcome measures included child’s urine cotinine and parental reports of child’s hours of SHS exposure and number of household cigarettes smoked. Implementation of household bans was also considered. No differences in outcomes were detected between intervention and control groups at follow-up. Limitations included high attrition and low rates of collection of objective measures (few children with urine cotinine samples). There continues to be a need for effective culturally and linguistically appropriate strategies that support reduction of household SHS exposure among children with asthma in low income, minority households.
KeywordsSHS exposure Behavioral modification Environmental tobacco smoke Childhood asthma Household smoking restrictions
Support for this work was provided by National Institutes of Health grants HL53957 from the National Heart, Lung and Blood Institute, Division of Lung Diseases, and CA16042 from the National Cancer Institute. Approval was obtained from the UCLA Office for Protection of Research Subjects, UCLA IRB #G94-09-1000-34. We wish to thank the adults and children who participated in the research, and the administrative and clinical staffs at our recruitment sites. We also express appreciation to Ms. Connie Sosnoff, Mr. Alberto Febo, Mr. Charles Perrino, Tuyen Hoang, Ph.D., Darlene Goldstein, Ph.D., Ms. Guadelupe Escobar, Ms. Claudia Huezo, Ms. Yanscy Flores, Ms. Melissa Aguayo, and Ms. Laura Hoyos for assistance in data collection and analysis; K. Michael Cummings, Ph.D., Mary Ann Lewis, R.N., Dr.P.H., F.A.A.N., Maria Hayes-Bautista, R.N., M.P.H., Lesa Walden, M.D. (VitalSigns, Inc. Santa Monica, CA), and Antronette K.Yancey, M.D., M.P.H. for assistance in developing the intervention materials and survey instruments.
- 5.U.S. Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: a report of the surgeon general. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2006.Google Scholar
- 7.U.S. Environmental Protection Agency. Fact sheet: national survey on environmental management of asthma and children’s exposure to ETS. Retrieved 10 Dec 2011, from, http://www.epa.gov/smokefree/pdfs/survey_fact_sheet.pdf (2011).
- 21.Priest N, Roseby R, Waters E, et al. Family and carer smoking control programmes for reducing children’s exposure to environmental tobacco smoke. Cochrane Database Syst Rev. 2008;(4):CD001746. doi: 10.1002/14651858.CD001746.pub2.
- 23.Curry SJ, Emmons KM. Theoretical models for predicting and improving compliance with breast cancer screening. Ann Behav Med. 1994;16(4):302–16.Google Scholar
- 26.Lozano P, Finkelstein JA, Carey VJ, et al. A multisite randomized trial of the effects of physician education and organizational change in chronic-asthma care—health outcomes of the Pediatric Asthma Care Patient Outcomes Research Team II Study. Arch Pediatr Adolesc Med. 2004;158(9):875–83.PubMedCrossRefGoogle Scholar
- 31.Cuellar I, Harris LC, Jasso R. An acculturation scale for Mexican American normal and clinical populations. Hisp J Behav Sci. 1980;2(3):199–217.Google Scholar
- 38.Centers for Disease Control and Prevention (CDC). State-specific prevalence of smoke-free home rules—United States, 1992–2003. MMWR Morb Mortal Wkly Rep. 2007;56(20):501–504.Google Scholar
- 39.Marin B, Marin G. Research with hispanic populations. Thousand Oaks: Sage Publications; 1991.Google Scholar
- 40.Gergen PJ, Fowler JA, Maurer KR, Davis WW, Overpeck MD. The burden of environmental tobacco smoke exposure on the respiratory health of children 2 months through 5 years of age in the United States: Third National Health and Nutrition Examination Survey, 1988–1994. Pediatrics. 1998;101(2):E8. Retrieved 13 Nov 2011, from, http://www.pediatrics.org/cgi/content/full/101/2/e8