Protecting Children from Second-Hand Smoke

DESCRIPTION (provided by investigator): Although public policies continue to be implemented to minimize Environmental Tobacco Smoke (ETS exposure) in the work place and in public places, ETS exposure in the home, where children are most likely to be exposed, remains an issue of great concern. We are proposing to develop a comprehensive program to promote and assist healthcare providers in counseling and advising patients how to reduce ETS exposure in the home. Our product consists of a CME training component, a kit of performance support tools and procedures for providers and staff to use to initiate and follow up on ETS interventions, a self-help workbook for providers to give to patients and their families, and an online patient support component. We plan to design a "moderate intensity" intervention model of clinician-provided advice and brief counseling, adapted from more extensive services/products used in previous efficacy studies. For many years now, clinical interventions for smoking cessation have been developed. To our knowledge, there are no comparable intervention programs that target ETS exposure, although a substantial amount of clinical trial data indicates the efficacy of clinical interventions for ETS exposure reduction. We believe the results from these studies are sufficient to warrant transferring clinical interventions from an experimental setting to the field. The aim of this SBIR Phase I project is to develop a pilot version of the proposed residential ETS reduction program, and then to conduct a formative evaluation of the pilot product. We will focus our efforts on obtaining extensive feedback from providers and patients that will allow us to fully elaborate and refine our product. This feedback will guide the tailoring of the program components to make them suitable for integration into clinicians' daily office practice and potentially more effective and less expensive than what has been done in earlier efficacy studies. The information we obtain in this formative evaluation will inform the design and development of the final product during SBIR Phase II, and the Phase II research design. The end goal of the proposed program, to be evaluated in Phase II, is reduction of residential ETS exposure and smoking cessation. Related objectives include changing provider behavior to increase the rate and effectiveness of ETS exposure interventions, and changing patient behavior to reduce ETS exposure or to stop smoking entirely.