Barriers and motivators to reducing secondhand smoke exposure in African American families of head start children: a qualitative study

Abstract

Objective: To identify barriers and motivators for reducing secondhand smoke exposure (SHSe) for families of African-American, lowincome, urban children. Method: Audiotaped intervention sessions of 52 African-American caregivers of Head Start children who reported being a smoker and/or had at least one smoker in the home were randomly sampled from a larger trial examining the effectiveness of a motivational-interviewing intervention in reducing child's SHSe. Counseling sessions were qualitatively coded to identify barriers and motivators to implementing a home smoking ban or quitting smoking.Results: African-American families identified several themes that were either or both barriers and motivators for SHSe reduction, including: asking others not to smoke, other family living in the home, neighborhood safety, absence of childcare, cost/availability of cessation tools, physician support and prevention of health problems. Discussion: Urban, low-income AfricanAmerican families face numerous barriers to reducing SHSe. Families were able to identify many motivators for reducing SHSe, suggesting an awareness of the importance for SHSe reduction but uncertainty in their confidence to change behaviors. Counseling should include tailoring to be most effective in supporting health behavior change. Greater emphasis on motivators is needed, such as low-cost/free cessation tools, engagement from physicians and greater involvement of extended family members.

The feasibility of an air purifier and secondhand smoke education intervention in homes of inner city pregnant women and infants living with a smoker

“…These trials included children with asthma and so parents may have been motivated to improve their child’s health. While we did not recruit based on the presence of a chronic illness, women may have been interested in decreasing their infant’s exposure to SHS but found it difficult, in particular if the smokers were older family members who owned the home (Hoehn et al, 2016). Multiple barriers to participation and retention exist in research studies among minority populations, including mistrust of medical research, inconvenient study protocols, transportation issues, and lack of access to information about available studies (El-Khorazaty et al, 2007; Nicholson et al, 2011).…”

Patterns of parents’ perspectives on protecting young children from secondhand smoke exposure: A Q‐methodology study

“…Attitudes towards SHSe included two subcategories: health hazards of various diseases (Chen et al, ; Department of Health & Human Services, ; DiFranza et al, ) and developing hazards (Chen et al, ; Department of Health & Human Services, ; DiFranza et al, ). Motivation towards SHSe prevention included three subcategories: benefits (Hoehn, Riekert, Borrelli, Rand, & Eakin, ; Passey et al, ; Wang et al, ), shaping children's behaviour (Hoehn et al, ; Passey et al, ) and parental responsibility (Centers for Diease Control & Prevention, ; Hoehn et al, ). Parental suggestions of SHSe prevention were reported (Centers for Diease Control & Prevention, ; Hoehn et al, ; Poland, Gastaldo, Pancham, & Ferrence, ; Rosen et al, ).…”

“…Motivation towards SHSe prevention included three subcategories: benefits (Hoehn, Riekert, Borrelli, Rand, & Eakin, ; Passey et al, ; Wang et al, ), shaping children's behaviour (Hoehn et al, ; Passey et al, ) and parental responsibility (Centers for Diease Control & Prevention, ; Hoehn et al, ). Parental suggestions of SHSe prevention were reported (Centers for Diease Control & Prevention, ; Hoehn et al, ; Poland, Gastaldo, Pancham, & Ferrence, ; Rosen et al, ). To understand parents’ responses and actions towards SHSe, we categorized them by location: at home, in public areas and in non‐smoking areas.…”

“…Attitudes towards SHSe included two subcategories: health hazards of various diseases (Chen et al, 2013;Department of Health & Human Services, 2014;DiFranza et al, 2004) and developing hazards (Chen et al, 2013;Department of Health & Human Services, 2014;DiFranza et al, 2004). Motivation towards SHSe prevention included three subcategories: benefits (Hoehn, Riekert, Borrelli, Rand, & Eakin, 2016;Passey et al, 2016;Wang et al, 2011), shaping children's behaviour (Hoehn et al, 2016;Passey et al, 2016) at home, in public areas and in non-smoking areas. Based on the designated categories, we invited 15 parents to share their experiences of SHSe prevention to develop sentences closely describing their experiences.…”

“…and parental responsibility (Centers for DieaseControl & Prevention, 2017;Hoehn et al, 2016). Parental suggestions of SHSe prevention were reported(Centers for Diease Control & Prevention, 2017;Hoehn et al, 2016;Poland, Gastaldo, Pancham, & Ferrence, 2009;Rosen et al, 2017). To understand parents' responses and actions towards SHSe, we categorized them by location:F I G U R E 1Parental perspectives on protecting young children from secondhand smoke exposure (SHSe) based on published literature .…”