Distance-based training in two community health centers to address tobacco smoke exposure of children

Abstract

BackgroundThe CEASE (Clinical Effort Against Secondhand Smoke Exposure) intervention was developed to help pediatricians routinely and effectively address the harms of family smoking behaviors. Based on paper versions of CEASE, we partnered with the American Academy of Pediatrics’ online education department and developed a completely distance-based training, including an online CME training, handouts and education materials for families, and phone and email support.MethodsThe pediatric offices of two low income health clinics with primarily Medicaid populations were selected for the study. Pre and post intervention data by survey of the parents was collected in both practices (Practice 1 n = 470; Practice 2 n = 177). The primary outcome for this study was a comparison of rates of clinician’s asking and advising parents about smoking and smoke-free home and cars.ResultsExit surveys of parents revealed statistically significant increases in rates of clinicians asking about parental smoking (22% vs. 41%), smoke-free rules (25% vs. 44%), and asking about other smoking household members (26% vs. 48%).ConclusionsThrough a completely distance based intervention, we were able to train pediatricians who see low income children to ask parents about smoking, smoke-free home and car rules, and whether other household members smoke. Implementing a system to routinely ask about family tobacco use and smoke-free home and car rules is a first step to effectively addressing tobacco in a pediatric office setting. By knowing which family members use tobacco, pediatricians can take the next steps to help families become completely tobacco-free.Trial registrationClinical trials number: NCT01087177

Smoking cessation promotion in the pediatric clinic: Increasing pediatricians’ rate of screening for second hand smoke exposure, counseling caregivers to stop smoking and referring caregivers to smoking cessation programs

“…Caregiver exit interviewers were used in five (Hipple et al, 2013;Hymowitz et al, 2008) (Hymowitz et al, 2001; J. D. Klein et al, 1995) while physician self-report surveys were used in four studies (Hymowitz et al, 2001; J. D. Klein et al, 1995) (Scal et al, 2004) (Collins et al, 2005) (Table 1). …”

“…Pediatric residents were the only subjects in 6 studies (Collins, D'Angelo, Stearns, & Campbell, 2005;Houston et al, 2006) (Hymowitz, Pyle, Haddock, & Schwab, 2008;Hymowitz, Schwab, & Eckholdt, 2001; J. D. Klein, Portilla, Goldstein, & Leininger, 1995;Lee et al, 2004;Scal, Hennrikus, Ehrlich, Ireland, & Borowsky, 2004), while pediatricians were the sole subjects in 2 studies (Beaty et al, 2013;Hipple, Nabi-Burza, Hall, Regan, & Winickoff, 2013) (Table 1). The effects of the intervention were investigated in both pediatricians and pediatric residents in 1 study (Sharifi et al, 2014) (Table 1).…”

“…Klein et al, 2010;Scal et al, 2004;Sharifi et al, 2014). Eight studies also assessed pediatricians' interventions on screening caregivers for smoking behaviors (Collins et al, 2005;Hipple et al, 2013;Houston et al, 2006;Hymowitz et al, 2008;Hymowitz et al, 2001;J. Klein et al, 2010;Sharifi et al, 2014)( (Beaty et al, 2013) while five studies examined the effect of an intervention on pediatricians' providing referrals to caregivers (Beaty et al, 2013;Hymowitz et al, 2008;Hymowitz et al, 2001; J.…”

“…Eight of the nine included studies examined the effect of pediatricians' screening on caregivers' smoking status (Beaty et al, 2013;Collins et al, 2005;Hipple et al, 2013;Houston et al, 2006;Hymowitz et al, 2008;Hymowitz et al, 2001; J. D. Klein et al, 1995;Sharifi et al, 2014). Of these studies, 4 used the NCI's 5A's intervention method (Collins et al, 2005;Hymowitz et al, 2008;Hymowitz et al, 2001; J. D. Klein et al, 1995), 2 used CEASE (Beaty et al, 2013;Hipple et al, 2013), one used EHR prompts (Sharifi et al, 2014) and one used feedback sessions to promote change (Houston et al, 2006).…”

“…Of these studies, 4 used the NCI's 5A's intervention method (Collins et al, 2005;Hymowitz et al, 2008;Hymowitz et al, 2001; J. D. Klein et al, 1995), 2 used CEASE (Beaty et al, 2013;Hipple et al, 2013), one used EHR prompts (Sharifi et al, 2014) and one used feedback sessions to promote change (Houston et al, 2006).…”