Motivating parents of kids with asthma to quit smoking: the PAQS project

Abstract

The Parents of Asthmatics Quit Smoking (PAQS) project contrasts two theory-based smoking cessation interventions for parents of children with asthma, and compares mechanisms of behavior change within and across theoretical perspectives. We hypothesize that enhancing the perception of risk to self and child will motivate smoking cessation more than standard approaches that emphasize building self-efficacy and coping skills for quitting in a population that is largely not motivated to quit smoking. Smokers (n = 288) and their asthmatic children who receive nurse-delivered in-home asthma education (as part of the insurance carrier's standard of care) are randomized into one of two treatment conditions: (1) the Behavioral Action Model (BAM), in which nurses emphasize goal setting and skill building to enhance self-efficacy to quit smoking, or 2) the Precaution Adoption Model (PAM), in which nurses tailor the intervention to the smoker's readiness to quit and incorporate biomarker feedback [i.e. level of carbon monoxide exposure to the smoker and level of environmental tobacco smoke (ETS) exposure to the child] in order to increase risk perception in smokers. In both conditions, smokers who are ready to quit receive the nicotine patch. Analyses will examine (1) quit rates, ETS level and motivation to quit as the primary dependent variables, (2) mediators of behavior change between and within conditions, and (3) relations between parent smoking outcomes and child asthma morbidity (i.e. ER visits and asthma symptoms) post-treatment. Results will help tailor interventions to this population, and identify mechanisms of behavior change that result in adaptive health outcomes for smokers and their children who have asthma.

Motivating Smokers in the Hospital Pulmonary Function Laboratory to Quit Smoking by Use of the Lung Age Concept

“…Coupling physiological feedback with motivational interviewing enhances the technique because a key component of this approach is to provide personalized feedback of risk to motivate subjects to change behavior (Borrelli et al, 2002). Motivational interviewing also allows a brief intervention that is suitable to the busy practice of a PFT laboratory (Colella & Laver, 2005;Lai et al, 2010).…”

Meta-analysis of Parental Protection of Children From Tobacco Smoke Exposure

“…Seventy-five full-text articles were read. Forty-five studies were excluded for the following reasons: no relevant outcomes, 18 studies [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55] ; the trial did not include a control group, 7 studies [56][57][58][59][60][61][62] ; the interventions were not aimed at parents of young children, 3 studies [63][64][65] ; the reporting period was ,1 month, 2 studies 66,67 ; data necessary for analysis were missing, 10 studies [68][69][70][71][72][73][74][75][76][77] ; the paper was a review article, 1 study 78 ; the article was a protocol, 2 studies 79,80 ; the article was a follow-up of a previous study, 1 study 81 ; there was no true control group (eg, 2 active interventions were compared), 1 study 82 .…”

Improving Care for Urban Children with Asthma: Design and Methods of the School-Based Asthma Therapy (SBAT) Trial

“…Previous studies suggest that face-to-face ETS reduction interventions for parents of children with asthma can yield substantial reductions in ETS exposure (41,42). Specifically, motivational interviewing (MI), a patient-centered counseling technique to build intrinsic motivation for change (43), has shown promise in helping caregivers of children with asthma quit smoking and reduce their children's exposure to ETS (44,45). The current study utilizes MI principles and is adapted from previous intervention programs by Borrelli and colleagues that focus on motivating parents of children with asthma to quit smoking (45).…”

“…Specifically, motivational interviewing (MI), a patient-centered counseling technique to build intrinsic motivation for change (43), has shown promise in helping caregivers of children with asthma quit smoking and reduce their children's exposure to ETS (44,45). The current study utilizes MI principles and is adapted from previous intervention programs by Borrelli and colleagues that focus on motivating parents of children with asthma to quit smoking (45). Patients are not confronted about the need for change; rather, the MI counselor helps the patient explore their reasons for engaging in the risky behavior (e.g., smoking, ETS exposure) and attempts to elicit the patient's own concerns about the risky behavior.…”