The proposed study will implement and evaluate two low- cost, exportable educational interventions for motivating parents/caregivers of children with asthma to establish smoke-free households. Parents/caregivers of 561 children ages 4-12 who are exposed to household environmental tobacco smoke (ETS) and brought for treatment to the emergency rooms of three Los Angeles hospitals-- Childrens Hospital Los Angeles, LAC/USC Medical Center, and White Memorial Medical Center--serving predominantly low-income Hispanic and African-American populations will be contacted. Spanish- or English- speaking parents/caregivers identified by telephone screening as having a household where smoking occurs will be enrolled and randomized to experimental or control conditions. Experimental Group 1 will receive an in-person counseling session and booster telephone calls, and Group 2 a video and household reminder kit. The Control Group will receive no intervention, and the child with asthma will receive usual care. Data will be collected at a baseline visit and two follow-ups (at 2 & 12 months post-intervention), conducted at the hospital where the subject was recruited. Parent/caregiver and child will be interviewed separately, and biological measurements will be taken on the child, including assessment of urine cotinine, pulmonary function, and expired CO. Depending on the child's age either s/he or the parent/caregiver will be asked to keep a symptomatology diary and pulmonary function record for two week-long periods immediately following in-person data collection. In a 10 percent random sample subset (N- 57), the child's urine also will be analyzed for nicotine. Data regarding emergency room and urgent care visits and hospitalizations occurring one year prior to, and during the study period will be collected through each hospital's computerized data system. Experimental and control groups will be compared for changes during the one-year study period. The study is designed to provide sufficient power to detect changes in biological measures of ETS exposure and in survey responses about ETS in the household. Available data will also enable study of potential effects of the intervention on other outcomes, including pulmonary function of the child, health care utilization by the child, and knowledge, attitudes, and practices related to smoking of the parent/caregiver.
| Streja, Leanne; Crespi, Catherine M; Bastani, Roshan et al. (2014) Can a minimal intervention reduce secondhand smoke exposure among children with asthma from low income minority families? Results of a randomized trial. J Immigr Minor Health 16:256-64 |
| Wong, Glenn C; Bernaards, Coen A; Berman, Barbara A et al. (2004) Do children with asthma and their parents agree on household ETS exposure? Implications for asthma management. Patient Educ Couns 53:19-25 |
| Berman, Barbara A; Wong, Glenn C; Bastani, Roshan et al. (2003) Household smoking behavior and ETS exposure among children with asthma in low-income, minority households. Addict Behav 28:111-28 |
| Wong, Glenn C; Berman, Barbara A; Hoang, Tuyen et al. (2002) Children's exposure to environmental tobacco smoke in the home: comparison of urine cotinine and parental reports. Arch Environ Health 57:584-90 |
