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Motivating
Parents of Kids with Asthma to Quit Smoking
This innovative home-based smoking cessation program targets
the parents of children with asthma. As part of their health insurer's standard of care,
these families receive home-based asthma education delivered by a nurse. In this study,
the nurse is also trained to deliver one of two smoking cessation interventions: (1)
the Behavioral Action Model (BAM), based on AHCPR guidelines (emphasizing goal setting and
problem-solving skills to enhance self-efficacy); and (2) the Precaution Adoption Process
Model (PAM), which incorporates specific biomarker feedback in order to heighten
perception of risk to self and to the child. Specifically, we will measure and provide
feedback on environmental tobacco smoke exposure to the child (e.g., "Your
child was exposed to as much smoke as if s/he smoked 5 cigarettes per day) using passive
dossimetry, as well as smoke exposure to the parent, using carbon monoxide. Key mechanisms
of behavior change will be compared in 288 caregivers (66% Medicaid) randomized to
either BAM or PAM. Outcome measures will include: quit rates, levels of environmental
tobacco smoke, identification of mediators of behavior change, and changes in asthma
morbidity and health care utilization. Follow-ups will be continued for one year
after the end of treatment. Investigators
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