Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Other Person-to-Person Education, Peer Counselor, Motivational Interviewing, Telephone Support, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Consultation (Parent/Family)

Intervention Description: The goals were to describe a smoking cessation intervention, the Tennessee Intervention for Pregnant Smokers program, and examine the impact on quit rates compared to usual care. Additionally we sought to examine reduction in smoking levels and number of quit attempts related to the intervention and finally to examine the impact of the intervention on birth outcomes.

Intervention Results: Over 28% of intervention group women quit smoking, compared to 9.8% in the control group. Two thirds of intervention group women significantly reduced smoking by delivery, with 40%+ attempting to quit at least once. Compared to controls, intervention group women saw significantly better birth outcomes, including newborns weighing 270g more and 50% less likely to have a neonatal intensive care unit admission. Among intervention group participants, those who quit smoking had significantly better birth outcomes than those who did not quit smoking.

Conclusion: Findings point to the potential for appropriately tailored pregnancy smoking interventions to produce substantial improvements in birth outcomes within populations with health disparities.

Study Design: RCT

Setting: Prenatal care clinics

Population of Focus: Pregnant women smokers who receive Medicaid and prenatal care

Data Source: Self-report of smoking behavior, exhaled CO, urine cotinine

Sample Size: 1486

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Motivational Interviewing, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: Premature infants are at high risk for respiratory disease, and secondhand smoke (SHS) exposure further increases their risk for developing respiratory illness and asthma. Yet, SHS exposure remains problematic in this vulnerable population. Our objective was to evaluate the effects of brief asthma education plus motivational interviewing counseling on reducing SHS exposure and improving respiratory outcomes in premature infants compared to asthma education alone.

Intervention Results: Caregivers in the treatment group reported significantly more home smoking bans (96% vs 84%, P = .03) and reduced infant contact with smokers after the intervention (40% vs 58%, P = .03), but these differences did not persist long term. At study end (8 months after neonatal intensive care unit discharge), treatment group infants showed significantly greater reduction in salivary cotinine versus comparison (−1.32 ng/mL vs −1.08 ng/mL, P = .04), but no significant differences in other clinical outcomes.

Conclusion: A community-based intervention incorporating motivational interviewing and asthma education may be helpful in reducing SHS exposure of premature infants in the short term. Further efforts are needed to support sustained protections for this high-risk group and ultimately, prevent acute and chronic respiratory morbidity. Strategies for successfully engaging families during this stressful period warrant attention.

Study Design: RCT

Setting: Community (home)

Population of Focus: Pre-term infants and SHSe

Data Source: Golisano Children’s Hospital. Rochester, NY

Sample Size: 165 caregivers and their infants born at ≤ 32 weeks’ gestational age, within 6 weeks of discharge from the NICU

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Motivational Interviewing, Pharmacotherapy (Nicotine)

Intervention Description: Secondhand smoke exposure is associated with asthma onset and exacerbation. Latino children have higher rates of asthma morbidity than other groups. The current study compared the effectiveness of a newly developed smoking cessation treatment with existing clinical guidelines for smoking cessation.

Intervention Results: Intent-to-treat analyses showed that 20.5% of participants in the PAM condition and 9.1% of those in the BAM condition were continuously abstinent at 2 months posttreatment (OR = 2.54; 95% CI = 0.91–7.10), whereas 19.1% of participants in the PAM condition and 12.3% of those in BAM condition were continuously abstinent at 3 months posttreatment (OR = 1.68; 95% CI = 0.64–4.37). Secondhand smoke exposure decreased only in the BAM condition (p < .001), an effect due to less smoking around the child among nonquitters in this condition. Asthma morbidity showed significant decreases in the posttreatment period for the PAM group only (p < .001).

Conclusion: Results provide support for targeting specific populations with theory-based interventions.

Study Design: RCT

Setting: Hospital in-patient settings and clinics, and Latino cultural events

Population of Focus: Latino caregivers who smoked and had a child with asthma under 18 years of age

Data Source: Parental self-report data, passive nicotine monitors.

Sample Size: 133 caregivers

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing

Intervention Description: We tested two aims: (1) the teachable moment (TM): whether second-hand smoke exposure (SHSe) feedback motivates cessation in parents of children with asthma versus parents of healthy children (HC); and (2) whether greater intervention intensity [enhanced-precaution adoption model (PAM)] produces greater cessation than a previously tested intervention (PAM).

Intervention Results: Aim 1: The teachable moment was supported at 7 day and 2 month measurements. Aim 2: enhanced PAM was more likely to achieve 30-day ppa at the primary end-point, 4 months.

Conclusion: Smoking cessation intervention (Motivational Interviewing plus biomarker feedback) appear to motivate smoking cessation more strongly among parents of asthmatic children than among parents of healthy children. Increased intervention intensity yields greater smoking cessation among parents of asthmatic children and better asthma outcomes.

Study Design: RCT

Setting: Community (home and telephone)

Population of Focus: Parents of children with asthma and healthy children (ages 3-17 years)

Data Source: Parental self-report data, passive nicotine monitors.

Sample Size: 560 smoking primary caregivers of children with asthma and healthy children

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Other Person-to-Person Education, Motivational Interviewing, Other Education, Intensive Therapy, Peer Counselor

Intervention Description: This report describes tobacco use prevalence among perinatal smokers identified through an "opt-out" inpatient smoking cessation clinical service.

Intervention Results: Between February 2014 and March 2016, 533 (10%) current and 898 (16%) former smokers were identified out of 5649 women admitted to the perinatal units. Current smokers reported an average of 11 cigarettes per day for approximately 12 years. Only 10% reported having made a quit attempt in the past year. The majority of smokers (56%) were visited by a bedside tobacco cessation counselor during their stay and 27% were contacted through the IVR system. Those counselled in the hospital were twice as likely (RR 1.98, CI 1.04-3.78) to be abstinent from smoking using intent-to-treat analysis at any time during the 30 days post-discharge.

Conclusion: This opt-out service reached a highly nicotine-dependent perinatal population, many of whom were receptive to the service, and it appeared to improve abstinence rates post-discharge. Opt-out tobacco cessation services may have a significant impact on the health outcomes of this population and their children.

Study Design: Quasi experimental cross sectional evaluation

Setting: Academic medical center

Population of Focus: Smokers admitted to the perinatal units

Data Source: In-patient records and follow up phone surveys

Sample Size: 5649

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Other Person-to-Person Education, CAREGIVER, Education/Training (caregiver), PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Motivational Interviewing, Motivational Interviewing/Counseling

Intervention Description: Intervention (INT) was a home-based asthma follow-up after ED visit and two visits for an environmental control educational program delivered by trained nurses and nurse practitioners to the child and caregiver. For caregivers of children with positive cotinine results, brief motivational interviewing sessions were conducted to implement total home smoking ban.

Intervention Results: Over half of children in the study tested positive for SHS. Targeting SHS exposure was major component of the intervention [but] no significant reduction in cotinine exposures was associated with the intervention at 12 months.

Conclusion: In this study, a home-based EC intervention was not successful in reducing asthma ED revisits in children with poorly controlled asthma with SHS exposure. Allergic sensitization, young age, and increased controller medication use were important predictors of asthma ED visits.

Study Design: Prospective randomized controlled trial

Setting: Home-based (following ED visit)

Population of Focus: Children with physician diagnosed persistent asthma, having two or more ED asthma visits or more than one hospitalization over the past 12 months and residing in the Baltimore metropolitan area

Data Source: For SHS exposure, child saliva samples collected during the ED visit and at 6- and 12-month follow up visits.

Sample Size: 222 inner city children ages 3-12

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing, Peer Counselor, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: To test an air cleaner and health coach intervention to reduce secondhand smoke exposure compared with air cleaners alone or no air cleaners in reducing particulate matter (PM), air nicotine, and urine cotinine concentrations and increasing symptom-free days in children with asthma residing with a smoker.

Intervention Results: The overall follow-up rate was high (91.3%). Changes in mean fine and coarse particulate matter (PM) concentrations (baseline to 6 months) were significantly lower in both air cleaner groups compared with the control group. No differences were noted in air nicotine or urine cotinine concentrations. The health coach provided no additional reduction in PM concentrations. Symptom-free days were significantly increased in both air cleaner groups compared with the control group.

Conclusion: Although the use of air cleaners can result in a significant reduction in indoor PM concentrations and a significant increase in symptom-free days, it is not enough to prevent exposure to secondhand smoke.

Study Design: 3-arm RCT

Setting: Hospital and home

Population of Focus: Inner-city children with asthma and SHSe

Data Source: Caregiver self-report, urine cotinine levels, and air nicotine concentrations

Sample Size: 126 children

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Motivational Interviewing/Counseling, PATIENT/CONSUMER, Motivational Interviewing, Educational Material, Pharmacotherapy (Nicotine), Educational Material (caregiver), Telephone Support

Intervention Description: In this randomized controlled trial, we tested a tobacco control intervention in families and specifically evaluated a tailored cessation intervention for the parents and/or caregivers (Ps/Cs) who were smokers while their children were simultaneously enrolled in tobacco prevention.

Intervention Results: Intervention group showed a larger increase in self-reported smoking abstinence over time than the control group. For cotinine, the intervention group showed a decrease from baseline and then maintenance through year 4, whereas the control group showed increases from baseline.

Conclusion: This study provides evidence that tailored cessation offered to Ps/Cs in their children’s schools during their children’s enrollment in tobacco prevention may contribute to more robust success in P/C cessation and a reduction of tobacco smoke exposure in children.

Study Design: 2-group RCT with repeated measures

Setting: Elementary school-based recruitment; Face-to-face or telephone motivational interviewing sessions

Population of Focus: Elementary schools with high enrollment percentages of African American children in fourth grade across 5 counties in a Southeastern state

Data Source: Parent and caregiver self-report, biochemical measures (saliva cotinine and exhaled carbon monoxide)

Sample Size: 453 parents and or caregivers

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, Motivational Interviewing, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: Individualized motivational intervention for 30 minutes with nurse counsellor; appropriate stage-matched intervention used to “increase motivation and lower resistance to quit”; telephone reminder 1 week after the intervention.

Intervention Results: Preliminary results showed that the quit rate in the intervention group was 7.5% (95% CI, 0–21) versus 2.5% (95% CI, 0–7) in the control group. A total of 15% of the intervention group versus 10% of the control group reduced smoking consumption by half; 20.0% of the intervention group versus 7.5% of the control group reported quit attempts in the past 30 days; and 17.5% of the intervention group versus 10% of the control group moved up the stage of readiness to quit. The results were not statistically significant because of the small sample size.

Conclusion: Preliminary results indicated that the IMI provided by nurses seemed to be effective in helping resistant parents of sick children stop smoking. They also suggested that it was acceptable and feasible to implement such intervention in a pediatric outpatient clinic/ward in Hong Kong.

Study Design: RCT

Setting: Hospital (pediatric ward/outpatient setting)

Population of Focus: Parents of sick children who smoked

Data Source: Parental self-report

Sample Size: 80 parents of sick children presenting to a clinic or admitted to a children’s ward of a major Hong Kong hospital

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Peer Counselor, CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling

Intervention Description: The aim of the "Don't smoke in our home" trial was to evaluate a counseling intervention focused on promoting totally smoke-free homes and cars (TSFHC) delivered to women with children resident in four Tuscan towns.

Intervention Results: Outcomes were: Reported smoking restrictions in home and car and change in smoking status reported. All participants independently of the study arm recorded significant increases of 12 and 15 percentage points in TSFH and TSFC, respectively. Few smokers quit smoking (7%), stopped smoking indoors (5%), and stopped smoking in cars (7%), with no differences between the intervention and control groups.

Conclusion: Adding brief counseling to written materials did not significantly increase TSFHC. However, delivering written materials only may produce modest but noteworthy TSFHC increases at the population level, even though the participants in the study did not represent a population-based sample, given the high proportion of highly educated women. Further studies are required to confirm these results.

Study Design: Two-group randomized controlled trial

Setting: Pediatric well visit

Population of Focus: Children exposed to SHS

Data Source: The trial staff recruited women aged 30-49 years with children in the waiting rooms of public health facilities, hospitals and outside of supermarkets

Sample Size: 218 women 30 to 49 years of age with children

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing/Counseling,

Intervention Description: The Shared Decision-Making Model for Adolescent Smoking Cessation integrates shared decision-making principles into smoking cessation interventions for adolescent smokers. It consists of three steps: "team talk," "option talk," and "decision talk." The model aims to engage adolescents in the decision-making process, clarify their preferences, and reach concordant goals with educators before taking action. It incorporates motivational interviews, brief counseling, and decision aids to support informed decision making and potentially improve smoking cessation outcomes.

Intervention Results: The primary outcome shows positive effects by both increasing the cessation rate (a 25% point abstinence rate at 3 month follow up) and decreasing the number of cigarettes smoked per day (60% of the participants at 3 month follow up) among 20 senior high school participants (mean age, 17.5 years; 95% male).

Conclusion: The results also show that the model can achieve the goal of SDM and optimal informed decision making, based on the positive SURE test and the satisfaction survey regarding the cessation model. The SDM cessation model can be further applied to different fields of adolescent substance cessation, yielding beneficial effects regarding reducing potential health hazards. The dissemination of the model may help more adolescent smokers to cease smoking worldwide.

Study Design: Pilot cohort study

Setting: National medical center in Taiwan

Population of Focus: Researchers, public health professionals, policymakers

Sample Size: 20 high school students

Age Range: ages 15-18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Motivational Interviewing, Telephone Support, Peer Counselor, Midwife, PROVIDER/PRACTICE, Nurse/Nurse Practitioner

Intervention Description: The aim of this pilot study was to evaluate the implementation of the American College of Obstetricians and Gynecologists' 5 A's smoking cessation intervention among pregnant women being cared for by 5 A's-trained midwives working with a team of nurse researchers in an effort to reduce prenatal smoking exposure. The evidence-based 5 A's smoking cessation program has been recommended for use in prenatal care by health care providers.

Intervention Results: Among the 35 women who enrolled in the study, 32 (91.4%) decreased smoking and 3 (8.6%) quit smoking by one month after the intervention. For those who continued to smoke, the average number of cigarettes smoked was reduced from 10 cigarettes per day at baseline to 8 cigarettes per day at one month, 7 cigarettes per day at 2 months, and 6 cigarettes per day by the end of pregnancy. The women further reduced their tobacco exposure by delaying the timing of initiating smoking in the morning and by increasing indoor smoking restrictions.

Conclusion: Midwives and nurses can be trained in the implementation of the evidence-based 5 A's smoking cessation program for incorporation into regular prenatal care of pregnant women who smoke. By guiding women in techniques aimed at reducing the amount and frequency of cigarette smoking, nurses and midwives facilitate a decrease in prenatal smoking exposure.

Study Design: Single group pre-post test evaluation pilot

Setting: Prenatal care clinics

Population of Focus: Pregnant women who smoked and were willing to quit or cut down smoking receiving prenatal care

Data Source: Surveys (self-report questionnaires)

Sample Size: 35

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing/Counseling,

Intervention Description: The brief motivational intervention for adolescent smokers in the study followed the motivational interviewing (MI) style, focusing on exploring pros and cons of smoking, providing personalized feedback, setting goals, and enhancing self-efficacy for change. Patients received guidance on envisioning their future with and without smoking, creating action plans, and overcoming barriers. The intervention aimed to increase motivation to quit and support smoking cessation efforts

Intervention Results: Self-report data indicated that 7-day abstinence rates at 6-month follow-up were significantly higher in the MI group than in the BA group, but this difference was not confirmed biochemically. Self-reported smoking rate (average cigarettes per day) was significantly lower at 1, 3, and 6 months follow-up than it was at baseline. Cotinine levels indicated reduced smoking for both groups at 6 months, but not at 1 month. At 3-month follow-up, only those in MI showed cotinine levels that were significantly reduced compared to baseline.

Conclusion: Findings offer some support for MI for smoking reduction among non-treatment-seeking adolescents, but overall changes in smoking were small.

Study Design: Randomized two group comparison

Setting: ED in an urban hospital in the Northeasth US

Population of Focus: Adolescent patients in the outpatient clinic or ED

Sample Size: 85 youth

Age Range: ages 14-19

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Intensive Therapy, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: We tested the efficacy of a behavioral counseling approach with underserved maternal smokers to reduce infant’s and preschooler’s secondhand smoke exposure.

Intervention Results: Participation in Philadelphia Family Rules for Establishing Smokefree Homes (FRESH) behavioral counseling was associated with lower child cotinine (β=-0.18, p=0.03) and reported tobacco smoke exposure (β=-0.57, p=0.03) at the end of treatment. Mothers in behavioral counseling smoked fewer cigarettes/day (β=-1.84, p=0.03) and had higher bioverified quit rates compared with controls (13.8% vs 1.9%, χ(2)=10.56, p<0.01). There was no moderating effect of other smokers living at home.

Conclusion: FRESH behavioral counseling reduces child secondhand smoke exposure and promotes smoking quit rates in a highly distressed and vulnerable population.

Study Design: Two-arm randomized trial

Setting: Community (home and telephone)

Population of Focus: Underserved children’s exposure to tobacco smoke

Data Source: Participants were recruited from lowincome neighborhoods in North and West Philadelphia

Sample Size: 300 families

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Community Health Workers (CHWs), Outreach (Provider), PATIENT/CONSUMER, Motivational Interviewing, Telephone Support, Home Visits

Intervention Description: To evaluate the effectiveness of a lay delivered intervention to reduce Latino children’s exposure to environmental tobacco smoke (ETS). The a priori hypothesis was that children living in households that were in the intervention group would have lower exposure over time than measurement only controls.

Intervention Results: There were no significant condition-by-time interactions. Significant or near significant time main effects were seen for children’s hair cotinine and parent’s report of exposure.

Conclusion: Applying a lay promotora model to deliver the behavioural problem solving intervention unfortunately was not effective. A likely explanation relates to the difficulty of delivering a relatively complex intervention by lay women untrained in behaviour change theory and research methods.

Study Design: Two group, randomized control trial

Setting: Community (home)

Population of Focus: Latino children

Data Source: Recruited from community organizations and venues such as Head Start Programs and cultural fairs

Sample Size: 143 Latino parents of children aged 1 to 9 who reported smoking at least 6 cigarettes a week

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Motivational Interviewing/Counseling,

Intervention Description: The study evaluated the impact of a public health strategy to counteract an 'epidemic panic' that occurred in the district of Palermo following four cases of meningococcal disease in the summer of 2016. The strategy included effective communication strategies to provide timely and effective information on appropriate prevention measures and regulated access for the population to receive vaccination services. Healthcare workers of the vaccination services targeted counseling to adolescents and young adults in order to promote greater confidence in vaccination

Intervention Results: The study found a significant increase in the anti-meningococcal vaccination coverage in each local health unit and at a regional level. Concurrent catch-up of other recommended vaccinations for age (diphtheria-tetanus-pertussis-poliomyelitis and papillomavirus) resulted in a further increase of administered doses.

Conclusion: The study concluded that a public health strategy that includes effective communication strategies and measures provided by public health authorities can lead to an increase in vaccination coverage in the target population and positive effects on vaccine compliance in the general population.

Study Design: The study used a retrospective observational design.

Setting: The study was conducted in the district of Palermo, Sicily, Italy.

Population of Focus: Adolescents and young adults.

Sample Size: The study included a total of 10,735 individuals.

Age Range: The target population included individuals aged 14-30 years.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Motivational Interviewing, Telephone Support, CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling

Intervention Description: Evaluate a smoking cessation intervention for women.

Intervention Results: The main outcome measure was self-reported abstinence from smoking 12 months after enrollment in the study, defined as not smoking, even a puff, during the 7 days prior to assessment. At both follow-ups, abstinence rates were twice as great in the intervention group as in the control group. The 12-month difference was statistically significant.

Conclusion: A pediatric clinic smoking cessation intervention has long-term effects in a socioeconomically disadvantaged sample of women smokers. The results encourage implementation of evidence-based clinical guidelines for smoking cessation in pediatric practice.

Study Design: Two-arm randomized trial (usual care vs. intervention)

Setting: Pediatric clinics serving ethnically diverse population of low-income families

Population of Focus: Self-identified women smokers whose children received care at participating clinics

Data Source: Women smokers whose children received care at participating clinics self-report.

Sample Size: 303 women smokers

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing, Pharmacotherapy (Nicotine), Referrals, PATIENT_CONSUMER

Intervention Description: The current randomized controlled trial (RCT) study aimed to evaluate the effectiveness of a multi-component smoking reduction intervention in parental smoking reduction and children's environmental tobacco smoke exposure reduction in clinical settings.

Intervention Results: Smoking parents in the intervention group had significantly more biochemically validated ≥50% smoking reduction than the control: 27.1 vs. 10.0% (OR = 3.34, 95% CI: 1.16-9.62, P = 0.02). The rate of self-reported ≥50% smoking reduction was also significantly higher in the intervention group than the control: 51.9 vs. 20.2% (OR = 4.40, 95% CI: 2.38-8.12, P < 0.001). For secondary outcomes, the rate of parental self-reported smoking cessation was higher in the intervention arm: 10.5 vs. 1.0% (OR = 12.17, 95% CI: 1.54-96.07, P < 0.001), however, no differences were detected in biochemically validated cessation and changes in children's passive smoke exposure between the groups.

Conclusion: Monthly smoking reduction counseling together with nicotine replacement therapy is more effective than simple verbal cessation advice in the smoking reduction for parents of pediatric patients. However, this study did not demonstrate differences in smoking cessation or reduction in children's passive smoke exposure with a 6-month follow-up. Achievement of a smoke-free environment remains challenging.

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Motivational Interviewing/Counseling, Assessment (caregiver), PATIENT/CONSUMER, Educational Material, Online Material/Education/Blogging, Motivational Interviewing, PARENT/FAMILY, Consultation (Parent/Family), Notification/Information Materials (Online Resources, Information Guide)

Intervention Description: A study was undertaken to determine the effectiveness of two brief multi-strategic child health nurse delivered interventions in: decreasing the prevalence of infants exposed to SHS; decreasing the prevalence of smoking amongst parent/carers of infants and increasing the prevalence of household smoking bans.

Intervention Results: When compared to the Control group at 12 months, no significant differences in the prevalence of infant exposure to SHS were detected from baseline to follow-up for Treatment condition 1 or Treatment condition 2. Similarly, no significant differences were detected in the proportion of parent/care givers who reported that they were smokers, or in the proportion of households reported to have a complete smoking ban.

Conclusion: Further research is required to identify effective interventions that can be consistently provided by child health nurses if the potential of such settings to contribute to reductions in child SHS exposure is to be realised.

Study Design: Cluster randomized controlled trial

Setting: Community well-child health clinics

Population of Focus: s Infants exposed to second hand smoke

Data Source: Data was collected via computer during the visit, child health clinic records

Sample Size: 1424 parents of children aged 0 to 4 years attending well-child health checks

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Motivational Interviewing/Counseling, SCHOOL, Head Start Participation

Intervention Description: To evaluate the effectiveness of motivational interviewing (MI) delivered in the context of a SHS education reduction initiative within Head Start to reduce preschool children’s SHS exposure.

Intervention Results: The primary outcome measure was household air nicotine levels measured by passive dosimeters. Secondary outcomes included child salivary cotinine, self-report of home smoking ban (HSB), and smoking status. Participants in the MI + education group had significantly lower air nicotine levels (0.29 vs. 0.40 mg), 17% increase in prevalence of caregiver-reported HSBs, and a 13% decrease in caregiver smokers compared with education-alone group (all P values < 0.05). Although group differences in salivary cotinine were not significant, among all families who reported having an HSB, salivary cotinine and air nicotine levels declined in both groups (P < 0.05).

Conclusion: MI may be effective in community settings to reduce child SHSe. More research is needed to identify ways to tailor interventions to directly impact child SHSe and to engage more families to make behavioral change.

Study Design: Randomized trial with two implementation groups, no controls

Setting: Head Start Program

Population of Focus: Children aged 6 months to 6 years whose caregivers reported a smoker living in the household and who spoke English

Data Source: Data collected by project staff

Sample Size: 350 children were recruited

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Home Visits, Telephone Support, Motivational Interviewing

Intervention Description: The objective of this study was to determine whether a motivational intervention for smoking parents of young children will lead to reduced household passive smoke exposure.

Intervention Results: The 6-month nicotine levels were significantly lower in MI households. Repeated measures analysis of variance across baseline, 3-month, and 6-month time points showed a significant time-by-treatment interaction, whereby nicotine levels for the MI group decreased significantly and nicotine levels for the SH group increased but were not significantly different from baseline.

Conclusion: This study targeted a large sample of racially and ethnically diverse low-income families, in whom both exposure and disease burden is likely to be significant. This is the first study to our knowledge that has been effective in reducing objective measures of passive smoke exposure in households with healthy children. These findings have important implications for pediatric health care providers, who play an important role in working with parents to protect children's health. Providers can help parents work toward reducing household passive smoke exposure using motivational strategies and providing a menu of approaches regardless of whether the parents are ready to quit.

Study Design: Randomized control study

Setting: Recruitment at community health centers, home based intervention

Population of Focus: Diverse low-income populations

Data Source: Air nicotine assessments and assessment of the participant’s carbon monoxide level with caregiver selfreport.

Sample Size: 291 participants

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Home Visits, CAREGIVER, Home Visit (caregiver), Education/Training (caregiver), Educational Material (caregiver), Assessment (caregiver), Motivational Interviewing/Counseling, Motivational Interviewing

Intervention Description: The aim of this study is to evaluate effects of the counseling method “Smoke-free children” that focuses on protection of infants.

Intervention Results: Forty-one mothers participated in the study, 26 in the intervention group and 15 in the control group. Cotinine was collected from 22 subjects in the intervention and 8 in the control group. Before the intervention, the mean cotinine level was 185 ng/mL in the intervention group and 245 ng/mL in the control group. After the intervention, cotinine levels were reduced in the intervention group (165 ng/mL) and increased in the control group (346 ng/mL). Yet, after the intervention, the mothers themselves reported more smoking in the intervention group than in the control group. Only weak correlations were found between self-reported smoking and cotinine.

Conclusion: The statistical analysis supports the view that a client-centered intervention, aimed at increasing self-efficacy, exerts a positive effect on maternal smoking in the prevention of infant exposure to ETS, when applied in a routine clinical setting.

Study Design: RCT

Setting: Child health centers

Population of Focus: Swedish mothers who had given birth to a healthy child

Data Source: Self-reporting of smoking; cotinine levels of mothers’ saliva

Sample Size: 26 mothers in the intervention group and 15 in the control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Telephone Support, CAREGIVER, Home Visit (caregiver), Assessment (caregiver), Attestation (caregiver), Motivational Interviewing/Counseling

Intervention Description: This pilot study evaluated the effectiveness of a nurse-delivered home-visiting program during the postpartum period that included a low-intensity smoking relapse-prevention intervention.

Intervention Results: Although both groups showed significant relapse from being smoke free, the intervention group was twice as likely to be smoke free at 3 and 6 months, and three times as likely to be smoke free at both times. The cotinine verification revealed a misclassification rate of 37% at the 6-month follow-up (i.e., participants self-reported as abstinent but shown by cotinine not to be abstinent).

Conclusion: The effectiveness of this brief, low-cost, and potentially replicable intervention in improving the rate of persistent postpartum smoke-free status for women who quit smoking during pregnancy is encouraging. A randomized trial of the approach is warranted.

Study Design: Pilot study; Prospective two-group design

Setting: Birthing hospital plus home visit

Population of Focus: English-speaking women who delivered healthy babies, resided in Franklin County, Ohio, and reported quitting smoking during pregnancy and at least 7 days before delivery

Data Source: Questionnaire that included smoking history and attitudes and intent to stay smoke free administered at baseline. Saliva sample for maternal cotinine analysis collected at baseline and 3 and 6 months for all participants who self-reported abstinence (defined as no smoking for the previous 7 days)

Sample Size: 97 in the baseline group and 122 in the intervention group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing, Counseling (Parent/Family),

Intervention Description: The intervention described in the provided PDF file was an individual educational information session with motivational interview (MI) techniques for immunization of infants. The session was delivered to mothers during their postpartum stay (24-48 hours after delivery) at the maternity ward by research nurses trained in MI theory and techniques. The MI intervention was oriented according to Prochaska’s stages of change, a model proposing that people go through several stages when wanting to change a behavior. Thus, each MI intervention was adapted to parents’ readiness to vaccinate their child. Using MI techniques, five points were discussed during this session: 1) summary of the six vaccine-preventable diseases at 2, 4, and 6 months of life; 2) vaccines administered at 2, 4, and 6 months and their effectiveness; 3) importance of the routine immunization schedule at 2, 4, and 6 months; 4) fears and side effects related to vaccination; and 5) organization of local vaccination services in the Eastern Townships ,[object Object],, ,[object Object],.

Intervention Results: The primary results of the study described in the provided PDF file indicated that the 20-minute intervention based on motivational interview (MI) techniques administered during postpartum appeared to be an encouraging tool to address suboptimal vaccination coverage during infancy. The study found that the intervention positively influenced the determinants of vaccination, leading to a global increase of 15% in mother’s vaccination intention. Additionally, the results were confirmed by a significant overall vaccination coverage increase for the 2-, 4-, and 6-month vaccinations. The study also aimed to evaluate the longer-term effects of the intervention on infant’s vaccination coverage at 13, 19, and 24 months of age, indicating a potential impact on vaccination coverage during the entire infancy period ,[object Object],, ,[object Object],.

Conclusion: An educational information session about immunization based on motivational interview techniques conducted during postpartum hospitalization could improve immunization during infancy.

Study Design: The study described in the provided PDF file utilized a quasi-experimental cohort design. It involved an individual educational information session with motivational interview techniques for immunization of infants, which was conducted for the experimental group, while

Setting: The setting is not explicitly stated in the given PDF file. However, it can be inferred that the study was conducted in the Eastern Townships region of Quebec, Canada, as the vaccination data were obtained from LOGIVAC, the immunization registry of the Eastern Townships region ,[object Object],. The study was conducted in the maternity ward of the CHUS (Centre Hospitalier Universitaire de Sherbrooke), which represents 95% of the total births in the region ,[object Object],.

Population of Focus: The target audience for the study described in the provided PDF file appears to be mothers who have given birth at the CHUS (Centre Hospitalier Universitaire de Sherbrooke) in the Eastern Townships region of Quebec, Canada. The study involved providing an individual educational information session with motivational interview techniques for immunization of infants during postpartum stay ,[object Object],, ,[object Object],. Additionally, the study population comprised the children of mothers who received the intervention (experimental group) and those who did not (control group) ,[object Object],.

Sample Size: The sample size for the study described in the provided PDF file was calculated to be 943 mothers per group, based on the need to identify a statistically significant improvement of 5% in the vaccine coverage of infants, with a power of 80% and a risk of alpha error of 0.05, taking into account a vaccine coverage of 80% and the 3000 annual births at the maternity ward of the CHUS ,[object Object],. However, it is not explicitly stated whether this sample size was achieved or not.

Age Range: The age range of the participants in the study described in the provided PDF file includes newborn infants up to 24 months of age. The study evaluated the impact of an educational information session on immunization during infancy, and the vaccination coverage was assessed at 3, 5, 7, 13, 19, and 24 months of age ,[object Object],, ,[object Object],.

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing,

Intervention Description: The intervention was a motivational interview (MI) based on the PromoVac program, which was offered to mothers directly at the maternity wards and tailored to their knowledge and beliefs. The control group received a standard educational leaflet on childhood vaccination.

Intervention Results: The study found that the MI-based intervention significantly increased vaccine coverage at 7 months of age compared to the control group. The intervention also improved vaccine coverage status at other ages and reduced the number of days under-immunized. Mothers in the intervention group had higher vaccination intention and lower vaccination hesitancy scores compared to the control group.

Conclusion: This first study evidenced that the intervention led to a marked increase in mothers’ intention to vaccinate, and vaccine coverage in their infants. The current study protocol aims at scaling up these results at a provincial level using a randomized controlled trial design.

Study Design: The study was a pragmatic, unblinded, parallel, randomized, controlled trial.

Setting: The study was conducted in the province of Québec, Canada.

Population of Focus: Mothers of infants born in the past 48 hours.

Sample Size: A total of 2750 mothers were included in the study.

Age Range: The study followed infants from birth to 36 months of age.

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing/Counseling,

Intervention Description: Anonymous Internet-based cross-sectional survey of postpartum women to gather information on various topics, including prenatal/postpartum care and family planning. The study used multivariable logistic regression to determine associations between the quantity of provider counseling (indexed as the number of family planning topics discussed with a healthcare provider) and women’s decisions regarding contraception and pregnancy spacing

Intervention Results: Receipt of high-quality postpartum contraceptive counseling was reported by 26%. At 3-months postpartum 70% of participants reported the same contraceptive preferences by category of effectiveness that they expressed at the time of delivery. Spanish-speaking, Hispanic foreign-born, and lower socioeconomic status women were less likely to receive high-quality counseling than their counterparts. High-quality counseling was associated with lower odds of preferring a less effective method (OR: 0.31, 95% CI: 0.18-0.52) and changing preference from an IUD or implant (OR: 0.34, 95% CI: 0.17-0.68).

Conclusion: High-quality postpartum contraceptive counseling is relatively rare and occurs less often among low SES and immigrant women. High-quality counseling appears to reinforce preferences for effective contraception.

Study Design: Cross-sectional survey

Setting: Respondents were at least 18 years old and has an infant between 3-9 months of age

Sample Size: 2850 women

Age Range: Respondents were at least 18 years old and has an infant between 3-9 months of age

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing, Referrals, Educational Material

Intervention Description: Home visiting programs represent an important primary prevention strategy for adverse prenatal health behaviors; the various ways in which home visiting programs impact prenatal smoking cessation and reduction behaviors remain understudied.

Intervention Results: A program effect was seen for smoking cessation such that clients who smoked less than ten cigarettes per day and those who smoked 20 or more cigarettes per day during the first trimester were more likely to achieve third trimester cessation than comparison women (p <0.01 and p = 0.01, respectively). Only for heavy smokers (20 or more cigarettes during the first trimester) was there a significant reduction in number of cigarettes smoked by the third trimester versus comparison women (p = 0.01). Clients expressed the difficulty of cessation, but addressed several harm-reduction strategies including reducing smoking in the house and wearing a smoking jacket. Clients also described smoking education that empowered them to ask others to not smoke or adopt other harm reducing behaviors when around their children.

Conclusion: While a significant impact on smoking cessation was seen, this study finds a less-clear impact on smoking reduction among women in home visiting programs. As home visiting programs continue to expand, it will be important to best identify effective ways to support tobacco-related harm reduction within vulnerable families.

Study Design: Cohort - Mixed methods using a retrospective cohort of propensity score

Setting: Home visiting programs

Population of Focus: English or Spanish speaking mothers who smoked during pregnancy who currently participated in a home visiting program and received welfare benefits

Data Source: Enrollment data, in-person or telephone interviews, birth certificate data

Sample Size: 10,296 women: 2595 study participants and 7701 controls

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling, Motivational Interviewing, Patient Reminder/Invitation, PROVIDER/PRACTICE, Nurse/Nurse Practitioner

Intervention Description: To determine if mothers receiving a smoking cessation intervention emphasizing health risks of environmental tobacco smoke (ETS) for their children have a higher quit rate than 1) mothers receiving routine smoking cessation advice or 2) a control group.

Intervention Results: Complete data (baseline and both follow-ups) were available for 166 subjects. There was no impact of group assignment on the quit rate, cigarettes/day, or stage of change. The Child Health Group intervention had a sustained effect on location where smoking reportedly occurred (usually outside) and on improved knowledge of ETS effects.

Conclusion: Further research is needed to devise more effective methods of using the pediatric health care setting to influence adult smoking behaviors.

Study Design: RCT

Setting: Primary care center in a large urban children’s hospital

Population of Focus: Female caregivers (16 years and older) who accompanied a child (under 12 years) to the Primary Care Center of Columbus Children’s Hospital for a health care visit for any chief complaint or well-child examination

Data Source: Baseline data on demographics and smoking topics collected by questionnaire; and 1- and 6-month follow-ups.

Sample Size: 479 mothers

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, CAREGIVER, Home Visit (caregiver), Motivational Interviewing/Counseling, PROVIDER/PRACTICE, Nurse/Nurse Practitioner

Intervention Description: To evaluate the impact of the School-Based Asthma Therapy trial on asthma symptoms among urban children with persistent asthma.

Intervention Results: The primary outcome was the number of symptom-free days during 2 weeks averaged across the pea asthma season (November-February). Children in the treatment group experienced more symptom-free days and better results on several other asthma-related measures. Full-year outcomes also showed a significant treatment effect. When comparing outcomes separately for children without and with smoke exposure in the home, results suggest an effect of the intervention for both groups of children. Primary findings were independent of any change in the child’s cotinine level, suggesting that the school-based care component alone is effective in reducing symptoms.

Conclusion: The School-Based Asthma Therapy intervention significantly improved symptoms among urban children with persistent asthma. This program could serve as a model for improved asthma care in urban communities.

Study Design: Randomized trial, with children stratified by smoke exposure in the home and randomized to a school-base care group or a usual care group

Setting: School, with intervention in the home

Population of Focus: Children aged 3 to 10 years with persistent, physician-diagnosed asthma in the Rochester City School District, with consent of the child’s primary care provider to participate in the study

Data Source: All families were given diaries to track their child’s symptoms, and outcomes were assessed by monthly telephone interviews. Saliva samples were collected from the child at the beginning and end of the study to determine the child’s level of cotinine. Medical records were reviewed for 10% of the sample to confirm office and emergency department visits and hospitalizations.

Sample Size: 530 children from 67 schools and preschools

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Community Health Services Policy, Motivational Interviewing/Counseling, Feedback,

Intervention Description: Contraception consultation combined with in-person brief interventions and motivational interviewing with support from community participants

Intervention Results: The study has shown preliminary success in changing behaviors and impacting how the community views the prevention of alcohol-exposed pregnancies. The CHOICES intervention was found to be acceptable and welcomed by the tribal community, indicating its potential for implementation with other interested populations. The program has demonstrated success in reducing the risk for alcohol-exposed pregnancies among participants, with the majority showing a reduction in risk through behavior changes such as increased use of birth control, reduced alcohol consumption, or a combination of both.

Conclusion: By incorporating community input and making appropriate modifications to the intervention materials, the program has been successful in addressing the issue of alcohol-exposed pregnancies within the American Indian community. The study highlights the importance of community-based participatory research (CBPR) in developing and implementing effective prevention programs. The researchers suggest that future implementation efforts can benefit from the methods and results discussed in the study to sustain and expand this important alcohol-exposed pregnancy prevention program. Overall, the study underscores the significance of primary prevention efforts, such as increasing the utilization of birth control, in reducing the risk of alcohol-exposed pregnancies, particularly among at-risk populations like American Indians

Study Design: The study design involves the modification and implementation of an existing alcohol-exposed pregnancy prevention program, Project CHOICES, to fit the needs and norms of the American Indian community, specifically the Oglala Sioux Tribe.

Setting: Oglala Sioux Tribe community,

Population of Focus: Non-pregnant American Indian women, particularly within the Oglala Sioux Tribe community

Sample Size: Not specified

Age Range: Reproductive age

Intervention Components (click on component to see a list of all articles that use that intervention): Community Health Services Policy, Motivational Interviewing/Counseling, Feedback,

Intervention Description: The intervention included MI counseling techniques, such as reflective listening and open questioning, to encourage participants to decrease binge drinking and/or increase birth control use to reduce the risk of alcohol-exposed pregnancies. The interventionists provided either two or four CHOICES sessions, held approximately 1-2 weeks apart, depending on the site's preference. Participants were given gift card incentives for participating in the intervention sessions and completing follow-up data collection. Additionally, referrals to local health care providers for birth control were provided, and participants were encouraged to make appointments to discuss their birth control options

Intervention Results: The results of the study showed a significant decrease in the risk of alcohol-exposed pregnancies (AEP) among American Indian women enrolled in the program

Conclusion: Even with minor changes to make the CHOICES intervention culturally and linguistically appropriate and the potential threats to program validity those changes entail, we found a significant impact in reducing AEP risk. This highlights the capacity for the CHOICES intervention to be implemented in a wide variety of settings and populations

Study Design: Pre-post intervention design

Setting: Three sites, two located on a reservation and a third that serves American Indian women in an urban setting

Population of Focus: Non-pregnant American Indian women at-risk for alcohol-exposed pregnancies due to binge drinking and being at-risk for unintended pregnancy

Sample Size: 193 women

Age Range: 18-46

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing, Enabling Services, Telephone Support

Intervention Description: To evaluate a web-based contingency management program (CM) and a phone-delivered cessation counseling program (Smoking Cessation for Healthy Births [SCHB]) with pregnant smokers in rural Appalachia who were ≤12 weeks gestation at enrollment.

Intervention Results: For CM, two of seven (28.57%) of the participants achieved abstinence, and three of 10 (30%) of those enrolled in SCHB were abstinent by late in pregnancy. Participants in CM attained abstinence more rapidly than those in SCHB. However, those in SCHB experienced less relapse to smoking, and a greater percentage of these participants reduced their smoking by at least 50%.

Conclusion: Based on this initial evaluation, the web-based CM and SCHB programs appeared to be feasible for use with rural pregnant smokers with acceptable program adherence for both approaches. Future researchers could explore combining these programs to capitalize on the strengths of each, for example, rapid smoking cessation based on CM incentives and better sustained cessation or reductions in smoking facilitated by the counseling support of SCHB.

Study Design: RCT pilot

Setting: Home- based smoking cessation programs

Population of Focus: English speaking pregnant women less than 12 weeks of pregnancy at the beginning in rural Appalachia

Data Source: Questionnaires, standardized scales, urinary cotinine levels

Sample Size: 17

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Intensive Therapy, Peer Counselor, Motivational Interviewing, Telephone Support, CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling

Intervention Description: To develop and test an intervention to reduce children’s exposure to secondhand smoke (SHS) at homes in Yerevan, Armenia.

Intervention Results: Hair nicotine concentration in the child was 17% lower in the intervention group. The follow-up survey revealed an increased proportion of households with smoking restrictions and decreased exposure of children to SHS in both groups. The adjusted odds of children’s less-than-daily exposure to SHS was 1.87 times higher in the intervention group and the geometric mean of mothers’ knowledge scores at follow-up was 10% higher in that group.

Conclusion: Intensive intervention is effective in decreasing children’s exposure to SHS through educating mothers and promoting smoking restrictions at home. However, superiority over minimal intervention to decrease children’s exposure was not statistically significant.

Study Design: RCT

Setting: Home visits

Population of Focus: Households with a nonsmoking mother and at least 1 child 2-6 years of age residing with at least 1 daily smoker

Data Source: Measures of air quality and child hair nicotine; parent self-report.

Sample Size: 250 households

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Presentation/Meeting/Information Session/Event, Training (Parent/Family), CAREGIVER, Home Visit (caregiver), Education/Training (caregiver), Motivational Interviewing/Counseling

Intervention Description: This study tested the efficacy of coaching to reduce environmental tobacco smoke ETS exposure among asthmatic Latino children.

Intervention Results: Intervention parents reported their children exposed to significantly fewer cigarettes than control parents by 4 months (post-coaching). Reported prevalence of exposed children decreased to 52% for intervention families but only 69% for controls. By month 4, cotinine levels decreased from 54% to 40% among intervention and increased from 43% to 49% among control children. However, cotinine levels decreased among controls to same level achieved by intervention families by the 13-month follow-up.

Conclusion: Asthma management education plus coaching can reduce ETS exposure more than expected from education alone, and decreases in the coached condition may be sustained for about a year. The delayed decrease in cotinine among controls is discussed.

Study Design: RCT

Setting: Community (home)

Population of Focus: Latino or Hispanic families with an asthmatic child who lived in a home with a smoker and was exposed to at least 6 cigarettes in the past week

Data Source: Reported ETS exposure, children’s urine cotinine, air nicotine monitors, and parent’s saliva cotinine were measured

Sample Size: 204 Latino children ages 3-17 years with asthma

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Training (Parent/Family), CAREGIVER, Education/Training (caregiver), Motivational Interviewing/Counseling

Intervention Description: To test the efficacy of behavioural counselling for smoking mothers in reducing young children's exposure to environmental tobacco smoke.

Intervention Results: Mothers’ reports of children’s exposure to their smoke in the home declined in the counseled group from 27.30 cigarettes/week at baseline to 3.66 at 12 months and in the controls from 24.56 to 8.38; the differences were significant. Most of the change in exposure was during the first three months. Children’s cotinine levels in both groups increased from baseline to three months but then declined slightly in the counselled group whereas it continued to climb in the control group; the same pattern occurred in the mothers.

Conclusion: Counselling was effective in reducing children's exposure to environmental tobacco smoke. Similar counselling in medical and social services might protect millions of children from environmental tobacco smoke in their homes.

Study Design: Randomized double blind controlled trial

Setting: Low income homes in San Diego county, California

Population of Focus: English and Spanish speaking mothers who smoked at least two cigarettes a day and exposed their child aged under 4 years to the smoke from at least one cigarette a day

Data Source: Mothers’ self-report and child urine cotinine measure. Mothers’ saliva was collected at each interview; those who reported stopping smoking were tested and cessation confirmed by cotinine concentration. One week before the three month interview nicotine monitors were placed in the homes of a randomly selected half of the families.

Sample Size: 108 mothers smoking at least 2 CPD with children under 4 years, using a supplemental nutrition program

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Presentation/Meeting/Information Session/Event, Training (Parent/Family), CAREGIVER, Home Visit (caregiver), Education/Training (caregiver), Educational Material (caregiver), Motivational Interviewing/Counseling, Notification/Information Materials (Online Resources, Information Guide), PATIENT/CONSUMER, Pharmacotherapy (Nicotine), Home Visits, Educational Material, Motivational Interviewing, Peer Counselor, Telephone Support

Intervention Description: We tested a combined intervention to reduce children's secondhand smoke exposure (SHSe) and help parents quit smoking.

Intervention Results: Parents’ reports of their smoking and children’s exposure showed moderate and significant correlation with children’s urine cotinine levels and home air nicotine. 13 intervention group mothers and 4 controls reported quitting smoking for 7 days prior to 1 or more study measurements without biochemical contradiction. Results of generalized estimating equations showed significantly greater decrease in reported SHSe and mothers’ smoking in the counseled group compared with controls. Reported indoor smoking and children’s urine cotinine decreased, yet group differences for changes were not significant.

Conclusion: Nicotine contamination of the home and resulting thirdhand exposure may have contributed to the failure to obtain a differential decrease in cotinine concentration. Partial exposure to counseling due to dropouts and lack of full participation from all family members and measurement reactivity in both conditions may have constrained intervention effects. Secondhand smoke exposure counseling may have been less powerful when combined with smoking cessation.

Study Design: Two-group, repeated measures RCT

Setting: Community (home)

Population of Focus: WIC clients in San Diego, California

Data Source: 3 weekly baseline child urine cotinine measures collected before trial randomization then reported and urine cotinine measures at 3 (midintervention), 6 (post-intervention), 12, and 18 months

Sample Size: 150 families

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Motivational Interviewing, Peer Counselor, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: Exposure to fine particulate matter in the home from sources such as smoking, cooking, and cleaning may put residents, especially children, at risk for detrimental health effects. A randomized clinical trial was conducted from 2011 to 2016 to determine whether real-time feedback in the home plus brief coaching of parents or guardians could reduce fine particle levels in homes with smokers and children.

Intervention Results: Intervention homes had significantly larger reductions than controls in daily geometric mean particle concentrations (18.8% reduction vs 6.5% reduction, p<0.001). Intervention homes’ average percentage time with high particle concentrations decreased 45.1% compared with a 4.2% increase among controls (difference between groups p<0.001).

Conclusion: Real-time feedback for air particle levels and brief coaching can reduce fine particle levels in homes with smokers and young children. Results set the stage for refining feedback and possible reinforcing consequences for not generating smoke-related particles.

Study Design: A randomized trial with two groups—intervention and control

Setting: Home-based

Population of Focus: Participants from predominantly low-income households with an adult smoker and a child under 14 years of age

Data Source: Real-time lights and sounds (programmed to emit a blinking yellow LED light and brief aversive auditory alert when levels of indoor particles reached a threshold as measured by a Dylos air monitor. Delayed particle feedback charts

Sample Size: 298 homes

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Presentation/Meeting/Information Session/Event, Training (Parent/Family), CAREGIVER, Home Visit (caregiver), Motivational Interviewing/Counseling

Intervention Description: We tested the effectiveness of a program consisting of motivational interviewing (MI) and feedback of urine cotinine to stop passive smoking (PS) in children at risk for asthma.

Intervention Results: After 6 months, a significant group difference was observed for the unverified parental report of stopping PS in children: 27% of parents in the intervention group versus 7% in the control group. For the verified parental report, the difference was similar (23% versus 7%) but was not statistically significant.

Conclusion: Despite a limited sample size, the results suggest that the intervention program is probably an effective strategy to stop PS in children. A program longer than 6 months might be necessary for a longer lasting intervention effect.

Study Design: RCT

Setting: Home-based (6 sessions)

Population of Focus: Families with children ages 0-13 with a high risk of asthma and passive smoking exposure

Data Source: Parental self-report, urine cotinine in children

Sample Size: 58 families

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing, Counseling (Parent/Family), Training (Parent/Family),

Intervention Description: Contraception and Alcohol Risk Reduction Internet Intervention (CARRII). CARRII is a fully automated, interactive, and tailored Internet intervention designed to reduce the risk of alcohol-exposed pregnancies. It included motivational interviewing techniques, open questioning, reflection, and goal setting. Participants completed online diaries that provided graphical feedback of their progress during each week of the intervention period. The intervention aimed to address risky drinking and contraception use, and it was based on the successful CHOICES paradigm for reducing alcohol-exposed pregnancy risk

Intervention Results: CARRII participants showed significant reductions in rate of unprotected sex from pretreatment (88.9%) to posttreatment (70.6%) (p < 0.04) and to 6-M follow-up (51.5%) (p = 0.001); rate of risky drinking from pretreatment (75.0%) to posttreatment (50.0%) (p < 0.02), but insignificant change from pretreatment to 6-M follow-up (57.6%) (p < 0.09); and rate of AEP risk from pretreatment (66.7%) to posttreatment (32.4%) (p = 0.001) and to 6-M follow-up (30.3%) (p = 0.005). PE participants demonstrated no significant changes on all 3 variables across all time points. Intent-to-treat group-by-time tests were not significant, but power was limited by missing diaries. Over 72% of CARRII participants completed all 6 Cores. Exploratory analyses suggest that higher program utilization is related to change.

Conclusion: These data show that CARRII was acceptable, feasible, promising to reduce AEP risk, and merits further testing in a fully powered RCT.

Study Design: pilot randomized clinical trial (RCT). The participants were randomly assigned to either the CARRII intervention group or the patient education (PE) control group

Setting: internet-based platform (CARRII)

Population of Focus: women who were at risk for alcohol-exposed pregnancies due to risky drinking and ineffective contraception use

Sample Size: 71 women

Age Range: 18-44

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Other Person-to-Person Education, Motivational Interviewing, Group Education

Intervention Description: This study retrospectively evaluated the effect of smoking cessation intervention in pregnant women with smoking.

Intervention Results: After 12-week treatment, participants in the treatment group did not significantly reduce the number of participants quit smoking; decrease daily cigarettes consumption, and quit attempts in pregnant smokers, compared with subjects in the control group. At delivery, the comparison also did not show significant differences in the number of participants quit smoking, decreasing daily cigarettes consumption, and quitting attempts in pregnant smokers, as well as all infant outcomes between 2 groups.

Conclusion: The results of this retrospective study did not found that smoking cessation intervention may help to quit smoking for pregnant smokers.

Study Design: Cohort study- Retrospective observation

Setting: University hospital clinic

Population of Focus: Pregnant smokers aged from 18 to 40 years old, 12 to 24 weeks of gestation, with current cigarette consumption of more than 1 cigarette daily who could walk for 20 minutes daily

Data Source: Self-report, Urine cotinine

Sample Size: 176

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, PARENT/FAMILY, CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling, Consultation/Counseling (Parent/Family), Counseling (Parent/Family)

Intervention Description: To determine whether repeated infancy-onset lifestyle counselling alters parental smoking and children's exposure to tobacco smoke.

Intervention Results: Parents' smoking decreased during the study similarly in the intervention and control groups. Of the 8-y-old children, 46% had detectable serum cotinine concentration, suggesting exposure to tobacco smoke during the past few days. All children were non-smokers. Serum cotinine concentrations did not differ between the intervention and control children. Children's cotinine values were highest in the families where either father or both parents were smokers.

Conclusion: Participation in the atherosclerosis prevention trial slightly decreased smoking among the intervention and control parents. However, counselling led to no differences in parental smoking between the two groups, or in exposure of the intervention and control children to tobacco smoke. This study suggests that more detailed and targeted intervention is required to achieve a significant effect on children's tobacco smoke exposure.

Study Design: Randomized prospective intervention trial

Setting: Pediatric well-child visits

Population of Focus: Families presenting at a well-baby clinic with a child 5 months old.

Data Source: Cotinine measurements of mothers, fathers, and children; Reported smoking of parents during annual office visit to pediatrician (via questionnaires and interviews)

Sample Size: 1062 families (Intervention= 540; Control = 522)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Multicomponent Approach, Quality Improvement/Practice-Wide Intervention, Motivational Interviewing/Counseling,

Intervention Description: From 2015 to 2018 we convened 2 learning collaboratives, named the Quality Improvement Network for Contraceptive Access, with 17 teams (representing 40 sites) from New York City-based hospitals and health centers using an adaptation of the Institute for Healthcare Improvement's Breakthrough Series Learning Collaborative model. Participating teams sought to implement evidence-informed recommendations to increase access.

Intervention Results: Learning collaborative teams successfully implemented all 4 of the recommendations in 95% of the participating sites. Patients who chose and received a most or moderately effective method increased from 22% to 38% in primary care, and from 0% to 17% in the immediate postpartum period. Patients who chose and received a long-acting-reversible contraceptive increased from 5% to 11% in primary care, and from 0% to 3% in immediate postpartum. Facilitating factors included the involvement of interdisciplinary teams, consideration of costs, utilization of peers to demonstrate change, and champions to drive change.

Conclusion: The application of evidence-informed recommendations using a structured quality improvement initiative increases contraceptive access.

Study Design: Pre-post intervention

Setting: New York City, NY

Sample Size: 17 organization representing 40 care delivery sites

Age Range: NA

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visit (caregiver), Motivational Interviewing/Counseling, Provider Training/Education,

Intervention Description: Identified in this article are 5 pillars for implementing CBPPC care in cases involving ethical considerations: (1) identification of biases, (2) utilization of a culturally safe approach, (3) communication, (4) assessment and support, and (5) knowledge of community resources.

Intervention Results: successful intervention

Conclusion: By facilitating the communication of patient and family needs and goals and by connecting patients and families with community resources to improve quality of life, CBPPC and hospice nurses play an essential role in decreasing stressors and suffering. The implementation of palliative care improves patient outcomes, enhances interprofessional and family communication, and reduces end-of-life cost burdens both to families and to health care systems; however, the time it takes a nurse to develop trusting relationships, consider family-centered education needs, connect families with accessible specialists, and address their own needs and possible biases is not easily coded for compensation in the current health care system. Without substantial CBPPC nurse involvement in this case, the outcome might have been far less satisfactory for the family. It is recommended that nurses and interprofessional teams implement the 5 crucial pillars discussed for providing ethical and safe palliative care.

Study Design: case review

Setting: CMC: community-based palliative care - a case study involving a family with a child who has a life-limiting genetic disease and the community-based pediatric palliative care (CBPPC) team that provided care in the family's home.

Population of Focus: CMC - healthcare professionals, particularly those involved in community-based pediatric palliative care.

Sample Size: 1 family

Age Range: children

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Community Health Workers (CHWs), PATIENT/CONSUMER, Home Visits, Educational Material, Other Person-to-Person Education, Peer Counselor, Motivational Interviewing, CAREGIVER, Home Visit (caregiver), Education/Training (caregiver), Educational Material (caregiver), Motivational Interviewing/Counseling

Intervention Description: We assessed the effectiveness of a community health worker intervention focused on reducing exposure to indoor asthma triggers.

Intervention Results: The high-intensity group improved significantly more than the low-intensity group in its pediatric asthma caregiver quality-of-life score (P=.005) and asthma-related urgent health services use (P=.026). Asthma symptom days declined more in the high-intensity group, although the across-group difference did not reach statistical significance (P= .138). Participant actions to reduce triggers generally increased in the high-intensity group. The projected 4-year net savings per participant among the high-intensity group relative to the low-intensity group were $189–$721.

Conclusion: Community health workers reduced asthma symptom days and urgent health services use while improving caregiver quality-of-life score. Improvement was greater with a higher-intensity intervention.

Study Design: RCT

Setting: Community (home)

Population of Focus: Families in low-income households with children with asthma

Data Source: In-home interviewing, dust sample and standardized home inspection

Sample Size: 274 randomized participants

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Other Person-to-Person Education, Telephone Support, Enabling Services, Educational Material, Motivational Interviewing, Peer Counselor

Intervention Description: This study evaluated a theory-guided cognitive-behavioral counseling (CBC) intervention for smoking cessation during pregnancy and postpartum. It also explored the mediating role of cognitive-affective variables on the impact of CBC.

Intervention Results: An intent-to-treat analysis found no differences between the two groups in 7-day point-prevalence abstinence. However, a respondents-only analysis revealed a significantly higher cessation rate in the CBC (37.3 %) versus the BP (19.0 %) condition at 5-months postpartum follow-up. This effect was mediated by higher quitting self-efficacy and lower cons of quitting.

Conclusion: CBC, based on the Cognitive-Social Health Information Processing model, has the potential to increase postpartum smoking abstinence by assessing and addressing cognitive-affective barriers among women who adhere to the intervention.

Study Design: RCT

Setting: University hospital prenatal care clinic

Population of Focus: Racial and ethnically diverse urban pregnant smokers

Data Source: Standard scales, self-report, urine cotinine

Sample Size: 277, 140 in the intervention group and 137 in the control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Peer Counselor, Telephone Support, Other Education, Motivational Interviewing, CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Motivational Interviewing/Counseling, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Consultation/Counseling (Parent/Family), Counseling (Parent/Family)

Intervention Description: We hypothesized that a multilevel treatment model integrating pediatric clinic-level AAR with individual-level, telephone counseling would promote greater long-term (12-month) child TSE reduction and parent smoking cessation than clinic-level AAR alone.

Intervention Results: Child TSE (urine cotinine) declined significantly in both intervention and control groups from baseline to 12-months with no between-group differences. There was s statistically significant effect on 12-month bioverified quit status-intervention group participants were 2.47 times more likely to quit smoking than those in the control group.

Conclusion: Pediatrician advice alone may be sufficient to increase parent protections of children from TSE. Integrating clinic-level intervention with more intensive individual-level smoking intervention is necessary to promote parent cessation.

Study Design: RCT

Setting: Telephone counseling

Population of Focus: Parents/caregivers

Data Source: Self-reported interview data

Sample Size: 327 were randomized (164-control and 163-intervention)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Assessment (Provider), Motivational Interviewing/Counseling,

Intervention Description: Screening, Brief Intervention, and Referral to Treatment (SBIRT) delivered either electronically or by a clinician.

Intervention Results: The study found that Screening, Brief Intervention, and Referral to Treatment (SBIRT) significantly decreased the number of days of primary substance use, including alcohol consumption, among women in reproductive healthcare centers. Pregnant women reported substance use, on average, about 17% fewer days per month than did non-pregnant women.

Conclusion: Screening, Brief Intervention, and Referral to Treatment (SBIRT) significantly reduced the number of days of primary substance use among women in reproductive healthcare centers. Both the electronic and clinician-delivered interventions were more effective in reducing substance use compared to enhanced usual care. However, there was no significant difference in treatment utilization between the intervention groups and the enhanced usual care group.

Study Design: Randomized controlled trial

Setting: Two urban academic hospital based clinics

Population of Focus: Nonpreganant and pregnant women who screened positive for substance use

Sample Size: 439 women

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Motivational Interviewing, Technology-Based Support,

Intervention Description: The aim of this study is to test the effects of an electronic screening and feedback tool and training for primary care clinicians on care and adolescent health behaviors. We conducted a stepped-wedge cluster randomized trial with six clinics randomly assigned to sequential crossover from control to intervention periods with clinician training between periods. Adolescents (ages 13-18) with a well visit during the control periods (n = 135) received usual care, while adolescents during the intervention periods (n = 167) received the electronic screening and feedback tool prior to their well visit, with results sent to their clinicians. Adolescents completed surveys at baseline, 1 day, 3 months, 6 months, and 12 months. Linear mixed effects models were used to examine associations between outcomes and treatment, controlling for time as a fixed effect and clinic as a random effect. All analyses employed intent-to-treat analyses and utilized multiple imputations for missing data.

Intervention Results: Adolescents who received the intervention had a higher rate of counseling for their endorsed risk behaviors during the well visit (45% vs. 33%, Wald's T = 2.29, p = .02). There were no significant intervention effects on adolescent satisfaction with the clinician or perception of patient centeredness. The intervention was associated with a small but statistically significant reduction in overall risk score relative to control at 3 months (-.63, 95% confidence interval [-1.07, -.19], Cohen's d = .21), but not at 6 or 12 months.

Conclusion: The results suggest that electronic screening and feedback may be associated with small reductions in risk behaviors at 3 months but that changes do not persist at longer term follow-up.

Study Design: Stepped-wedge cluster randomized trial

Setting: Six Puget Sound Pediatric Research Network Clinics located in Western Washington

Population of Focus: Adolescents aged 13-18 who had a scheduled well-child visit at a participating clinic were invited

Sample Size: 302 participants (135 adolescents in the control group and 167 adolescents in the intervention group)

Age Range: Adolescents aged 13-18

Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Motivational Interviewing/Counseling, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Consultation/Counseling (Parent/Family), Counseling (Parent/Family), Educational Material (caregiver)

Intervention Description: Children with asthma who are exposed to environmental tobacco smoke are at increased risk for adverse health consequences. An experimental design was used to evaluate a minimal-contact intervention aimed at modifying parents' smoking behavior in their homes.

Intervention Results: More treatment (35%) than control (17%) subjects reported smoking outside their homes at posttest (and their children’s cotinine levels were lower), but this difference was not statistically significant.

Conclusion: difference was not statistically significant.

Study Design: Experimental design

Setting: Pediatric pulmonary clinics in U of MI

Population of Focus: Parents of children with asthma

Data Source: Parent questionnaire on smoking status and child urine sample.

Sample Size: 92 families randomly assigned

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Adult-led Support/Counseling/Remediation, Motivational Interviewing,

Intervention Description: The intervention described was a nine-month mentorship program for high school-aged adolescent females living in a low socio-economic status neighborhood. The program provided a mix of online and face-to-face interaction between adolescent aged program participants and a volunteer mentor that were leaders in various occupational fields. Four employment skills workshops that focused on skill development were also provided to mentees by the organization during the 9-month period. All mentors received mandatory training in a group setting with other mentors at the outset of the program that lasted for part of one day before they began their relationship with their mentee. This mentoring program was unique in that it focused specifically on adolescent female participants living in a low-income neighborhood and combined mentorship with concrete professional development and skills to impart to girls.

Intervention Results: The results of the study identified three general thematic categories that help to explain mentors' motivation to volunteer as a mentor: social propensity, psychological propensity, and organizational dynamics. These categories were interrelated and provided a broad conceptual framework to consider when seeking volunteers to act as mentors for high school-aged adolescent females.

Conclusion: The conclusion of the study was that organizations can better support recruitment and retention in youth development programs by incorporating the findings of this study into their recruitment process for volunteers.

Study Design: The study design was a pragmatic qualitative research design.

Setting: non-profit community-based youth mentorship program in Toronto, Canada

Population of Focus: adult, female mentors who volunteer to mentor high school-aged adolescent females living in a low socio-economic status neighborhood.

Sample Size: 22 adult, female mentors

Age Range: 16-17

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visits, Educational Material, Motivational Interviewing, PATIENT_CONSUMER, Feedback

Intervention Description: This study aimed to change parents’ perceptions of exposure by providing information on second- and third-hand exposure and personalised information on children’s exposure [NIH.

Intervention Results: Parental perceptions of exposure (PPE) were significantly higher at the study end (94.6 ± 17.6) compared to study beginning (86.5 ± 19.3) in intervention and enhanced control groups (t(72) = −3.950; p < 0.001). PPE at study end were significantly higher in the intervention group compared to the regular control group (p = 0.020). There was no significant interaction between time and group. Parallel changes in parental smoking behaviour were found. Parental perceptions of exposure were increased significantly post intervention, indicating that they can be altered.

Conclusion: By making parents more aware of exposure and the circumstances in which it occurs, we can help parents change their smoking behaviour and better protect their children.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, Motivational Interviewing, Educational Material

Intervention Description: To estimate the effectiveness of pregnancy smoking cessation support delivered by short message service (SMS) text message and key parameters needed to plan a definitive trial.

Intervention Results: Using the validated, continuous abstinence outcome, 5.4% (11 of 203) of MiQuit participants were abstinent versus 2.0% (four of 204) of usual care participants [odds ratio (OR) = 2.7, 95% confidence interval (CI) = 0.93-9.35]. The Bayes factor for this outcome was 2.23. Completeness of follow-up at 36 weeks gestation was similar in both groups; provision of self-report smoking data was 64% (MiQuit) and 65% (usual care) and abstinence validation rates were 56% (MiQuit) and 61% (usual care). The incremental cost-per-quitter was £133.53 (95% CI = -£395.78 to 843.62).

Conclusion: There was some evidence, although not conclusive, that a text-messaging programme may increase cessation rates in pregnant smokers when provided alongside routine NHS cessation care.

Study Design: RCT

Setting: Women, Infants and Children clinics in Ohio

Population of Focus: Women 16 years and over, less than 25 weeks pregnant, who had smoked at least five cigarettes daily before pregnancy and at least one per day at enrolment, able to understand written English and owned a mobile phone with text messaging functionality

Data Source: Surveys, data from mobile text system, exhaled breath CO, saliva cotinine

Sample Size: 407 -203 to MQUIT, 204 to usual care

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Counseling (Parent/Family), CAREGIVER, Motivational Interviewing/Counseling, Attestation (caregiver)

Intervention Description: The current study examined home and full (i.e., home plus car) smoking ban adoption as secondary outcomes to a randomized controlled trial targeting reduced secondhand smoke exposure (SHSe) for children under treatment for cancer.

Intervention Results: Regardless of group assignment, there was an increase in home (odds ration [OR] = 1.16, p = .074) and full (OR = 1.37, p = .001) smoking ban adoption across time. Families in the intervention group were more likely to adopt a full ban by 3 months, but this difference was nonsignificant by 12 months.

Conclusion: Smoking bans are in-line with Healthy People 2020’s tobacco objectives and may be more feasible for parents with medically compromised children for immediate SHSe reduction. Furthermore, interventions targeting full smoking bans may be a more effective for comprehensive elimination of SHSe.

Study Design: RCT

Setting: Pediatric oncology hospital setting

Population of Focus: Parents (at least 1 adult smoker in home) of children under treatment for cancer

Data Source: Parent self-report on household and car smoking behavior, demographic, psychosocial, and medical/treatmentrelated information.

Sample Size: 119 families randomized

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing, Pharmacotherapy (Nicotine), PATIENT_CONSUMER

Intervention Description: The aim of this pilot study was to establish the feasibility and potential efficacy of providing motivational advice and NRT (MA+NRT) to families of NICU infants.

Intervention Results: The primary outcome was accepting NRT patches (MA+NRT) and use of NRT. Bayesian analyses modeled NRT use as a function of treatment group. Most MA+NRT participants (81.3%; n=13) accepted the patches. No Quitline participants called the Quitline. NRT use differed across groups, indicating a 0.907 posterior probability that a positive effect for MA+NRT exists (RR=2.32, 95% CI=[0.68-11.34]).

Conclusion: This study demonstrated feasibility and acceptability for offering NRT and motivational advice to NICU parents and supports further intervention refinement with NICU families.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Motivational Interviewing, PROVIDER/PRACTICE, Provider Training/Education

Intervention Description: We assessed whether smoking cessation improved among pregnant smokers who attended Women, Infants and Children (WIC) Supplemental Nutrition Program clinics trained to implement a brief smoking cessation counseling intervention, the 5As: ask, advise, assess, assist, arrange.

Intervention Results: Of 71,526 pregnant smokers at WIC enrollment, 23% quit. Odds of quitting were higher among women who attended a clinic after versus before clinic staff was trained (adjusted odds ratio, 1.16; 95% confidence interval, 1.04–1.29). The adjusted mean infant birth weight was, on average, 96 g higher among women who reported quitting (P < 0.0001), regardless of clinic training status.

Conclusion: Training all Ohio WIC clinics to deliver the 5As may promote quitting among pregnant smokers, and thus is an important strategy to improve maternal and child health outcomes.

Study Design: Quasi experimental cross sectional

Setting: Women, Infants and Children clinics in Ohio

Population of Focus: All pregnant women in their first trimester who reported smoking attending a Women, Infants and Children clinic in Ohio that was trained to use the 5A’s smoking cessation package

Data Source: Self-report, medical records

Sample Size: 71526

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Incentives, Motivational Interviewing

Intervention Description: The purpose of this study is to test in a clinical prenatal care setting the effectiveness of the Smoke-Free Moms intervention, which provides pregnant women a series of financial incentives for smoking cessation.

Intervention Results: Of 175 eligible pregnant women enrolled, 134 women were followed to the postpartum visit (Intervention n=66, Control n=68). The quit rates during pregnancy did not differ between groups (Intervention 36.4%, Control 29.4%, p=0.46). However, significantly more intervention mothers quit and continued as nonsmokers postpartum (Intervention 31.8%, Control 16.2%, p=0.04). In a logistic regression model including baseline sociodemographic, depressed mood, stress, and readiness to quit items, confidence in being able to quit predicted both cessation outcomes. The financial incentive intervention was an independent predictor of cessation in pregnancy through postpartum.

Conclusion: Financial incentives with existing smoking-cessation counseling by staff in low-income clinical prenatal programs led to cessation that continued during the postpartum period. Further study in larger populations is indicated.

Study Design: Cohort- control trial with non-random assignment

Setting: Prenatal clinics in federally qualified health centers

Population of Focus: Low income pregnant smokers served in clinic settings who had not spontaneously quit on learning of their pregnancy and were still smoking at the time of their first prenatal visit

Data Source: Surveys, urine cotinine

Sample Size: 175 started program, 134 followed through to postpartum visit

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing,

Intervention Description: The intervention in the PIVOT with MI trial involves motivational interviewing (MI) as a brief intervention to address vaccine hesitancy among parents. MI is a patient-centered counseling approach designed to elicit behavior change by helping individuals explore and resolve ambivalence. The trial aims to assess the impact of MI on parental vaccine acceptance and child immunization rates ,[object Object],.

Intervention Results: Results will be disseminated through peerreviewed manuscripts and conference presentations.

Conclusion: Improving clinician communication with VHPs is critical to increasing childhood vaccine uptake.

Study Design: The study design involves a robust approach to minimize contamination, selection, ascertainment, and participant biases. It utilizes a cluster randomized controlled trial (cRCT) design, with practices as the unit of randomization. The trial also includes a fidelity substudy to assess clinician-parent vaccine communication practices ,[object Object],, ,[object Object],, ,[object Object],.

Setting: The trial setting involves 24 primary care practices across two US states, which facilitates generalizability and provides a knowledge base for how an intervention can be integrated within a real-world practice setting ,[object Object],.

Population of Focus: The target audience of the PIVOT with MI trial includes children under the age of 2 who are involved as research participants. Additionally, the trial involves English-speaking vaccine-hesitant parents and participating clinicians within the primary care practices ,[object Object],.

Sample Size: The trial aims to enroll 600 vaccine-hesitant parent/newborn pairs, with 300 pairs in each arm of the study. This sample size is designed to provide adequate statistical power to detect a decrease in underimmunization rates and is based on preliminary data regarding the mean percentage of days underimmunized for specific vaccines ,[object Object],.

Age Range: The trial involves children under the age of 2, specifically those who are receiving health supervision at participating primary care practices ,[object Object],.

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Counseling (Parent/Family), PATIENT/CONSUMER, Motivational Interviewing, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: Our objectives were to determine the effectiveness of a brief primary care intervention directed at parents who smoke in reducing babies’ TSP exposure, and to establish variables related to greater exposure.

Intervention Results: During follow-up, TSP-avoidance strategies improved more in the IG than in the CG: 35.4% and 26.9% ( p=0.006) at home, and 62.2% and 53.1% in cars (p=0.008). Logistic regression showed adjusted ORs for appropriate measures in the IG versus CG of 1.59 (95% CI 1.21 to 2.09) at home and 1.30 (95% CI 0.97 to 1.75) in cars. Hair samples showed that 78.7% of the babies tested were exposed. Reduced nicotine concentration was associated with improved implementation of effective strategies reported by parents at home (p=0.029) and in cars (p=0.014).

Conclusion: The intervention produced behavioural changes to avoid TSP exposure in babies. The proportion of babies with nicotine (>=1ng/mg) in hair samples at baseline is a concern.

Study Design: RCT

Setting: Primary care well-child visit

Population of Focus: Babies whose parents were smokers

Data Source: Outcomes were measured by parents’ reported strategies to avoid TSP exposure. Baseline clinical data and characteristics of each baby’s TSP exposure were collected, along with infant hair samples and parents’ tobacco use and related attitudes/ behaviors.

Sample Size: 1101 families

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing, , PATIENT_CONSUMER, Feedback

Intervention Description: We offered 102 participants smoking cessation advice, using motivational interviewing and exhaled carbon monoxide measurements to help them quit smoking.

Intervention Results: In total, 16 of 102 participants quit smoking, with 4 lost to follow-up. A further 40 participants cut down on how much they smoked.

Conclusion: Formal screening questions on smoking and the provision of smoking cessation advice should form a regular part of all respiratory clinics where CYP and their parents are seen. Simple smoking cessation interventions can lead to reduced smoking in this population.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Incentives, Educational Material, Peer Counselor, Motivational Interviewing, Pharmacotherapy (Nicotine), Other Person-to-Person Education, Group Education, Community-Based Group Education

Intervention Description: To assess the feasibility and acceptability of implementing a culturally tailored, intensive smoking cessation program, including contingency-based financial rewards (CBFR), for pregnant Aboriginal women.

Intervention Results: Twenty-two of 38 eligible women (58%) enrolled in the program, with 19 (86% remaining at the end of their pregnancy. The program was highly acceptable to both women and providers. Feasibility issues included challenges providing twice-weekly visits for 3 weeks and running fortnightly support groups. Of the 19 women who completed the program, 15 (79%) reported a quit attempt lasting >=24 hours, and 8 (42%) were CO-confirmed as not smoking in late pregnancy. The rewards were perceived to help motivate women, but the key to successful quitting was considered to be the intensive support provided.

Conclusion: 'Stop Smoking in its Tracks' was acceptable and is likely to be feasible to implement with some modifications. The program should be tested in a larger study.

Study Design: Single group pre-post test

Setting: Aboriginal Maternal and Infant Health Services clinics

Population of Focus: Pregnant aboriginal women seeking prenatal care at health services sites who were smoking and older than 16 years and less than 20 weeks gestation who were local residents

Data Source: Self-reported smoking levels, breath CO

Sample Size: 38, 19 completed the program

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Motivational Interviewing, Educational Material, Other Person-to-Person Education

Intervention Description: This randomized controlled pilot study evaluated feasibility and potential efficacy of a social-cognitive theory (SCT)-based biomarker feedback intervention among pregnant Alaska Native (AN) smokers.

Intervention Results: High rates of treatment compliance, study retention, and treatment acceptability were observed in both groups. 7-day point prevalence smoking abstinence rates at delivery verified with urinary cotinine were the same in both study groups (20% intent-to-treat analysis, 26% per-protocol). SCT-based measures did not change differentially from baseline by study group.

Conclusion: This trial supports the feasibility and acceptability of providing biomarker feedback within the clinical care delivery system, but the intervention did not promote increased smoking cessation during pregnancy compared to usual care.

Study Design: RCT- pilot

Setting: Primary care center

Population of Focus: Pregnant Alaskan native women who smoked receiving prenatal care at a primary care center in Anchorage, AK

Data Source: Urine cotinine levels, phone interviews

Sample Size: 60 -30 intervention, 30 control

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Other Person-to-Person Education, Motivational Interviewing, Telephone Support, PATIENT_CONSUMER

Intervention Description: In this report, we provide a cohort profile, and 8-week prolonged abstinence (8-week PA) and relapse findings from the first year of follow-up (n = 233).

Intervention Results: We found: (1) 28.4% achieved 8-week PA, (2) At a median of 6.2 months of follow-up after achieving 8-week PA, 23.2% of enrolled subjects reported tobacco cessation, and (3) a high rate of loss to follow-up (44%). In addition, our modeling indicated that the odds of relapse/smoking after enrollment was significantly higher in young mothers, non-Hispanic mothers (White, Black/African-American), mothers in the first and third trimester, and rural mothers.

Conclusion: Formative quantitative and qualitative research on the CTTP cohort will consider the effects of a range of implementation science (number of intervention sessions, addition of a mHealth component, distance to care) and individual (partner/household smoking, birth outcomes, NICU) outcome measures for the purpose of scaling up the CTTP model.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Pharmacotherapy (Nicotine), PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), CAREGIVER, Motivational Interviewing/Counseling, Motivational Interviewing

Intervention Description: Although many Latinos in the US smoke, they receive assistance to quit less often than non-Latinos. To address this disparity, we recruited Latino couples into a randomized controlled trial and provided a smoking cessation program during a teachable moment, when men’s partners were pregnant.

Intervention Results: We found high rates of cessation but no arm differences in smoking rates at the end of pregnancy (0.31 vs. 0.30, materials only vs. counseling, respectively) and 12 months after randomization (postpartum: 0.39 vs. 0.38). We found high quit rates among nondaily smokers but no arm differences (0.43 vs. 0.46 in pregnancy and 0.52 vs. 0.48 postpartum). Among daily smokers, we found lower quit rates with no arm differences but effects favoring the intervention arm (0.13 vs. 0.16 in pregnancy and 0.17 vs. 0.24 postpartum).

Conclusion: A less intensive intervention promoted cessation equal to more intensive counseling. Postpartum might be a more powerful time to promote cessation among Latino men. Impact Less intensive interventions when delivered during teachable moments for Latino men could result in a high smoking cessation rate and could reduce disparities.

Study Design: RCT

Setting: Community (home)

Population of Focus: Pregnant Latinas and their partners who smoked from 10 county health departments

Data Source: Surveys at end of pregnancy, 3-mo postpartum and 12-mo postpartum; also saliva samples for cotinine analysis.

Sample Size: 348 randomized couples

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling

Intervention Description: Smoking caregivers of children hospitalized for respiratory illness at the University of New Mexico were offered a smoking cessation intervention during the child's hospitalization.

Intervention Results: Fourteen percent of participants in the counseling group and 5% in the brief message group were self-reported quitters at 6 months. A significant percentage of smoking parents of children hospitalized for respiratory illness are willing to receive smoking cessation counseling while their child is in the hospital. Abstinence rates appear similar to other pediatric office-based interventions. Child hospitalization should be considered an important opportunity to provide parents with smoking cessation services, particularly since many smoking parents will not have access to these services elsewhere.

Conclusion: Child hospitalization should be considered an important opportunity to provide parents with smoking cessation services, particularly since many smoking parents will not have access to these services elsewhere.

Study Design: RCT

Setting: Community (hospitalization for Respiratory Illness)

Population of Focus: Parents of children hospitalized for respiratory illness

Data Source: Validated questionnaires and Fagerstrom test for nicotine dependence (self-report) All participants were followed by phone at 3 and 6 months posthospitalization for quit attempts.

Sample Size: 42 randomly assigned parents

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing/Counseling, Notification/Information Materials (Online Resources, Information Guide), Text Messaging,

Intervention Description: At half of the centres, midwives provided the standard Spanish postpartum contraceptive counselling (control group, CG). At the other half, supplemental perinatal contraceptive counselling was provided in addition to standard counselling (intervention group, IG) at different time points during pregnancy and postpartum. This consisted of a leaflet and a blog with practical information about all contraceptive options plus a short reminder message in the mobile phone during the third quarter of pregnancy and a face-to-face or a virtual meeting lasting 20 min in the first 15 days postpartum. Midwives used ad hoc questionnaires to collect information at week 30 of pregnancy (recruitment), and week 6, month 6 and month 12 postpartum.

Intervention Results: 975 women were eligible for analysis (482 in the CG and 493 in the IG). ~33% women had resumed sexual intercourse by week 6, and nearly all by months 6 and 12. Use and effectiveness of contraceptives was similar in both groups at week 6 and month 6. At month 12, more women in the IG used more effective contraception and less women used contraceptives considered somewhat effective vs. those of the CG (P = 0.006). When considering the place of origin, this was only true for Spanish women. Women of other origins had a much higher use of very effective contraceptives at month 12 also in the CG, with contraceptive counselling having scarce effect. On multivariate analysis, conducted only in Spanish women, the additional counselling resulted in a higher use of highly effective methods while having a university degree increased 3.6 times the OR for this behaviour. A bias towards fostering use of very effective contraceptives among women with low education was seen in standard clinical practice. Satisfaction with counselling and the type of contraception chosen was higher in the IG.

Conclusion: Our study has shown that the supplemental counselling tested has a moderate impact on contraceptive use and use of effective contraception in postpartum women. Results of this effort were seen after 6 months postpartum. A possible bias towards women who were more socially vulnerable was found in standard clinical practice, which reduced the effectiveness of the intervention in women who were otherwise the most needy.

Study Design: Randomized controlled trial

Setting: Primary care clinic in National Health Care System, Catalonia, Spain

Sample Size: 975 women (482 in control group; 493 in intervention group)

Age Range: At least 18 years old, no maximum age provided

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Motivational Interviewing, Screening Tool Implementation,

Intervention Description: Health risk behaviors are the most common sources of morbidity among adolescents. Adolescent health guidelines (Guidelines for Preventive Services by the AMA and Bright Futures by the Maternal Child Health Bureau) recommend screening and counseling, but the implementation is inconsistent. This study aims to test the efficacy of electronic risk behavior screening with integrated patient-facing feedback on the delivery of adolescent-reported clinician counseling and risk behaviors over time. This was a randomized controlled trial comparing an electronic tool to usual care in five pediatric clinics in the Pacific Northwest. A total of 300 participants aged 13-18 years who attended a well-care visit between September 30, 2016, and January 12, 2018, were included. Adolescents were randomized after consent by employing a 1:1 balanced age, sex, and clinic stratified schema with 150 adolescents in the intervention group and 150 in the control group. Intervention adolescents received electronic screening with integrated feedback, and the clinicians received a summary report of the results. Control adolescents received usual care. Outcomes, assessed via online survey methods, included adolescent-reported receipt of counseling during the visit (measured a day after the visit) and health risk behavior change (measured at 3 and 6 months after the visit).

Intervention Results: Of the original 300 participants, 94% (n=282), 94.3% (n=283), and 94.6% (n=284) completed follow-up surveys at 1 day, 3 months, and 6 months, respectively, with similar levels of attrition across study arms. The mean risk behavior score at baseline was 2.86 (SD 2.33) for intervention adolescents and 3.10 (SD 2.52) for control adolescents (score potential range 0-21). After adjusting for age, gender, and random effect of the clinic, intervention adolescents were 36% more likely to report having received counseling for endorsed risk behaviors than control adolescents (adjusted rate ratio 1.36, 95% CI 1.04 to 1.78) 1 day after the well-care visit. Both the intervention and control groups reported decreased risk behaviors at the 3- and 6-month follow-up assessments, with no significant group differences in risk behavior scores at either time point (3-month group difference: β=-.15, 95% CI -0.57 to -0.01, P=.05; 6-month group difference: β=-.12, 95% CI -0.29 to 0.52, P=.57).

Conclusion: Although electronic health screening with integrated feedback improves the delivery of counseling by clinicians, the impact on risk behaviors is modest and, in this study, not significantly different from usual care. More research is needed to identify effective strategies to reduce risk in the context of well-care.

Study Design: Randomized controlled trial

Setting: Five pediatric clinics in the Pacific Northwest

Population of Focus: Adolescents aged 13-18 years who attended a well-care visit at the pediatric clinics in Washington State

Sample Size: 300 adolescents (150 in intervention group and 150 in control group)

Age Range: Adolescents aged 13-18 years

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Oral Health Education, Assistance in Making Dental Appointment, Motivational Interviewing

Intervention Description: This study tested a behavioral intervention to increase dental attendance among rural Oregonian low-income women and their children.

Intervention Results: After the intervention, dental attendance for women in the prenatal period was 92.4% for those in the motivational interviewing (MI) group compared to 94.4% for those in the health education (HE) group (RR = 0.98; 95% CI = 0.93-1.04). No significant difference was observed between the two groups at follow-up.

Conclusion: High attendance may be attributable to the counselors' patient navigator function.

Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling, Education/Training (caregiver)

Intervention Description: This study tested a behavioral intervention to increase dental attendance among rural Oregonian low-income women and their children.

Intervention Results: Compared to statewide PRAMS, attendance was higher during pregnancy for study mothers (45% statewide; 95% CI = 40-50%) and for their children by 24 months (36% statewide; 95% CI = 27-44%).

Conclusion: Prenatal or postpartum motivational interviewing/counseling (MI) did not lead to greater attendance when compared to HE alone and cost more to implement. High attendance may be attributable to the counselors' patient navigator function.

Study Design: RCT

Setting: Four rural counties in OR

Population of Focus: Children of pregnant women aged ≥15 years in their first or second trimester eligible for Medicaid

Data Source: Medicaid claims; maternal self-report

Sample Size: Prenatal MI/Postpartum MI (n=121) Prenatal MI/Postpartum HE (n=50) Prenatal HE/Postpartum MI (n=134) Prenatal HE/Postpartum HE (n=44)

Age Range: not specified

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Assessment, PARENT/FAMILY, Counseling (Parent/Family), PATIENT/CONSUMER, Motivational Interviewing, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: Tobacco smoke exposure (TSE) harms children, who are often “captive smokers” in their own homes. Project Zero Exposure is a parent-oriented, theory-based intervention designed to reduce child TSE. This paper reports on findings from the pilot study, which was conducted in Israel from 2013 to 2014

Intervention Results: Twenty-six of the 29 recruited families completed the study. The intervention was feasible to implement and acceptable to participants. Among the 17 children with reliable hair samples at baseline and follow-up, log hair nicotine dropped significantly after the intervention (P = .04), hair nicotine levels decreased in 64.7% of children, and reductions to levels of nonexposed children were observed in 35.3% of children. The number of cigarettes smoked by parents (P = .001) and parent-reported child TSE declined (P = .01). Logistical issues arose with measurement of all objective measures, including air nicotine, which did not decline; home air particulate matter; and hair nicotine.

Conclusion: A program based on motivational interviewing and demonstrating TSE and contamination to parents in a concrete and easily understandable way is a promising approach to protect children from TSE. Further research is needed to enhance current methods of measurement and assess promising interventions.

Study Design: Single group pre- and post-test design

Setting: Home-based with child biomarker and home air quality feedback

Population of Focus: Parents from families in which smoking occurred were recruited from areas adjacent to NA’AMAT child day care centers by using the snowball technique

Data Source: Baseline questionnaire (reported exposure, child health, demographics). Objective assessments of child TSE via biomarkers (hair nicotine) and measurement of home air quality (air nicotine, particulate matter). Motivational interviewing action plan. Follow-up questionnaire (reported exposure).

Sample Size: 26 of the 29 recruited families completed the study

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing, Adult-led Support/Counseling/Remediation, YOUTH, PATIENT_CONSUMER, Feedback

Intervention Description: This study assessed the effect of Project Zero Exposure-an intervention program designed to help parents protect children from TSE-on children's exposure.

Intervention Results: Most enrolled families completed the trial (IG: 98.6%[68/69], RCG: 97.1%[68/70]). Log hair nicotine (LHN [ng/mg]) decreased in both the IG (Baseline: -1.78 ± 1.91, Follow-up: -2.82 ± 1.87, p = .003) and RCG (Baseline: -1.79 ± 1.54, Follow-up: -2.85 ± 1.73, p = .002), but did not differ between groups at study end (p = .635). Three of five parentally-reported outcomes showed improvement over time in the IG, and one in the RCG. Among IG participants, 90% found hair nicotine feedback useful.

Conclusion: No difference between the intervention and control groups was found on the objective biomarker, LHN. Child TSE decreased during the trial in intervention and control groups. Trial participation, which included hair nicotine monitoring, may have contributed to decreasing exposure in both groups. Concurrent control group improvements may partially explain lack of proven intervention benefit. Biomarker monitoring warrants further investigation for reduction of child TSE.

Intervention Components (click on component to see a list of all articles that use that intervention): Nurse/Nurse Practitioner, Quality Improvement/Practice-Wide Intervention, Motivational Interviewing,

Intervention Description: The American Academy of Pediatrics (AAP) recommends primary care-based health promotion for obesity prevention at all visits, focusing on nutrition and activity. In this quality improvement project, a primary care innovation was developed to support parents in promoting healthy habits in their children ages 2 to 5 years old. Nurse-led telephone support using motivational interviewing was implemented during two follow-up phone calls aimed at helping parent-child dyads reach self-created activity or nutrition goals.

Intervention Results: Parent-rated confidence and motivation related to meeting these goals showed significant increases. During the second call, 80% self-reported goal completion and high satisfaction with the visits. Registered nurses reported a significant increase in their self-efficacy of communication with parents.

Conclusion: This project showed the feasibility of using nurse telephone visits in an urban low-income primary care setting to improve parental recognition and understanding of healthy habits that align with American Academy of Pediatrics recommendations for obesity prevention.

Study Design: Program evaluation

Setting: An urban pediatric primary care clinic within a large academic institution in the U.S. Midwest. The clinic served as the medical home for approximately 7,000 children, with a predominantly low-income and diverse patient population. The healthcare team consisted of registered nurses, medical assistants, attending physicians, and pediatric residents.

Population of Focus: Parent-child dyads with children who were identified as overweight, obese, or at risk for overweight/obesity based on their body mass index (BMI) or parent-identified nutrition or physical activity habits.

Sample Size: 50 parent-child dyads

Age Range: Children aged 24 to 67 months

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, Peer Counselor, Educational Material, Motivational Interviewing, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family)

Intervention Description: To test the effectiveness of tailored quitline (telephone) counselling among smoking parents recruited into cessation support through their children's primary schools.

Intervention Results: Parents who received quitline counselling were more likely to report 7-day point-prevalence abstinence at 12-month assessment [34.0 versus 18.0%, odds ratio (OR) = 2.35, confidence interval (CI) = 1.56–3.54] than those who received a standard self-help brochure. Parents who received quitline counselling were more likely to use nicotine replacement therapy (P < 0.001) than those who received a standard self-help brochure. Among parents who did not achieve abstinence, those who received quitline counselling smoked fewer cigarettes at 3-month (P < 0.001) and 12-month assessment (P < 0.001), were more likely to make a quit attempt (P < 0.001), to achieve 24 hours' abstinence (P < 0.001) and to implement a complete home smoking ban (P < 0.01).

Conclusion: Intensive quitline support tailored to smoking parents is an effective method for helping parents quit smoking and promoting parenting practices that protect their children from adverse effects of smoking.

Study Design: RCT

Setting: Home-based telephone counseling

Population of Focus: Smoking parents

Data Source: Parent and child each completed a separate questionnaire. The primary outcome measure was 7-day pointprevalence abstinence at 12-month follow-up.

Sample Size: 512 parents who were smokers enrolled in RCT with children between the 9 and 12 years old

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing/Counseling,

Intervention Description: Preconception consultations focusing on behavioral change

Intervention Results: Of the 259 included participants, paired analyses were available in 177 participants for self-reported outcomes and in 82 for biomarker outcomes. Baseline self-reported prevalence of no folic acid use was 36%, smoking 12%, weekly alcohol use 22%, and binge drinking 17%. Significant changes in prevalence toward better lifestyle during follow-up were seen for folic acid use (both self-reported, P < .001; and biomarker confirmed, P ¼ .008) and for self-reported binge drinking (P ¼ .007)

Conclusion: This study suggests that PCC contributes to initiation of folic acid supplementation and cessation of binge drinking in women who intend to become pregnant. Although based on a small sample, the study adds to the limited body of evidence regarding the benefits of PCC in improving periconception health

Study Design: Prospective cohort study

Setting: Deprived neighborhoods in 14 Dutch municipalities

Population of Focus: Women who intend to become pregnant

Sample Size: 259 women

Age Range: 18-41

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Motivational Interviewing, PARENT/FAMILY, Counseling (Parent/Family), Telephone Support

Intervention Description: The intervention was a randomized-controlled pilot study of a brief, motivational SHS exposure intervention was conducted with mothers of infants hospitalized in a NICU, with the primary aim of reducing household SHS exposure via the implementation of home and car smoking bans. Caregivers were randomized to two sessions of motivational interviewing conducted in the hospital, usual care, or usual care-reduced measurement with follow-up at 1- and 6-months post discharge. The motivational interviewing group had 2 hospital-based sessions of approximately 40 minutes each, 2 personalized letters, and 2 phone feedback sessions targeting infant ETS reduction.

Intervention Results: Lower rates of total smoking bans (both home and car) in the usual care-reduced measurement group but not significantly different for home alone. 63.6% receiving motivational interviewing had a ban by 1-month post-discharge compared to 20% of the usual care group. Six months’ post discharge, fewer smoking bans were noted in the usual care-reduced measurement relative to motivational interviewing and usual care. While report of smoking bans increased in frequency, no differences were detected in household nicotine levels. However, there was a 10.8% decrease in household nicotine level from 1-6 months’ post-discharge. Participant report or smoking bans and results from nicotine monitors are two distinct measures of SHS exposure, with different sources of error and will not necessarily demonstrate identical data patterns.

Conclusion: We conclude that recruitment and intervention with NICU parents in a SHSe study is feasible, although improvements are needed. MI as implemented did not increase effects over assessment alone. Thus, assessment and discussion of SHSe in the NICU may increase the likelihood of a smoke-free home post-discharge, yet more intensive intervention is needed to strengthen effects. Effective interventions to reduce SHSe in households with NICU infants at high respiratory risk could result in substantial decreases in adverse health effects and the very large associated costs. This study was supported by grant R40MC08962 through the U.S. Department of Health and Human Services, Maternal and Child Health Research Program.

Study Design: Three-group RCT

Setting: Ill-child healthcare setting (NICU, respiratory)

Population of Focus: Primary caregivers of infants at high respiratory risk in the NICU who reported a smoker in the household

Data Source: Air nicotine monitors; infant endtidal carbon monoxide; intervieweradministered questionnaire at baseline and all follow-up assessments to determine smoking bans; and psychosocial and infant severity measures for cognitive and behavioral processes using the Experiential and Behavioral Subscales.

Sample Size: 144 mothers with infants in the NICU

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing, Adult-led Support/Counseling/Remediation, PATIENT_CONSUMER, YOUTH, Incentives

Intervention Description: To evaluate a hospital-initiated intervention to reduce tobacco smoke exposure in infants in the neonatal intensive care unit.

Intervention Results: The intervention effect on infant cotinine was not significant, except among mothers who reported high baseline readiness/ability to protect their infant (P ≤ .01) and mothers who completed the study within 6 months postdischarge (per protocol; P ≤ .05). Fewer mothers in the motivational interviewing plus financial incentives condition were smoking postdischarge (P ≤ .01). More mothers in the motivational interviewing plus financial incentives group reported a total home and car smoking ban at follow-up (P ≤ .05).

Conclusion: Motivational interviewing combined with financial incentives reduced infant tobacco smoke exposure in a subset of women who were ready/able to protect their infant. The intervention also resulted in less maternal smoking postpartum. More robust interventions that include maternal and partner/household smoking cessation are likely needed to reduce the costly effects of tobacco smoke exposure on children and their families.

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing,

Intervention Description: A brief, hospital-initiated, adaptive motivational interviewing plus acceptance and commitment therapy (MIACT) intervention to facilitate substance-use treatment initiation and reproductive planning postpartum among mothers who used substances during pregnancy. The brief MIACT was developed as an adaptive intervention with treatment intensity (1, 2 or 3 sessions; about 45 min each) dependent upon verification of participant response. The MIACT intervention was delivered by masters-level counselors or a doctoral-level social worker. Participants assigned to the CC condition met with a trained research assistant and/or NICU social worker who offered support along with a list of referrals for substance use disorder treatment.

Intervention Results: Results indicated that during treatment the MIACT group demonstrated an 84% probability of benefit relative to CC with regard to initiating treatment (RR=1.5), however the effect was not seen at follow-up. MIACT was also associated with an increased probability of attending a postpartum obstetrics visit (RR=1.4), and receiving contraception during treatment and at both follow-ups, with posterior probabilities of 96% or higher and relative risks ranging from 1.5 to 5.1 at varying timepoints. Substance use rates for the MIACT versus CC were higher at follow-up.

Conclusion: Brief, hospital-initiated interventions can assist postpartum mothers who use substances to enter treatment and obtain contraception in order to reduce future substance-exposed pregnancies.

Study Design: Parallel group, randomized controlled design

Setting: Hospital

Population of Focus: Mothers with an infant admitted to a neonatal intensive care unit if they or their infant tested positive for an illicit substance at delivery or had a documented positive drug screen during pregnancy

Sample Size: 64

Age Range: Women of chilbearing age

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), PATIENT/CONSUMER, Educational Material, CAREGIVER, Educational Material (caregiver), Counseling (Parent/Family), Peer Counselor, Motivational Interviewing/Counseling

Intervention Description: We report on a randomized controlled trial conducted between 1996 and 2001 to evaluate a minimal contact behavioral counseling intervention to decrease household SHS exposure among children with asthma from low-income, predominantly ethnic minority families.

Intervention Results: The intervention was unsuccessful with respect to reduction of household smoking and household SHS exposure of these children. In addition, while most households that remained in the study reported full household smoking bans by the end of the study, the study team found no difference in control/intervention households citing a ban on smoking.

Conclusion: Despite these results, our study provided several important insights. The “null” results of our trial suggest that a minimal intervention with limited contact may not suffice to achieve a reduction in household tobacco exposure among low income minority families that have children with asthma. However, although no intervention/control group differences were found, our study suggests that it is possible to implement household restrictions that were not previously in place, including among low-income and minority families, since most households reported implementing full smoking bans by the end of the study (136 of the original 242 at baseline, 56%). This is significant in light of the implications of such restrictions for reduced exposure [43] and the association of bans with smoking cessation and decreased cigarette consumption. Our research also points to the need for further study of the process by which change occurs, i.e., what changes families believe they are making and actually achieve.

Study Design: RCT

Setting: Community (home)

Population of Focus: Children 2-14 years of age with asthma and a parent or guardian from each child’s household

Data Source: Parental survey (baseline data); urine cotinine; air nicotine monitor readings; and in-person follow-up.

Sample Size: 242 child/adult dyads

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing/Counseling,

Intervention Description: We enrolled patients in a single-blinded, one-to-one, randomized, controlled trial to assess the impact of enhanced family planning counseling immediately after a viable preterm birth in the inpatient setting. Participants received either structured counseling with an emphasis on LARC by a family planning specialist (intervention) or routine postpartum care (control). We followed participants to the primary outcome of LARC use 3 months postpartum.

Intervention Results: We followed 121 participants for 3 months. Primary outcome data were available for 119 participants (61 intervention, 58 control). We found no demographic differences between the groups. Participants in the intervention group were significantly more likely to use LARC at 3 months postpartum compared with controls (51% vs. 31%; p < .05). For every six women who received the counseling intervention, one additional woman was using a LARC method at 3 months.

Conclusion: After a preterm birth, brief LARC-focused, structured counseling before hospital discharge significantly increased LARC method use at 3 months postpartum.

Study Design: Singe blinded, randomized controlled trial

Setting: University of Utah Hospital, Salt Lake City, Utah

Sample Size: 150 women separated into control and intervention groups

Age Range: 18-45 women who delivered a viable prematurei nfant

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Counseling (Parent/Family), CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: This randomized controlled trial tested the efficacy of parent-based behavioral counseling for reducing secondhand smoke exposure (SHSe) among children with cancer. It also examined predictors of smoking and SHSe outcomes.

Intervention Results: Reductions in parent-reported smoking and exposure were observed in both the intervention and control conditions. There was a significantly greater reduction in parent-reported smoking and child SHSe at 3 months for the intervention group compared with the control group. Child SHSe was significantly lower at 12 months relative to baseline in both groups. Children's cotinine levels did not show significant change over time in either group. Exposure outcomes were influenced by the number of smokers at home, smoking status of the parent participating in the trial, and the child's environment (home versus hospital) the day before the assessment.

Conclusion: Children's SHSe can be reduced by advising parents to protect their child from SHSe, combined with routine reporting of their child's exposure and cotinine testing, when delivered in the context of the pediatric cancer setting. More intensive interventions may be required to achieve greater reductions in SHSe.

Study Design: RCT

Setting: Ill-child healthcare setting (hospital)

Population of Focus: Parents or guardians of nonsmoking children with cancer, <18 years, at least 30 days post diagnosis, and living with at least one adult smoker

Data Source: Parent reports (child SHS exposure and smoking), child urine cotinine assays, parent satisfaction survey.

Sample Size: 135 parents or guardians

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Counseling (Parent/Family), CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: To explore the reach of a German population-based household sample using proactive recruitment and to test the efficacy of a behavioral change counseling intervention including feedback about children's urine cotinine level (CUCL).

Intervention Results: CUCL below the detection limit in the IG was found in 43.2% at baseline and 44.6% at follow-up and in 44.8% of the CG at baseline and 47.2% at follow-up. The CUCL difference between follow-up and baseline was smaller in the CG than in the IG. The effect was not significant.

Conclusion: Data revealed a high reach of the target population but failed to identify an intervention effect.

Study Design: RCT

Setting: Community (home and telephone)

Population of Focus: Households with at least one child aged below 4 and at last one current smoker

Data Source: Baseline assessment, biomarkers with urine cotinine.

Sample Size: 852 household completed the study protocol: n=428 intervention group; n=424 control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Nurse/Nurse Practitioner, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), PATIENT/CONSUMER, Educational Material, CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling, Motivational Interviewing, Peer Counselor

Intervention Description: We conducted a population-based trial to evaluate the efficacy of an intervention aimed at preventing exposure of young children to parental tobacco smoke.

Intervention Results: A strong association was found between social class and smoking behavior, in particular smoking during meals at home. The intervention itself had limited effectiveness in decreasing the number of smokers. The effect was stronger in mothers and in higher social groups. Among the "white-collar" families belonging to the intervention group, the proportion of mothers who stopped smoking was 3 times higher than in the control group (not statistically significant).

Conclusion: Educational interventions against smoking should be planned taking into account the difference in efficacy according to social class.

Study Design: Control trial with nonrandom assignment

Setting: Community (population based survey) and well-child health care visit

Population of Focus: Parents of newborn babies living in the town of Rivoli before 3 month compulsory vaccination

Data Source: Baseline (pre-intervention) and followup (2 and 4 years post-intervention) questionnaires

Sample Size: 1015 parents with 402 in the intervention group and 613 in the control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Motivational Interviewing, Other Education, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling, Education/Training (caregiver)

Intervention Description: To examine the long-term maintenance of a previously reported behavioral counseling intervention to reduce asthmatic children's exposure to environmental tobacco smoke (ETS).

Intervention Results: The originally reported analysis of baseline to 12 months was reanalyzed with a more robust restricted maximum likelihood procedure. The 2-year follow-up period was analyzed similarly. Significantly greater change occurred in the counseling group than the control groups and was sustained throughout the 2 years of follow-up. Further exploratory analyses suggested that printed counseling materials given to all participants at month 12 (conclusion of the original study) were associated with decreased exposure in the control groups.

Conclusion: Such long-term maintenance of behavior change is highly unusual in the general behavioral science literature, let alone for addictive behaviors. We conclude that ETS exposure can be reduced and that a clinician-delivered treatment may provide substantial benefit.

Study Design: Three-group RCT

Setting: Ill-child healthcare setting (pediatric allergy clinic)

Population of Focus: Families of children with asthma (6 to 17 years) including at least one parent who smoked in the home

Data Source: Interview data, pulmonary function testing, daily peak flow measures, symptom diary recordings, urinary cotinine, environmental air sampling, and permanent product (e.g., cigarette butt counts).

Sample Size: 91 families

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Counseling (Parent/Family), CAREGIVER, Motivational Interviewing/Counseling, Home Visit (caregiver), PATIENT/CONSUMER, Home Visits, Motivational Interviewing

Intervention Description: Secondhand smoke (SHS) is a significant cause of acute respiratory illness (ARI) and 5 times more common in indigenous children. A single-blind randomized trial was undertaken to determine the efficacy of a family centered SHS intervention to reduce ARI in indigenous infants in Australia and New Zealand.

Intervention Results: Two hundred and ninety-three mother/infant dyads were randomized and followed up. Three quarters of mothers smoked during pregnancy and two thirds were smoking at baseline (as were their partners), with no change for more than 12 months. Reported infant exposure to SHS was low (≥95% had smoke-free homes/cars). Infant CCRs were higher if one or both parents were smokers and if mothers breast fed their infants. There was no effect of the intervention on ARI events [471 intervention vs. 438 usual care (reference); incidence rate ratio = 1.10, 95% confidence intervals (CI) = 0.88–1.37, p = .40].

Conclusion: Despite reporting smoke-free homes/cars, mothers and their partners continue to smoke in the first year of infants’ lives, exposing them to SHS. Emphasis needs to be placed on supporting parents to stop smoking preconception, during pregnancy, and postnatal.

Study Design: Single-blind randomized trial

Setting: Community (homes)

Population of Focus: Indigenous mothers/infants from homes with more than one smoker

Data Source: Baseline data at home visit; Baseline, 2 month, and 3 month quantitative and qualitative process evaluation indicators; outcome data from face-toface home visits and urine samples

Sample Size: 293 mother/infant dyads

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), CAREGIVER, Motivational Interviewing/Counseling, Educational Material (caregiver)

Intervention Description: To assess counseling to caregivers and classroom health education interventions to reduce environmental tobacco smoke exposure of children aged 5–6 years in China.

Intervention Results: At the 6-month follow-up, children’s urinary cotinine was significantly lower (Z = –3.136; p = 0.002) and caregivers’ 7-day quit rate was significantly higher (34.4% versus 0%) (p < 0.001; adjusted OR = 1.13; 95% CI: 1.02–1.26) in the intervention than control group.

Conclusion: Helping caregivers quitting smoke combined with classroom-based health education was effective in reducing children’s environmental tobacco smoke exposure. Larger-scale trials are warranted.

Study Design: RCT

Setting: Community (preschools)

Population of Focus: Children ages 5-6 and their caregivers from six districts and one county in Changsha in families where one or more parent/caregiver smoked

Data Source: Caregiver interviews; child urine cotinine feedback

Sample Size: 65 smoker caregivers and their children with 33 in the intervention group and 32 in the control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Motivational Interviewing, Educational Material, Other Person-to-Person Education, Community-Based Group Education, Group Education, Incentives

Intervention Description: Given serious consequences of maternal smoking, we aimed to develop and test a multicomponent behavioral intervention to enhance smoking cessation during pregnancy.

Intervention Results: The estimated smoking cessation rate was 70.0% (21/30) at the second week of the intervention, and 63.3% (19/30) at the conclusion of the 8-week intervention assuming the dropouts as smoking. In interrupted time series analysis, the mean daily number of cigarettes smoked among quitters decreased by 6.52, 5.34, and 4.67 among early, delayed, and late intervention groups, respectively. Quitters' mean urine cotinine level maintained stably high before the intervention but decreased rapidly to the nonsmoking range once the intervention was initiated. Most participants (85.7%) reported meeting or exceeding expectations, and 100% would recommend the program to others.

Conclusion: This pilot multicomponent intervention was feasible and acceptable to most participants, resulting in a high smoking cessation rate among pregnant smokers who were unlikely to quit spontaneously.

Study Design: Cohort-Multiple-baseline intervention pilot studymultiple interrupted time series approach

Setting: Community-based prenatal clinics

Population of Focus: English speaking pregnant women who are current smokers without alcohol or drug dependency or mental health disorders

Data Source: Urine cotinine, self-report calendar of cigarette use

Sample Size: 30

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing, Pharmacotherapy (Nicotine), Referrals, PATIENT_CONSUMER

Intervention Description: We tested the efficacy of a smoking cessation intervention for parents of hospitalized children.

Intervention Results: Of 1641 eligible families approached, 252 were randomized (15%); 149 families had follow-up data at 12 months (59%). In the adjusted analysis, there was no difference between the groups in smoke free home rules, or child cotinine level; in an intention-to-treat analysis, 15% in the intervention group versus 8% of controls reported quit (p=0.07).

Conclusion: A smoking cessation intervention can be delivered to parents of hospitalized children. While hospitalization provides an opportunity to help parents quit smoking, more efficient and effective engagement strategies are needed to optimize tobacco control success.

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Counseling (Parent/Family), CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: Secondhand tobacco smoke exposure impairs the control of pediatric asthma. Evidence of the efficacy of interventions to reduce children’s exposure and improve disease outcomes has been inconclusive.

Intervention Results: In the sample overall, the children in the LET’S intervention had lower follow-up lnCCR values compared with the children in usual care, but the group difference was not significant (β coefficient = −0.307, P = .064), and there was no group difference in the odds of having > one asthma-related medical visit (β coefficient = 0.035, P = .78). However, children with high-risk asthma had statistically lower follow-up lnCCR values compared with children in usual care (β coefficient = −1.068, P = .006).

Conclusion: The LET’S intervention was not associated with a statistically significant reduction in tobacco smoke exposure or use of health-care services in the sample as a whole. However, it appeared effective in reducing exposure in children at high risk for subsequent exacerbations.

Study Design: RCT

Setting: Ill-child healthcare setting (respiratory disorders)

Population of Focus: Caregivers of children aged 3 to 12 years with asthma and reported smoke exposure

Data Source: Caregiver interview, urine collection, and spirometry

Sample Size: 352 caregivers with 178 in the intervention group and 174 in the control

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Counseling (Parent/Family), CAREGIVER, Motivational Interviewing/Counseling, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Notification/Information Materials (Online Resources, Information Guide), Educational Material (caregiver), Education/Training (caregiver)

Intervention Description: To determine the effectiveness of a cotinine-feedback, behaviorally based education intervention in reducing environmental tobacco smoke (ETS) exposure and health-care utilization of children with asthma.

Intervention Results: The intervention was associated with a significantly lower odds ratio (OR) for more than one acute asthma medical visit in the follow-up year, after adjusting for baseline visits (total visits, 87; OR, 0.32; p = 0.03), and a comparably sized but nonsignificant OR for one or more hospitalization (OR, 0.34; p = 0.14). The follow-up CCR measurement and the determination of whether smoking was prohibited inside the home strongly favored the intervention group (n = 51) (mean difference in CCR adjusted for baseline, −0.38; p = 0.26; n = 51) (60; OR [for proportion of subjects prohibiting smoking], 0.24; p = 0.11; n = 60).

Conclusion: This intervention significantly reduced asthma health-care utilization in ETS-exposed, low-income, minority children. Effects sizes for urine cotinine and proportion prohibiting smoking were moderate to large but not statistically significant, possibly the result of reduced precision due to the loss of patients to active follow-up. Improving ETS reduction interventions and understanding their mechanism of action on asthma outcomes requires further controlled trials that measure ETS exposure and behavioral and disease outcomes concurrently.

Study Design: RCT

Setting: Community (pediatric pulmonary service of a pediatric hospital)

Population of Focus: Parents of children 3 to 12 years of age with asthma who were ETS exposed

Data Source: Interview data, pulmonary function, urine cotinine, asthma medications, health care utilization.

Sample Size: 87 parents

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Counseling (Parent/Family), CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: The objective of this study was to test the feasibility and acceptability of introducing an intervention to address mothers' and fathers' smoking during the postpartum hospitalization.

Intervention Results: Enrolling mothers and father into tobacco treatment services during the immediate postpartum hospital stay is feasible and seems to stimulate quit attempts. The birth of an infant presents a teachable moment to reach both parents and to provide cessation assistance. Results were not significant for self-reported 7-day abstinence or 24-hour quit attempts.

Conclusion: Enrolling mothers and fathers into tobacco treatment services during the immediate postpartum hospital stay is feasible and seems to stimulate quit attempts. The birth of an infant presents a teachable moment to reach both parents and to provide cessation assistance.

Study Design: Quasi-experimental RCT

Setting: Well-child healthcare setting (hospital and community child health checks)

Population of Focus: Mothers and fathers of newborns recruited on the postnatal ward who were current smokers or recent quitters

Data Source: Saliva cotinine measurements; SmokeFree Families Core Assessment Forms, HEDIS Measures Interview Survey.

Sample Size: 101 mothers and fathers with 48 in the intervention group and 53 in control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Assessment (Provider), Motivational Interviewing/Counseling,

Intervention Description: Electronically delivered screening, brief intervention, and referral to treatment (e-SBIRT); clinician delivered SBIRT, and enhanced usual care

Intervention Results: Both clinician-delivered SBIRT and electronically-delivered SBIRT produced modest and statistically significant effects in promoting abstinence from substances.

Conclusion: The study concluded that both clinician-delivered SBIRT and electronically-delivered SBIRT interventions were effective in promoting abstinence from substances among women in reproductive health settings. While abstinence from the primary substance was a rare outcome in the sample, both interventions showed modest and statistically significant effects. The ease of implementation and relatively low cost of the e-SBIRT intervention suggest its practicality for implementing brief interventions at scale for at-risk women. Further optimization efforts and large-scale implementations could be facilitated by the ease with which electronic interventions can be modified and disseminated.

Study Design: 3-group randomized controlled trial

Setting: Urban academic healthcare settings with a predominantly minority population

Population of Focus: Pregnant and nonpregnant women seeking reproductive health services who may be abusing substances

Sample Size: 439 women

Age Range: Mean age of 34.2 years

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Telephone Support, Other Person-to-Person Education, Peer Counselor, Motivational Interviewing, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family)

Intervention Description: Mobile-phone-based smoking cessation intervention has been shown to increase quitting among smokers.

Intervention Results: All findings were between intervention group B and control. No differences found between intervention group A and control or between groups A and B. Father self-reported smoking abstinence at 6 months was significantly increased in group B compared to control and even higher at 12 months. Although no reduction in self-reported exposure rates were found at 6 months, the rate as 12 months was significantly decreased in group B when compared to control group.

Conclusion: The findings suggest that adding mHealth interventions to traditional face-to-face health counseling may be an effective way to increase male smoking cessation and reduce mother and newborn SHS exposure in the home.

Study Design: Single-blind randomized control trial

Setting: Home-based (baseline, 6 months, 12 months with in person counseling); Mobile-based

Population of Focus: Parents of newborns

Data Source: Self-report survey data.

Sample Size: 342 (114 in each of the three groups)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Home Visits, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), Telephone Support, Motivational Interviewing, CAREGIVER, Motivational Interviewing/Counseling, Outreach (caregiver), Home Visit (caregiver)

Intervention Description: The aim of this randomized-controlled trial was to evaluate the effectiveness of an intensive intervention to reduce children’s environmental tobacco smoke (ETS) exposure at their home compared with a minimal intervention.

Intervention Results: The levels of cotinine in the intensive intervention and minimal intervention groups in the final follow-up were significantly lower than the initial levels. The proportion of mothers reporting a complete smoking ban at home in the final follow-up was higher in the intensive intervention group than the minimal intervention group. This increase was statistically significant. The education provided during the home visits and the reporting of the urinary cotinine levels of the children were effective in lowering the children’s exposure to ETS at their home. The decrease in cotinine levels was higher in the intensive intervention group than the minimal intervention group but the difference was not statistically significant.

Conclusion: The education provided during the home visits and the reporting of the urinary cotinine levels of the children were effective in lowering the children’s exposure to ETS at their home.

Study Design: RCT

Setting: Community (home and hospital)

Population of Focus: Mothers of children aged 1-5 who lived in the Cengizhan district of Izmir in Turkey, who smoked and/or whose spouses smoked

Data Source: Urinary cotinine samples and forms

Sample Size: 80 mothers with 40 in the intensive intervention group and 40 in the minimal intervention group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Counseling (Parent/Family), CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: The present randomized controlled trial tested the effectiveness of a behavioral counseling program for reducing children's exposure to environmental tobacco smoke (ETS). Counseling was delivered by clinic staff as part of well-child health care services in a community clinic setting.

Intervention Results: In both groups, children’s reported exposure to their mothers’ tobacco smoke in the home declined steeply from baseline to 6-months post-test and remained essentially level during follow-up. The sharpest decline occurred by 3 months. Children’s urinary cotinine concentrations did not show a significant chance over time in either the intervention or control group. Mothers’ self-reported 7-day quit status did not vary by experimental group at 3, 6, or 12 months. At 12 months, a significant group difference was found in SCN- verified 7-day quit status.

Conclusion: Findings on the fidelity of treatment implementation suggest that the structure and funding of the community clinic health care system and associated staff turnover and training issues resulted in participants receiving a less efficacious intervention than in our past efficacy trials. Implications for future effectiveness trials are discussed.

Study Design: RCT

Setting: Well-child healthcare setting (community clinic)

Population of Focus: English or Spanish-speaking smoking mothers with children aged 4 or younger

Data Source: Children’s urinary cotinine measures, saliva samples from mothers, parent report from interviews at baseline, 3, 6, and 12 months, and nicotine monitors.

Sample Size: 150 mothers with 76 in the intervention group and 74 in the control group

Age Range: Not specified