期刊论文详细信息
BMC Pediatrics
How to minimize children’s environmental tobacco smoke exposure: an intervention in a clinical setting in high risk areas
Boel Andersson Gäre3  Agneta Abrahamsson2  AnnaKarin Johansson4  Noomi Carlsson1 
[1] Department of Public Health and Medical Care, Jönköping County Council, Box 1024, SE-551 11 Jönköping, Sweden;Department of Health and Society, University College of Kristianstad, SE-291 88, Kristianstad, Sweden;The Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Box 1026, SE-551 11 Jönköping,Sweden;Department of Medicine and Health, Division of Nursing Science, Faculty of Health Sciences, Linköping University, SE-581 83, Linköping, Sweden
关键词: Passive smoking;    Tobacco smoke prevention;    Child Health Care;    Children;   
Others  :  1144891
DOI  :  10.1186/1471-2431-13-76
 received in 2012-08-27, accepted in 2013-05-02,  发布年份 2013
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【 摘 要 】

Background

Despite the low prevalence of daily smokers in Sweden, children are still being exposed to environmental tobacco smoke (ETS), primarily by their smoking parents. A prospective intervention study using methods from Quality Improvement was performed in Child Health Care (CHC). The aim was to provide nurses with new methods for motivating and supporting parents in their efforts to protect children from ETS exposure.

Method

Collaborative learning was used to implement and test an intervention bundle. Twenty-two CHC nurses recruited 86 families with small children which had at least one smoking parent. Using a bundle of interventions, nurses met and had dialogues with the parents over a one-year period. A detailed questionnaire on cigarette consumption and smoking policies in the home was answered by the parents at the beginning and at the end of the intervention, when children also took urine tests to determine cotinine levels.

Results

Seventy-two families completed the study. Ten parents (11%) quit smoking. Thirty-two families (44%) decreased their cigarette consumption. Forty-five families (63%) were outdoor smokers at follow up. The proportion of children with urinary cotinine values of >6 ng/ml had decreased.

Conclusion

The intensified tobacco prevention in CHC improved smoking parents’ ability to protect their children from ETS exposure.

【 授权许可】

   
2013 Carlsson et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Blackburn C, Spencer N, Bonas S, Coe C, Dolan A, Moy R: Effect of strategies to reduce exposure of infants to environmental tobacco smoke in the home: cross sectional survey. BMJ 2003, 327(7409):257.
  • [2]Johansson A, Hermansson G, Ludvigsson J: How should parents protect their children from environmental tobacco-smoke exposure in the home? Pediatrics 2004, 113(4):e291-295.
  • [3]Ding D, Wahlgren DR, Liles S, Matt GE, Oliver M, Jones JA, Hovell MF: A second reporter matters: agreement between parents’ and children’s reports of smoking bans in families. Am J Prev Med 2011, 40(5):572-575.
  • [4]Priest N, Roseby R, Waters E, Polnay A, Campbell R, Spencer N, Webster P, Ferguson-Thorne G: Family and carer smoking control programmes for reducing children’s exposure to environmental tobacco smoke. Cochrane Database Syst Rev 2008., 4CD001746
  • [5]Alwan N, Siddiqi K, Thomson H, Lane J, Cameron I: Can a community-based ‘smoke-free homes’ intervention persuade families to apply smoking restrictions at homes? J Public Health (Oxf) 2011, 33(1):48-54.
  • [6]Precioso J, Samorinha C, Calheiros JM, Macedo M, Antunes H, Campos H: Second hand smoke (SHS) exposure in children. An evaluation of a preventative measure. Rev Port Pneumol 2010, 16(1):57-72.
  • [7]Edvardsson K, Garvare R, Ivarsson A, Eurenius E, Mogren I, Nystrom ME: Sustainable practice change: professionals’ experiences with a multisectoral child health promotion programme in Sweden. BMC Health Serv Res 2011, 11:61. BioMed Central Full Text
  • [8]Crone MR, Verlaan M, Willemsen MC, van Soelen P, Reijneveld SA, Sing RA, Paulussen TG: Sustainability of the prevention of passive infant smoking within well-baby clinics. Health Educ Behav 2006, 33(2):178-196.
  • [9]Chen X, Stanton B, Hopper J, Khankari N: Sources, locations, and predictors of environmental tobacco smoke exposure among young children from inner-city families. J Pediatr Health Care 2011, 25(6):365-372.
  • [10]Mangrio E, Hansen K, Lindstrom M, Kohler M, Rosvall M: Maternal educational level, parental preventive behavior, risk behavior, social support and medical care consumption in 8-month-old children in Malmo Sweden. BMC Publ Health 2011, 11(1):891. BioMed Central Full Text
  • [11]Wallby T, Hjern A: Parental region of birth, socio-economic status and infants’ exposure to second-hand smoke. Acta Paediatr 2008, 97(11):1542-1545.
  • [12]Bolte G, Fromme H: Socioeconomic determinants of children’s environmental tobacco smoke exposure and family’s home smoking policy. Eur J Public Health 2009, 19(1):52-58.
  • [13]Laaksonen M, Rahkonen O, Karvonen S, Lahelma E: Socioeconomic status and smoking: analysing inequalities with multiple indicators. Eur J Public Health 2005, 15(3):262-269.
  • [14]Wallby T, Hjern A: Child health care uptake among low-income and immigrant families in a Swedish county. Acta Paediatr 2011, 100(11):1495-1503.
  • [15]Berlin A, Johansson SE, Tornkvist L: Working conditions and cultural competence when interacting with children and parents of foreign origin–primary child health nurses’ opinions. Scand J Caring Sci 2006, 20(2):160-168.
  • [16]Developement of smoking and socioeconomic differences (Rökningens utveckling och socioekonomiska skillnader); http://www.fhi.se/Aktuellt/Nyheter/Rokningens-utveckling-och-socioekonomiska-skillnader/ webcite
  • [17]Polanska K, Hanke W, Ronchetti R, van den Hazel P, Zuurbier M, Koppe JG, Bartonova A: Environmental tobacco smoke exposure and children’s health. Acta Paediatr Suppl 2006, 95(453):86-92.
  • [18]Goksor E, Amark M, Alm B, Gustafsson PM, Wennergren G: The impact of pre- and post-natal smoke exposure on future asthma and bronchial hyper-responsiveness. Acta Paediatr 2007, 96(7):1030-1035.
  • [19]Breast feeding and smoking behaviour among parents - Children born 2007 Amning och föräldrars rökvanor - barn födda 2007); http://www.socialstyrelsen.se/publikationer2009/2009-10-115 webcite (In Swedish
  • [20]Carlsson N, Johansson A, Hermansson G, Andersson-Gare B: Child health nurses’ roles and attitudes in reducing children’s tobacco smoke exposure. J Clin Nurs 2010, 19(3–4):507-516.
  • [21]Carlsson N, Johansson A, Hermansson G, Andersson-Gare B: Parents’ attitudes to smoking and passive smoking and their experience of the tobacco preventive work in child health care. J Child Health Care 2011, 15(4):272-286.
  • [22]Crossing the quality chasm: a New health system for the 21st century. http://www.nap.edu/openbook.php?isbn=0309072808 webcite
  • [23]Bero LA, Grilli R, Grimshaw JM, Harvey E, Oxman AD, Thomson MA: Getting research findings into practice: closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. BMJ: British Medical Journal 1998, 317(7156):465.
  • [24]Open comparisons (Öppna jämförelser). http://www.skl.se/vi_arbetar_med/oppnajamforelser/halso-_och_sjukvard_2/ojhs2010 webcite
  • [25]Langely GJ, Moen RD, Nolan KM, Nolan TW, Norman CL, Provost LP: The improvement guide. A practical approach to enhancing organizational performance. San Fransisco: Jossey-Bass; 2009.
  • [26]Peterson A, Carlhed R, Lindahl B, Linström G, Åberg C, Andersson Gare B, Bojestig M: Improving guidline adherence through intensive quality improvement and the Use of a national quality register in sweden for acute myocardial infarction. Qual Manag Health Care 2007, 16(1):25-37.
  • [27]Johnson JK, Barach PR: Quality improvement methods to study and improve the process and outcomes of pediatric cardiac care. Prog Pediatr Cardiol 2011, 32(2):147-153.
  • [28]Hettema JE, Hendricks PS: Motivational interviewing for smoking cessation: a meta-analytic review. J Consult Clin Psychol 2010, 78(6):868-884.
  • [29]Hurt RD, Ebbert JO, Hays JT, McFadden DD: Treating tobacco dependence in a medical setting. CA Cancer J Clin 2009, 59(5):314-326.
  • [30]Ellström P-E, Eklund J, Kock H, Lindström L, Melin U: Nowledge creation through collaborative research: an emerging model. Falun; Linköping: HSS-99 Conference, Falun; CMTO Research Papers, CMTO Linköping University; 1999.
  • [31]Dawson D, Endacott R: Implementing quality initiatives using a bundled approach. Intensive Crit Care Nurs 2011, 27(3):117-120.
  • [32]Soderlund LL, Madson MB, Rubak S, Nilsen P: A systematic review of motivational interviewing training for general health care practitioners. Patient Educ Couns 2011, 84(1):16-26.
  • [33]Johansson A, Halling A, Hermansson G, Ludvigsson J: Assessment of smoking behaviors in the home and their influence on children’s passive smoking: development of a questionnaire. Ann Epidemiol 2005, 15(6):453-459.
  • [34]Carlsson N, Alehagen S, Andersson Gare B, Johansson A: “Smoking in children’s environment test”: a qualitative study of experiences of a new instrument applied in preventive work in child health care. BMC Pediatr 2011, 11(1):113. BioMed Central Full Text
  • [35]Boldemann C, Gilljam H, Lund KE, Helgason AR: Smoking cessation in general practice: the effects of a quitline. Nicotine Tob Res 2006, 8(6):785-790.
  • [36]Tobacco-free children (Tobaksfria barn). http://www.fhi.se/PageFiles/7013/Tobaksfria_barn_webb.pdf webcite (In Swedish)
  • [37]Kennedy A, Sapsis KF, Stokley S, Curtis CR, Gust D: Parental attitudes toward human papillomavirus vaccination: evaluation of an educational intervention, 2008. J Health Commun 2011, 16(3):300-313.
  • [38]Vogt C, Schaefer M: Knowledge matters–impact of two types of information brochure on contraceptive knowledge, attitudes and intentions. Eur J Contracept Reprod Health Care 2012, 17(2):135-143.
  • [39]Andersson-Ellström A: Mödrahälsovård, sexuell och reproduktiv hälsa. Stockholm: Svensk förening för obstetrik och gynekologi; 2008.
  • [40]Ekström A, Widström A, Nissen E: Does continuity of care by well-trained breastfeeding counselors improve a mother’s perception of support? Birth 2006, 33(2):123-130.
  • [41]Jansson A, Petersson K, Uden G: Nurses’ first encounters with parents of new-born children–public health nurses’ views of a good meeting. J Clin Nurs 2001, 10(1):140-151.
  • [42]Øvretveit J, Bate P, Cleary P, Cretin S, Gustafson D, McInnes K, McLeod H, Molfenter T, Plsek P, Robert G: Quality collaboratives: lessons from research. Qual Saf Health Care 2002, 11(4):345-351.
  • [43]Nembhard IM: Learning and improving in quality improvement collaboratives: which collaborative features do participants value most? Heal Serv Res 2009, 44(2p1):359-378.
  • [44]Ayers LR, Beyea SC, Godfrey MM, Harper DC, Nelson EC, Batalden PB: Quality improvement learning collaboratives. Qual Manag Health Care 2005, 14(4):234-247.
  • [45]Benowitz NL: Cotinine as a biomarker of environmental tobacco smoke exposure. Epidemiol Rev 1996, 18(2):188-204.
  • [46]Rubak S, Sandbaek A, Lauritzen T, Christensen B: Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract 2005, 55(513):305-312.
  • [47]Robinson J, Kirkcaldy AJ: Disadvantaged mothers, young children and smoking in the home: mothers’ use of space within their homes. Health Place 2007, 13(4):894-903.
  • [48]Robinson J, Kirkcaldy AJ: ‘You think that I’m smoking and they’re not’: why mothers still smoke in the home. Soc Sci Med 2007, 65(4):641-652.
  • [49]Rosen LJ, Noach MB, Winickoff JP, Hovell MF: Parental smoking cessation to protect young children:a systematic review and meta-analysis. Pediatrics 2012, 129(1):141-152.
  • [50]Strecher VJ, Bauman KE, Boat B, Fowler MG, Greenberg R, Stedman H: The role of outcome and efficacy expectations in an intervention designed to reduce infants’ exposure to environmental tobacco smoke. Health Educ Res 1993, 8(1):137-143.
  • [51]Winickoff JP, Tanski SE, McMillen RC, Ross KM, Lipstein EA, Hipple BJ, Friebely J, Klein JD: Acceptability of testing children for tobacco-smoke exposure: a national parent survey. Pediatrics 2011, 127(4):628-634.
  • [52]Becker AB, Manfreda J, Ferguson AC, Dimich-Ward H, Watson WT, Chan-Yeung M: Breast-feeding and environmental tobacco smoke exposure. Arch Pediatr Adolesc Med 1999, 153(7):689-691.
  • [53]Donovan EF, Ammerman RT, Besl J, Atherton H, Khoury JC, Altaye M, Putnam FW, Van Ginkel JB: Intensive home visiting is associated with decreased risk of infant death. Pediatrics 2007, 119(6):1145-1151.
  • [54]Kuo AA, Inkelas M, Lotstein DS, Samson KM, Schor EL, Halfon N: Rethinking well-child care in the United States: an international comparison. Pediatrics 2006, 118(4):1692-1702.
  • [55]Greenhalgh T, Robert G, Bate P, Macfarlane F, Kyriakidou O: Diffusion of innovations in health service organisations. Malden, Massachusetts: Blackwell Publishing Ltd; 2005.
  • [56]Berlin A, Tornkvist L, Hylander I: Watchfully checking rapport with the primary child health care nurses - a theoretical model from the perspective of parents of foreign origin. BMC Nurs 2010, 9:14. BioMed Central Full Text
  • [57]Hadziabdic E, Heikkila K, Albin B, Hjelm K: Migrants’ perceptions of using interpreters in health care. Int Nurs Rev 2009, 56(4):461-469.
  • [58]Kale E, Syed HR: Language barriers and the use of interpreters in the public health services. A questionnaire-based survey. Patient Educ Couns 2010, 81(2):187-191.
  • [59]Flores G: The impact of medical interpreter services on the quality of health care: a systematic review. Med Care Res Rev 2005, 62(3):255-299.
  • [60]The Swedish health and medical services act. (Hälso- och sjukvårdslagen). (Hälso- och sjukvårdslagen); http://www.notisum.se/rnp/sls/lag/19820763.htm webcite (In Swedish)
  • [61]Yousey Y: Family attitudes about tobacco smoke exposure of young children at home. MCN Am J Matern Child Nurs 2007, 32(3):178-183.
  • [62]Walshe K: Understanding what works–and why–in quality improvement: the need for theory-driven evaluation. Int J Qual Health Care 2007, 19(2):57-59.
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