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A randomized trial of a family-based smoking prevention intervention in managed care
Susan J Curry1, Jack Hollis, Terry Bush
1Center for Health Studies, Group Health Cooperative, Seattle, WA, USA. suecurry@uic.edu
Insights
A family-based smoking prevention program for youth aged 10-12 did not reduce tobacco use. However, it did increase parent-child discussions about smoking, highlighting the importance of these conversations.
Area of Science:
- Public Health
- Adolescent Health
- Tobacco Control
Background:
- Youth tobacco use remains a significant public health concern, with declining initiation ages.
- Healthcare settings offer a unique opportunity to engage families in preventing youth tobacco use.
- This study assessed a smoking prevention intervention targeting parents and children (aged 10-12) within a managed care setting.
Purpose of the Study:
- To evaluate the effectiveness of a mailed, multi-component smoking prevention intervention for parents and children.
- To determine if the intervention reduces smoking susceptibility, experimentation, or use in adolescents.
- To assess the impact of the intervention on parent-child communication regarding smoking.
Main Methods:
- A randomized controlled trial with two arms: usual care versus the intervention package.
- The intervention included a mailed kit, telephone outreach, child materials, physician cues, and a parent newsletter.
- Outcomes (smoking susceptibility, experimentation, 30-day use) were measured via child surveys at 20-month follow-up.
Main Results:
- The study enrolled 4,026 families with an 88% follow-up response rate.
- The intervention showed no significant effect on primary outcomes of smoking susceptibility or use.
- A statistically significant, though modest, increase in parent-child discussions about smoking was observed.
Conclusions:
- A minimal-intensity, family-based smoking prevention program was ineffective in reducing youth tobacco use or susceptibility.
- Despite disappointing results, continued development of innovative tobacco prevention strategies is crucial.
- Parents and healthcare systems remain vital channels for delivering prevention messages to youth.
Background:
Each day more than 2000 youth under age 18 become daily smokers and the age of tobacco initiation has been going down. Health care settings can partner with families to encourage parent-child interactions that prevent youth tobacco use. This study evaluates a smoking prevention intervention package for parents and children (aged 10-12) provided through their managed care organization.
Methods:
A two-arm (usual care vs intervention) randomized trial was employed. The intervention included a mailed parental smoking prevention kit, outreach follow-up telephone calls to the parent by a health educator, child materials, medical record cues for physicians to deliver prevention messages, and parent newsletter. Outcome measures were susceptibility to smoking, experimentation with smoking, and smoking in the past 30 days as assessed by 20-month follow-up surveys of children.
Results:
A total of 4,026 families enrolled in the study. The response rate to the 20-month follow-up was 88%. There were no significant effects of the intervention on any of the primary outcomes. The intervention was associated with modest but statistically significant increases in parent-child discussions of smoking related topics.
Conclusions:
A minimal-intensity family-based prevention program did not significantly reduce rates of susceptibility or tobacco use among youth aged 10-12 at baseline and 11 to 14 at follow-up. Development and evaluation of innovative approaches to tobacco use prevention must continue, despite our disappointing results. Parents and health care systems are too important to abandon as channels for prevention messages.
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