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Reducing Environmental Tobacco Smoke in Latino Children

Institution: San Diego State University Research Foundation
Investigator(s): Terry Conway, Ph.D.
Award Cycle: 1997 (Cycle 6) Grant #: 6PT-2002H Award: $1,085,128
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Integrated Research Project
Abstracts

Initial Award Abstract
Environmental Tobacco Smoke (ETS) has been associated with a variety of illnesses in children, including increased rates of respiratory illness, middle ear infections, decreased lung function, asthma, and Sudden Infant Death Syndrome. Reducing children's exposure to ETS would have an enormous impact not only on the health of exposed children, but also on the economic costs associated with increased health care expenditures. Many children, however, continue to be exposed to ETS in the home, often by smoking parents or relatives who may not fully realize the possible harm to their children. Previous studies have identified different levels and types of ETS exposure among subgroups of the U.S. population. Less educated and lower income groups are likely to be at greatest risk for smoking and ETS exposure. Young Latino children may be especially likely to be at high risk for ETS exposure, as having low income is a well-replicated risk factor for smoking and a substantial portion of Latinos in San Diego county live in low income households. Furthermore, a recent survey in San Diego County found that 43% of Latinos reported having either no restrictions or only a partial ban on smoking inside their homes.

The primary goal of this research is to evaluate a behavioral problem-solving approach, based on operant and social learning theory, to reduce ETS exposure among young Latino children identified through the Head Start program of San Diego County. Intervention efforts will be directed toward a key member (e.g., the mother) of the household in which the child lives, and this person will be guided by trained promotoras to do problem solving aimed at lowering the target child's exposure to ETS from all sources in the household. The promotoras will be bicultural and bilingual members identified from the local Latino community.

This longitudinal study has a 2 x 4 mixed design, with one betweenď·“groups factor (intervention vs. measurement-only control) and one repeated measures factor with four assessments made over approximately a 17-month period (baseline, one week post intervention, 6 months and 12 months post intervention). Participants (n=300) will be randomly assigned either to the control group or to receive the 6-session intervention. The intervention sessions will involve behavioral problem-solving techniques such as contracting, shaping, positive reinforcement, and stimulus cues to assist the household contact in achieving ETS reduction goals. Reports of the child's exposure to ETS in the home and urine cotinine levels, collected at all four assessments, will serve as the primary dependent variables.

The present proposal stems logically from our previous and ongoing studies of ETS and tobacco control in general. In addition, much of our experience with tobacco control studies and community-based research has focused specifically on Latino populations. This experience has taught us the need for culturally-specific attention to tobacco control in this population and the promising use of promotoras as a means of facilitating lasting change in tobacco use, including ETS exposure to children. The research team assembled to this end brings much expertise both in ETS exposure reduction and in Latino health promotion.
Publications

Intervention to Reduce ETS Exposure in Latino Children: Null Effects on Hair Biomarkers and Parents Reports (2004)
Periodical: Tobacco Control Index Medicus:
Authors: Conway, T.L., Woodruff, S.I., Edwards, C.C., Hovell, M.F., & Klein, J. ART
Yr: 2004 Vol: Nbr: Abs: Pg:

Acceptability and validity of hair collection from Latino Children to assess exposure to environmental tobacco smoke (2003)
Periodical: Nicotine and Tobacco Research Index Medicus:
Authors: Woodruff, S.I., Conway, T.L., Woodruff, S.I., & Edwards C.C. ABS
Yr: 2003 Vol: 5 Nbr: 3 Abs: Pg: 375-385