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Nicotine Tob Res. 2018 Dec 5. doi: 10.1093/ntr/nty256. [Epub ahead of print]

Disseminating a Smoke Free Homes program to low SES households in the US through 2-1-1: Results of a national impact evaluation.

Author information

1
Rollins School of Public Health, Emory University, Atlanta GA.
2
George Warren Brown School of Social Work, Washington University, St. Louis MO.
3
School of Public Health, University of Texas Health Sciences Center, Houston TX.
4
Gillings School of Global Public Health, Chapel Hill NC.
5
Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego CA.
6
Info Line, Akron OH.
7
Heart of Florida United Way, Orlando FL.
8
United Way 2-1-1, Cleveland OH.
9
Community Service Council, Tulsa OK.
10
United Ways of Alabama, Montgomery AL.
11
Brown School, Washington University, St. Louis MO.

Abstract

Introduction:

Given homes are now a primary source of secondhand smoke exposure (SHS) in the US, research-tested interventions that promote smoke-free homes should be evaluated in real-world settings to build the evidence-base for dissemination. This study describes outcome evaluation results from a dissemination and implementation study of a research-tested program to increase smoke-free home rules through US 2-1-1 helplines.

Methods:

Five 2-1-1 organizations, chosen through a competitive application process, were awarded grants of up to $70,000. 2-1-1 staff recruited participants, delivered the intervention, and evaluated the program. 2-1-1 clients who were recruited into the program allowed smoking in the home, lived in households with both a smoker and a nonsmoker or child, spoke English, and were at least 18 years old. Self-reported outcomes were assessed using a pre-post design, with follow-up at two-months post baseline.

Results:

2,345 households (335 to 605 per 2-1-1 center) were enrolled by 2-1-1 staff. Most participants were female (82%), smokers (76%), and half were African American (54%). Overall, 40.1% (n=940) reported creating a full household smoking ban. Among the nonsmoking adults reached at follow-up (n=389), days of SHS exposure in the past week decreased from 4.9 (SD=2.52) to 1.2 (SD=2.20). Among the 1,148 smokers reached for follow-up, 211 people quit, an absolute reduction in smoking of 18.4% (p<0.0001), with no differences by gender.

Conclusions:

Among those reached for two-month follow-up, the proportion who reported establishing a smoke-free home was comparable to or higher than smoke-free home rates in the prior controlled research studies.

Implications:

Dissemination of this brief research-tested intervention via a national grants program with support from university staff to five 2-1-1 centers increased home smoking bans, decreased secondhand smoke exposure, and increased cessation rates. While the program delivery capacity demonstrated by these competitively-selected 2-1-1s may not generalize to the broader 2-1-1 network in the US, or social service agencies outside of the US, partnering with 2-1-1s may be a promising avenue for large scale dissemination of this smoke-free homes program and other public health programs to low SES populations in the US.

PMID:
30517679
DOI:
10.1093/ntr/nty256

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