Hovell Melbourne F, Meltzer Susan B, Wahlgren Dennis R, Matt Georg E, Hofstetter C Richard, Jones Jennifer A, Meltzer Eli O, Bernert J Thomas, Pirkle James L
Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California 92123, USA.
Pediatrics. 2002 Nov;110(5):946-56. doi: 10.1542/peds.110.5.946.
This study tested the efficacy of coaching to reduce environmental tobacco smoke (ETS) exposure among asthmatic Latino children.
After asthma management education, families were randomly assigned to no additional service (control condition) or to coaching for ETS exposure reduction (experimental condition).
The study was conducted in San Diego, California.
Two hundred four Latino children (ages 3-17 years) with asthma participated.
Approximately 1.5 hours of asthma management education was provided; experimental families also obtained 7 coaching sessions ( approximately 45 minutes each) to reduce ETS exposure.
Reported ETS exposure and children's urine cotinine were measured.
Parents in the coached condition reported their children exposed to significantly fewer cigarettes than parents of control children by 4 months (postcoaching). Reported prevalence of exposed children decreased to 52% for the coached families, but only to 69% for controls. By month 4, mean cotinine levels decreased among coached and increased among control children. Cotinine prevalence decreased from 54% to 40% among coached families, while it increased from 43% to 49% among controls. However, cotinine levels decreased among controls to the same level achieved by coached families by the 13-month follow-up.
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.
本研究测试了指导干预对于减少患有哮喘的拉丁裔儿童接触环境烟草烟雾（ETS）的效果。
在进行哮喘管理教育后，家庭被随机分配至不接受额外服务（对照条件）或接受减少ETS接触指导（实验条件）。
该研究在加利福尼亚州圣地亚哥进行。
204名患有哮喘的拉丁裔儿童（年龄3至17岁）参与了研究。
提供了约1.5小时的哮喘管理教育；实验组家庭还接受了7次指导课程（每次约45分钟）以减少ETS接触。
测量报告的ETS接触情况以及儿童尿液中的可替宁水平。
接受指导的实验组家庭的家长报告，在指导干预4个月后（指导后），他们的孩子接触香烟的数量明显少于对照组家庭的孩子。报告显示，接受指导的家庭中接触香烟的儿童患病率降至52%，而对照组仅降至69%。到第4个月时，接受指导的儿童的可替宁平均水平下降，而对照组儿童的可替宁平均水平上升。接受指导的家庭中可替宁患病率从54%降至40%，而对照组则从43%升至49%。然而，在13个月的随访中，对照组儿童的可替宁水平下降至与接受指导的家庭相同的水平。
哮喘管理教育加指导干预比单纯教育更能减少ETS接触，且接受指导干预组的减少效果可能持续约一年。文中讨论了对照组可替宁水平延迟下降的情况。
