通过 2-1-1 向美国社会经济地位较低的家庭传播无烟家庭计划：全国影响评估结果。
Disseminating a Smoke-free Homes Program to Low Socioeconomic Status Households in the United States Through 2-1-1: Results of a National Impact Evaluation.
机构信息
Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA.
George Warren Brown School of Social Work, Washington University, St. Louis, MO.
出版信息
Nicotine Tob Res. 2020 Apr 17;22(4):498-505. doi: 10.1093/ntr/nty256.
INTRODUCTION
Given homes are now a primary source of secondhand smoke (SHS) exposure in the United States, 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 2 months post baseline.
RESULTS
A total of 2345 households (335-605 per 2-1-1 center) were enrolled by 2-1-1 staff. Most participants were female (82%) and 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 1148 smokers reached for follow-up, 211 people quit, an absolute reduction in smoking of 18.4% (p < .0001), with no differences by gender.
CONCLUSIONS
Among those reached for 2-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 SHS exposure, and increased cessation rates. Although the program delivery capacity demonstrated by these competitively selected 2-1-1s may not generalize to the broader 2-1-1 network in the United States, or social service agencies outside of the United States, 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 socioeconomic status populations in the United States.
简介
由于如今美国家庭已成为二手烟暴露的主要来源，应当在真实环境中对促进无烟家庭的经过研究验证的干预措施进行评估，以构建推广的证据基础。本研究描述了一项通过美国 2-1-1 求助热线增加无烟家庭规定的经研究验证的计划的传播和实施研究的结果评估。
方法
通过竞争性申请程序，选择了五个 2-1-1 组织，为每个组织提供了最高 70000 美元的赠款。2-1-1 工作人员招募参与者、提供干预措施并评估该计划。被招募参与该计划的 2-1-1 客户允许在家中吸烟，与吸烟者和不吸烟者或儿童同住，会说英语，年龄至少 18 岁。使用前后设计评估自我报告的结果，在基线后 2 个月进行随访。
结果
共有 2345 户家庭（每个 2-1-1 中心 335-605 户）由 2-1-1 工作人员招募。大多数参与者为女性（82%）和吸烟者（76%），其中一半为非裔美国人（54%）。总体而言，40.1%（n=940）报告创建了全面的家庭禁烟令。在随访时接触到的非吸烟成年人中（n=389），过去一周内接触二手烟的天数从 4.9（SD=2.52）减少到 1.2（SD=2.20）。在 1148 名随访的吸烟者中，211 人戒烟，绝对戒烟率为 18.4%（p<.0001），性别间无差异。
结论
在进行 2 个月随访的人群中，报告建立无烟家庭的比例与之前的对照研究中的无烟家庭率相当或更高。
意义
通过一项全国性赠款计划，由大学工作人员向五个 2-1-1 中心提供支持，传播了这种经过研究验证的干预措施，增加了家庭禁烟令，减少了二手烟暴露，并提高了戒烟率。虽然这些经过竞争性选择的 2-1-1 展示的计划实施能力可能无法推广到美国更广泛的 2-1-1 网络或美国以外的社会服务机构，但与 2-1-1 合作可能是在美国向社会经济地位较低的人群大规模推广这种无烟家庭计划和其他公共卫生计划的一个有前途的途径。
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