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NAQC Newsroom: Research

The ONE Step Initiative: Quality Improvement in a Pediatric Clinic for Secondhand Smoke Reduction

Wednesday, November 13, 2013  
Posted by: Natalia Gromov
Bunik M, Cavanaugh KL, Herrick D, Mehner L, Venugopalakrishnan J, Crane LA, Puma J. Pediatrics. 2013 Aug;132(2):e502-11.

This study tested whether a quality improvement activity around smoking counseling led to changes in assessment of smoking history by medical staff as well as smoking or other behaviors affecting children’s secondhand smoke (SHS) exposure. The ONE Step intervention included training medical assistants and other health care providers to ask whether caregivers of pediatric patients smoke, advise caregivers to smoke outside and quit if ready, and refer smoking caregivers to the Colorado telephone QuitLine. The intervention also included electronic medical record prompts and required documentation regarding smoking. Change in rates of assessment of smoking were measured using chart review. Caregiver behavior change was assessed by an initial survey at baseline and follow-up survey by phone at 6 and 12 months from study entry. Results showed that 97% of caregivers reported discussions of SHS with providers was acceptable. 14% of smoking caregivers had quit at 6 months, and 13% had quit at 12 months. 63% and 70% of caregivers had reduced SHS exposure at 6 and 12 months respectively. The study authors conclude that ONE Step was feasible to deliver in a busy outpatient setting, acceptable to families, and appears to have resulted in decreased exposure to SHS among pediatric patients.

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