Disseminating a Smoke Free Homes Program to Low SES Households in the US Through 2-1-1: Results of a
Thursday, January 3, 2019
Posted by: Natalia Gromov
Łucja T Bundy, Regine Haardörfer, Michelle C Kegler, Shadé Owolabi, Carla J Berg, Cam Escoffery, Tess Thompson, Patricia Dolan Mullen, Rebecca Williams, Mel Hovell, Tanya Kahl, Dayanne Harvey, Adrianne Price, Donnie House, Becky W Booker, Matthew W Kreuter.
Disseminating a Smoke Free Homes Program to Low SES Households in the US Through 2-1-1: Results of a National Impact Evaluation.
Nicotine & Tobacco Research, nty256, https://doi.org/10.1093/ntr/nty256
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. 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. 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. 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. 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.
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