Brief Interventions to Create Smoke-Free Home Policies in Low-Income Households: Texas Effectiveness Trial (SFH)

The burden of tobacco use falls disproportionately on low-income populations, through high rates of primary smoking and exposure to secondhand smoke. The remarkable progress in creating smoke-free environments in the U.S over the past two decades has left smoker's homes as one of the primary sources of exposure to secondhand smoke for both children and nonsmoking adults. Intervention research that identifies effective and practical strategies for reaching the minority of households that still allow smoking in the home has considerable potential to reduce smoke exposure, but suitable channels to reach low-income families are limited.

The proposed research will systematically test an intervention designed to create smoke-free homes in low income households among 2-1-1 callers. During this randomized control trial, researchers will disseminate and evaluate a brief smoke-free homes intervention through the established infrastructure of a Texas 2-1-1 call center. 2-1-1 is a nationally designated 3-digit telephone exchange, similar to 9-1-1 for emergencies or 4-1-1 for directory assistance, that links callers to community-based health and social services. The main hypothesis to be tested is that a higher proportion of households in the intervention group will establish and maintain a smoke-free home than in the measures-only control group.

Study Overview

• Status: Completed
• Conditions: Chronic Disease
• Intervention / Treatment: Behavioral: Educational print materials and coaching call

• Study Type: Interventional
• Enrollment (Actual): 508
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Texas
    • Houston, Texas, United States, 77030
      • University of Texas School of Public Health

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Must be 18 years of age or older.
• Must speak and understand English.
• Must smoke and live with at least one other non-smoking person OR be a non-smoker who lives with a smoker(s).
• Must not have a total smoking ban in their home.

Exclusion Criteria:

• Participants who are in immediate crisis
• Participants who are calling to be transferred to the TIERS program
• Participants who are homeless or facing homelessness

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; Participant receives usual care.
Experimental: Intervention; Educational print materials and coaching call: Intervention group participants receive three sets of mailed educational materials about making their home smoke-free and once coaching call.	Behavioral: Educational print materials and coaching call; Intervention group participants receive three sets of mailed educational materials about making their home smoke-free and one coaching call.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Presence of a total home smoking ban	Change from baseline in reported total home smoking bans at 3-month and 6-month follow-up

Secondary Outcome Measures

Outcome Measure	Time Frame
Weekly secondhand smoke exposure for non-smokers	Change from baseline in reported secondhand smoke exposure for non-smokers at 3-month and 6-month follow-up
Cessation attempts (for smokers)	Change from baseline in reported cessation attempts (for smokers) at 3-month and 6-month follow-up
Number of cigarettes smoked (for smokers)	Change from baseline in reported number of cigarettes smoked (for smokers) at 3-month and 6-month follow-up
Stage of change to quit smoking (for smokers)	Change from baseline in stage of change to quit smoking (for smokers) at 3-month and 6-month follow-up
Cessation (for smokers)	Change from baseline in cessation (for smokers) at 3-month and 6-month follow-up

Collaborators and Investigators

• Sponsor: The University of Texas Health Science Center, Houston
• Collaborators: National Cancer Institute (NCI); Washington University School of Medicine; Emory University; University of North Carolina, Chapel Hill
• Investigators: Principal Investigator: Maria E Fernandez, PhD, The University of Texas Health Science Center, Houston; Principal Investigator: Patricia D Mullen, DrPH, The University of Texas Health Science Center, Houston; Principal Investigator: Lara Savas, PhD, The University of Texas Health Science Center, Houston; Study Director: Jo Ann A Gutierrez, MPH, The University of Texas Health Science Center, Houston

Publications and helpful links

General Publications

• Kegler MC, Escoffery C, Bundy L, Berg CJ, Haardorfer R, Yembra D, Schauer G. Pilot study results from a brief intervention to create smoke-free homes. J Environ Public Health. 2012;2012:951426. doi: 10.1155/2012/951426. Epub 2012 May 17.
• Escoffery C, Bundy L, Carvalho M, Yembra D, Haardorfer R, Berg C, Kegler MC. Third-hand smoke as a potential intervention message for promoting smoke-free homes in low-income communities. Health Educ Res. 2013 Oct;28(5):923-30. doi: 10.1093/her/cyt056. Epub 2013 May 13.
• Mullen PD, Savas LS, Bundy LT, Haardorfer R, Hovell M, Fernandez ME, Monroy JA, Williams RS, Kreuter MW, Jobe D, Kegler MC. Minimal intervention delivered by 2-1-1 information and referral specialists promotes smoke-free homes among 2-1-1 callers: a Texas generalisation trial. Tob Control. 2016 Oct;25(Suppl 1):i10-i18. doi: 10.1136/tobaccocontrol-2016-053045.

Study record dates

Study Major Dates

• Study Start: March 1, 2014
• Primary Completion (Actual): January 1, 2015
• Study Completion (Actual): November 1, 2015

Study Registration Dates

• First Submitted: March 24, 2014
• First Submitted That Met QC Criteria: March 24, 2014
• First Posted (Estimate): March 27, 2014

Study Record Updates

• Last Update Posted (Estimate): March 14, 2016
• Last Update Submitted That Met QC Criteria: March 11, 2016
• Last Verified: March 1, 2016

More Information

Terms related to this study

• Keywords: Environmental Tobacco Smoke; Secondhand smoke; Secondhand smoke exposure; Smoke-free homes; Smoke-free homes ban
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Chronic Disease
• Other Study ID Numbers: HSC-SPH-13-0902; U10CA154282-03