Minimal intervention delivered by 2-1-1 information and referral specialists promotes smoke-free homes among 2-1-1 callers: a Texas generalisation trial

• Type of Material: Article
• Authors: Patricia Dolan Mullen, University of Texas; Lara S Savas, University of Texas; Łucja T Bundy, Emory University; Regine Haardoerfer, Emory University; Mel Hovell, San Diego State University; Maria E Fernandez, University of Texas; Jo Ann A Monroy, University of Texas; Rebecca S Williams, University of North Carolina Chapel Hill; Matthew W Kreuter, Washington University; David Jobe, United Way of Greater Houston; Michelle Kegler, Emory University
• Language: English
• Date: 2016-10-01
• Publisher: BMJ Publishing Group
• Publication Version: Final Published Version
• Copyright Statement: Published by the BMJ Publishing Group Limited.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1136/tobaccocontrol-2016-053045
• Title of Journal or Parent Work: Tobacco Control
• ISSN: 0964-4563
• Volume: 25
• Issue: Suppl 1
• Start Page: i10
• End Page: i18
• Grant/Funding Information: This publication was supported by the National Cancer Institute's State and Community Tobacco Control Research Initiative (grant number U01CA154282).
• Keywords: EXPOSURE; CANCER; Secondhand smoke; Prevention; HEALTH DISPARITIES; Environment; CESSATION; Public, Environmental & Occupational Health; SECONDHAND SMOKE; ENVIRONMENTAL TOBACCO-SMOKE; YOUNG-CHILDREN; PREGNANT-WOMEN; TRANSLATION; Life Sciences & Biomedicine; Science & Technology; Socioeconomic status; RANDOMIZED CONTROLLED-TRIAL
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health

Abstract

BACKGROUND: Replication of intervention research is reported infrequently, limiting what we know about external validity and generalisability. The Smoke Free Homes Program, a minimal intervention, increased home smoking bans by United Way 2-1-1 callers in randomised controlled trials in Atlanta, Georgia and North Carolina. OBJECTIVE: Test the programme's generalisability-external validity in a different context. METHODS: A randomised controlled trial (n=508) of English-speaking callers from smoking-discordant households (≥1 smoker and ≥1 non-smoker). 2-1-1 Texas/United Way HELPLINE call specialists serving the Texas Gulf Coast recruited callers and delivered three mailings and one coaching call, supported by an online tracking system. Data collectors, blind to study assignment, conducted telephone interviews 3 and 6 months postbaseline. RESULTS: At 3 months, more intervention households reported a smoke-free home (46.6% vs 25.4%, p<0.0001; growth model intent-to-treat OR=1.48, 95% CI 1.241 to 1.772, p<0.0001). At 6 months, self-reported full bans were 62.9% for intervention participants and 38.4% for controls (OR=2.19). Texas trial participants were predominantly women (83%), single-smoker households (76%) and African-American (65%); half had incomes ≤US$10 000/year (50%). Texas recruitment was <50% of the other sites. Fewer callers reported having a smoker in the household. Almost twice the callers with a household smoker declined interest in the programme/study. CONCLUSIONS: Our findings in a region with lower smoking rates and more diverse callers, including English-speaking Latinos, support programme generalisability and convey evidence of external validity. Our recruitment experience indicates that site-specific adjustments might improve recruitment efficiency and reach.