Author: Mak, Yim-wah
Title: Telephone-based proactive smoking cessation intervention for parents of young children : a randomized controlled trial
Degree: Ph.D.
Year: 2005
Subject: Hong Kong Polytechnic University -- Dissertations
Smoking cessation programs -- China -- Hong Kong
Tobacco habit -- China -- Hong Kong -- Prevention
Youth -- China -- Hong Kong -- Tobacco use
Department: School of Nursing
Pages: xxv, 311, [41] leaves ; 30 cm
Language: English
Abstract: This was a randomized controlled trial (RCT) to compare the effectiveness of a proactive telephone-based counseling program based on Prochaska's transtheoretical model of behavior change together with educational materials to help smoking parents of young children to quit. Smoking parents of young children were randomized into two groups: intervention group received printed self-help materials and three-session telephone-based smoking cessation counseling delivered by trained counselors; control group received printed self-help materials only. The smoking cessation telephone interview guidelines and counseling protocol were developed and used as a reference for the counselors as the empirical and theoretical basis of the interviews and smoking cessation counseling. A set of structured questionnaire was developed and validated for data collection at baseline and at 1, 3 and 6 month follow up. The overall psychometric properties of the questionnaires were good, with content validity index of 0.94, internal consistency from 0.60-0.86 and test-retest reliability, intra class correlation coefficient at 0.69-1.0. Significant agreement of self-reported smoking status with expired CO concentration (kappa at 0.70) and spousal validation were found. Of the 1,420 eligible parents contacted, 1,149 parents (80.9%) completed the proactive telephone interview. A total of 952 smoking parents agreed to take part in the trial, with 467 parents were randomized in the intervention group and 485 in the control group. The majority of the smoking parents were daily smokers (n=880, 92.4%), and 808 (85.9%) of them smoked at home. The mean number of cigarettes smoked per day was 14.5. At the baseline measure, most parents (67.9%) were at the 'pre-contemplation' stage based on Prochaska's model of behavior change. By the end of the 6-month intervention period, 87.8% adhered to the trial. Using analysis by the 'intention to treat' principle, the 7-day point prevalence quit rate at the 6-month follow-up was statistically significantly higher in the intervention group (17.6%, 82/467) than the control group (10.5%, 51/485) (p<0.005). The absolute risk reduction was 7.1% (95% CI: 2.7-11.5%). The number needed to treat to get one additional smoker to quit was 14 (95% CI: 9 to 37). The odds ratio of quitting was 1.8 (95% CI: 1.2-2.6), adjusted for age, number of years smoked, alcohol dependency and marital locus of control. A stepwise logistic regression model identified the significant predictors of quitting as being randomized to the intervention group, being at the 'action stage' at baseline, smoking 10 or fewer cigarettes daily in the previous month, having the index child with frequent morning cough, and having confidence in one's ability to quit. In this study, a counseling protocol that is essential for counselors in smoking cessation was developed, the psychometric properties of the questionnaires was established, as well as the validity of the spousal proxy reports and biochemical validations of smoking status. The findings show that this proactive telephone counseling has been accepted and effective in helping smoking parents of young children to quit in Hong Kong.
Rights: All rights reserved
Access: open access

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