Pbert, L., Flint, A. J., Fletcher, K. E., Young, M. H., Druker, S., & DiFranza, J. R. (2008). Effect of a pediatric practice-based smoking prevention and cessation intervention for adolescents: A randomized, controlled trial. Pediatrics, 121 (4), e738-e747.
Air It Out
|Program Title||Air It Out|
|Purpose||Designed to promote smoking cessation and smoking prevention among adolescents. (2008)|
|Program Focus||Motivation, Smoking Cessation and Tobacco Use Prevention|
|Population Focus||Current Smokers and Non-smokers|
|Age||Adolescents (11-18 years)|
|Race/Ethnicity||American Indian, Asian, Black, not of Hispanic or Latino origin, Hispanic or Latino, White, not of Hispanic or Latino origin|
|Setting||Clinical, Home-based, Suburban, Urban/Inner City|
|Funded by||NCI (Grant number(s): R01CA8025401A1)|
|User Reviews||(Be the first to write a review for this program)|
- 26 hours of training for peer counselors
- Approximately 2-3 minutes for the provider-delivered component of the intervention, which is designed to be delivered during the course of a regularly scheduled clinical visit
- 15-30 minutes for the peer counseling session that takes place immediately after the provider component
- Four 10-minute booster telephone calls by peer counselors at 2, 6, 12, and 21 weeks after the initial clinical visit
- Air it Out Brochure
- Air it Out Quit Kit
A randomized clinical study evaluated the effects of a pediatric practice-based smoking prevention and cessation intervention for adolescents (aged 13 to 17) on tobacco abstinence rates at 6- and 12-month follow-ups. Eight pediatric primary care clinics were stratified by size and randomly assigned to either the Air it Out intervention or a usual care control condition. Providers in the usual care clinics received no Air it Out training or materials to provide to patients. All 13- to17-year-old patients scheduled for routine or acute care office visits were eligible to participate in the study, regardless of their smoking status. Study participants were recruited through letters on physicians' letterhead, telephone calls, and postings in the clinics. A research assistant met with interested adolescent patients at the clinic, and parental consent and youth assent were obtained. Because randomization occurred at the level of the practice, adolescent participants were not aware of group assignments, and providers only knew their clinic's assignment. Air it Out intervention clinics received a 1-hour group training session for providers (pediatricians, nurse practitioners, physician assistants, and pediatric residents), who practiced the intervention algorithm in pairs. Two to 4 weeks later, providers met individually with the project director for practice and feedback to ensure fidelity to the intervention algorithm. The algorithm was attached to each participating patient's medical chart. The intervention clinics were each assigned an older peer counselor who was recruited, trained, and paid hourly by the investigators to deliver a brief motivational interviewing counseling session after the provider component and conduct follow-up telephone sessions. The main outcome was the percentage of participating adolescents reporting cigarette smoking abstinence at the 6- and 12-month follow-ups. Adolescents were shown a carbon monoxide monitor and told that it might be used to confirm their self-reported smoking status. Abstinence was defined by one of the following reports: (1) never smoked cigarettes; (2) have smoked one or two puffs but not in the past year; or (3) have smoked in the past year but not in the past 30 days.
A total of 2,711 patients (aged 13 to 17) were recruited from 4,721 patients approached (recruitment rate of 57%); about 90% came from routine well clinic visits and 10% from acute care visits. Baseline data were available from 2,709 adolescents (1,344 in the intervention clinics and 1,365 in usual care clinics) who had an average age of 16.85 years. Fifty-four percent of the participants were female and 91% were White. The intervention clinics had more female and Hispanic participants and more individuals with attention deficit disorder/attention deficit with hyperactivity disorder compared with the usual care clinics. Providers in both the Air it Out and usual care clinics did not differ with respect to any baseline characteristics. They had an average age of 42 and expressed greater confidence in preventing cigarette smoking initiation than in aiding cessation.
At baseline, adolescent patients who reported never having smoked or having smoked one or two puffs but not in the past year were classified as nonsmokers, and those who reported smoking occasionally or regularly were classified as current smokers. Follow-up assessment rates were 99.6% (2,700) at the 6-month follow-up and 99.2% (2,690) at the 12-month follow-up. Participating smokers were less likely than nonsmokers to complete the final follow-up assessment.
- A higher percentage of baseline nonsmokers in the Air it Out intervention than usual care clinics were still abstinent at the 6-month (98.2% versus 96.5%, p=0.022) and 12-month (96.8% versus 95.5%, p=0.044) follow-ups.
- A higher percentage of baseline smokers in the Air it Out intervention than usual care clinics reported being abstinent at the 6-month follow-up (36.4% versus 24.6%, p=0.026). The percentage of baseline smokers reporting abstinence at the 12-month follow-up did not differ between the Air it Out intervention and usual care clinics (25.3% versus 27.7%, n.s.).
Please click on the related program(s) to review.
- They are by the same developer/investigator with the same theoretical basis, focus but have different materials that are designed for different target audiences.
Pbert,L.; Fletcher,K.E.; Flint,A.J.; Young,M.H.; Druker,S.; DiFranza,J. (2006). Smoking prevention and cessation intervention delivery by pediatric providers, as assessed with patient exit interviews. Pediatrics, 118 (3), e810-e824.
Fiore, M. C., Bailey, W. C., Cohen, S. J., Dorfman, S. F., Goldstein, M. G., Gritz, E., Wewers, M. E. (2000). Clinical practice guideline: Treating tobacco use and dependence. In Rockville, MD: U.S. Department of Health and Human Services, Public Health Service. (Ed.), 1-196.
Pierce, J. P., Choi, W. S., Gilpin, E. A., Farkas, A. J., & Merritt, R. K. (1996). Validation of susceptibility as a predictor of which adolescents take up smoking in the United States. Health Psychology, 15 (5), 355-361.
Wellman,R.J.; DiFranza,J.R.; Pbert,L.; Fletcher,K.E.; Flint,A.; Young,M.H.; Druker,S. (2006). A comparison of the psychometric properties of the hooked on nicotine checklist and the modified Fagerstrom tolerance questionnaire. Addiction Behaviors, 31 (3), 486-495.
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