Informing schools about children's chronic illnesses: parents' opinions

Parents of 217 chronically ill children and adolescents were surveyed concerning their opinions about disclosing medical information to schools. The sample consisted of parents of more than one third of the children and adolescents meeting inclusion criteria who were seen at a university-based pediatric clinic during a 10-week period. Parents were asked (1) whether schools need information about 16 health items, (2) who in the school should know, and (3) who should provide this information. Parents' willingness to disclose information was compared with family and child demographic data. Parents strongly believed that (1) teachers need to be informed and (2) parents should be the primary informers. The consensus that schools need information did not vary with family and child demographics. However, parents of children with poor illness prognosis, greater likelihood of emergencies, and visible illnesses were more supportive of disclosure. Most parents indicated that physicians should provide information on 10 of the 16 items. Physicians were viewed as particularly appropriate informers about recognizing emergencies and medication effects. Only 21% of the parents were aware of any prior contact between the medical care giver and the school concerning their child's illness. Thus, parents want schools informed and believe physicians should be involved in providing information.     

Detained Adolescents' Attitudes about Pregnancy and Parenthood.

INTRODUCTION: The purpose of this study was to examine attitudes and behaviors associated with parenthood and pregnancy among adolescents in the juvenile justice system. METHOD: A cross-sectional survey of attitudes and behaviors about parenthood was conducted with 300 adolescents residing in three juvenile detention centers. RESULTS: Data revealed high rates of risky behaviors that resulted in parenthood/pregnancy and generally positive attitudes about being an adolescent parent. Positive attitudes about parenthood (P = .000) and lower self-efficacy to not have sex (P = .021) were significantly correlated with having been pregnant or having fathered a child. Logistic regression showed positive attitudes about parenthood and the combination of drinking and driving together were significant predictors of pregnancy (P 相似文献   

Measuring parent attributes and supervision behaviors relevant to child injury risk: examining the usefulness of questionnaire measures

OBJECTIVE: This study aimed to identify self report questionnaire measures of parent attributes and behaviors that have relevance for understanding injury risk among children 2-5 years of age, and test a new Parent Supervision Attributes Profile Questionnaire (PSAPQ) that was developed to measure aspects of protectiveness and parent supervision. METHODS: Naturalistic observations were conducted of parents' supervision of children on playgrounds, with questionnaires subsequently completed by the parent to measure parent education, family income, parent personality attributes, attributes relevant to parent supervision, and beliefs about parents' control over the child's health status. These measures were then related to children's risk taking and injury history. RESULTS: Visual supervision, auditory supervision, and physical proximity were highly intercorrelated, indicating that parents employed all types of behaviors in service of supervision, rather than relying predominantly on one type of supervisory behavior. Physical proximity was the only aspect of supervision behavior that served a protective function and related to children's risk taking behaviors: parents who remained close to their children had children who engaged in less risk taking. On questionnaires, parents who reported more conscientiousness, protectiveness, worry about safety, vigilance in supervision, confidence in their ability to keep their child safe, and belief in control over their child's health had children who showed less risk taking and/or experienced fewer injuries. The new PSAPQ measure was associated with specific aspects of supervision as well as children's risk taking and injury history. CONCLUSIONS: This study reveals several parent attributes and behaviors with relevance for child injury risk that can be measured via self report questionnaires, including the new PSAPQ.     

Home, school, and neighborhood environment factors and youth physical activity

This study examined the contributions of home, school, and neighborhood factors related to youth physical activity (PA). Adolescents (ages 12-18; N = 137) and parents of younger children (ages 5-11; N = 104) from three US metropolitan areas completed surveys. Youth PA was estimated from six items assessing overall physical activity. Bivariate analyses between environment factors and PA were significant correlations in each environmental setting for adolescents (r's:0.16-0.28), but for parents of children, only for the home and neighborhood settings (r's: 0.14-0.39). For adolescents, pieces of equipment at home, family recreation membership, equipment at school, and neighborhood aesthetics explained 15.8% of variance in PA. For younger children (based on parent report), pieces of equipment at home, neighborhood traffic safety, walking/cycling facilities, and street connectivity explained 21.4% of the variance in PA. Modifiable factors like increasing access to equipment at home and school, and improving neighborhood aesthetics may impact youth PA. To optimize explanation of youth PA, factors from multiple environments need to be considered.     

Preventing conduct problems and improving school readiness: evaluation of the Incredible Years Teacher and Child Training Programs in high-risk schools

Background: School readiness, conceptualized as three components including emotional self‐regulation, social competence, and family/school involvement, as well as absence of conduct problems play a key role in young children's future interpersonal adjustment and academic success. Unfortunately, exposure to multiple poverty‐related risks increases the odds that children will demonstrate increased emotional dysregulation, fewer social skills, less teacher/parent involvement and more conduct problems. Consequently intervention offered to socio‐economically disadvantaged populations that includes a social and emotional school curriculum and trains teachers in effective classroom management skills and in promotion of parent–school involvement would seem to be a strategic strategy for improving young children's school readiness, leading to later academic success and prevention of the development of conduct disorders. Methods: This randomized trial evaluated the Incredible Years (IY) Teacher Classroom Management and Child Social and Emotion curriculum (Dinosaur School) as a universal prevention program for children enrolled in Head Start, kindergarten, or first grade classrooms in schools selected because of high rates of poverty. Trained teachers offered the Dinosaur School curriculum to all their students in bi‐weekly lessons throughout the year. They sent home weekly dinosaur homework to encourage parents’ involvement. Part of the curriculum involved promotion of lesson objectives through the teachers’ continual use of positive classroom management skills focused on building social competence and emotional self‐regulation skills as well as decreasing conduct problems. Matched pairs of schools were randomly assigned to intervention or control conditions. Results: Results from multi‐level models on a total of 153 teachers and 1,768 students are presented. Children and teachers were observed in the classrooms by blinded observers at the beginning and the end of the school year. Results indicated that intervention teachers used more positive classroom management strategies and their students showed more social competence and emotional self‐regulation and fewer conduct problems than control teachers and students. Intervention teachers reported more involvement with parents than control teachers. Satisfaction with the program was very high regardless of grade levels. Conclusions: These findings provide support for the efficacy of this universal preventive curriculum for enhancing school protective factors and reducing child and classroom risk factors faced by socio‐economically disadvantaged children.     

Violence risk and protective factors among youth held back in school.

OBJECTIVE: To identify risk and protective factors for violence perpetration among youth with a history of grade retention. DESIGN: Longitudinal analysis of in-home interviews of 13,781 adolescents in grades 7 through 12 conducted in 1995 and 1996. METHODS AND MEASURES: Serious interpersonal violence perpetration at time 2 by time 1 independent variables including measures of community and school context, family context, and individual characteristics. RESULTS: The 20% of girls and 28% of boys who had repeated 1 or more grades were more likely than those who had not to be in the top quintile of violence perpetration at time 2 (P <.001). For both girls and boys with a history of grade repetition, predictive risk factors with an odds ratio of 3 or greater (P <.001) included time 1 violence perpetration, violence victimization, weapon carrying, school problems, and alcohol and marijuana use. Although a high grade point average was a significant protective factor against violence perpetration for both girls (odds ratio, 0.36; P <.05) and boys (odds ratio, 0.23; P <.001), performance on a validated measure of verbal knowledge was not associated with violence perpetration over the study period. School connectedness, parent-family connectedness, and emotional well-being were also significant universal protectors against violence perpetration. CONCLUSIONS: Youth who are held back in school are at heightened risk for violence perpetration. Violence-related behaviors and substance use considerably increase the likelihood of this outcome. The findings suggest that schools can participate in violence prevention by providing youth with a positive community and academic experience.     

The association between health risk behaviors and sexual orientation among a school-based sample of adolescents

OBJECTIVE: This study is one of the first to examine the association between sexual orientation and health risk behaviors among a representative, school-based sample of adolescents. DESIGN: This study was conducted on an anonymous, representative sample of 4159 9th- to 12th-grade students in public high schools from Massachusetts' expanded Centers for Disease Control and Prevention 1995 Youth Risk Behavior Survey. Sexual orientation was determined by the following question: "Which of the following best describes you?" A total of 104 students self-identified as gay, lesbian, or bisexual (GLB), representing 2.5% of the overall population. Of GLB youth, 66.7% were male and 70% were white (not Hispanic). Health risk and problem behaviors were analyzed comparing GLB youth and their peers. Those variables found to be significantly associated with GLB youth were then analyzed by multiple logistic regression models. RESULTS: GLB youth were more likely than their peers to have been victimized and threatened and to have been engaged in a variety of risk behaviors including suicidal ideation and attempts, multiple substance use, and sexual risk behaviors. Four separate logistic regression models were constructed. Model I, Onset of Behaviors Before Age 13, showed use of cocaine before age 13 years as strongly associated with GLB orientation (odds ratio [OR]: 6.10; 95% confidence interval [CI] = 2.45-15.20). Early initiation of sexual intercourse (2.15; 10.6-4.38), marijuana use (1.98; 1.04-4.09), and alcohol use (1.82; 1.03-3.23) also was associated with GLB orientation. Model II, Lifetime Frequencies of Behaviors, showed that frequency of crack cocaine use (1.38; 1.06-1.79), inhalant use (1.30; 1.05-1.61), and number of sexual partners (1.27; 1.06-1.43) was associated with GLB orientation. Model III, Frequency of Recent Behaviors, showed smokeless tobacco use in the past 30 days (1.38; 1. 20-1.59) and number of sexual partners in the previous 3 months (1. 47; 1.31-1.65) were associated with GLB orientation. Model IV, Frequency of Behaviors at School, showed having one's property stolen or deliberately damaged (1.23; 1.08-1.40) and using marijuana (1.29; 1.05-1.59) and smokeless tobacco (1.53; 1.30-1.81) were associated with GLB orientation. Overall, GLB respondents engaged disproportionately in multiple risk behaviors, reporting an increased mean number of risk behaviors (mean = 6.81 +/- 4.49) compared with the overall student population (mean = 3.45 +/- 3.15). CONCLUSION: GLB youth who self-identify during high school report disproportionate risk for a variety of health risk and problem behaviors, including suicide, victimization, sexual risk behaviors, and multiple substance use. In addition, these youth are more likely to report engaging in multiple risk behaviors and initiating risk behaviors at an earlier age than are their peers. These findings suggest that educational efforts, prevention programs, and health services must be designed to address the unique needs of GLB youth.     

Adolescent Health Risk Behaviors: Parental Concern and Concordance Between Parent and Adolescent Reports

Objective

We investigated which adolescent health risk behaviors are of concern to parents generally, according to adolescent age, gender, and in the context of perceived risk. We compared adolescent and parent reports of the presence of health-risk behaviors and factors predicting agreement.

Adolescent and parent perceptions on youth participation in risk behavior research

OBJECTIVES: To assess and compare parent and adolescent views on the importance of risk behavior research and the need for parental consent and to identify predictors of views. DESIGN: Confidential survey. SETTING: Adolescent, general pediatrics clinics. PARTICIPANTS: Adolescents aged 14 to 17 years presenting alone (solo) or with a parent or guardian (paired) and parents or guardians. Of 265 eligible pairs (199 solo adolescents), 134 (93) had useable surveys. The proportion of females in the parent or guardian, paired adolescent, and solo adolescent groups was 92%, 59%, and 75%, respectively; and the proportion of African Americans in these groups was 67%, 69%, and 91%, respectively. MAIN OUTCOME MEASURES: Views on the importance of and requirement of parental consent for confidential risk behavior research. RESULTS: Most parents (98%), paired adolescents (99%), and solo adolescents (100%) believed confidential risk behavior research surveys with teenagers were important; greater than 90% of all groups believed surveys should be conducted. The proportion of parents, paired adolescents, and solo adolescents that endorsed requiring parental permission was 84%, 53%, and 19%, respectively. Parents were less likely to endorse requiring permission if they had confidential health concerns as teenagers and were more likely to endorse requiring permission if their child was younger or female, if they believed their child had sex, and if they were a parent vs a guardian. Adolescents were more likely to endorse requiring permission if they were younger, not African American, and had more educated parents. Adolescents presenting with parents were more likely to endorse requiring permission. CONCLUSIONS: Parents and adolescents believed risk behavior research with adolescents was important. Most parents believed parental permission is needed for participation. Compared with parents, fewer adolescents believed parental consent was necessary. It is not clear what effect requirement of parental permission would have on participation or validity. Further research is needed to elucidate views on adolescent risk behavior research.     

Multidimensional Poverty Among Adolescents in 38 Countries: Evidence from the Health Behaviour in School-aged Children (HBSC) 2013/14 Study

This study applied UNICEF’s Multiple Overlapping Deprivation Analysis (MODA) framework to adolescents (aged 11, 13 and 15) in 37 European countries and Canada using data from the 2013/14 Health Behaviour in School-aged Children survey. It is one of the first applications of MODA based entirely on data collected from adolescents themselves rather than from household reference persons on their behalf. Unlike most other multidimensional child poverty studies, the present analysis focuses on non-material, relational aspects of child poverty. Substantial cross-country variation was found in the prevalence of adolescent deprivations in nutrition, perceived health, school environment, protection from peer violence, family environment and information access. These single dimensions of poverty did not closely relate to national wealth and income inequality. However, when we looked at deprivation in three or more dimensions (i.e., multidimensional poverty), we found association with income inequality. In most countries, girls were at a higher risk of multidimensional poverty than boys. In addition, adolescents who lived with both parents in the household or reported higher family wealth were consistently less poor than other adolescents, in both single and multiple dimensions. The results of this study show the interconnectedness of social (family, school support) and psychological (health and violence) dimensions of poverty for adolescents in higher income countries. Children poor in the domains of family and school environment are also likely to be poor in terms of perceived health and protection from peer violence.     

Parent–Child Discrepancies in Perceived Parental Sacrifice and Achievement Motivation of Chinese Adolescents Experiencing Economic Disadvantage

Based on a sample of 275 intact Chinese families having at least one child aged 11 to 16 experiencing economic disadvantage in Hong Kong, the relationship between parent-adolescent discrepancies in perceived parental sacrifice and adolescent achievement motivation was examined. It was found that parents and adolescents had different perceptions of parental sacrifice, with adolescents perceived lower levels of parental sacrifice than did their parents. Although the effect size of father-adolescent discrepancy in perceived paternal sacrifice was greater than mother-adolescent discrepancy in perceived maternal sacrifice, results indicated that mother-adolescent discrepancy in perceived maternal sacrifice negatively predicted adolescent achievement motivation in poor Chinese families, whereas father-adolescent discrepancy in perceived paternal sacrifice did not. The present study is the first scientific study showing that parent–child discrepancy in perceived parental sacrifice influences achievement motivation of poor Chinese adolescents, which provides insight for researchers, youth counsellors, and family practitioners to give more attention to the dyadic interactions on resource allocation among Chinese family members experiencing economic disadvantage.     

Racial variation in self-labeled child abuse and associated internalizing symptoms among adolescents who are high risk

One thousand and ten Non-Hispanic White, African American, Hispanic, and Asian Pacific Islander youth who were high risk and receiving public sector services were interviewed regarding history of child emotional and physical abuse and current internalizing symptoms. The study examined whether race moderated the association between adolescents' reports of specific parent behaviors and their self-labeling as victims of abuse. The study also examined whether reports of parental behaviors or self-labeled abuse better predicted internalizing symptoms, and whether these associations differed by race. When reporting punitive parent behavior, Non-Hispanic White youth were more likely to describe themselves as abused compared to Asian Pacific Islanders. Reported punitive parental behaviors accounted for more variance in internalizing symptoms than did self-labeled abuse. Reports of parent behaviors were more strongly related to concurrent internalizing symptoms among ethnic minority youth than among Non-Hispanic White youth. Results are discussed in the context of cultural competence in identification of child abuse.     

Media and risky behaviors

Liliana Escobar-Chaves and Craig Anderson investigate two important trends among American youth and examine the extent to which the two trends might be related. First, the authors note that U.S. youth are spending increasing amounts of time using electronic media, with the average American youngster now spending one-third of each day with some form of electronic media. Second, the authors demonstrate that American adolescents are engaging in a number of unhealthful behaviors that impose huge societal costs. Escobar-Chaves and Anderson detail the extent of five critical types of adolescent health risk behaviors identified by the Centers for Disease Control and Prevention-obesity, smoking, drinking, sexual risk taking, and violence. Obesity, the authors note, has become an epidemic among America's young people. Cigarette smoking among adolescents is one of the ten leading health indicators of greatest government concern. Alcohol abuse and alcohol dependence are widespread problems among the nation's youth and are the source of the three leading causes of death among youth. More than 20 percent of American high school students have sexual intercourse for the first time before they reach the age of fourteen. And twelve- to twenty-year-olds perpetrated 28 percent of the single-offender and 41 percent of multiple-offender violent crimes in the United States in 2005. Escobar-Chaves and Anderson present and evaluate research findings on the influence of electronic media on these five risk behaviors among adolescents. Researchers, they say, have found modest evidence that media consumption contributes to the problem of obesity, modest to strong evidence that it contributes to drinking and smoking, and strong evidence that it contributes to violence. Research has been insufficient to find links between heavy media exposure and early sexual initiation. The authors note the need for more large-scale longitudinal studies that specifically examine the cumulative effects of electronic media on risky health behavior.     

Surveying adolescents: Focusing on positive development

Although risk behaviours can threaten healthy youth development, reducing risks alone is not sufficient to help youth successfully negotiate adolescence. Promoting protective factors that buffer risk, such as family and school connectedness, community engagement and positive peer support, are also important for helping youth to thrive. Since 1992, the Adolescent Health Surveys conducted by McCreary Centre Society (Vancouver, British Columbia) have monitored both risk behaviours and protective factors among high school students across British Columbia. They have shown that, contrary to media images and community perceptions, the majority of young people are not exposed to risk factors such as violence and abuse; most do not have unprotected sex, drink and drive, use illegal drugs or consider suicide. They have also documented key protective factors that are linked to lower rates of risk behaviours and more positive outcomes, even for youth who face unsafe environments, family problems and other stressors. The shift toward assessing and promoting protective factors is a major paradigm change in adolescent health care, and clinicians can be an important partner with families and schools to foster healthy youth development.     

Reducing adolescents' aggressive and hostile behaviors: randomized trial effects of a brief family intervention 4 years past baseline

OBJECTIVE: To examine the long-term effects of a brief family intervention on aggressive and hostile behaviors of adolescents in the general population. DESIGN: Randomized trial including 22 public schools assigned to the Iowa Strengthening Families Program or a control condition. Analyses supported sample representativeness and failed to show differential attrition effects 4 years after baseline. INTERVENTION: Seven-session intervention for parents and their sixth-grade children. MEASURES: The multi-informant, multimethod measures included independent observer ratings of adolescent aggressive and hostile behaviors in adolescent-parent interactions, family-member report of aggressive and hostile behaviors in those interactions, and adolescent self-report of aggressive and destructive conduct across settings. Data were collected during the 6th (preintervention and postintervention), 7th, 8th, and 10th grades. RESULTS: All measures showed a generally positive trend in intervention-control group differences over time. During 10th grade, significant intervention-control differences were found for adolescent self-report of aggressive and destructive conduct (P =. 01), with relative reduction rates ranging from 31.7% to 77.0%. Significant differences were shown for observer-rated aggressive and hostile behaviors in adolescent-parent interactions (P =.01); differences in family member reports of those behaviors were not significant. Supplemental analyses of both interactional behavior measures, specific to parent sex, indicated significant experimental group differences in interactions with mothers (P =.04 for both measures) but not with fathers. CONCLUSIONS: Brief family competency-training interventions designed for general populations can reduce aggressive and hostile behaviors in adolescents' interactions with parents and adolescent aggressive behaviors outside of the home setting. Thus, this type of intervention has important public health implications. Arch Pediatr Adolesc Med. 2000;154:1248-1257.     

School Readiness Coaching in the Pediatric Clinic: Latinx Parent Perspectives

BackgroundChildren who enter school developmentally ready for kindergarten are more likely to succeed academically, be healthy and lead productive lives. However, low-income and minority children often enter kindergarten behind their more affluent peers. Pediatric clinics, as trusted family partners, are well positioned to provide school readiness (SR) support.ObjectiveTo explore Latinx parent perceptions of a clinic-based SR coaching intervention using qualitative methods. Intervention was a 1-hour visit with an SR coach (bilingual community health worker trained to assess child SR, role model SR skills and provide educational tools and community resources).MethodsQualitative theme analysis of Latinx parent semistructured interviews completed 6 to 9 months after SR coaching intervention (June 2016–February 2017). Parent-child pairs received the SR coaching intervention (N = 74), postintervention interviews (N = 50) were completed, audio recorded, and transcribed. Iterative team-based coding and inductive thematic analysis of interviews were conducted.ResultsThree domains emerged and included the SR coaching model, community SR resources, and parent SR knowledge. Subthemes included 1) Parents valued the one-to-one SR coaching intervention, were receptive to coach recommendations and believed other parents would benefit from SR coaching; 2) Parents tried new early literacy activities with their child; 3) Despite positive intervention effects, parents lacked a comprehensive understanding of SR.ConclusionA brief clinic-based SR coaching intervention with a bilingual SR coach was well received by low-income Latinx parents and increased parent SR behaviors. Expanded implementation and further quantitative evaluation using school entry child-specific data are needed to quantify effects.     

Factors associated with bicycle helmet use among young adolescents in a multinational sample.

OBJECTIVE: To determine factors associated with variation in bicycle helmet use by youth of different industrialized countries. DESIGN: A multinational cross sectional nationally representative survey of health behaviors including symptoms, risk taking, school setting, and family context. SETTING: School based survey of 26 countries. SUBJECTS: School students, ages 11, 13, and 15 years totaling 112,843. OUTCOME MEASURES: Reported frequency of bicycle helmet use among bicycle riders. RESULTS: Reported helmet use varied greatly by country from 39.2% to 1.9%, with 12 countries reporting less than 10% of the bicycle riders as frequent helmet users and 14 countries more than 10%. Reported helmet use was highest at 11 years and decreased as children's age increased. Use was positively associated with other healthy behaviors, with parental involvement, and with per capita gross domestic product of the country. It is negatively associated with risk taking behaviors. Countries reported to have interventions promoting helmet use, exemplified by helmet giveaway programmes, had greater frequency of reported helmet use than those without programmes. CONCLUSIONS: Bicycle helmet use among young adolescents varies greatly between countries; however, helmet use does not reach 50% in any country. Age is the most significant individual factor associated with helmet for helmet using countries. The observation that some helmet promotion programmes are reported for countries with relatively higher student helmet use and no programmes reported for the lowest helmet use countries, suggests the possibility of a relation and the need for objective evaluation of programme effectiveness.     

Measuring family management of transplant tasks: The transplant responsibility questionnaire

Little is known about how parents and youth perceive their roles in post‐transplant management and how this relates to post‐transplant adherence. The goals of this study are to (1) describe a new measure, the TRQ, (2) to describe parent and child performance on the TRQ, and to (3) determine the relationship between the TRQ and adherence. We hypothesized that older youth would describe higher post‐transplant self‐care behaviors, parents would underestimate youth self‐care, and greater parent involvement would be associated with better adherence. Participants included 59 parent–child dyads. Inclusion criteria included: (i) youth aged 7–18 yr and (ii) at least three months post‐kidney or post‐liver transplant. Parents and youth completed the TRQ, and adherence was measured by s.d. of sequential immunosuppressant blood levels. Youth perceived greater levels of self‐care than their parents perceived. Older youth reportedly engaged in more self‐care than younger youth. Less than 25% of the sample was non‐adherent, and non‐adherence was unrelated to performance on the TRQ. The TRQ may have utility as a clinical tool to address areas for improvement in youth self‐care. The high degree of parental involvement likely explains the high degree of adherence in this sample.     

The Living Conditions of Children with Shared Residence – the Swedish Example

Among children with separated parents, shared residence – i.e., joint physical custody where the child is sharing his or her time equally between two custodial parents’ homes – is increasing in many Western countries and is particularly common in Sweden. The overall level of living among children in Sweden is high; however, the potential structural differences between children in various post-separation family arrangements have not been sufficiently studied. Potential risks for children with shared residence relate to the daily hassles and stress when having two homes. This study aims at investigating the living conditions of children with shared residence compared with children living with two custodial parents in the same household and those living with one custodial parent, respectively. Swedish national survey data collected from children aged 10–18 years (n ≈ 5000) and their parents were used. The outcomes were grouped into: Economic and material conditions, Social relations with parents and peers, Health and health behaviors, Working conditions and safety in school and in the neighborhood, and Culture and leisure time activities. Results from a series of linear probability models showed that most outcomes were similar for children with shared residence and those living with two custodial parents in the same household, while several outcomes were worse for children living with one parent. However, few differences due to living arrangements were found regarding school conditions. This study highlights the inequalities in the living conditions of Swedish children, with those living with one parent having fewer resources compared with other children.     

State-of-the-art interventions for office-based parental tobacco control

Parental tobacco use is a serious health issue for all family members. Child health care clinicians are in a unique and important position to address parental smoking because of the regular, multiple contacts with parents and the harmful health consequences to their patients. This article synthesizes the current evidence-based interventions for treatment of adults and applies them to the problem of addressing parental smoking in the context of the child health care setting. Brief interventions are effective, and complementary strategies such as quitlines will improve the chances of parental smoking cessation. Adopting the 5 A's framework strategy (ask, advise, assess, assist, and arrange) gives each parent the maximum chance of quitting. Within this framework, specific recommendations are made for child health care settings and clinicians. Ongoing research will help determine how best to implement parental smoking-cessation strategies more widely in a variety of child health care settings.