Parents Quit IT: Tailored Messaging and Decision Supports to Help Parents Quit Smoking in Pediatric Settings
Statement of Problem
Secondhand smoke exposure affects more than 40 percent of youth in the U.S., greatly increasing their risk of disease morbidity and mortality. Children are often exposed to secondhand smoke by their caregivers, so helping parents quit smoking is imperative to protecting children and families from the harms of tobacco.
For some families, bringing their children to the pediatrician is their only point of contact with the health care system. Therefore, pediatricians are uniquely positioned to intervene with intergenerational family services to better address those families’ unmet needs in order to improve the health of the child. Unfortunately, appropriate treatments are delivered to parent smokers less than three percent of the time.
Pediatric providers routinely delivering tobacco control to parents would provide a major intergenerational family service in the U.S., as tobacco use annually leads to 480,000 preventable deaths, including almost one-third of all cancer deaths, and $300 billion in tobacco-attributable costs. However, there is a lack of understanding of effective pediatrician-parent communication regarding tobacco cessation treatment and possibilities for interventions. A multidisciplinary research approach combining decision science and clinical informatics could maximize the effectiveness of such interventions while simplifying, standardizing and systematizing parental treatment for tobacco use in pediatric clinical practice.
Building upon preliminary work with the support of a multidisciplinary mentoring team, we’re launching a project to create and evaluate a novel intervention to provide caregiver-focused tobacco cessation services in pediatric settings. To aid pediatric providers in delivering tobacco treatment to caregivers, this study will create a clinical decision support (CDS) tool embedded within the electronic health record (EHR). Grounded in behavioral economics and informatics design methods, this research aims to accomplish several goals.
First, we will develop carefully framed messages using a theory-based approach in order to optimize initiation of tobacco cessation treatment for parent smokers who accompany their children for outpatient pediatric care. We suspect that framed messages that leverage parents’ concern for their child’s health and that are delivered by pediatric clinicians will increase the number of caregivers who start tobacco cessation treatment.
Second, we aim to develop a CDS system to effectively prompt clinicians to consistently deliver these framed messages for tobacco cessation treatment. Health systems would hopefully be able to feasibly incorporate evidence-based messaging to clinicians and parents into clinical practice using a CDS tool.
Finally, using the messages and CDS system developed in the first two sections of the study, we plan to conduct a pilot trial of an evidence-based intervention to improve parent tobacco cessation rates in preparation for a large-scale pragmatic trial. We hope that our messaging-based intervention will be feasible for clinicians and will increase cessation treatment initiation among caregivers.
The results from this study will build toward the development of a testable, theory-driven intervention that will open the door for future R01 grants supporting the testing of CDS interventions that address parent smoking in pediatric settings. These research efforts and associated training are aimed at the development of smoking cessation interventions, ultimately targeting vulnerable populations and that health systems could scale for broad population impact moving forward.
Children's Hospital of Philadelphia, PolicyLab. Parents Quit IT: Tailored Messaging and Decision Supports to Help Parents Quit Smoking in Pediatric Settings [Online]. Available at: http://www.policylab.chop.edu [Accessed: plug in date accessed here].