AbstractBackground: The socio-structural barriers for reducing secondhand smoke exposure (SHSe) among children with asthma may be insurmountable for low-income caregivers. Health promoting financial incentives (HPFIs) are increasingly being used in the adult population to motivate and sustain tobacco-reduction behaviors. We assessed barriers to SHSe reduction and means to overcome them through the design of an HPFI-based, caregiver-targeted SHSe reduction study. Methods: Using a mixed-methods design, we conducted semi-structured in-depth interviews among low-income primary caregivers of children with asthma residing in Baltimore City. Quantitative data using an online survey were used to augment interview findings. Results: Home smoking restrictions were a frequently referenced strategy for decreasing SHSe, but interviewees (n = 22) described the complex social pressures that undermine reduction efforts. Caregivers redirected conversations from broadly implemented smoking bans towards targeted reduction s...
Introduction: Financial incentives can support smoking cessation, yet low acceptability may limit the wider implementation of such schemes. Few studies have examined how smokers view financial-incentive interventions aimed at reducing smoking prevalence. Methods: We recruited a sample of 623 smokers from an internet panel to a survey assessing support for, and perceived effectiveness of, financial incentives for smoking cessation. We used descriptive statistics, plus logistic regression, to test...
Last. Lori Pbert(UMMS: University of Massachusetts Medical School)H-Index: 42
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Importance While the proportion of adults who smoke cigarettes has declined substantially in the past decade, socioeconomic disparities in cigarette smoking remain. Few interventions have targeted low socioeconomic status (SES) and minority smokers in primary care settings. Objective To evaluate a multicomponent intervention to promote smoking cessation among low-SES and minority smokers. Design, Setting, and Participants For this prospective, unblinded, randomized clinical trial conducted betwe...
Health incentive schemes aim to produce healthier behaviors in target populations. They may do so both by making incentivized options more salient and by making them less costly. Changes in costs o ...
#2C. Jean Ogborn(JHUSOM: Johns Hopkins University School of Medicine)H-Index: 4
Last. Arlene M. Butz(JHUSOM: Johns Hopkins University School of Medicine)H-Index: 27
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Abstract Background Disadvantaged minority children are disproportionately affected by asthma. This group is also known to frequently use the emergency department (ED) for asthma care. Understanding decisions for use of the ED is important to prevent high cost. Objective To examine caregiver factors associated with the decision to use the ED for asthma care in inner-city children with asthma. Methods One hundred fifty participants in a randomized clinical trial testing the effectiveness of a hom...
Abstract Background It is not known whether large financial incentives enhance long-term smoking cessation rates outside clinical or workplace settings. Objectives The goal of this study was to test whether large financial incentives improved long-term smoking cessation rates in low-income smokers, in a general population setting, without face-to-face or telephone counseling. Methods This was a 2-arm, parallel group, individually randomized controlled trial, with follow-up after 3, 6, and 18 mon...
#1Lara J. Akinbami(USPHS: United States Public Health Service)H-Index: 33
#2Alan E. Simon(CDC: Centers for Disease Control and Prevention)H-Index: 21
Last. Lauren M. Rossen(CDC: Centers for Disease Control and Prevention)H-Index: 22
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BACKGROUND: Childhood asthma prevalence doubled from 1980 to 1995 and then increased more slowly from 2001 to 2010. During this second period, racial disparities increased. More recent trends remain to be described. METHODS: We analyzed current asthma prevalence using 2001–2013 National Health Interview Survey data for children ages 0 to 17 years. Logistic regression with quadratic terms was used to test for nonlinear patterns in trends. Differences between demographic subgroups were further ass...
Background: Government interventions are critical to addressing the global tobacco epidemic, a major public health problem that continues to deepen. We systematically synthesize research evidence on the effectiveness of government tobacco control policies promoted by the Framework Convention on Tobacco Control (FCTC), supporting the implementation of this international treaty on the tenth anniversary of it entering into force. Methods: An overview of systematic reviews was prepared through syste...
Secondhand smoke (SHS) exposure among children is associated with a wide variety of adverse health risks, including: asthma, otitis media, respiratory infections, impaired lung growth and function, decreased exercise tolerance, cognitive impairments, behavior problems, and sudden infant death syndrome. Unfortunately, over 40% of children aged 3–11 years—15.1 million children—are currently exposed to SHS, with nearly 70% of black children in this age group being exposed. Over the past three decad...
BackgroundFinancial incentives promote many health behaviors, but effective ways to deliver health incentives remain uncertain. MethodsWe randomly assigned CVS Caremark employees and their relatives and friends to one of four incentive programs or to usual care for smoking cessation. Two of the incentive programs targeted individuals, and two targeted groups of six participants. One of the individual-oriented programs and one of the group-oriented programs entailed rewards of approximately $800 ...
#1Arlene M. Butz(JHUSOM: Johns Hopkins University School of Medicine)H-Index: 27
#2Jean Ogborn(JHUSOM: Johns Hopkins University School of Medicine)H-Index: 5
Last. Mary E. Bollinger(UMB: University of Maryland, Baltimore)H-Index: 22
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Abstract Background One goal of guideline-based asthma therapy is minimal use of short-acting β 2 agonist (SABA) medications. Inner-city children with asthma are known to have high SABA use. Objective To examine factors associated with high SABA use in inner-city children with asthma. Methods One hundred inner-city children with persistent asthma were enrolled into a randomized controlled trial of an emergency department (ED) and home intervention. All children underwent serologic allergen speci...
Last. Arlene Butz(Johns Hopkins University)H-Index: 28
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Background The primary aim was to evaluate the efficacy of financial incentives for reducing paediatric tobacco smoke exposures (TSEs) through motivating cigarette usage reduction among low-income maternal caregivers and members of their social network. Design Randomised control pilot trial over a 6-month study follow-up time period. The study was undertaken from May 2017 to -May 2018. Once monthly follow-up visits occurred over the 6-month study period. Setting Baltimore City, Maryland, USA. Pa...
Last. Arlene Butz(Johns Hopkins University)H-Index: 28
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(1) Background: Monthly variability in smoking behaviors in caregivers of pediatric asthmatics yields questions of how much and when does smoking reduction result in improved environmental and clinical outcomes. (2) Methods: Post hoc analysis of data from a 6 month pilot randomized-control trial occurring from May 2017 to May 2018 in Baltimore City (MD, USA). The initial trial’s primary intervention explored the utility of financial incentives in modifying caregiver smoking behaviors. Post hoc a...
Last. David W. Sosnowski(VCU: Virginia Commonwealth University)H-Index: 3
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INTRODUCTION: Compared to the general smoking population, low-income smokers face elevated challenges to success in evidence-based smoking cessation treatment. Moreover, their children bear increased disease burden. Understanding behavioral mechanisms related to successful reduction of child tobacco smoke exposure (TSE) could inform future smoking interventions in vulnerable, underserved populations. METHODS: Smoking parents were recruited from pediatric clinics in low-income communities and ran...
AbstractObjective: Considering that unknown psychopathology might play a role in the management of pediatric asthma, this study examines how self-esteem and psychosocial family environment (child-r...