Grant Number:	5R01CA105183-05 Interpret this number
Primary Investigator:	Collins, Bradley
Organization:	Temple Univ Of The Commonwealth
Project Title:	Shs Treatment for Postpartum African American Smokers
Fiscal Year:	2008

DESCRIPTION (provided by applicant): More than 19 million children in the U.S. are exposed to second-hand smoke (SHS) on a daily basis. Infants are the most susceptible to SHS harm, and for children under five, SHS exposure causes more deaths than all unintentional childhood injuries combined. In response to Healthy People 2010 goals and NCI priorities, this trial aims to reduce infant SHS exposure in an under-served urban African American (AA) population while simultaneously promoting smoking cessation among the postpartum (Pp) mothers. The proposed 16-week trial, "Philadelphia FRESH (Family Rules for Establishing Smoke-free Homes)," will randomize 450 Pp mothers of children up to two years old into two treatment groups. Mothers randomized to the multimodal, individualized treatment (MIT) will receive 1.) pediatrician advice, 2.) two intensive, family-centered, in-home behavioral counseling sessions, 3.) a culturally-sensitive treatment manual mailed in four sections, biweekly starting week 1, and 4.) seven follow-up phone counseling sessions. Mothers in the standard care control (SCC) group will receive pediatrician assessment, advice, and one comprehensive self-help manual with information on SHS and its reduction, smoking cessation, and relapse prevention. We predict that through 12-month follow-up, the MIT group will demonstrate better infant SHS exposure and maternal smoking outcomes (measured by self-report, infant urine cotinine, and maternal saliva cotinine) than the SCC group. Our trial will also test the mediating influence of social support, perceived infant vulnerability to SHS, and negative affect on smoking outcomes by incorporating treatment components to boost and sustain natural maternal support systems, increase knowledge of SHS risks and benefits of SHS reduction, and improve mood management. We hypothesize that improvements in these variables will positively impact treatment outcome. Finally, our trial will test the moderating effects of baseline weight concerns and depression symptoms. We hypothesize a main effect for baseline weight concerns and depression on outcomes, as well as an interaction: moms with greater baseline weight concern and depression will have better outcomes in MIT compared to SCC. We will use GEE analysis to test hypothesized smoking behavior changes across baseline, 8-week, 16-week (EOT), 3-mo and 12-month follow-up time points and explore the influence of moderating variables. Path analysis will test mediating variables' influence on outcomes.




Long-term Results From the FRESH RCT: Sustained Reduction of Children's Tobacco Smoke Exposure.
Authors: Collins B.N. , Nair U.S. , DiSantis K.I. , Hovell M.F. , Davis S.M. , Rodriguez D. , Audrain-McGovern J. .
Source: American journal of preventive medicine, 2020 Jan; 58(1), p. 21-30.
EPub date: 2019-11-21.
PMID: 31759804
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Increasing Home Smoking Restrictions Boosts Underserved Moms' Bioverified Quit Success.
Authors: Collins B.N. , Nair U.S. , Davis S.M. , Rodriguez D. .
Source: American journal of health behavior, 2019-01-01; 43(1), p. 50-56.
PMID: 30522566
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The Influence of Health Messaging Source and Frequency on Maternal Smoking and Child Exposure among Low-Income Mothers.
Authors: Lavery A.M. , Nair U. , Bass S.B. , Collins B.N. .
Source: Journal of communication in healthcare, 2016; 9(3), p. 200-209.
EPub date: 2016-09-19.
PMID: 28729883
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Reducing Underserved Children's Exposure to Tobacco Smoke: A Randomized Counseling Trial With Maternal Smokers.
Authors: Collins B.N. , Nair U.S. , Hovell M.F. , DiSantis K.I. , Jaffe K. , Tolley N.M. , Wileyto E.P. , Audrain-McGovern J. .
Source: American journal of preventive medicine, 2015 Oct; 49(4), p. 534-44.
EPub date: 2015-05-28.
PMID: 26028355
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SHS-Related Pediatric Sick Visits are Linked to Maternal Depressive Symptoms among Low-Income African American Smokers: An Opportunity for Intervention in Pediatrics.
Authors: Collins B.N. , Nair U.S. , Shwarz M. , Jaffe K. , Winickoff J. .
Source: Journal of child and family studies, 2013 Oct; 22(7), p. 1013-21.
PMID: 24339721
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Factors associated with maternal depressive symptoms among low-income, African American smokers enrolled in a secondhand smoke reduction programme.
Authors: Shwarz M. , Collins B.N. , Nair U.S. .
Source: Mental health in family medicine, 2012 Dec; 9(4), p. 275-87.
PMID: 24294302
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Pediatric Secondhand Smoke Exposure: Moving Toward Systematic Multi-Level Strategies to Improve Health.
Authors: Collins B.N. , Ibrahim J. .
Source: Global heart, 2012 Jul; 7(2), p. 161-165.
PMID: 24040587
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Longer previous smoking abstinence relates to successful breastfeeding initiation among underserved smokers.
Authors: Collins B.N. , DiSantis K.I. , Nair U.S. .
Source: Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, 2011 Dec; 6(6), p. 385-91.
EPub date: 2011-01-21.
PMID: 21254795
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Proactive recruitment predicts participant retention to end of treatment in a secondhand smoke reduction trial with low-income maternal smokers.
Authors: Collins B.N. , Wileyto E.P. , Hovell M.F. , Nair U.S. , Jaffe K. , Tolley N.M. , Audrain-McGovern J. .
Source: Translational behavioral medicine, 2011 Sep; 1(3), p. 394-9.
PMID: 24073063
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Residential smoking restrictions are not associated with reduced child SHS exposure in a baseline sample of low-income, urban African Americans.
Authors: Collins B.N. , Ibrahim J.K. , Hovell M. , Tolley N.M. , Nair U.S. , Jaffe K. , Zanis D. , Audrain-McGovern J. .
Source: Health, 2010 Nov; 2(11), p. 1264-1271.
PMID: 23875066
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Associations among breastfeeding, smoking relapse, and prenatal factors in a brief postpartum smoking intervention.
Authors: Disantis K.I. , Collins B.N. , McCoy A.C.S. .
Source: Acta obstetricia et gynecologica Scandinavica, 2010; 89(4), p. 582-586.
PMID: 20235894
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Smoking-related weight concerns among underserved, black maternal smokers.
Authors: Collins B.N. , Nair U. , Hovell M.F. , Audrain-McGovern J. .
Source: American journal of health behavior, 2009 Nov-Dec; 33(6), p. 699-709.
PMID: 19320618
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Pediatric otolaryngologists' actions regarding secondhand smoke exposure: pilot data suggest an opportunity to enhance tobacco intervention.
Authors: Mueller D.T. , Collins B.N. .
Source: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2008 Sep; 139(3), p. 348-52.
PMID: 18722210
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Pediatricians' practices and attitudes about environmental tobacco smoke and parental smoking.
Authors: Collins B.N. , Levin K.P. , Bryant-Stephens T. .
Source: The Journal of pediatrics, 2007 May; 150(5), p. 547-52.
PMID: 17452234
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