Grant Number:	4R01CA127127-10 Interpret this number
Primary Investigator:	Winickoff, Jonathan
Organization:	Massachusetts General Hospital
Project Title:	Changing Pediatric Office Systems Nationally to Address Parental Tobacco Use
Fiscal Year:	2016

DESCRIPTION (provided by applicant): The goal of this renewal application is to transform routine pediatric outpatient practice to assist parents quitting smoking in order to help eliminate tobacco use in families. In our Phase I RCT (R01-CA127127), framing the intervention from the practice perspective using the Chronic Care Model (Wagner) and the Prevention System (Solberg), we demonstrated dramatic office systems changes without additional resource added to practices, showing 14-fold increased rates of delivering tobacco control assistance in a practice-based research network, and justifying significant investment to disseminate nationally. The intervention included three key implementation steps to address parental smoking in the child healthcare setting: (1) motivational messaging; (2) proactive referral to quitlines; and (3) pharmacologic management of tobacco dependence. The intervention was recently named an "innovation in medicine" by AHRQ. In the proposed Phase II trial, in close collaboration with the American Academy of Pediatrics (AAP), the largest pediatrics professional organization in the United States, we will perform a two-arm RCT to address the critical unanswered questions of generalizability, sustainability, and cost- effectiveness of the intervention using a national 20-ste sample of pediatric practices. The Phase II intervention will be augmented to address key barriers identified in Phase 1 and to enhance generalizability and sustainability by: (1) including facilitated nicotine replacement delivery-compliant with new national Medicaid coverage standards and (2) including an innovative additional dissemination and sustainability component, developed with a separate NCI ARRA grant--an online, tailored, self-paced module where clinicians work on a full practice implementation over the course of several months of self study and hands-on improvement cycles. The module satisfies the new American Board of Pediatrics Maintenance of Certification Performance in Practice requirement creating a natural "pull" for the training. The Specific Aims include: " Aim 1. to implement and sustain adherence to evidence-based guidelines at the clinical level; " Aim 2. to facilitate behavior change among parents and evaluate cost per quit among parents who smoke; " Aim 3. to study systems changes and the processes that affect them at the practice level. Building on the success of Phase 1, the generalizable training systems to be studied in this application will enhance the adoption, implementation, and sustainability of the intervention, making it widely transportable throughout pediatric practice nationally and providing a critical return on decades of NIH investment in developing the evidence base for tobacco control. The project will have significant impact by yielding an effective, theoretically-based, rapidly disseminable, and sustainable strategy to address tobacco use in families through child healthcare settings in the United States.




Cost-effectiveness of a Smoking Cessation Intervention for Parents in Pediatric Primary Care.
Authors: Drouin O. , Sato R. , Drehmer J.E. , Nabi-Burza E. , Hipple Walters B. , Winickoff J.P. , Levy D.E. .
Source: Jama Network Open, 2021-04-01 00:00:00.0; 4(4), p. e213927.
EPub date: 2021-04-01 00:00:00.0.
PMID: 33792730
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Smoking Cessation Treatment for Parents Who Dual Use E-Cigarettes and Traditional Cigarettes.
Authors: Nabi-Burza E. , Drehmer J.E. , Walters B.H. , Willemsen M.C. , Zeegers M.P.A. , Winickoff J.P. .
Source: Journal Of Smoking Cessation, 2021; 2021, p. 6639731.
EPub date: 2021-03-17 00:00:00.0.
PMID: 34306227
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Innovations in parental smoking cessation assistance delivered in the child healthcare setting.
Authors: Nabi-Burza E. , Winickoff J.P. , Drehmer J.E. , Gorzkowski J.A. , Klein J.D. , Levy D.E. , Ossip D.J. , Regan S. , Rigotti N.A. , Hipple Walters B. .
Source: Translational Behavioral Medicine, 2020-10-08 00:00:00.0; 10(4), p. 1039-1052.
PMID: 31157864
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Smoking Cessation Treatment for Parents Who Are Light or Very Light Smokers in the Pediatric Setting.
Authors: Drehmer J.E. , Luo M. , Nabi-Burza E. , Walters B.H. , Winickoff J.P. .
Source: Academic Pediatrics, 2020-10-07 00:00:00.0; , .
EPub date: 2020-10-07 00:00:00.0.
PMID: 33035731
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Pediatric Office Delivery of Smoking Cessation Assistance for Breast-Feeding Mothers.
Authors: Drehmer J.E. , Ossip D.J. , Nabi-Burza E. , Hipple Walters B. , Gorzkowski J.A. , Winickoff J.P. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2020-03-16 00:00:00.0; 22(3), p. 346-353.
PMID: 30521040
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Parental Smoking and E-cigarette Use in Homes and Cars.
Authors: Drehmer J.E. , Nabi-Burza E. , Hipple Walters B. , Ossip D.J. , Levy D.E. , Rigotti N.A. , Klein J.D. , Winickoff J.P. .
Source: Pediatrics, 2019 Apr; 143(4), .
EPub date: 2019-03-11 00:00:00.0.
PMID: 30858346
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Guidance for the Clinical Management of Thirdhand Smoke Exposure in the Child Health Care Setting.
Authors: Drehmer J.E. , Walters B.H. , Nabi-Burza E. , Winickoff J.P. .
Source: Journal Of Clinical Outcomes Management : Jcom, 2017 Dec; 24(12), p. 551-559.
PMID: 29217965
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A Cross-sectional Study Of Happiness And Smoking Cessation Among Parents
Authors: Drehmer J.E. , Hipple B. , Ossip D.J. , Nabi-Burza E. , Winickoff J.P. .
Source: Journal Of Smoking Cessation, 2017 Mar; 12(1), p. 6-14.
PMID: 28163788
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Proactive enrollment of parents to tobacco quitlines in pediatric practices is associated with greater quitline use: a cross-sectional study.
Authors: Drehmer J.E. , Hipple B. , Nabi-Burza E. , Ossip D.J. , Chang Y. , Rigotti N.A. , Winickoff J.P. .
Source: Bmc Public Health, 2016-06-24 00:00:00.0; 16, p. 520.
EPub date: 2016-06-24 00:00:00.0.
PMID: 27342141
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Public support for raising the age of sale for tobacco to 21 in the United States.
Authors: Winickoff J.P. , McMillen R. , Tanski S. , Wilson K. , Gottlieb M. , Crane R. .
Source: Tobacco Control, 2016 May; 25(3), p. 284-8.
PMID: 25701856
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Clinician Telephone Training to Reduce Family Tobacco Use: Analysis of Transcribed Recordings.
Authors: Walters B.H. , Ossip D.J. , Drehmer J.E. , Nabi-Burza E. , Whitmore R. , Gorzkowski J. , Winickoff J.P. .
Source: Journal Of Clinical Outcomes Management : Jcom, 2016 Feb; 23(2), p. 79-86.
PMID: 29497272
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Overcoming challenges in the changing environment of practice-based research.
Authors: Finch S.A. , Wasserman R. , Nabi-Burza E. , Hipple B. , Oldendick R. , Winickoff J.P. .
Source: Annals Of Family Medicine, 2015 Sep; 13(5), p. 475-9.
PMID: 26371270
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Black versus white differences in rates of addressing parental tobacco use in the pediatric setting.
Authors: Dempsey J. , Regan S. , Drehmer J.E. , Finch S. , Hipple B. , Klein J.D. , Murphy S. , Nabi-Burza E. , Ossip D. , Woo H. , et al. .
Source: Academic Pediatrics, 2015 Jan-Feb; 15(1), p. 47-53.
PMID: 25528125
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The parent-child dyad and risk perceptions among parents who quit smoking.
Authors: Mahabee-Gittens E.M. , Collins B.N. , Murphy S. , Woo H. , Chang Y. , Dempsey J. , Weiley V. , Winickoff J.P. .
Source: American Journal Of Preventive Medicine, 2014 Nov; 47(5), p. 596-603.
PMID: 25201508
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Retail impact of raising tobacco sales age to 21 years.
Authors: Winickoff J.P. , Hartman L. , Chen M.L. , Gottlieb M. , Nabi-Burza E. , DiFranza J.R. .
Source: American Journal Of Public Health, 2014 Nov; 104(11), p. e18-21.
PMID: 25211755
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Sustainability of a parental tobacco control intervention in pediatric practice.
Authors: Winickoff J.P. , Nabi-Burza E. , Chang Y. , Regan S. , Drehmer J. , Finch S. , Wasserman R. , Ossip D. , Hipple B. , Woo H. , et al. .
Source: Pediatrics, 2014 Nov; 134(5), p. 933-41.
PMID: 25332492
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Enhancing the electronic health record to increase counseling and quit-line referral for parents who smoke.
Authors: Sharifi M. , Adams W.G. , Winickoff J.P. , Guo J. , Reid M. , Boynton-Jarrett R. .
Source: Academic Pediatrics, 2014 Sep-Oct; 14(5), p. 478-84.
PMID: 25169159
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Thirdhand smoke beliefs of parents.
Authors: Drehmer J.E. , Ossip D.J. , Nabi-Burza E. , Rigotti N.A. , Hipple B. , Woo H. , Chang Y. , Winickoff J.P. .
Source: Pediatrics, 2014 Apr; 133(4), p. e850-6.
PMID: 24590745
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Triple tobacco screen: opportunity to help families become smokefree.
Authors: Nabi-Burza E. , Winickoff J.P. , Finch S. , Regan S. .
Source: American Journal Of Preventive Medicine, 2013 Dec; 45(6), p. 728-31.
PMID: 24237914
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Strict smoke-free home policies among smoking parents in pediatric settings.
Authors: Ossip D.J. , Chang Y. , Nabi-Burza E. , Drehmer J. , Finch S. , Hipple B. , Rigotti N.A. , Klein J.D. , Winickoff J.P. .
Source: Academic Pediatrics, 2013 Nov-Dec; 13(6), p. 517-23.
PMID: 24238677
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Implementation of a parental tobacco control intervention in pediatric practice.
Authors: Winickoff J.P. , Nabi-Burza E. , Chang Y. , Finch S. , Regan S. , Wasserman R. , Ossip D. , Woo H. , Klein J. , Dempsey J. , et al. .
Source: Pediatrics, 2013 Jul; 132(1), p. 109-17.
PMID: 23796741
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Parent smoker role conflict and planning to quit smoking: a cross-sectional study.
Authors: Friebely J. , Rigotti N.A. , Chang Y. , Hall N. , Weiley V. , Dempsey J. , Hipple B. , Nabi-Burza E. , Murphy S. , Woo H. , et al. .
Source: Bmc Public Health, 2013-02-22 00:00:00.0; 13, p. 164.
EPub date: 2013-02-22 00:00:00.0.
PMID: 23433098
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Parents smoking in their cars with children present.
Authors: Nabi-Burza E. , Regan S. , Drehmer J. , Ossip D. , Rigotti N. , Hipple B. , Dempsey J. , Hall N. , Friebely J. , Weiley V. , et al. .
Source: Pediatrics, 2012 Dec; 130(6), p. e1471-8.
PMID: 23147972
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Pediatrician interventions and thirdhand smoke beliefs of parents.
Authors: Drehmer J.E. , Ossip D.J. , Rigotti N.A. , Nabi-Burza E. , Woo H. , Wasserman R.C. , Chang Y. , Winickoff J.P. .
Source: American Journal Of Preventive Medicine, 2012 Nov; 43(5), p. 533-6.
PMID: 23079177
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The Clinical Effort Against Secondhand Smoke Exposure (CEASE) Intervention: A Decade of Lessons Learned.
Authors: Winickoff J.P. , Hipple B. , Drehmer J. , Nabi E. , Hall N. , Ossip D.J. , Friebely J. .
Source: Journal Of Clinical Outcomes Management : Jcom, 2012 Jan; 19(9), p. 414-419.
PMID: 24379645
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Acceptability of testing children for tobacco-smoke exposure: a national parent survey.
Authors: Winickoff J.P. , Tanski S.E. , McMillen R.C. , Ross K.M. , Lipstein E.A. , Hipple B.J. , Friebely J. , Klein J.D. .
Source: Pediatrics, 2011 Apr; 127(4), p. 628-34.
PMID: 21422089
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Regulation of smoking in public housing.
Authors: Winickoff J.P. , Gottlieb M. , Mello M.M. .
Source: The New England Journal Of Medicine, 2010-06-17 00:00:00.0; 362(24), p. 2319-25.
PMID: 20554988
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Addressing Family Smoking in Child Health Care Settings.
Authors: Hall N. , Hipple B. , Friebely J. , Ossip D.J. , Winickoff J.P. .
Source: Journal Of Clinical Outcomes Management : Jcom, 2009 Aug; 16(8), p. 367-373.
PMID: 20448841
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Parental Dual Use of e-Cigarettes and Traditional Cigarettes.
Authors: Nabi-Burza E. , Regan S. , Walters B.H. , Drehmer J.E. , Rigotti N.A. , Ossip D.J. , Gorzkowski J.A. , Levy D.E. , Winickoff J.P. .
Source: Academic Pediatrics, 2019 Sep - Oct; 19(7), p. 842-848.
EPub date: 2019-04-11 00:00:00.0.
PMID: 30981026
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