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Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 14.2: Smoking in the Household

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Strategy. Telephone Counseling + Education Materials

Approach. Provide telephone counseling + educational materials to reduce children’s exposure to secondhand smoke in the home.

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Overview. Research indicates that using tobacco smoke quit lines, 2-1-1 call centers, or other programs that provide telephone counseling and educational materials to establish a home smoking ban and/or quit or reduce smoking can be effective. Examples of studies with positive outcomes used a variety of educational materials (e.g., a guide to establishing a smoke-free home; materials based on parent’s “stage of change”), and one or more coaching calls with trained counselors.1-4

Evidence. Moderate. Research has consistently showed positive results for this strategy. The strategy of using telephone-based counseling + educational materials to reduce children’s exposure to secondhand smoke in the home has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Parents/caregivers.

Outcome. Establishment of a household smoking ban; Reduction or cessation of cigarette consumption. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. There are currently 2 ESMs across all states/jurisdictions that align with components of this intervention strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Provide telephone counseling + educational materials to reduce children’s exposure to secondhand smoke in the home,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of parents/caregivers who receive telephone counseling and education materials on how to establish a smoke-free home.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of parents/caregivers who receive telephone counseling and education materials on how to establish a smoke-free home.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of parents/caregivers who report increased understanding of how to create a smoke-free home.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of parents/caregivers who report implementing a household smoking ban.
  • Percent of parents/caregivers who report a reduction or cessation of cigarette consumption.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


Reference:

1 Bundy LT, Haardörfer R, Kegler MC, Owolabi S, Berg CJ, Escoffery C, Thompson T, Mullen PD, Williams R, Hovell M, Kahl T, Harvey D, Price A, House D, Booker BW, Kreuter MW. (2018). Disseminating a Smoke Free Homes program to low SES households in the US through 2-1-1: Results of a national impact evaluation. Nicotine & Tobacco Research. 2018 Dec 5. doi: 10.1093/ntr/nty256.

2 Kegler MC, Bundy L, Haardorfer R, Escoffery C, Berg C, Yembra D, et al. A minimal intervention to promote smokefree homes among 2-1-1 callers: a randomized controlled trial. American Journal of Public Health 2015;105(3):530–7.

3 Abdullah ASM, Lam TH, Mak YW, Loke AY. A randomized control trial of a smoking cessation intervention on parents of young children - a preliminary report (POS2-011). Society for Research on Nicotine and Tobacco 10th Annual Meeting, 2005 February 18-21; Phoenix, AZ. 2005:65.

4 Schuck K, Bricker JB, Otten R, Kleinjan M, Brandon TH, Engels RC. Effectiveness of proactive quitline counselling for smoking parents recruited through primary schools: results of a randomized controlled trial. Addiction 2014;109 (5):830–41.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.