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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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paper cutout people holding a used cigaretteSchool-based Counseling + Education Materials

MCH Strategy. Provide in-person counseling in a school setting + educational materials to reduce child exposure to secondhand smoke in the home.

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Overview. Research indicates that interventions providing individualized counseling to parents or group counseling to parent/child dyads in a school setting can produce positive outcomes to reduce children’s exposure to tobacco smoke in their homes, and reduce parental cigarette consumption.1,2

Evidence. Emerging. Initial research showed positive results for providing counseling in a school-based setting to parents, and parent/child dyads, to reduce child exposure to second-hand smoke. Further research is needed to identify critical components and confirm effects. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Parents or parent/child dyads.

Outcome. Reduction of secondhand tobacco smoke exposure in the home and reduction of parental smoking. 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 is currently 1 ESM 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 strategy “Provide in-person counseling in a school setting + educational materials to reduce child 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 who receive counseling and educational materials in a school-based setting to reduce a child’s exposure to secondhand smoke in the home.
  • Number of parents/caregivers who receive individualized support to quit smoking from their child’s school.

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

  • Percent of parents who receive counseling and educational materials in a school-based setting to reduce a child’s exposure to secondhand smoke in the home.
  • Percent of parents/caregivers who receive individualized support to quit smoking from their child’s school.

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

  • Number of parents who report a readiness to quit smoking.
  • Number of parents who formulate a plan for implementing a smoke-free home.

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

  • Percent of parents/caregivers who quit or reduce smoking.
  • Percent of parents/caregivers who establish a home-smoking ban.
  • Percent of parents/caregivers that maintain long-term quit rates.

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 Caldwell AL, Tingen MS Nguyen JT, Andrews JO, Heath J, Waller JL, Treiber FA. (2018). Parental Smoking Cessation: Impacting Children’s Tobacco Smoke Exposure in the Home. Pediatrics. 2018 Jan;141(Suppl 1):S96-S106. doi: 10.1542/peds.2017-1026M.

2 Chen YT, Hsiao FH, Lee CM, Wang RH, Chen PL. Effects of a parent-child interactive program for families on reducing the exposure of school-aged children to household smoking. Nicotine & Tobacco Research 2016;18(3):330–40.

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.