title: Distance-based training in two community health centers to address tobacco smoke exposure of children.
abstract: BACKGROUND
  The CEASE (Clinical Effort Against Secondhand Smoke Exposure) intervention was developed to help pediatricians routinely and effectively address the harms of family smoking behaviors. Based on paper versions of CEASE, we partnered with the American Academy of Pediatrics' online education department and developed a completely distance-based training, including an online CME training, handouts and education materials for families, and phone and email support.
  
  
  METHODS
  The pediatric offices of two low income health clinics with primarily Medicaid populations were selected for the study. Pre and post intervention data by survey of the parents was collected in both practices (Practice 1 n = 470; Practice 2 n = 177). The primary outcome for this study was a comparison of rates of clinician's asking and advising parents about smoking and smoke-free home and cars.
  
  
  RESULTS
  Exit surveys of parents revealed statistically significant increases in rates of clinicians asking about parental smoking (22% vs. 41%), smoke-free rules (25% vs. 44%), and asking about other smoking household members (26% vs. 48%).
  
  
  CONCLUSIONS
  Through a completely distance based intervention, we were able to train pediatricians who see low income children to ask parents about smoking, smoke-free home and car rules, and whether other household members smoke. Implementing a system to routinely ask about family tobacco use and smoke-free home and car rules is a first step to effectively addressing tobacco in a pediatric office setting. By knowing which family members use tobacco, pediatricians can take the next steps to help families become completely tobacco-free.
  
  
  BACKGROUND
  Clinical trials number: NCT01087177.
authors.affiliation: Center for Child and Adolescent Health Research and Policy, Massachusetts General Hospital, 50 Staniford Street Suite 901, Boston, MA 02144, USA.
authors.forename: Bethany
authors.initials: B
authors.lastname: Hipple
authors.forename: Emara
authors.initials: E
authors.lastname: Nabi-Burza
authors.forename: Nicole
authors.initials: N
authors.lastname: Hall
authors.forename: Susan
authors.initials: S
authors.lastname: Regan
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Winickoff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001900:Boston; D002648:Child; D002669:Child Welfare; D003151:Community Health Centers; D020375:Education, Distance; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000193:education*; D010353:Patient Education as Topic; D010372:Pediatrics / Q000193:education*; D011203:Poverty; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D057566:Self Report; D012907:Smoking / Q000628:therapy; D000074606:Smoking Prevention; D017216:Telemedicine; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution