title: Barriers and motivators to reducing secondhand smoke exposure in African American families of head start children: a qualitative study.
abstract: To identify barriers and motivators for reducing secondhand smoke exposure (SHSe) for families of African-American, low-income, urban children.
  
  
  
  Audiotaped intervention sessions of 52 African-American caregivers of Head Start children who reported being a smoker and/or had at least one smoker in the home were randomly sampled from a larger trial examining the effectiveness of a motivational-interviewing intervention in reducing child's SHSe. Counseling sessions were qualitatively coded to identify barriers and motivators to implementing a home smoking ban or quitting smoking.
  
  
  
  African-American families identified several themes that were either or both barriers and motivators for SHSe reduction, including: asking others not to smoke, other family living in the home, neighborhood safety, absence of childcare, cost/availability of cessation tools, physician support and prevention of health problems.
  
  
  
  Urban, low-income African-American families face numerous barriers to reducing SHSe. Families were able to identify many motivators for reducing SHSe, suggesting an awareness of the importance for SHSe reduction but uncertainty in their confidence to change behaviors. Counseling should include tailoring to be most effective in supporting health behavior change. Greater emphasis on motivators is needed, such as low-cost/free cessation tools, engagement from physicians and greater involvement of extended family members.
authors.affiliation: Department of Psychology, University of Maryland Baltimore County, Baltimore, MD, 21250, USA jhoehn1@umbc.edu.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Hoehn
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, 21224, USA.
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Riekert
authors.affiliation: Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA, 02118, USA.
authors.forename: Belinda
authors.initials: B
authors.lastname: Borrelli
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, 21224, USA.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Rand
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, 21224, USA.
authors.forename: Michelle N
authors.initials: MN
authors.lastname: Eakin
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D018479:Early Intervention, Educational; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009042:Motivation; D062405:Motivational Interviewing; D036301:Qualitative Research; D000074606:Smoking Prevention / Q000379:methods; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*
chemical_list: D014028:Tobacco Smoke Pollution