Abstract
BackgroundEspecially children at risk for asthma are sensitive to the detrimental health effects of passive smoke (PS) exposure, like respiratory complaints and allergic sensitisation. Therefore, effective prevention of PS exposure in this group of vulnerable children is important. Based on previous studies, we hypothesized that an effective intervention program to prevent PS exposure in children is possible by means of a motivational interviewing tailored program with repeated contacts focussing on awareness, knowledge, beliefs (pros/cons), perceived barriers and needs of parents, in combination with feedback about urine cotinine levels of the children. The aim of the PREPASE study is to test the effectiveness of such an intervention program towards eliminating or reducing of PS exposure in children at risk for asthma. This article describes the protocol of the PREPASE study.MethodsThe study is a one-year follow-up randomized controlled trial. Families with children (0–13 years of age) having an asthma predisposition who experience PS exposure at home are randomized into an intervention group receiving an intervention or a control group receiving care as usual. The intervention is given by trained research assistants. The intervention starts one month after a baseline measurement and takes place once per month for an hour during six home based counselling sessions. The primary outcome measure is the percentage of families curtailing PS exposure in children (parental report verified with the urine cotinine concentrations of the children) after 6 months. The secondary outcome measures include: household nicotine level, the child’s lung function, airway inflammation and oxidative stress, presence of wheezing and questionnaires on respiratory symptoms, and quality of life. A process evaluation is included. Most of the measurements take place every 3 months (baseline and after 3, 6, 9 and 12 months of study).ConclusionThe PREPASE study incorporates successful elements of previous interventions and may therefore be very promising. If proven effective, the intervention will benefit the health of children at risk for asthma and may also create opportunity to be tested in other population.Trial registration numberNTR2632
Highlights
Children at risk for asthma are sensitive to the detrimental health effects of passive smoke (PS) exposure, like respiratory complaints and allergic sensitisation
Hypothesis The hypothesis of the PREPASE study (PREvention of PAssive Smoke Exposure) is that an effective intervention towards eliminating or reducing PS exposure in children with a high risk of asthma is possible by means of a motivational interviewing tailored program with repeated contacts focussing on awareness, knowledge, beliefs, perceived barriers and needs of parents, in combination with feedback about urine cotinine levels of the children
The effect of the intervention will be assessed by comparing the intervention and control group with respect to the percentage of stopping of PS exposure in children 6 months after the start of the intervention
Summary
Children at risk for asthma are sensitive to the detrimental health effects of passive smoke (PS) exposure, like respiratory complaints and allergic sensitisation. The aim of the PREPASE study is to test the effectiveness of such an intervention program towards eliminating or reducing of PS exposure in children at risk for asthma. Positive effects on stopping PS exposure in children have been described for behavioural counselling methods, such as motivational interviewing (MI) [12]. Behavioural counselling alone is probably not enough for an effective, long-lasting intervention effect to prevent PS exposure in children [15,16]. The addition of repeated feedback on children’s urinary cotinine levels to behaviour-changing strategies seemed to reduce the urine cotinine concentrations in children and the proportion of parents quitting smoking [17,18]. An intervention program that incorporates all successful elements of earlier studies may have high chance of being effective
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