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1 From the Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health; and the Research Service, San Diego VA Healthcare System
2 From the Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University
3 From the Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health; and the Department of Political Sciences, San Diego State University
Study objective: To examine the long-term maintenance of a previously reported behavioral counseling intervention to reduce asthmatic children's exposure to environmental tobacco smoke (ETS).
Participants: Families of asthmatic children (6 to 17 years), including at least one parent who smoked in the home, recruited from four pediatric allergy clinics.
Design: Participants were randomized to one of three groups: behavioral counseling to reduce ETS exposure, self-monitoring control, and usual medical care control. Counseling concluded at month 6, and the original trial ended at month 12. Two follow-up interviews occurred at months 20 and 30.
Measurements and results: The originally reported analysis of baseline to 12 months was reanalyzed with a more robust restricted maximum likelihood procedure. The 2-year follow-up period was analyzed similarly. Significantly greater change occurred in the counseling group than the control groups and was sustained throughout the 2 years of follow-up. Further exploratory analyses suggested that printed counseling materials given to all participants at month 12 (conclusion of the original study) were associated with decreased exposure in the control groups.
Conclusion: Such long-term maintenance of behavior change is highly unusual in the general behavioral science literature, let alone for addictive behaviors. We conclude that ETS exposure can be reduced and that a clinician-delivered treatment may provide substantial benefit.
Key Words: asthma • behavioral medicine • cancer • counseling • environmental tobacco smoke exposure • maintenance • passive smoke exposure • prevention
Submitted on May 14, 1996
Accepted on August 26, 2007
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