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A randomized trial of parental behavioral counseling and cotinine feedback for lowering environmental tobacco smoke exposure in children with asthma: results of the LET'S Manage Asthma trial


, : A randomized trial of parental behavioral counseling and cotinine feedback for lowering environmental tobacco smoke exposure in children with asthma: results of the LET'S Manage Asthma trial. Chest 139(3): 581-590

Secondhand tobacco smoke exposure impairs the control of pediatric asthma. Evidence of the efficacy of interventions to reduce children's exposure and improve disease outcomes has been inconclusive. Caregivers of 519 children aged 3 to 12 years with asthma and reported smoke exposure attended two baseline assessment visits, which involved a parent interview, sampling of the children's urine (for cotinine assay), and spirometry (children≥5 years). The caregivers and children (n=352) with significant documented exposure (cotinine≥10 ng/mL) attended a basic asthma education session, provided a third urine sample, and were randomized to the Lowering Environmental Tobacco Smoke: LET'S Manage Asthma (LET'S) intervention (n=178) or usual care (n=174). LET'S included three in-person, stage-of-change-based counseling sessions plus three follow-up phone calls. Cotinine feedback was given at each in-person session. Follow-up visits at 6 and 12 months postrandomization repeated the baseline data collection. Multivariate regression analyses estimated the intervention effect on the natural logarithm of the cotinine to creatinine ratio (lnCCR), use of health-care services, and other outcomes. In the sample overall, the children in the LET'S intervention had lower follow-up lnCCR values compared with the children in usual care, but the group difference was not significant (β coefficient=-0.307, P=.064), and there was no group difference in the odds of having>one asthma-related medical visit (β coefficient=0.035, P=.78). However, children with high-risk asthma had statistically lower follow-up lnCCR values compared with children in usual care (β coefficient=-1.068, P=.006). The LET'S intervention was not associated with a statistically significant reduction in tobacco smoke exposure or use of health-care services in the sample as a whole. However, it appeared effective in reducing exposure in children at high risk for subsequent exacerbations. ClinicialTrials.gov; No.: NCT00217958; URL: clinicaltrials.gov.

US$19.90

PMID: 20864611

DOI: 10.1378/chest.10-0772


Other references

Ulisses, C.; Camara, T.R.; Willadino, L.; Albuquerque, C.C. de; Martins, L.S.S.; Freitas, N.S.A. de, 2002: Isoenzyme characterization of the clones of banana Nanicao subjected to salinity. This study is aimed to identify isoenzymatic variations in banana plants derived from buds of cultivar Nanicao subjected to in vitro selection with 80 and 100 mol m-3 of NaCl. After acclimatization, plants were cultivated for 30 days in a greenhou...

Etheridge, D.M.; Pearman, G.I.; Fraser, P.J., 1992: Changes in tropospheric methane between 1841 and 1978 from a high accumulation-rate Antarctic ice core. Tellus Series B Chemical & Physical Meteorology 44(4): 282-294

Johansson, B., 1998: Fall injuries among elderly persons living at home. Falls and their consequences are a major health problem for elderly people. The aim of this study is to describe and analyse registered fall injuries in people 65 years and older, living in their own homes, during one year. In a local health care...

Kanthimathinathan, H.Krishnan.; Sundararajan, S.B.; Laker, S.; Scholefield, B.R.; Morris, K.P., 2016: Targeting Glycemic Control After Pediatric Cardiac Surgery: The Influence of Age on Insulin Requirement. Factors influencing the development of hyperglycemia and pattern of insulin requirement in children undergoing cardiac surgery are poorly understood. This study investigated the impact of age on the pattern of hyperglycemia and insulin requirement...

Schlax William N., 1986: Unsuitability of Hanford, Washington site for a nuclear waste repository. Annual Meeting - Association of Engineering Geologists 29: 63

Melloada, S., 1965: Lactation And Its Problems. Ii. Revista Brasileira de Medicina 22: 1-10

Smith, F.T.H., 1967: A Victorian record of the Shining bronze-cuckoo Chalcites lucidus. Australian Bird Watcher, 3: 39-40

Conomos T.J.; Gross M.G., 1968: Mixing of columbia river and ocean waters in summer. Journal of the Sanitary Engineering Division Proceedings of the American Society of Civil Engineers 94(SA5): 979-994

Smith, B.A., 1955: Polypoid rhabdomyosarcoma of the bladder: sarcoma botryoides. Minnesota Medicine 38(4): 215-219

Willner, S., 1971: Follow-up study of scoliosis material from Linköping. Nordisk Medicin 85(8): 256-256