Browsing by Author "Segan C."
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Item Effect of a family-centered, secondhand smoke intervention to reduce respiratory illness in Indigenous infants in Australia and New Zealand: a randomized controlled trial.(2015-02-17) Walker N.; Johnston V.; Glover M.; Bullen C.; Trenholme A.; Chang A.; Morris P.; Segan C.; Brown N.; Fenton D.; Hawthorne E.; Borland R.; Parag V.; Von blaramberg T.; Westphal D.; Thomas D.Introduction: Secondhand smoke (SHS) is a significant cause of acute respiratory illness (ARI) and 5 times more common in Indigenous children. A single-blind randomized trial was undertaken to determine the efficacy of a family centered SHS intervention to reduce ARI in Indigenous infants in Australia and New Zealand. Method(s): Indigenous mothers/infants from homes with >=1 smoker were randomized to a SHS intervention involving 3 home visits in the first 3 months of the infants' lives (plus usual care) or usual care. The primary outcome was number of ARI-related visits to a health provider in the first year of life. Secondary outcomes, assessed at 4 and 12 months of age, included ARI hospitalization rates and mothers' report of infants' SHS exposure (validated by urinary cotinine/creatinine ratios [CCRs]), smoking restrictions, and smoking cessation. Result(s): Two hundred and ninety-three mother/infant dyads were randomized and followed up. Three quarters of mothers smoked during pregnancy and two thirds were smoking at baseline (as were their partners), with no change for more than 12 months. Reported infant exposure to SHS was low (>=95% had smoke-free homes/cars). Infant CCRs were higher if one or both parents were smokers and if mothers breast fed their infants. There was no effect of the intervention on ARI events [471 intervention vs. 438 usual care (reference); incidence rate ratio = 1.10, 95% confidence intervals (CI) = 0.88-1.37, p = .40]. Conclusion(s): Despite reporting smoke-free homes/cars, mothers and their partners continue to smoke in the first year of infants' lives, exposing them to SHS. Emphasis needs to be placed on supporting parents to stop smoking preconception, during pregnancy, and postnatal.Copyright © The Author 2014.Item Reducing smoking among Indigenous populations: new evidence from a review of trials.(2013-08-05) Johnston V.; Westphal D.W.; Glover M.; Thomas D.P.; Segan C.; Walker N.Introduction: Previous reviews have concluded that to be effective, evidence-based tobacco control interventions should be culturally adapted to Indigenous populations. We undertook a systematic review to critically examine this hitherto conclusion. Method(s): We searched MEDLINE, PsychInfo, EMBASE, and Cochrane databases from 1980 to May 2012 for controlled trials. We included studies that recruited nonIndigenous and Indigenous participants to assess differences in impact of nonadapted interventions across ethnic groups and whether adapted interventions are more effective for Indigenous participants. Result(s): Five studies were included. Three tested the effectiveness of enhanced Quitline protocols with cessation products over usual Quitline care, and two trialed a culturally adapted cessation counseling intervention using mobile phones. Three studies did not demonstrate a significant effect of the intervention for both Indigenous and nonIndigenous participants; two were pharmacotherapy studies using nicotine replacement therapy and the third was a trial of a multimedia phone intervention. The fourth study found a significant effect of a behavioral intervention using text messaging for Indigenous and nonIndigenous participants. The final study found a significant effect in favor of very low nicotine cigarettes compared with usual care; results were similar across ethnic groups. Discussion(s): There is likely no significant difference between Indigenous and nonIndigenous populations regarding the efficacy of smoking cessation products, and we provide some promising evidence on the efficacy of behavioral interventions delivered via mobile phone technology. We demonstrate that not all tobacco control interventions can or necessarily need to be culturally adapted for Indigenous populations although there are circumstances when this is important. © The Author 2013. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.