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Optimizing Smoke-free Residential Housing Policies

P

President and Fellows of Harvard College

Status

Completed

Conditions

Second Hand Tobacco Smoke
Smoking, Tobacco
Smoking Cessation

Treatments

Behavioral: Adaptive Intervention

Study type

Interventional

Funder types

Other

Identifiers

NCT04791722
MAHHU0041-18

Details and patient eligibility

About

This project will be conducted to investigate activities on housing-related health and safety issues. The focus of this project is the development of evidence-based approaches to implement smoke-free policies to reduce harms associated with exposure to secondhand smoke (SHS).

Full description

Chronic exposure to secondhand smoke (SHS) is a major health concern for public housing residents. While the prevalence of adult cigarette smoking in the United States has declined to 15.1% in 2015, recent data show that 34% of public housing residents still smoke. A federal rule issued by HUD now requires Public Housing Agencies (PHAs) to adopt a smoke-free policy to reduce SHS exposure. However, no evidence-based approaches are available to support post-adoption implementation by PHAs to ensure that the rule yields optimal benefits for residents. This research gap also applies to the larger population of affordable housing properties that are likely to adopt smoke-free rules in the future. The focus of this research is the development of evidence-based approaches to implement smoke-free policies to reduce harms associated with exposure to secondhand smoke (SHS).

The investigators will use six key implementation strategies identified in earlier research on the experiences of early-adopter PHAs. The investigators will partner with a for-profit affordable housing management company that recently expanded its portfolio with the acquisition of 55 affordable housing properties in Pennsylvania, Ohio, West Virginia, Virginia and Kentucky. This provides a unique opportunity to address the implementation research gap, because these properties are in geographic locations where the smoking rate is close to twice the national smoking rate. The for-profit affordable housing management company has committed to adopting a smoke-free policy in these properties, to go into effect in early 2020.

Using an established implementation science framework to guide the approach, the investigators will work with property managers and staff of properties located in five high-smoking states to strategically incorporate the six implementation strategies to reduce SHS exposure among affordable housing residents. The findings will provide accessible, practical, and effective evidence for property managers and staff to support ongoing efforts to optimize the impact of a smoke-free residential policy. The investigators will test this approach in a geographic region with high smoking rates and a disproportionate burden of tobacco-related mortality, covering western Pennsylvania, southern Ohio, West Virginia, Virginia and Kentucky.

Enrollment

386 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Property Manager Inclusion Criteria:

  • Property Manager (or designated appointee) at one of the 12 selected sites implementing a smoke-free policy

Property Manager Exclusion Criteria:

  • None

Resident Inclusion Criteria:

  • Aged 18 and over
  • A resident of the housing development (12 selected sites) implementing the smoke-free policy

Resident Exclusion Criteria:

  • Unable/unwilling to complete surveys

Trial design

Primary purpose

Prevention

Allocation

Randomized

Interventional model

Sequential Assignment

Masking

None (Open label)

386 participants in 3 patient groups

Wave 1
Active Comparator group
Description:
Properties in Wave 1 (n=4) will implement a smoke-free policy on January 1, 2020.
Treatment:
Behavioral: Adaptive Intervention
Wave 2
Experimental group
Description:
Properties in Wave 2 (n=4) will implement a smoke-free policy on May 1, 2020.
Treatment:
Behavioral: Adaptive Intervention
Wave 3
Experimental group
Description:
Properties in Wave 3 (n=4) will implement a smoke-free policy on October 1, 2020.
Treatment:
Behavioral: Adaptive Intervention

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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