Ongoing projects

Smoke-Free Homes intervention to improve children’s respiratory health: an effectiveness and implementation study in primary care paediatric services
Exposure to tobacco smoke increases the risk of respiratory diseases and other health problems in children. In Spain, exposure to tobacco smoke at home has remained high and stable among children over the last decade. Currently, in Spain, about 42% of all households and about 70% of households where people who smoke live allow smoking in their home. This results in a significant prevalence and burden of exposure at home, especially for children, who are more vulnerable to the health risks associated with tobacco smoke exposure. Children exposed to tobacco smoke are more likely to develop infections of lower respiratory tract, otitis media, and suffer from asthma exacerbations.
Children exposed to tobacco smoke are more likely to develop infections of lower respiratory tract, otitis media, and suffer from asthma exacerbations. Adopting the voluntary norm of not smoking at home reduces exposure among all household members, motivates and increases the chances of smokers quitting, denormalises smoking, and prevents home fires.
To evaluate the effectiveness, implementation, and economic outcomes of an evidence-based intervention that promotes the voluntary adoption of smoke-free homes in households with children, delivered via paediatric primary care services in Catalonia.
Specific objectives:
– To design a comprehensive set of strategies for screening and referral to receive the smoke-free home intervention in paediatric services at primary care centres in Catalonia, using a systematic participatory approach (implementation mapping).
– To evaluate the effectiveness and implementation of the smoke-free home intervention in two groups of households with children, with and without respiratory conditions, in terms of:
a) self-reported prevalence of smoke-free home adoption and changes in smoking behaviour of participants.
b) general data and respiratory health outcomes in the paediatric population using survey and mendical records data.
c) implementation outcomes assessed with the RE-AIM framework.
– To evaluate the cost-effectiveness of the smoke-free home intervention delivered through paediatric primary care services in Catalonia.
– To compare the effectiveness, implementation and economic outcomes between two groups of households with children, with and without respiratory conditions.
This is a mixed-methods research study with an integrated sequential design. The primary design will be a randomized controlled trial (RCT), supported by an explanatory qualitative study.
The study has two phases:
Phase 1: Qualitative participatory study
Implementation mapping will be used to implement non-disruptive and acceptable strategies to enhance the adoption, implementation and maintenance of the intervention by healthcare professionals in routine care.
Phase 2: An effectiveness-implementation hybrid type 2
An effectiveness-implementation hybrid type 2 study will be conducted using a RCT design to assess the intervention’s effectiveness, implementation and economic outcomes. These outcomes will be compared between two study groups (two simultaneous RCTs): households with children with and without respiratory conditions.
The intervention targets households where smoking is allowed (non-smoke-free home). Eligible households will have at least one minor (0-15 years) and at least one adult who smokes daily at home, either indoors or “outdoors” (e.g., on the balcony).
3 years (30 April 2026-30 April 2029)
Fundació La Marató 3cat, 2024 call for respiratory diseases
Total budget: 299.982 € (Budget ICO: 184.920€)
Tobacco Control Unit, Catalan Institute of Oncology (ICO) / Bellvitge Biomedical Research Institute (ICO-IDIBELL)
Jordi Gol Primary Care Research Institute (IDIAPJGol)
Dr. Marcela Fu i Dr. Pere Toran
Laura Antón
Montse Ballbè
Isabel Barroso
Pablo Bautista
Yolanda Castellano
Clara Fábregas
Esteve Fernández
Marcela Fu (IP)
Xiuchao Guo
Anna Mar López
Cristina Martínez
Laura Perdiguero
Armando Peruga
Olena Tigova
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