Community Partners for Advancing Smokefree Environments

Background: There has been little attention dedicated toward assessing children's exposure to secondhand smoke (SHS) in community based settings. Given that low SES children are more likely to be exposed to SHS, developing partnerships with organizations that serve this population are critical to reduce health risks. The purpose of this study was to examine the extent to which federally funded Pennsylvania Head Start programs implemented clinical policies and practices related to reducing parental tobacco use and children's exposure to second hand smoke.

Methods: We surveyed 66 federally funded Pennsylvania Head Start programs to assess practices related to reducing children's exposure to SHS. Overall 42 (66%) of programs completed the assessment and 14 agencies participated in a training to integrate SHS interventions.

Results: Most (90%) Head Start programs believed that it is part of their mission to protect children from the exposure to SHS, although none had developed approaches. Only 2 of the agencies currently assessed youth's exposure to secondhand smoke and both of these agencies currently participate in an externally funded tobacco project. Six month follow-up data found that none of the 14 agencies who voluntarily participated in the policy training changed clinical practices to assess for children's exposure to SHS. Reasons for not modifying policy included: lack of organizational support from administrators and inadequate time to work on the issue.

Conclusion: Both policy and regulatory approaches may be necessary to increase organizational and practitioner behaviors toward educating and intervening with parents who expose their children to secondhand smoke risks.