Effectiveness of Interventions to Reduce Exposure to Parental Secondhand Smoke at Home among Children in China: A Systematic Review
Abstract
:1. Introduction
2. Objective of the Present Study
3. Methods
3.1. Search Strategy
3.2. Selection Criteria
3.3. Study Selection
3.4. Data Extraction
3.5. Study Quality
4. Results
4.1. Study Characteristics (n = 13)
4.1.1. Intervention Arms and Components
4.1.2. Mode of Delivering the Intervention and Providers of the Intervention
4.1.3. Intervention Intensity
4.1.4. Length of Follow-Up
4.1.5. Theoretical Framework
4.1.6. Control Group Intervention
4.2. Intervention Outcomes Related to Tobacco Consumption by Parents
4.2.1. Quit Rate
4.2.2. Other Smoking-Related Results
4.3. Intervention Outcomes Related to Child and Family Health
4.3.1. Children’s Health and Behaviors
4.3.2. Parent Practiced not Smoking at Home
4.4. Quality Appraisal
5. Discussion
5.1. Principal Findings
5.2. Methodology
5.2.1. Intervention Strategies and Approaches
5.2.2. Intervention Target
5.2.3. Intervention Effects in the Long Term
5.2.4. Methods and Measurements
5.3. Strengths and Limitations of the Study
5.4. Comparison with Other Studies
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Abdullah et al., 2015 [32] | Yu et al., 2017 [24] | Yau, 2011 [30] | Chen et al., 2016 [33] | Abdullah et al., 2005 [28] | Chan et al., 2008 [29] | Yang, 2007 [34] | Li, 2000 [22] | Liang & Wang, 2001 [25] | |
---|---|---|---|---|---|---|---|---|---|
1. Was the study described as randomized, a randomized trial, a randomized clinical trial, or an RCT? | Yes | Yes | Yes | Yes | Yes | Yes | Yes | No | No |
2. Was the method of randomization adequate (i.e., use of randomly generated assignment)? | Yes | Yes | Yes | Yes | Yes | Yes | Yes | NR | NR |
3. Was the treatment allocation concealed (so that assignments could not be predicted)? | Yes | NR | Yes | NR | Yes | Yes | NR | NR | NR |
4. Were the study participants and providers blinded to treatment group assignment? | NR | NR | No | NR | NR | No | NR | NR | NR |
5. Were the people assessing the outcomes blinded to the participants’ group assignments? | Yes | NR | Yes | NR | Yes | NR | NR | NR | NR |
6. Were the groups similar at baseline on important characteristics that could affect outcomes (e.g., demographics, risk factors, co-morbid conditions)? | Yes | Yes | Yes | Yes | Yes | Yes | NR | NR | NR |
7. Was the overall drop-out rate from the study at the endpoint 20% or lower of the number allocated to treatment? | No | Yes | No | Yes | Yes | Yes | Yes | Yes | Yes |
8. Was the differential drop-out rate (between treatment groups) at endpoint 15 percentage points or lower? | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
9. Was there high adherence to the intervention protocols for each treatment group? | Yes | NR | Yes | NR | NR | NR | NR | NR | NR |
10. Were other interventions avoided or similar in the groups (e.g., similar background treatment)? | Yes | No | Yes | Yes | Yes | NR | NR | NR | NR |
11. Were outcomes assessed using valid and reliable measures, implemented consistently across all study participants? | Yes | No | Yes | Yes | Yes | No | No | No | No |
12. Did the authors report that the sample size was sufficiently large to be able to detect a difference in the main outcome between groups with at least 80% power? | No | Yes | Yes | No | No | NR | Yes | No | No |
13. Were outcomes reported or subgroups analyzed pre-specified (i.e., identified before analyses were conducted)? | Yes | Yes | Yes | Yes | Yes | Yes | Yes | NR | NR |
14. Were all randomized participants analyzed in the group to which they were originally assigned, i.e., did they use an intention-to-treat analysis? | No | No | Yes | Yes | Yes | Yes | Yes | No | No |
Quality rating (good, fair, or poor) | Poor | Poor | Fair | Fair | Fair | Poor | Poor | Poor | Poor |
Additional Comments (If POOR, please state why): | the drop-out rates in both studies groups were over 40%, and no ITT analysis was done | participants who were using other services or support for smoking cessation were not excluded from the study | the dropout rates in both study groups were over 20% | all the data analysed were reported by the smokers’ spouse (i.e., non-smoking mothers) | group difference in demographic characteristics and smoking-related characteristics at baseline were not reported in this study | some important details about methodology were not reported in this study, and some participants in both groups were non-smokers | some important details about methodology were not reported in this study, the only assessment tool used in this study was developed by the authors without reliability and validity test |
Huang et al., 2016 [31] | Liu et al., 2007 [26] | Meng et al., 2004 [23] | Huang, 2008 [27] | |
---|---|---|---|---|
1. Was the study question or objective clearly stated? | Yes | Yes | Yes | Yes |
2. Were eligibility/selection criteria for the study population pre-specified and clearly described? | Yes | No | No | Yes |
3. Were the participants in the study representative of those who would be eligible for the test/service/intervention in the general or clinical population of interest? | Yes | CD | No | Yes |
4. Were all eligible participants the met the pre-specified entry criteria enrolled? | Yes | CD | CD | Yes |
5. Was the sample size sufficiently large to provide confidence in the findings? | NR | NR | NR | NR |
6. Was the test/service/intervention clearly described and delivered consistently across the study population? | Yes | Yes | Yes | Yes |
7. Were the outcome measures pre-specified, clearly defined, valid, reliable, and assessed consistently across all study participants? | Yes | Yes | No | Yes |
8. Were the people assessing the outcomes blinded to the participants’ exposure/ interventions? | Yes | NR | NR | NR |
9. Was the loss to follow-up after baseline 20% or less? Were those lost to follow-up accounted for in the analysis? | No | No | No | Yes |
10. Did the statistical methods examine changes in outcome measures from before to after the intervention? Were statistical tests done that provided p values for the pre-to-post changes? | Yes | No | No | Yes |
11. Were outcome measures of interest taken multiple times before the intervention and multiple times after the intervention? (i.e., did they use an interrupted time-series design) | No | No | No | No |
12. If the intervention was conducted at a group level (e.g., a whole hospital, a community, etc.) did the statistical analysis take into account the use of individual-level data to determine effects at the group levels? | NA | NA | NA | NA |
Quality rating (good, fair, or poor) | Fair | Poor | Poor | Fair |
Additional Comments (If POOR, please state why): | some important details about methodology were not reported in this study, which makes the results unreliable | some important details about methodology were not reported in this study, which makes the results unreliable |
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Zhou, Y.H.; Mak, Y.W.; Ho, G.W.K. Effectiveness of Interventions to Reduce Exposure to Parental Secondhand Smoke at Home among Children in China: A Systematic Review. Int. J. Environ. Res. Public Health 2019, 16, 107. https://doi.org/10.3390/ijerph16010107
Zhou YH, Mak YW, Ho GWK. Effectiveness of Interventions to Reduce Exposure to Parental Secondhand Smoke at Home among Children in China: A Systematic Review. International Journal of Environmental Research and Public Health. 2019; 16(1):107. https://doi.org/10.3390/ijerph16010107
Chicago/Turabian StyleZhou, Yan Hua, Yim Wah Mak, and Grace W. K. Ho. 2019. "Effectiveness of Interventions to Reduce Exposure to Parental Secondhand Smoke at Home among Children in China: A Systematic Review" International Journal of Environmental Research and Public Health 16, no. 1: 107. https://doi.org/10.3390/ijerph16010107