A clinical practice guideline for treating tobacco use and dependence: 2008 update. A U.S. Public Health Service report

Behavior change is a critical part of effective health care. The final decision to become healthier, however, is that of the patient and not the practitioner. Anyone who has treated patients knows ...

Motivational Interviewing in Health Care: Helping Patients Change Behavior

Teachable moments for health behavior change: A concept analysis

There is increasing demand for physicians in pediatric settings to address not only the physical but also the psychosocial health of their child and adolescent patients. Brief interventions (BIs) and in particular Motivational interviewing (MI) offer an efficient means of targeting behavioral developmental and social problems within the context of pediatric practice. This review addresses the patient-centered care foundation of and empirical support for brief pediatric interventions including educational and media-based interventions MI-based prevention and intervention with health risk behaviors procedural pain control and adherence to treatment recommendations. In addition developmental considerations and future directions for BI research in pediatric practice are summarized. (excerpt)

https://jamanetwork.com/journals/jamapediatrics/articlepdf/486200/PRA50003.pdf

Brief interventions and motivational interviewing with children, adolescents, and their parents in pediatric health care settings: a review.

Purpose of review This review provides the reader with an overview of the early and the late phase of the immediate allergic reaction. Furthermore, recent publications are presented that could reveal important new insights into the mechanisms of allergic inflammation. Recent findings Recent work on the possible roles of nerve growth factor, nitric oxide synthases, several CC chemokines and other mediators is presented. Summary Allergic rhinitis is characterized by the clinical symptoms of sneezing, itching, rhinorrhea, and nasal congestion. Frequently, these are accompanied by eye, ear and throat symptoms or postnasal drip. The symptoms arise as a result of inflammation induced by IgE-mediated immune response to a specific allergen. Inflammatory mediators are released and cells are activated and recruited to the mucosa. In this review, early and late phase responses of the allergic type I reaction are described, including the different cell types and mediators involved. Special attention is paid to new inflammatory processes to provide the reader with recent information.

Mediators of inflammation in the early and the late phase of allergic rhinitis.

Objective Parental smoking is associated with increased rates and severity of childhood respiratory illness. No previous studies have examined child hospitalization as an opportunity for parental smoking cessation. We evaluated the feasibility of implementing a smoking cessation intervention for parents at the time of child hospitalization for respiratory illness. Methods We performed a prospective cohort study of smoking parents who had a child who was admitted to an academic children's hospital for a respiratory illness between January and April 2000. All enrollees were offered the Stop Tobacco Outreach Program, which includes an initial motivational interview, written materials, nicotine replacement therapy (NRT), telephone counseling, and fax referral to parents' primary clinician. The primary outcome was completion of all 3 counseling sessions. Two-month follow-up outcomes were quit attempts, cessation, NRT use, primary care visits, household smoking prohibition, and satisfaction. Results A total of 126 smoking parents met eligibility criteria, and 71 (56%) enrolled in the study. Of the 71, 80% completed all counseling sessions and 56% accepted free NRT at the time of enrollment. At the 2-month follow-up, of the 71 initial enrollees, 49% reported having made a quit attempt that lasted at least 24 hours, 21% reported not smoking a cigarette in the last 7 days, 27% reported having used NRT, and 38% had had a visit with their own primary clinician. The proportion of parents who reported rules prohibiting smoking in the house increased (29% vs 71%). Parental rating of the overall usefulness of the program was 4.3 +/- 0.9 (1 standard deviation) on the 5-point scale 1 = not at all and 5 = a great extent. Conclusions This study demonstrates the feasibility of engaging parents in smoking cessation interventions at the time of child hospitalization for respiratory illness. Previous work done in a similar sample of parental smokers has shown extremely low ever-use rates of cessation programs. High rates of acceptance of in-hospital and telephone counseling in this study support the notion of child hospitalization as a teachable moment to address parental smoking.

Valerie J. Hillis

Papers

A smoking cessation intervention for parents of children who are hospitalized for respiratory illness: the stop tobacco outreach program.

for Respiratory Illness: The Stop Tobacco Outreach Program A Smoking Cessation Intervention for Parents of Children Who Are Hospitalized