The Healthy Homes Study: Protocol for a cluster randomized trial of a place-based smoke-free home intervention in affordable housing.
<h4>Introduction</h4>Comprehensive clean air policies reduce exposure to secondhand tobacco and cannabis smoke, as well as nicotine aerosols, and improve health outcomes. However, these policies often do not apply to the eight million residents of multiunit affordable housing, many of wh...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2025-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0328786 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849225165447102464 |
|---|---|
| author | Mark R Hawes Deepalika Chakravarty Jing Cheng Margaret A Handley Janice Y Tsoh Tracy Kuo Lin Robert A Hiatt Maya Vijayaraghavan |
| author_facet | Mark R Hawes Deepalika Chakravarty Jing Cheng Margaret A Handley Janice Y Tsoh Tracy Kuo Lin Robert A Hiatt Maya Vijayaraghavan |
| author_sort | Mark R Hawes |
| collection | DOAJ |
| description | <h4>Introduction</h4>Comprehensive clean air policies reduce exposure to secondhand tobacco and cannabis smoke, as well as nicotine aerosols, and improve health outcomes. However, these policies often do not apply to the eight million residents of multiunit affordable housing, many of whom are from minoritized populations. One strategy to promote smoke-free living environments is to increase the voluntary adoption of no-smoking rules in the home.<h4>Methods</h4>We describe the protocol for the Healthy Homes study-a wait-list cluster randomized controlled trial of a smoke-free home intervention for affordable housing residents. The intervention was adapted from a prior version using the Capability Opportunity Motivation-Behavior (COM-B) model and the Behavior Change Wheel. We will enroll 544 residents at 48 affordable housing sites across Northern California. Sites will be randomized to intervention or wait-list control. Resident participants will receive a one-hour coaching session on how to adopt a smoke-free home. Housing staff will be trained as lay health workers to provide brief cessation coaching. Residents and staff will complete follow-up visits at 3 and 6 months. The intervention will be delivered in English, Spanish, Chinese (Mandarin and Cantonese), and Vietnamese. The primary resident outcome is voluntary adoption of a smoke-free home for 90 days or more at 6 months. The secondary outcome is carbon monoxide-verified point prevalence tobacco abstinence. For lay health workers, the primary outcome is change in Smoking Knowledge, Attitudes, and Practices scores. We will assess cost-effectiveness and use the Consolidated Framework for Implementation Research to evaluate implementation outcomes, including characteristics of successful adopters and multilevel drivers of behavior change.<h4>Discussion</h4>Expanding access to smoke-free affordable housing is critical for reducing racial and ethnic health inequities. This study has the potential to support voluntary smoke-free home adoption, increase quitting, and reduce secondhand smoke exposure among affordable housing residents.<h4>Trial registration</h4>ClinicalTrials.gov NCT06170437. |
| format | Article |
| id | doaj-art-30efbfde0a64417da1db826ea38b277f |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-30efbfde0a64417da1db826ea38b277f2025-08-25T05:31:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032878610.1371/journal.pone.0328786The Healthy Homes Study: Protocol for a cluster randomized trial of a place-based smoke-free home intervention in affordable housing.Mark R HawesDeepalika ChakravartyJing ChengMargaret A HandleyJanice Y TsohTracy Kuo LinRobert A HiattMaya Vijayaraghavan<h4>Introduction</h4>Comprehensive clean air policies reduce exposure to secondhand tobacco and cannabis smoke, as well as nicotine aerosols, and improve health outcomes. However, these policies often do not apply to the eight million residents of multiunit affordable housing, many of whom are from minoritized populations. One strategy to promote smoke-free living environments is to increase the voluntary adoption of no-smoking rules in the home.<h4>Methods</h4>We describe the protocol for the Healthy Homes study-a wait-list cluster randomized controlled trial of a smoke-free home intervention for affordable housing residents. The intervention was adapted from a prior version using the Capability Opportunity Motivation-Behavior (COM-B) model and the Behavior Change Wheel. We will enroll 544 residents at 48 affordable housing sites across Northern California. Sites will be randomized to intervention or wait-list control. Resident participants will receive a one-hour coaching session on how to adopt a smoke-free home. Housing staff will be trained as lay health workers to provide brief cessation coaching. Residents and staff will complete follow-up visits at 3 and 6 months. The intervention will be delivered in English, Spanish, Chinese (Mandarin and Cantonese), and Vietnamese. The primary resident outcome is voluntary adoption of a smoke-free home for 90 days or more at 6 months. The secondary outcome is carbon monoxide-verified point prevalence tobacco abstinence. For lay health workers, the primary outcome is change in Smoking Knowledge, Attitudes, and Practices scores. We will assess cost-effectiveness and use the Consolidated Framework for Implementation Research to evaluate implementation outcomes, including characteristics of successful adopters and multilevel drivers of behavior change.<h4>Discussion</h4>Expanding access to smoke-free affordable housing is critical for reducing racial and ethnic health inequities. This study has the potential to support voluntary smoke-free home adoption, increase quitting, and reduce secondhand smoke exposure among affordable housing residents.<h4>Trial registration</h4>ClinicalTrials.gov NCT06170437.https://doi.org/10.1371/journal.pone.0328786 |
| spellingShingle | Mark R Hawes Deepalika Chakravarty Jing Cheng Margaret A Handley Janice Y Tsoh Tracy Kuo Lin Robert A Hiatt Maya Vijayaraghavan The Healthy Homes Study: Protocol for a cluster randomized trial of a place-based smoke-free home intervention in affordable housing. PLoS ONE |
| title | The Healthy Homes Study: Protocol for a cluster randomized trial of a place-based smoke-free home intervention in affordable housing. |
| title_full | The Healthy Homes Study: Protocol for a cluster randomized trial of a place-based smoke-free home intervention in affordable housing. |
| title_fullStr | The Healthy Homes Study: Protocol for a cluster randomized trial of a place-based smoke-free home intervention in affordable housing. |
| title_full_unstemmed | The Healthy Homes Study: Protocol for a cluster randomized trial of a place-based smoke-free home intervention in affordable housing. |
| title_short | The Healthy Homes Study: Protocol for a cluster randomized trial of a place-based smoke-free home intervention in affordable housing. |
| title_sort | healthy homes study protocol for a cluster randomized trial of a place based smoke free home intervention in affordable housing |
| url | https://doi.org/10.1371/journal.pone.0328786 |
| work_keys_str_mv | AT markrhawes thehealthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT deepalikachakravarty thehealthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT jingcheng thehealthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT margaretahandley thehealthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT janiceytsoh thehealthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT tracykuolin thehealthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT robertahiatt thehealthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT mayavijayaraghavan thehealthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT markrhawes healthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT deepalikachakravarty healthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT jingcheng healthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT margaretahandley healthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT janiceytsoh healthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT tracykuolin healthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT robertahiatt healthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing AT mayavijayaraghavan healthyhomesstudyprotocolforaclusterrandomizedtrialofaplacebasedsmokefreehomeinterventioninaffordablehousing |