Optimizing Smoke-free Residential Housing Policies

NCT ID: NCT04791722

Last Updated: 2021-11-16

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 386 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2019-05-20
• Study Completion Date: 2021-11-01

Brief Summary

This project will be conducted to investigate activities on housing-related health and safety issues. The focus of this project is the development of evidence-based approaches to implement smoke-free policies to reduce harms associated with exposure to secondhand smoke (SHS).

Detailed Description

Chronic exposure to secondhand smoke (SHS) is a major health concern for public housing residents. While the prevalence of adult cigarette smoking in the United States has declined to 15.1% in 2015, recent data show that 34% of public housing residents still smoke. A federal rule issued by HUD now requires Public Housing Agencies (PHAs) to adopt a smoke-free policy to reduce SHS exposure. However, no evidence-based approaches are available to support post-adoption implementation by PHAs to ensure that the rule yields optimal benefits for residents. This research gap also applies to the larger population of affordable housing properties that are likely to adopt smoke-free rules in the future. The focus of this research is the development of evidence-based approaches to implement smoke-free policies to reduce harms associated with exposure to secondhand smoke (SHS).

The investigators will use six key implementation strategies identified in earlier research on the experiences of early-adopter PHAs. The investigators will partner with a for-profit affordable housing management company that recently expanded its portfolio with the acquisition of 55 affordable housing properties in Pennsylvania, Ohio, West Virginia, Virginia and Kentucky. This provides a unique opportunity to address the implementation research gap, because these properties are in geographic locations where the smoking rate is close to twice the national smoking rate. The for-profit affordable housing management company has committed to adopting a smoke-free policy in these properties, to go into effect in early 2020.

Using an established implementation science framework to guide the approach, the investigators will work with property managers and staff of properties located in five high-smoking states to strategically incorporate the six implementation strategies to reduce SHS exposure among affordable housing residents. The findings will provide accessible, practical, and effective evidence for property managers and staff to support ongoing efforts to optimize the impact of a smoke-free residential policy. The investigators will test this approach in a geographic region with high smoking rates and a disproportionate burden of tobacco-related mortality, covering western Pennsylvania, southern Ohio, West Virginia, Virginia and Kentucky.

Conditions

Smoking, Tobacco; Second Hand Tobacco Smoke; Smoking Cessation

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: SEQUENTIAL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: NONE

Study Groups

Wave 1

Properties in Wave 1 (n=4) will implement a smoke-free policy on January 1, 2020.

Group Type: ACTIVE_COMPARATOR

Adaptive Intervention

Intervention Type: BEHAVIORAL

The investigators will conduct an adaptive intervention using six key implementation strategies identified in earlier research on the experiences of public housing authorities adopting a smoke-free housing policy: resident engagement, smoking cessation support, smoker compliance strategies, smoke-free policy enforcement, staff training and community partnership development. The implementation approach will be tailored for each property by varying the order and intensity of smoke-free policy implementation approaches. The design will determine the optimal plan for utilizing the six implementation strategies by learning from the challenges and successes of other properties (previous waves) and providing support to property managers to refine an implementation plan.

Wave 2

Properties in Wave 2 (n=4) will implement a smoke-free policy on May 1, 2020.

Group Type: EXPERIMENTAL

Adaptive Intervention

Intervention Type: BEHAVIORAL

The investigators will conduct an adaptive intervention using six key implementation strategies identified in earlier research on the experiences of public housing authorities adopting a smoke-free housing policy: resident engagement, smoking cessation support, smoker compliance strategies, smoke-free policy enforcement, staff training and community partnership development. The implementation approach will be tailored for each property by varying the order and intensity of smoke-free policy implementation approaches. The design will determine the optimal plan for utilizing the six implementation strategies by learning from the challenges and successes of other properties (previous waves) and providing support to property managers to refine an implementation plan.

Wave 3

Properties in Wave 3 (n=4) will implement a smoke-free policy on October 1, 2020.

Group Type: EXPERIMENTAL

Adaptive Intervention

Intervention Type: BEHAVIORAL

The investigators will conduct an adaptive intervention using six key implementation strategies identified in earlier research on the experiences of public housing authorities adopting a smoke-free housing policy: resident engagement, smoking cessation support, smoker compliance strategies, smoke-free policy enforcement, staff training and community partnership development. The implementation approach will be tailored for each property by varying the order and intensity of smoke-free policy implementation approaches. The design will determine the optimal plan for utilizing the six implementation strategies by learning from the challenges and successes of other properties (previous waves) and providing support to property managers to refine an implementation plan.

Interventions

Adaptive Intervention

The investigators will conduct an adaptive intervention using six key implementation strategies identified in earlier research on the experiences of public housing authorities adopting a smoke-free housing policy: resident engagement, smoking cessation support, smoker compliance strategies, smoke-free policy enforcement, staff training and community partnership development. The implementation approach will be tailored for each property by varying the order and intensity of smoke-free policy implementation approaches. The design will determine the optimal plan for utilizing the six implementation strategies by learning from the challenges and successes of other properties (previous waves) and providing support to property managers to refine an implementation plan.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Property Manager (or designated appointee) at one of the 12 selected sites implementing a smoke-free policy

• Aged 18 and over
• A resident of the housing development (12 selected sites) implementing the smoke-free policy

Exclusion Criteria

• None

• Unable/unwilling to complete surveys

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Harvard School of Public Health (HSPH)

OTHER

Sponsor Role: lead

Responsible Party

Vaughan Rees

Director, Center for Global Tobacco Control

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Harvard TH Chan School of Public Health

Boston, Massachusetts, United States

Countries

United States

Other Identifiers

MAHHU0041-18

Identifier Type: -

Identifier Source: org_study_id