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Originally published by 2 Minute Medicine® (view original article). Reused on AccessPediatrics with permission.

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1. For children aged 20 years old, lower levels of serum cotinine were found in the supportive parenting intervention group compared to the control group.

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2. Parents in the intervention group were also more likely to utilize supportive parenting techniques for children ages 11 to 16 years when compared to the control group.

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Evidence Rating Level: 1 (Excellent)

Study Rundown:

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A commonly studied topic in medicine, and particularly in pediatrics, involves effective strategies to decrease rates of smoking in youth, which is commonly associated with coronary heart disease, stroke, and different types of cancers. In this study, African American families and their 11 year old children were enrolled in a supportive parenting program until the children were 20 years old, at which levels of serum cotinine (a biomarker for recent smoking) was measured. Results demonstrated significantly lower levels of cotinine in the intervention group when compared to the control group. Mediation analysis confirmed that this was due to the parenting intervention at age 11. In addition, parents in the intervention group were also more likely to utilize supportive parenting techniques for children ages 11 to 16 years when compared to the control group. One limitation of this study was the lack of a baseline cotinine level for comparison before the trial. In addition, the sample population was only African American, limiting the generalizability of this study. Providers can use these findings to suggest an intervention program for youth and families who struggle with smoking in order to help decrease their risk of future disease.

In-Depth [randomized controlled trial]:

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Families chosen to be part of this study were enrolled in the Strong African American Families (SAAF) program, a family centered preventive intervention that was designed to enhance supportive parenting of African American preadolescents (age 11) from the rural southern United States. A total of 257 families were randomly assigned to the SAAF program intervention, whereas 167 were assigned to a control group. In the intervention group, parents attended 7 meetings during which parents and youth participated in prevention programming. Parents learned about emotional support, discipline, family routines, and expectations for drug use, while youth learned about the importance of rules, dealing with racism, and the value of setting goals. The intervention group demonstrated significantly lower cotinine levels at age 20 (M=0.672, SD=0.048) than control participants (M=0.824, SD=0.059, p=0.046). Survey (self-reported) results also demonstrated that parents in the intervention group had increased use of supportive parenting techniques for children ages 11 to 16 (M=0.183, SD=0.121) compared to controls (M=-0.085, SD=0.152, p=0.016). Overall, the results suggest that the lower cotinine levels were due to improved supportive parenting. Mediation analysis revealed that the increase in supportive parenting was largely responsible for the effects it had on smoking among African American youth.

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