Rationale

Recent research conducted by the study team suggests that 38% of Hunter children live in a home with at least one smoker and as many as 47% have a detectable level of cotinine in their urine which is an indicator of tobacco smoke absorption. Children exposed to Environmental Tobacco Smoke (ETS) are at greater risk of experiencing health conditions including childhood otitis media, SIDS, asthma and lower respiratory tract illness. The primary source of childhood exposure to ETS is smoking parents, hence interventions directed at modifying parental behaviour including encouraging smoking cessation and the implementation of smoking restrictions in homes can be effective in reducing ETS exposure.

Health services involved in the maternity-to-child and family health service continuum offer a unique opportunity to deliver a multi contact, multi faceted ETS care intervention. These services, including in-patient delivery services, neonatal intensive care units (NICUs), out-patient postnatal services (Child and Family Health Services- CFHS) and paediatric inpatient services, offer the potential for the delivery of an integrated continuum of ETS preventive care services to large numbers of ETS exposed children.

Paediatric facilities are an ideal setting for the provision of information on the dangers of ETS exposure as the community expect and accept preventive health advice provided in health care settings and view health professionals as credible sources of information. Research by the study team, in conjunction with the NSW Centre for Health Promotion, has identified that only 30% of 154 paediatric health care settings in NSW provide adequate assessment of child ETS exposure and, of these, only 45% provide subsequent preventive care. The study team has identified that within the Hunter, although some systems exist to support the screening of ETS risk, best-practice screening and care delivery is not universally implemented.

Aims and objectives

The overall aim of the project is to reduce the prevalence of ETS exposure amongst children attending Hunter Health facilities.

The specific objectives are to:

• Increase best practice ETS screening amongst children attending Hunter Health facilities.
• Increase the provision of best practice ETS care to children attending Hunter Health facilities.

Overview of service

In collaboration with Kaleidoscope services throughout Hunter Health, best practice screening and care protocols for the prevention of tobacco related harm in children will be developed and implemented. To support the implementation of these enhancements to service delivery, an organisational change model will be applied which will focus on system and procedure enhancements, such as changes to existing databases and forms, facilitating senior leadership and management support, quality control including performance feedback, staff training and effective communication.

For more information about this service, please contact HNEPH