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Child MaltreatmentSFSCNCT05000632

Smoke Free SafeCare: Establishing a Smoke Free Home in CPS-involved Families

A study testing Smoke Free SafeCare and Standard SafeCare in people with Child Maltreatment and Smoking Behaviors, run by Georgia State University at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Smoke Free SafeCare (SFSC) is a proposed braided intervention consisting of two evidence-based interventions: Some Things are Better Outside (STBO), aimed at promoting smoke free home rules, and SafeCare, aimed at reducing child maltreatment and improving mother and child outcomes. Read more about this study

Who is it for?
Ages 18 to 89 yearsHealthy volunteers can take part
Conditions the study is for
Child Maltreatment, Smoking Behaviors
What is being tested?
Smoke Free SafeCare and Standard SafeCare
Could I receive a placebo?
No, everyone receives an active treatment
How many people
268 participants
Where
1 siteUnited States
Study dates
19 Apr 2022to Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 89 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Provider Inclusion Criteria:

  • SafeCare providers in this study must 1) have completed the SafeCare workshop and passed field Certification (9 sessions of SafeCare delivered with fidelity according to the SafeCare Fidelity Checklist); 2) be employed at an accredited SafeCare agency in a target state based on Centers for Disease Control and Prevention (CDC) adult smoking data or prior SafeCare research documenting high smoking rates.

Caregiver Inclusion Criteria:

  • Caregivers in this study must meet the following inclusion criteria to participate: 1) Referred to a SafeCare Provider study participant; 2) Reports in-home smoking behavior by herself or another person (person must reside in the home 3 or more nights a week) 3) Caregiver must be aged 18 or older and 4) Mother must be a parent to a child between the ages of 0 and 5 (or 0 - 9 if in the state of Oklahoma).

Provider Exclusion Criteria:

  • SafeCare providers will be excluded if they have planned for significant employment leave, resignation, or promotion during the study period.

Caregiver Exclusion Criteria:

  • We will exclude those who 1) Report that no one smokes in the home; 2) Demonstrate an inability to understand their responsibilities as outlined in the consent form. This will be determined as the research staff verbally go through the consent form with the mothers. If mothers do not understand the consent form and subsequent procedures, they will be excluded.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Manderley Recinos contact

(404) 413-1146

mrecinos2@gsu.edu

Shannon Self-Brown Principal Investigator contact

4044133500

sselfbrown@gsu.edu

United States1 site, 1 recruiting
  • Georgia State University

    Atlanta, Georgia, 30302

    Manderley Recinos, MA, 4044131146, mrecinos2@gsu.edu

    Shannon Self-Brown, PhD, 4044131283, sselfbrown@gsu.edu

    Recruiting

Other trials in United States

About this study

Official title: Establishing Smoke-free Homes With Families Involved in Child Protective Services: Effectiveness-implementation Trial of an Integrated Program

Smoke Free SafeCare (SFSC) is a proposed braided intervention consisting of two evidence-based interventions: Some Things are Better Outside (STBO), aimed at promoting smoke free home rules, and SafeCare, aimed at reducing child maltreatment and improving mother and child outcomes. STBO is effective in creating smoke free homes and reducing second-hand smoke in low-SES (socioeconomic status) households. SafeCare is an effective parent training program that is broadly disseminated in child protective services in the United States. SafeCare is a promising mechanism to effectively increase the reach of STBO to reduce SHS (secondhand smoke) exposure in families with documented high rates of tobacco use and children with cumulative risk for negative health outcomes.

Read the detailed description

Longitudinal studies have found beneficial effects of prevention and intervention efforts for children exposed to poverty and other adverse experiences on long-term health and a range of social and psychological outcomes. Evidence-based intervention programs exist for smoke-free homes and for child maltreatment risk. However, to our knowledge, no programs jointly target SHS (secondhand smoke) exposure and maltreatment risk, despite the evidence that these risk factors often co-occur for children living in low-SES households.

Some Things are Better Outside (STBO) is a brief intervention that is highly effective in promoting adoption of smoke-free home rules among low-SES households. Three randomized controlled trials (RCTs) documented significant intervention effects, with 40.0 to 62.9% of clients reporting a smoke-free home when reached for follow-up at 6 months post-baseline. Self-reported smoke-free homes were validated by air nicotine at 3-months post-baseline. STBO was also effective in a dissemination trial conducted with five 2-1-1 agencies across multiple states. The six-week intervention was designed to be easy to deliver, consisting of three mailings of print materials and a 15-20 minute coaching call.

SafeCare is a brief parenting intervention that is highly effective in reducing child maltreatment perpetration and improving behavioral outcomes for Child Protective Services-involved (CPS-involved) parents of young children (0 to 5 years) as the result of child physical abuse or neglect (the two most common forms of substantiated maltreatment). SafeCare is delivered in the home over 18-weeks, and the curriculum focuses on promotion of positive parenting skills, home safety, and child health. SafeCare is disseminated through the National SafeCare Training and Research Center (NSTRC) at Georgia State University (GSU), directed by Self-Brown (MPI) and Whitaker (Co-I).

In considering the best approaches for targeting SHS, it is imperative to consider how to integrate interventions with documented success for improving smoke-free rules and with high levels of parent engagement (which STBO has consistently demonstrated), into effective parenting intervention programs, such as SafeCare (which has also been demonstrated to be highly engaging). Thoughtful integration would ensure the maintenance of active ingredients for both programs, and parent engagement.

The goal of Smoke Free SafeCare is to conduct an effectiveness-implementation hybrid trial type 1 of the SFSC intervention for parents with substantiated maltreatment. This braided intervention will be compared to standard SafeCare.

The study aims are as follows:

  1. To conduct an effectiveness-implementation hybrid trial type 1.
  2. Compare SFSC to standard SafeCare on the addition of a full smoking ban in the home, and maintenance and stability of the smoking ban.
  3. Understand impact and sustainability of SFSC on parenting outcomes.
  4. Examine the variability in SFSC effects across sites and client characteristics.

This project will implement a mixed methods approach to gain insight about the perceived feasibility and impact of SFSC with mothers who report at least two risk factors at initial screening that are commensurate with child maltreatment perpetration risk. Understanding whether there is additive benefit to the integration of these programs will inform policy for best practices of programs serving low-SES families, and will further establish a structured approach for systematically integrating evidence-based programs for populations who have cumulative risk.

Being tested
Smoke Free SafeCare, Standard SafeCare
Medical subject headings
Smoking

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Smoke Free SafeCareBehavioural

    Also called SFSC

    SFSC is the systematically braided curriculum which combines both SafeCare and STBO programs, but in a new delivery format. To take full advantage of the home delivery mechanism of SafeCare, the content delivery of STBO has been adapted so that original mailings will be delivered in the SafeCare sessions. STBO has been fully braided into the Health and Safety modules. One of these interventions will be delivered first throughout the course of the study. The Smoke Free SafeCare intervention will involve 25 providers receiving training for the SFSC program. They will each recruit 10 mothers and conduct the SFSC program for each family. Overall, 250 families will receive the SFSC intervention.

  • Standard SafeCareBehavioural

    Also called SafeCare

    SafeCare is a brief parenting intervention that is highly effective in reducing child maltreatment perpetration and improving behavioral outcomes for CPS-involved parents of young children (0 to 5 years) as the result of child physical abuse or neglect (the two most common forms of substantiated maltreatment). The Standard SafeCare intervention will involve 25 SafeCare providers delivering the SafeCare program as usual. They will each recruit 10 mothers and conduct SafeCare for each family. Overall, 250 families will receive the standard SafeCare.

Study groups in NCT05000632
Study groupRoleWhat they receive
Smoke Free SafeCare (SFSC)ExperimentalProviders randomized to this group will receive additional SFSC training and will disseminate SFSC program to families who report having a smoker in the home.
Receives: Behavioral: Smoke Free SafeCare
Standard SafeCareActive comparatorProviders randomized to this group will disseminate the Standard SafeCare program to families who report having a smoker in the home.
Receives: Behavioral: Standard SafeCare

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Smoke Free Home Rules (Questionnaire)

    Mothers will answer questions specific to smoke free home rules implemented in their home.

    Measured: This outcome will be assessed at baseline.

  2. Change in Smoke Free Home Rules (Questionnaire)

    Mothers will answer questions specific to smoke free home rules implemented in their home.

    Measured: This outcome will be assessed at the 8 week time point.

  3. Change in Smoke Free Home Rules (Questionnaire)

    Mothers will answer questions specific to smoke free home rules implemented in their home.

    Measured: This outcome will be assessed at the 20 week time point.

  4. Change in Smoke Free Home Rules (Questionnaire)

    Mothers will answer questions specific to smoke free home rules implemented in their home.

    Measured: This outcome will be assessed at the 1 year time point.

  5. Time-Weighted Average Airborne Nicotine - Smoke Free Home Validation

    Research staff will place an air nicotine monitor in one room in which the family spends the most time. The monitors, the size of a petri dish, will be labeled and left in place for 7 days. For quality assurance and control, one blank sample per 10 samples will be included, along with duplicate samples collected for 10% of the total sample. Research staff will return to the home after 7 days to collect the monitor. Time-weighted average airborne nicotine will be assayed. The amount of nicotine collected is determined in the laboratory using gas chromatographic analysis. The sensitivity of these devices is sufficient to quantify low levels of passive smoke exposures over a period of a few days. Outcome is reported in micrograms of nicotine per cubed meter.

    Measured: This outcome will be assessed at the 8-week time point.

  6. Change in Time-Weighted Average Airborne Nicotine - Smoke Free Home Validation

    Research staff will place an air nicotine monitor in one room in which the family spends the most time. The monitors, the size of a petri dish, will be labeled and left in place for 7 days. For quality assurance and control, one blank sample per 10 samples will be included, along with duplicate samples collected for 10% of the total sample. Research staff will return to the home after 7 days to collect the monitor. Time-weighted average airborne nicotine will be assayed. The amount of nicotine collected is determined in the laboratory using gas chromatographic analysis. The sensitivity of these devices is sufficient to quantify low levels of passive smoke exposures over a period of a few days. Outcome is reported in micrograms of nicotine per cubed meter.

    Measured: This outcome will be assessed at the 1 year time point.

Secondary outcomes (16)
  1. Parenting Young Children Survey (PYCS)

    Parenting behavior

    Measured: Assessed at baseline

  2. Parenting Young Children Survey (PYCS)

    Parenting behavior

    Measured: Assessed at 8-week

  3. Parenting Young Children Survey (PYCS)

    Parenting behavior

    Measured: Assessed at 20-week

  4. Parenting Young Children Survey (PYCS)

    Parenting behavior

    Measured: Assessed at 1 year

  5. Perceived Stress Scale

    Measure of personal stress; Min: 0, Max: 5; Higher scores indicated higher perceived stress

    Measured: Assessed at baseline

  6. Perceived Stress Scale

    Measure of personal stress; Min: 0, Max: 5; Higher scores indicated higher perceived stress

    Measured: Assessed at 8 week

  7. Perceived Stress Scale

    Measure of personal stress; Min: 0, Max: 5; Higher scores indicated higher perceived stress

    Measured: Assessed at 20 week

  8. Perceived Stress Scale

    Measure of personal stress; Min: 0, Max: 5; Higher scores indicated higher perceived stress

    Measured: Assessed at 1 year

  9. Parenting Stress Inventory (PSI)

    Parent stress

    Measured: Assessed at baseline

  10. Parenting Stress Inventory (PSI)

    Parent stress

    Measured: Assessed at 8-week

  11. Parenting Stress Inventory (PSI)

    Parent stress

    Measured: Assessed at 20 week

  12. Parenting Stress Inventory (PSI)

    Parent stress

    Measured: Assessed at 1 year

  13. Smoking Cessation Questionnaire

    These questions assess parents attempts to stop or minimize smoking behaviors

    Measured: Assessed at baseline

  14. Smoking Cessation Questionnaire

    These questions assess parents attempts to stop or minimize smoking behaviors

    Measured: Assessed at 8-week

  15. Smoking Cessation Questionnaire

    These questions assess parents attempts to stop or minimize smoking behaviors

    Measured: Assessed at 20-week

  16. Smoking Cessation Questionnaire

    These questions assess parents attempts to stop or minimize smoking behaviors

    Measured: Assessed at 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Aug 2021
  2. Study start19 Apr 2022
  3. Primary completionDec 2026 (estimated)
  4. Study completionDec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants will be randomized at the provider level. Provider participants will be randomized into either Smoke Free SafeCare or Standard SafeCare. Their arm designation will then determine the group that mother participants will be assigned to.
Masking
Single blind
Who is masked
Investigator
Enrolment
268 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05000632
Sponsor's protocol ID
H21543
Acronym
SFSC
Status last verified
Apr 2026
First submitted
14 Jul 2021
Last updated
24 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: All collected individual participant data related to a dataset on parent and implementation outcomes have the potential to be shared with other researchers, if requested.

Publications

  • Perry EW, Self-Brown S, Koontz K, Haardorfer R, Whitaker DJ, Spears CA, Huang J, Kegler M. Evaluating the effectiveness of Smoke-Free Home SafeCare, an integrated intervention, among families at risk for secondhand smoke exposure and child maltreatment in the United States: a study protocol for a hybrid type 1 trial. Trials. 2024 Oct 7;25(1):661. doi: 10.1186/s13063-024-08466-2.

    PubMed 39375710
  • Self-Brown S, Perry EW, Recinos M, Cotner MA, Guastaferro K, Owolabi S, Spears CA, Whitaker DJ, Huang J, Kegler MC. Systematic braiding of Smoke-Free Home SafeCare to address child maltreatment risk and secondhand smoke exposure: findings from a pilot study. Pilot Feasibility Stud. 2023 May 12;9(1):81. doi: 10.1186/s40814-023-01303-4.

    PubMed 37173799

Questions about this trial

What is this clinical trial studying?

A study testing Smoke Free SafeCare and Standard SafeCare in people with Child Maltreatment and Smoking Behaviors, run by Georgia State University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 24 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Manderley Recinos ((404) 413-1146, mrecinos2@gsu.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Smoke Free Home Rules (Questionnaire) (time frame: This outcome will be assessed at baseline.). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05000632, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Apr 2026.

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