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Insights from the Cancer Control Field:
Smoke-Free Homes: Some Things are Better Outside in San Diego, CA

At a Glance

The Catholic Charities Diocese of San Diego uses Smoke-Free Homes: Some Things Are Better Outside to reduce the harmful effects of second-hand smoke exposure. Read this case study narrative to learn how the organization implemented the program and how it can be used in your setting.

Challenges and Lessons Learned

Accepting Limitations to Recruitment

The Catholic Charities Diocese of San Diego faced the challenge of not being able to translate the materials. In the past, the organization was able to translate various tobacco control materials into eight different languages. Given the large number of community members who speak languages other than English, not being able to translate the materials may have impacted the organization’s recruitment numbers. However, the implementer still saw the benefits of using this smoke-free home program and plans to continue doing so “for the sake of the kids.”

Using Technical Assistance

The program developers at Emory Winship Cancer Institute are readily available to help implementers with any program challenges (e.g., questions about using the tracking tool, conducting coaching calls). Therefore, the Catholic Charities Diocese of San Diego recommends contacting the developers for program support.

Public Health Challenge

Since 1964, approximately 2.5 million non-smokers have died due to exposure to second-hand smoke. Among adults, who are most commonly exposed at home or at work, second-hand smoke causes heart disease, stroke, and lung cancer. Children, who are most often exposed to second-hand smoke in the home, are placed at greater risk of ear infections, more frequent and severe asthma attacks, respiratory symptoms and infections, and sudden infant death syndrome (SIDS). An estimated two out of every five children aged 3-11 in the United States are exposed to second-hand smoke regularly.

The U.S. Surgeon General recommends that adults maintain smoke-free homes to protect the health of their loved ones. Communities can encourage adults to implement smoking bans in their homes to reduce second-hand smoke exposure. The Catholic Charities Diocese of San Diego chose to implement the evidence-based program, Smoke-Free Homes: Some Things Are Better Outside, to reduce the exposure to second-hand smoke within its community.

The Setting

The Catholic Charities Diocese of San Diego was established in 1922 and has a long history of providing community support. The individuals who championed the use of Smoke-Free Homes within the Catholic Charities Diocese of San Diego have been implementing tobacco control and prevention programs at the organization since 1994.

Because the organization had successfully implemented tobacco control programs in the past, including with immigrants from Africa and Southeast Asia, the organization was interested in implementing Smoke-Free Homes. In addition, since many of the intervention’s activities can be conducted over the phone, the organization saw the opportunity to broaden its potential impact.

We chose to implement Smoke-Free Homes: Some Things Are Better Outside because many of the activities can be conducted over the phone and through the mail, allowing us to reach more people.

—Project Director

The Approach

The Catholic Charities Diocese of San Diego was awarded a 5-year grant from the California Department of Public Health. This grant funded the Smoke-Free Homes program at the organization and included face-to-face training, training materials (e.g., implementation manual), a tool to track mailings and coaching calls, printed materials for participants, and technical assistance.

The team lead from the Catholic Charities Diocese of San Diego attended a 2-day training at Emory University in Atlanta, Georgia, in November 2015. After she completed the training, she and her supervisor trained four staff members to conduct the participant recruitment component of the program. With the goal of enrolling 500 participants in the program, the staff started recruiting participants after receiving clearance from the program developers in January 2016.

The Catholic Charities Diocese of San Diego did not make any changes to the program components, using the program as intended. Within a day of an eligible participant being enrolled in the program, the Tobacco Education Clearinghouse of California sends him or her the first generated mailing, which includes interactive components (e.g., window cling, posters, pledge card).

Two weeks later, the team lead conducts the coaching call. The purpose of the 10- to 20-minute call is to discuss the mailed materials and the importance of implementing a smoke-free policy at home (banning smoking in all rooms of the house). The team lead makes up to six attempts to complete the coaching call with each participant.

After the coaching call is completed, the participant receives the first incentive (e.g., $20 gift card to Starbucks, Subway, Office Depot, or Staples).

The second mailing, transmitted through text message, discusses the challenges of implementing a home smoking ban. Later, a third mailing (sent through the mail) includes testimonials from others that have successfully implemented a smoking ban.

Lastly, at 3-month follow-up, participants receive a short call to assess whether they implemented a smoke-free home policy. After completing the followup call, they receive another incentive (e.g., $25 gift card to Starbucks, Subway, Office Depot, or Staples).

The Catholic Charities Diocese of San Diego receives technical assistance on an as-needed basis from the program developers. Additionally, the developers host bi-monthly calls with all their program implementers to share updates and answer questions. The program developers also conduct the program evaluation and provide data to implementers on the number of attempts to enroll participants and the number enrolled.

The Catholic Charities Diocese of San Diego has recruited more than 3,000 potential participants and successfully enrolled more than 150 participants. The organization has hopes to continue the program for another 5 years and is in the process of writing a proposal for another grant.

Questions and Answers

How long is a smoker enrolled in the program?

After a smoker is enrolled in the program, he or she receives three mailings, one coaching call, and one follow-up call over a 3-month period.

Did the implementer adapt the program?

No, the Catholic Charities Diocese of San Diego agreed to use the program as designed and did not make any changes to the program’s components.

Find Out More

To learn more about Smoke-Free Homes: Some Things Are Better Outside and how to use the program at your organization, view the program summary at: https://ebccp.cancercontrol.cancer.gov/programDetails.do?programId=28303637

Contact

The Implementer

Girma Gobezie
Catholic Charities Diocese of San Diego

The Developer

Michelle Kegler, DrPH, MPH
Emory Winship Cancer Institute
mkegler@emory.edu
(404) 712-9957