Systematic braiding of Smoke-Free Home SafeCare to address child maltreatment risk and secondhand smoke exposure: findings from a pilot study

Shannon Self-Brown, Elizabeth W. Perry, Manderley Recinos, Michaela A. Cotner, Kate Guastaferro, Shadé Owolabi, Claire A. Spears, Daniel J. Whitaker, Jidong Huang, Michelle C. Kegler

Research output: Contribution to journalArticlepeer-review


Background: Exposure to secondhand tobacco smoke (SHS) and child maltreatment are preventable threats to child health. Few evidence-based interventions target both SHS and child maltreatment risk. The purpose of this paper is to describe the systematic braiding process of two evidence-based programs to address child SHS in the home and maltreatment perpetration risk, and present results from the formative work and pilot study. Methods: The first 4 steps of the systematic braiding process were completed, including the following: (1) the identification of core elements of both programs, (2) the development of an initial draft of the braided curriculum (Smoke-Free Home SafeCare — SFH-SC), (3) an acceptability and feasibility pilot of SFH-SC with caregivers of young children who reported a smoker living in the home (N = 8), and (4) feedback collection on the braided curriculum from SafeCare Providers (N = 9). Results: Experts identified common pedagogical and theoretical underpinnings for the two programs and braided Smoke-Free Homes: Some Things Are Better Outside into two SafeCare modules. Caregiver feedback from the pilot demonstrated that participants were engaged with SFH-SC and felt supported and comfortable discussing SHS intervention content with the SFH-SC Provider. Caregiver self-reports indicated a slight increase in smoke-free home rules from baseline to follow-up and a notable reduction in parent stress on the Parent Stress Index of 5.9 points (SD = 10.2). SafeCare Provider feedback following intensive review of the curriculum indicated high feasibility for SFH-SC delivery. Conclusions: Parent and Provider findings suggest SFH-SC is a viable intervention that has potential to reduce the public health impact of SHS and child maltreatment for at-risk families. Protocol: The protocol for the pilot is not published elsewhere; however, the full protocol for the hybrid trial can be found here: . Trial registration: NCT, NCT05000632. Registered 14 July 2021, there is not a separate registration number for the pilot.

Original languageEnglish (US)
Article number81
JournalPilot and Feasibility Studies
Issue number1
StatePublished - Dec 2023


  • Child maltreatment
  • Child protection
  • Parenting
  • Smoke-free home
  • Systematic braiding

ASJC Scopus subject areas

  • Medicine (miscellaneous)


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