Pediatric Emergency Department Decision Support System to Reduce Secondhand Smoke

The study will be the first to develop and evaluate a Pediatric Emergency Department (PED)
Decision Support System (DSS)-Electronic Medical Records (EMR) System to facilitate the
identification of smokers and the delivery of a Second Hand Smoke (SHSe) exposure
intervention to caregivers who bring their child to the PED. The investigators will conduct a
two-phased project to develop, refine, and integrate a Decision Support System into the
current electronic medical record system. In Phase I, the investigators will develop a
three-part DSS with prompts to: 1) ASK about child SHSe and caregiver smoking 2) Use a
software program (REDCap) to ADVISE caregivers to reduce their child's SHSe via total smoking
home and car bans and quitting smoking, and 3) ASSIST caregivers to quit by directly
connecting them to their choice of free cessation resources (e.g., Quitline, txt2quit,
smokefree.gov) during the PED visit. If the investigators discover that a teen participant is
a smoker, the investigators will provide them with resources for the Quitline, tx2quit, and
teen.smokefree.gov. The investigators will create reports to provide feedback to nurses on
their SHSe counseling behaviors. Nurses will provide input on program content, functions, and
design. In Phase II, the investigators will conduct a 3-month feasibility trial to test the
results of implementing the DSS on changes in nurse SHSe-related behaviors, and child and
caregiver outcomes.

Inclusion Criteria:

- Nurses who work at least 2 shifts per week

- Current smokers accompanying their 0-18 year old child to the Emergency Department or
Urgent Care

Exclusion Criteria:

- Non English speaking families