{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T04:15:45Z","timestamp":1772856945520,"version":"3.50.1"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T00:00:00Z","timestamp":1731542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Wilhelm\u2019s Department of Family Medicine and Community Health"},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis Musculoskeletal and Skin Diseases","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K12 AR084223"],"award-info":[{"award-number":["K12 AR084223"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Household secondhand smoke (SHS) exposure remains a significant health issue for racially and ethnically minoritized children in the United States. Delivering parental tobacco treatment during pediatric primary care visits can reduce children\u2019s SHS exposure. This study examined current tobacco screening practices and health system stakeholder perceptions of facilitators and barriers to addressing tobacco use during pediatric visits among racially and ethnically minoritized parents.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted 25 semistructured interviews with clinicians, staff, and health system leaders from five pediatric primary care clinics in Minneapolis\u2013St. Paul, Minnesota. The study was informed by the Health Equity Implementation Framework. Interviews were analyzed using both directed content and thematic analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Participants identified multilevel facilitators and barriers to addressing parental tobacco use in minoritized families. Within the clinical encounter, barriers included linguistic and cultural barriers, health system navigational challenges, medical mistrust, low levels of clinician and staff knowledge, skills, and confidence, time constraints, and lack of alignment with external metrics. Facilitators centered on leveraging interpreters\u2019 cultural knowledge and the presence of culturally congruent clinicians and staff to reduce medical mistrust and stigma, developing linguistically and culturally relevant resources, and integrating prompts and resources into the electronic health record. Participants described how lessons from previous system change mechanisms would facilitate this work.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Addressing health system, training and resources, and linguistic and cultural barriers among clinicians and staff is essential to strengthen their capacity to address household SHS exposure among racially and ethnically minoritized populations as a component of pediatric preventive care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>Clinicians and health system staff perceive unique barriers to identifying and addressing parental tobacco use among racially and ethnically minoritized parents during pediatric primary care visits. Solutions to expand tobacco treatment access to minoritized parents in pediatric settings must attend to clinician training needs on tobacco treatment, embedding clinical encounter resources and reminders that match the linguistic and cultural needs and preferences of their patient populations, and increasing access to high-quality interpreting services and culturally congruent staff.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntae264","type":"journal-article","created":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T05:45:48Z","timestamp":1731563148000},"page":"822-829","source":"Crossref","is-referenced-by-count":2,"title":["Addressing Tobacco Screening and Treatment Among Racially and Ethnically Minoritized Parents in Pediatric Clinics: Barriers and Facilitators"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1562-0400","authenticated-orcid":false,"given":"April K","family":"Wilhelm","sequence":"first","affiliation":[{"name":"Department of Family Medicine and Community Health, Program in Health Disparities Research, University of Minnesota , Minneapolis, MN ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Anthropology, College of Liberal Arts, University of Minnesota , Minneapolis, MN ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele L","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Community Health, Program in Health Disparities Research, University of Minnesota , Minneapolis, MN ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2246-9825","authenticated-orcid":false,"given":"Steven S","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Minnesota , Minneapolis, MN ,","place":["USA"]},{"name":"Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System , Minneapolis, MN ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junia N","family":"de Brito","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Community Health, University of Minnesota , Minneapolis, MN ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3561-8276","authenticated-orcid":false,"given":"Rebekah J","family":"Pratt","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Community Health, Program in Health Disparities Research, University of Minnesota , Minneapolis, MN 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