{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T13:03:28Z","timestamp":1792242208917,"version":"4.4.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T00:00:00Z","timestamp":1707350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Public Health Service","award":["CA162839"],"award-info":[{"award-number":["CA162839"]}]},{"name":"Public Health Service","award":["CA192950"],"award-info":[{"award-number":["CA192950"]}]},{"name":"Public Health Service","award":["P30CA051008"],"award-info":[{"award-number":["P30CA051008"]}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Multilevel interventions in healthcare settings (e.g. Ask, Advise, and Connect; AAC) can reduce tobacco product use among adult patients: their effectiveness in pediatric practice is largely unknown. We implemented an AAC model in pediatric primary care to deter children\u2019s tobacco use, and evaluated its effectiveness in a single-arm trial. At wellness visits, young patients (ages 12\u201317) completed a tablet-based assessment (Ask) of lifetime and current tobacco use. These data were made available within the electronic health record to pediatric primary care providers for preventive counseling (Advise). Providers then referred patients to an e-health evidence-based tobacco control intervention (Connect). Tobacco control outcomes were examined in the clinic population (N = 2219) and in a sample of patients (N = 388, 62% female, 39% non-White, M age = 15) over time, along with intervention engagement. Population use of tobacco products decreased following introduction of AAC (more than 2-fold). At the patient level, most children (80.9%) engaged with the intervention: those who were Black or African American, who never used tobacco products\/were not susceptible to use, and who used fewer non-cigarette tobacco products were more likely to engage, but only after multiple prompts versus a single prompt. Engagement was positively associated with lowering children\u2019s susceptibility to using tobacco at follow-up. A pediatric AAC model holds promise in deterring youth tobacco use, including among historically marginalized populations who may require additional support.<\/jats:p>","DOI":"10.1093\/tbm\/ibae002","type":"journal-article","created":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T22:29:05Z","timestamp":1707431345000},"page":"241-248","source":"Crossref","is-referenced-by-count":3,"title":["A multilevel intervention in pediatric primary care for youth tobacco control: Outcomes of implementing an Ask, Advise, and Connect model"],"prefix":"10.1093","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6605-0743","authenticated-orcid":false,"given":"Darren","family":"Mays","sequence":"first","affiliation":[{"name":"Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center , Columbus, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M","family":"Macisco","sequence":"additional","affiliation":[{"name":"Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center , Columbus, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten B","family":"Hawkins","sequence":"additional","affiliation":[{"name":"MedStar Georgetown University Hospital, Georgetown University Medical Center , Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Marcelo M","family":"Sleiman","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center, Georgetown University , Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Rose","family":"Yockel","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center, Georgetown University , Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoulong","family":"Xie","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center, Georgetown University , Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4583-2911","authenticated-orcid":false,"given":"Lilianna","family":"Phan","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center, Georgetown University , Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4035-7632","authenticated-orcid":false,"given":"George","family":"Luta","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center, Georgetown University , Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Lobo","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center, Georgetown University , Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anisha","family":"Abraham","sequence":"additional","affiliation":[{"name":"Children\u2019s National Health System , Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander V","family":"Prokhorov","sequence":"additional","affiliation":[{"name":"MD Anderson Cancer Center , Houston, TX ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth P","family":"Tercyak","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center, Georgetown University , Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,2,8]]},"reference":[{"key":"2025052600563455400_CIT0001","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.jadohealth.2014.08.025","article-title":"Long-term health and medical cost impact of smoking prevention in adolescence","volume":"56","author":"Wang","year":"2015","journal-title":"J Adolesc Health"},{"key":"2025052600563455400_CIT0002","first-page":"1","article-title":"Use of selected clinical preventive services to improve the health of infants, children, and adolescents\u2014United States, 1999\u20132011. 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