scholarly journals Using a Collaborative Approach to Tobacco Control Efforts in Marginalized Communities

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Crystal Robertson ◽  
Hadii M. Mamudu ◽  
Mary Ann Littleton ◽  
Rafie Boghozian ◽  
Daniel Owusu ◽  
...  
Keyword(s):  
Community Engagement ◽  
Tobacco Control ◽  
Tobacco Use ◽  
Low Income ◽  
Evidence Based ◽  
Multiple Sources ◽  
Community Based ◽  
Screening Programs ◽  
Northeast Tennessee ◽  
Policies And Programs

ObjectiveTo examine community engagement as a means to strengthentobacco-related policies and programs use in marginalizedpopulations.IntroductionAlthough significant progress has been made in tobacco control inthe United States (US) over the past 50 years, more than 15% of thepopulation currently use tobacco products.1Tobacco use continuesto be the leading cause of preventable death, contributing to over480,000 deaths and about $300 billion in economic costs each year.To achieve theHealthy People 2020(HP2020) objective of 12%national adult smoking rate by 2020, it is important to focus ourtobacco control efforts on surveillance and addressing disparitiesin tobacco use prevalence and tobacco-induced diseases acrossdifferent subpopulations and geographic areas.2Utah reportedthe lowest prevalence rate (9.7% in 2014), while rates as high as28% were identified in central Appalachia. Modern epidemiologyis limited in its ability to explain patterns of tobacco use andtobacco-related interventions and policies in these highly prevalent,marginalized environments. Therefore, a combination of quantitativeand community-based participatory research (CBPR), as proposedin Public Health 3.0, will expand the scope and reach to addressall factors of tobacco use, including cross-sector collaboration andmulti-level actions.3This study aimed to comprehensively investigatecounties in the Northeast Tennessee region where tobacco useprevalence is disproportionately highest, and to identify regionaland culturally specific evidence-based practices for tobacco control.Additionally, the study examined how these practices can be scaledup to address similar high tobacco use and disadvantaged populationselsewhere in the US and worldwide.MethodsGrounded by the CBPR framework, a mixed-methods approachtriangulated multiple sources of data using a three-prong assemblageofProtection,Prevention, andCessation, to develop tobaccocontrol recommendations and goals as part of a Population HealthImprovement Plan for Tennessee. Information gained from healthcouncil discussions, focus groups, interviews, and stakeholdermeetings were combined with quantitative analyses of secondarydata from Tennessee Department of Health, school-based surveys,and qualitative analyses conducted for descriptive and inferentialstatistics. All discussions and interviews involving 222 individualsfrom 91 organizations were recorded and organized using NVivo10, thematically coded using grounded theory, and analyzed usingdescriptive statistics. The results utilized aggregated themes generatedfrom the data.ResultsTobacco use in the Northeast Tennessee region comprises cigarettesmoking and smokeless tobacco, with increasing uptake of electroniccigarettes across all age groups. Among others, culture of tobaccouse and cultivation was identified as the most salient factor fortobacco use. Reducing tobacco use requires a foundation built oninformatics, community engagement, and a model for sustainablefunding to support infrastructure and program interventions. Whilestate and national policies and programs have received less attentionin this region, several effective community-based policies andprograms to prevent tobacco use were identified, including incentiveprograms such as Baby and Me, voluntary smoke-free campuspolicies by businesses and colleges, 100% screening programs byhospitals, and nicotine-free employee population. Overall, a total of25 recommendations were identified, with 14 aimed at protection,four at prevention, and seven at cessation. These recommendationsculminated into five overarching goals:Protectthe population fromtobacco and secondhand smoke exposure through policy enforcementand implementation and counter-marketing;Preventinitiation oftobacco use with comprehensive youth-focused programs that increaseknowledge and awareness;Expandaccess to cessation resources andtreatment, especially in high risk populations;Fostercollaborationand partnership; andMonitordata for evaluation and validity.ConclusionsThis is one of the few comprehensive attempts to address the socialdynamics of tobacco use and identify population and geographicpolicies and programs in highly prevalent communities. Amongthe myriad issues identified, the expansion of surveillance data toinform tobacco policy and culturally-tailored tobacco policies andprograms are essential to reduce tobacco use in population subgroups.Combining CBPR with actionable data can spur innovations inlocal efforts, highlight social determinants of health, and contributeto evidence-based policy. While the results of this study primarilyprovide in-depth descriptions of central Appalachia’s tobacco-relatedrisks and their perceptions of and reactions to tobacco preventionintervention, the policies and programs identified through the processmay be more readily adopted and scaled-up to address the disparitiesin tobacco use and tobacco-induced diseases, particularly pertainingto low-income, disadvantaged, and hard-to-reach populations.

Implementing Evidence-Based Tobacco Use Treatment in Community Health Centers in Vietnam

2018 ◽  
Author(s):  
Mark Parascandola ◽  
Donna Shelley
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Community Health Centers ◽  
Evidence Based ◽  
Middle Income ◽  
Global Epidemic ◽  
Middle Income Countries ◽  
Tobacco Control Policies ◽  
Policies And Programs

Although tobacco use has been declining in most high-income countries, it has remained constant or increased in other areas of the world, shifting to low- and middle-income countries (LMICs). The Framework Convention on Tobacco Control (FCTC) was adopted in 2003 to address the growing global epidemic of tobacco use. The 181 countries that are parties to the treaty are required to adopt a range of evidence-based tobacco control policies and programs, including access to tobacco use treatment. This case study provides an overview of the progress and gaps in implementing the FCTC and demonstrates the application of implementation science methods to identify and address barriers to implementing a cessation interventions in the context of a health system in an LMIC.

Abstract MP043: Awareness of Hypertension and Determinants of Treatment in a Community-Based Observational Sample in Da Nang, Viet Nam

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Zachary P Boas ◽  
Annette L Fitzpatrick ◽  
Quang V Ngo ◽  
James P Logerfo
Keyword(s):  
Blood Pressure ◽  
Low Income ◽  
World Health ◽  
Viet Nam ◽  
Behavioral Modification ◽  
Community Based ◽  
Major Health Problem ◽  
Screening Programs ◽  
Urban Regions ◽  
Undiagnosed Hypertension

Introduction: Hypertension in Viet Nam is becoming an increasing source of mortality and morbidity. While data collection on hypertension in resource poor environments has been improving through the use of standardized surveys, little is known about how well treatments are being applied. Knowledge of gaps in diagnosis and treatment is necessary if appropriate public health programs are to developed. Using a community based observational sample in the Da Nang province of Viet Nam, we studied both the prevalence of undiagnosed hypertension, as well as the types of treatment those with hypertension received. Methods: Randomized cluster sampling methods were used to identify adults age 35 years and older in six communes of Da Nang province, Viet Nam. Using World Health Organization guidelines, data were collected on subject’s demographics, medical history, blood pressure and health behaviors. Subjects were also instructed to bring all medications they take regularly which were then recorded. Separate multivariate logistic regressions were used to identify both factors associated with awareness of hypertension as well as factors influencing whether one received medical therapy. Results: The initial survey examined 1,621 adults with 557 (34.5%) having hypertension. Of those, only 232 (41.7%) were aware of the diagnosis. Being male (OR 0.52, 95% CI: 0.36–0.75), older (OR 1.03, 95% CI: 1.02–1.05 per year) and having a low income (OR 1.11, 95% CI: 1.05–1.16 per million dong/month) were each independently associated with being unaware of one’s hypertension. Of those who were aware of their hypertension, 212 (91.4%) had been recommended some behavioral modification (exercise, decreased sodium intake, smoking cessation, or weight loss). Two-thirds (152/229) reported having taken antihypertensives in the past two weeks. Reported use of medication differed by region, 109/150 (72.7%) in urban regions versus 43/79 (54.4%) in rural/mixed-urban regions (p<0.05), but was not associated with any other demographic. Eighty-nine (38.9%) of those aware of their hypertension had adequately controlled blood pressure when evaluated, and this did not differ based on reported medication use. We were able to determine the actual medications used in 91 of the 152 (59.9%). Seven people were on dual therapy, the remainder were on monotherapy. Calcium channel blockers (54, 59.3%) and ACE inhibitors (36, 39.6%) were the most common therapies. Conclusions: Undiagnosed hypertension remains a major health problem in the Da Nang province of Viet Nam. The vast majority of those aware of their hypertension were receiving at least some level of behavioral modification with a smaller, but substantial, majority receiving medications. Screening programs focused on young and poor men may be a rich target for improving hypertension control in Viet Nam.

scholarly journals The Implementation of Evidence-Based Obesity Education Curricula to Prevent Cancer in a Predominantly Mexican–American Community on the U.S.-Mexico Border

2021 ◽  
Author(s):  
Roy Valenzuela ◽  
Alma Morales ◽  
Jon Sheen ◽  
Sylvia Rangel ◽  
Jennifer J. Salinas
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
Mexican Americans ◽  
Weight Status ◽  
Cognitive Theory ◽  
Underserved Populations ◽  
Evidence Based ◽  
Community Based ◽  
Incidence And Mortality ◽  
Low Income Housing

Abstract Although cancer is the leading cause of death among Mexican-Americans, few community-based programs target obesity reduction as a way to reduce the prevalence of obesity-related cancer in underserved populations. Evidence suggests that obesity correlates with 13 types of cancer. The objective is to provide an overview of evaluation and selection of evidence-based content; details of the implementation process; modifications needed to tailor education programs to specific needs of different target audiences; and demonstrate challenges of implementing a community-based prevention program intended to reduce cancer incidence and mortality in Mexican-Americans. We used the Social Cognitive Theory (SCT) to develop a 10-topic menu of educational classes using elements of multiple evidence-based curricula. Outcome measures for physical activity and nutrition were determined using the International Physical Activity Questionnaire (IPAQ) and the Dietary Screener Questionnaire (DSQ). Weight status was determined using weight, body fat, and body mass index (BMI). To date, 2845 adults received wellness education from our program. Multiple delivery models were used to reach a larger audience; they included a 4-week model, 5-week model, employer model, low-income housing, 1- and 2-h sessions, and clinic encounters. Individuals were given education at multiple community locations including senior centers (14%), churches (0.6%), employers (17.6%), low-income housing (8.2%), community centers (16.6%), clinics (11.5%), and schools (32.5%). Our study indicates that our delivery model is feasible and can disseminate evidence-based obesity education. Further investigation is necessary to assess long-term behavioral change and to assess the most effective model for delivery.

scholarly journals Impact of India’s National Tobacco Control Programme on bidi and cigarette consumption: a difference-in-differences analysis

2018 ◽  
Vol 29 (1) ◽  
pp. 103-110 ◽  
Author(s):  
Gaurang P Nazar ◽  
Kiara C-M Chang ◽  
Swati Srivastava ◽  
Neil Pearce ◽  
Anup Karan ◽  
...  
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Low Income ◽  
Poor Performance ◽  
Control Programme ◽  
Cigarette Consumption ◽  
Mortality Reduction ◽  
Consumer Expenditure ◽  
Difference In Differences ◽  
Cross Sectional

BackgroundDespite the importance of decreasing tobacco use to achieve mortality reduction targets of the Sustainable Development Goals in low-income and middle-income countries (LMICs), evaluations of tobacco control programmes in these settings are scarce. We assessed the impacts of India’s National Tobacco Control Programme (NTCP), as implemented in 42 districts during 2007–2009, on household-reported consumption of bidis and cigarettes.MethodsSecondary analysis of cross-sectional data from nationally representative Household Consumer Expenditure Surveys (1999–2000; 2004–2005 and 2011–2012). Outcomes were: any bidi/cigarette consumption in the household and monthly consumption of bidi/cigarette sticks per person. A difference-in-differences two-part model was used to compare changes in bidi/cigarette consumption between NTCP intervention and control districts, adjusting for sociodemographic characteristics and time-based heterogeneity.FindingsThere was an overall decline in household-reported bidi and cigarette consumption between 1999–2000 and 2011–2012. However, compared with control districts, NTCP districts had no significantly different reductions in the proportions of households reporting bidi (adjusted OR (AOR): 1.03, 95% CI: 0.84 to 1.28) or cigarette (AOR: 1.01 to 95% CI: 0.82 to 1.26) consumption, or for the monthly per person consumption of bidi (adjusted coefficient: 0.07, 95% CI: −0.13 to 0.28) or cigarette (adjusted coefficient: −0.002, 95% CI: −0.26 to 0.26) sticks among bidi/cigarette consuming households.InterpretationOur findings indicate that early implementation of the NTCP may not have produced reductions in tobacco use reflecting generally poor performance against the Framework Convention for Tobacco Control objectives in India. This study highlights the importance of strengthening the implementation and enforcement of tobacco control policies in LMICs to achieve national and international child health and premature NCD mortality reduction targets.

Curtailing Tobacco Use Among Youth: Evaluation of Project 4-Health

2002 ◽  
Vol 29 (6) ◽  
pp. 656-682 ◽  
Author(s):  
Carol N. D’Onofrio ◽  
Joel M. Moskowitz ◽  
Marc T. Braverman
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Behavioral Intention ◽  
Program Effectiveness ◽  
Youth Leadership ◽  
Long Term Effects ◽  
Short Term ◽  
Community Based ◽  
Youth Groups

This article reports the development and evaluation of Project 4-Health, a theory-driven, research-based program to prevent tobacco use among youth enrolled in 4-H clubs throughout California. Additional goals were to involve youth in discouraging others’tobacco use and to develop youth leadership for tobacco control. To assess program effectiveness, 72 clubs were matched and randomly assigned to the program or control condition. Of 1,853 eligible club members, 88.6% completed the pretest. Of these, 79.5% completed a posttest 4 months after conclusion of program delivery, and 77.6% completed a second posttest 2 years later. Short-term effects were found on 7 of 24 outcome measures, indicating changes in knowledge, attitudes, and behavioral intention, but not in social influence variables or behaviors. No long-term effects were observed. Discussion considers how the challenges of designing, delivering, and evaluating the intervention influenced results and implications for preventing tobacco use through community-based youth groups.

scholarly journals A Community-Based “Street Team” Tobacco Cessation Intervention by and for Youth and Young Adults

2020 ◽  
Author(s):  
Anne Saw ◽  
Crystal Nicole Steltenpohl
Keyword(s):  
Young Adults ◽  
Tobacco Control ◽  
Tobacco Use ◽  
Tobacco Cessation ◽  
Team Approach ◽  
Post Intervention ◽  
Community Based ◽  
Team Members ◽  
Youth And Young Adults

Most tobacco users initiate use as youth or young adults. To promote tobacco cessation for this group and encourage non-users’ engagement in tobacco control efforts, a community-based organization developed a “Street Team” brief outreach intervention that enlisted youth and young adults to encourage their peers to stop tobacco use through a brief intervention. Street Team members provided education, a Quit Kit, and referrals to cessation resources at a total of 27 community events over a four-year period. Tobacco users (n = 279) completed assessments of tobacco use, quit intention, and quit self-efficacy at baseline. Self-reports of cessation outcomes including past week abstinence were assessed 1-, 3-, and 6-months post-intervention. Perceptions of the intervention were gathered from Street Team members (n = 28) and intervention participants post-intervention. T-tests and χ2-tests were used to compare those who completed at least one follow-up assessment to those lost to follow-up. Time effects were analyzed using fixed effect models. Missing = using analyses indicate 16.1, 18.6, and 12.5% 7-day quit rate at 1-, 3-, and 6-months follow-up. Feedback from intervention participants indicate the intervention was acceptable and that discussions with Street Team members and provision of quit kits motivated tobacco users to consider quitting. All Street Team members responded positively to their participation in the intervention. This Street Team approach for youth and young adults is promising as an effective approach to the promotion of tobacco cessation among users and engagement and empowerment in tobacco control efforts among non-users.

scholarly journals Disseminating an Evidence-Based Tobacco Control Intervention for School Teachers in India: Overview and Preliminary Findings

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 55-55
Author(s):  
Eve Nagler ◽  
Mangesh Pednekar ◽  
Dhirendra Sinha ◽  
Keyuri Adhikari ◽  
Mary Vriniotis ◽  
...  
Keyword(s):  
Policy Implementation ◽  
Tobacco Control ◽  
Tobacco Use ◽  
Role Models ◽  
Large Scale ◽  
Program Effectiveness ◽  
Evidence Based ◽  
School Teachers ◽  
Tobacco Use Cessation ◽  
Intervention Cluster

PURPOSE In India in 2010, tobacco use accounted for more than 1 million deaths. There is a profound need for evidence-based interventions (EBIs) that promote tobacco control on a large scale, particularly in low- and middle-income countries. Our goal was to identify creative strategies for the broad-based implementation of tobacco control EBIs that can be embedded in existing organizational infrastructures and accommodate the realities of low-resource settings. We built on an intervention for schoolteachers, called the Tobacco-Free Teachers/Tobacco-Free Society (TFT-TFS) program, which had been shown to be efficacious in increasing tobacco use cessation and tobacco policy implementation in a cluster randomized controlled trial in the Bihar School Teachers’ Study. Teachers in India are an important channel for promoting tobacco control given their roles as community leaders and role models. This study tested whether TFT-TFS can be successfully implemented by building capacity within the education department to train and support headmasters to implement TFT-TFS in their schools. METHODS Six blocks from 3 districts in Bihar, India, were randomly assigned into either the intervention or control arm. Using a cascade-training model, intervention cluster coordinators—who routinely interact with headmasters—were trained to train headmasters from their respective clusters to implement TFT-TFS over 1 academic year. This study used a noninferiority design to test if program implementation will not be inferior to the high standards demonstrated in the Bihar School Teachers’ Study and assessed program effectiveness in improving cessation and policy implementation. RESULTS Nearly all of the 46 trained intervention cluster coordinators further trained more than 90% of the 218 headmasters to implement TFT-TFS. Preliminary data also indicate that two thirds of headmasters reported implementing 3 of 4 program components. Additional findings will be available Spring 2020. CONCLUSION This research is innovative because it systematically examines the process of scaling up one of the first EBIs to promote tobacco use cessation among teachers in India.

scholarly journals Global Trends in Tobacco Cigarette Use among Adolescents: Prevalence of Use and Evidence Based Cessation Interventions

2020 ◽  
Vol 1 (Fall/Winter) ◽  
pp. 1-15
Author(s):  
Rejoic Addae
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
World Health ◽  
Current Evidence ◽  
Evidence Based ◽  
Cigarette Use ◽  
Global Trends ◽  
Tobacco Cigarette ◽  
The World ◽  
The Impact

Tobacco use remains a global problem, and as a demographic group, adolescents are at a high risk of its adverse effects. In addition, disparities exist in strategies to address tobacco control, particularly among youth from low-socioeconomic backgrounds. The health risks associated with tobacco use provide a compelling reason for all nations to prioritize addressing and regulating its use and providing sustainable funding sources for training healthcare professionals and others under Article 14 of the World Health Framework Convention on Tobacco Control (FCTC). This article has four primary goals: (1) to provide an overview of the 2005 World Health Organization’s international public health treaty - the World Health FCTC; (2) to examine the prevalence of tobacco cigarette use among adolescents globally and the impact of cultural/social influences on use; (3) to provide an overview of current evidence based smoking cessations interventions that have shown success with this group; and (4) to discuss the overarching social work implications and practice when working with adolescents who use tobacco cigarettes.

The heterogeneous impact of a successful tobacco control campaign: a case study of Mauritius

2017 ◽  
Vol 27 (1) ◽  
pp. 83-89 ◽  
Author(s):  
Hana Ross ◽  
Leelmanee Moussa ◽  
Tom Harris ◽  
Rajive Ajodhea
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Low Income ◽  
Tobacco Consumption ◽  
Control Measures ◽  
Control Policies ◽  
Tobacco Control Policies ◽  
Tobacco Tax ◽  
The Impact ◽  
Low Income Households

BackgroundMauritius has one of the highest smoking prevalences in Africa, contributing to its high burden of non-communicable diseases. Mauritius implemented a series of tobacco control measures from 2009 to 2012, including tobacco tax increases. There is evidence that these policies reduced tobacco consumption, but it is not clear what impact they had across different socioeconomic groups.MethodThe impact of tobacco control measures on different income groups was analysed by contrasting household tobacco expenditures reported in 2006–2007 and 2012 household expenditure surveys. We employed the seemingly unrelated regression model to assess the impact of tobacco use on other household expenditures and calculated Gini coefficients to assess tobacco expenditure inequality.ResultsFrom 2006 to 2012, excise taxes and retail cigarette prices increased by 40.6% and 15.3% in real terms, respectively. These increases were accompanied by numerous non-price tobacco control measures. The share of tobacco-consuming households declined from 35.7% to 29.3%, with the largest relative drop among low-income households. The Gini coefficient of household tobacco expenditures increased by 10.4% due to decreased spending by low-income households. Low-income households demonstrated the largest fall in their tobacco budget shares, and the impact of tobacco consumption on poverty decreased by 26.2%. Households that continued purchasing tobacco reduced their expenditures on transportation, communication, health, and education.ConclusionsThese results suggest that tobacco control policies, including sizeable tax increases, were progressive in their impact. We conclude that tobacco use increases poverty and inequality, but stronger tobacco control policies can mitigate the impact of tobacco use on impoverishment.

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