Promoting Smoke-Free Homes in Rural American Indian Households

在美国印第安农村家庭推广无烟家庭

• 批准号: 10371944
• 负责人: MICHELLE C KEGLER
• 金额: $ 88.79万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-10 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10371944
• 关键词: Address; Adoption; Adult; Advocate; Alaska; Alaska Native; American Indians; Area; California; Cancer Control; Centers for Disease Control and Prevention (U.S.); Child; Collaborations; Communities; Education; Effectiveness; Effectiveness of Interventions; Ensure; Ethnic group; Evidence based intervention; Family; Focus Groups; Funding; Future; General Population; Great Plains; Health; Health Service Area; Health system; Home; Household; Housing; Intervention; Iowa; Low income; Maintenance; Malignant Neoplasms; Methods; Michigan; Mission; Modeling; National Cancer Institute; Native Americans; Nebraska; North Dakota; Oklahoma; Outcome; Participant; Performance; Peripheral; Persons; Phase; Policies; Population; Positioning Attribute; Prevalence; Prevention Research; Process; Program Development; Public Health; Quality of life; Randomized; Readiness; Research; Risk; Rural; Rural Community; Series; Smoke; Smoke-free home; Smoker; Smoking; Source; South Dakota; Structure; Testing; Tobacco; Tobacco Control Research; Tobacco use; Tribes; United States Indian Health Service; Waiting Lists; cancer health disparity; cancer prevention; dissemination trial; effectiveness evaluation; effectiveness testing; effectiveness trial; efficacy trial; environmental tobacco smoke; environmental tobacco smoke exposure; evidence base; follow-up; health disparity; improved; indexing; innovation; intertribal; member; non-smoker; non-smoking; northern plains; process evaluation; programs; racial and ethnic; rural Americans; rural area; rural residence; scale up; shared decision making; smoking cessation; tribal community; tribal leader; tribal member; tribal organization; web site

ABSTRACT Smoke-free homes are an innovative and relatively untapped strategy for cancer prevention in rural American Indian communities. Smoking rates are not only higher among rural than urban residents, but also higher among American Indians relative to other major racial/ethnic groups in the U.S. Smoke-free homes, less common in homes with adults who smoke, can reduce exposure to secondhand smoke (SHS) and support cessation. The proposed research builds on an established partnership between the Emory Prevention Research Center (EPRC) and two members of the CDC-funded National Native Network to evaluate the adaptation of an evidence-based intervention to promote smoke-free homes. The Inter-Tribal Council of Michigan (ITCM) represents 12 federally recognized tribes in Michigan; the Great Plains Tribal Leaders Health Board (GPTLHB) represents 17 sovereign American Indian nations within a four-state area (North Dakota, South Dakota, Nebraska and Iowa), plus a service area. Using a participatory process, the EPRC partnered with the ITCM and the National Native Network to adapt a smoke-free homes intervention for American Indian/Alaska Native (AI/AN) families. The original intervention was evaluated through a series of studies, from efficacy to effectiveness to dissemination, and is listed on NCI’s Evidence-Based Cancer Control Programs website. The adaptation involved a systematic process, including 10 focus groups on creating smoke-free homes in AI/AN families and input on appropriate messaging for smoke-free homes and traditional use of tobacco with tribes in Michigan, California, Oklahoma and Alaska. We are now well-positioned to test the effectiveness of the adapted intervention. Using a participatory approach operationalized through a Steering Committee with shared decision-making, our aims are to: 1) pre-test and refine the adapted Smoke-Free Homes: Respect our Past, Protect our Future intervention to ensure cultural appropriateness for specific tribal partners; 2) evaluate the impact of the adapted intervention on establishment of smoke-free home rules among American Indian households using a randomized wait-list controlled trial with three and six month follow-up, and explore its impact on smoke-free vehicles, cessation attempts, smoking cessation, and support for smoke- free tribal housing; 3) conduct a mixed methods process evaluation of the intervention to assess reach, adoption, implementation, contextual influences, and maintenance potential from tribal, organizational and participant perspectives, and 4) assess changes in community readiness to address smoke-free multi-unit tribal housing. This research builds on a successful collaboration with the potential to create an innovative and effective model for promoting smoke-free homes in rural areas, and for reducing SHS among American Indian nonsmokers and children and related cancer disparities. The significant capacity of our partnership has great potential for widespread dissemination of the intervention should it prove effective.

抽象的 无烟的房屋是美国农村地区的一种创新且相对尚未开发的预防癌症的策略 印度社区。农村的吸烟率不仅比城市居民高，而且还高 在美国与其他主要种族/族裔的美国印第安人中，在美国无烟的房屋中 在有吸烟的成年人的房屋中常见，可以减少二手烟（SHS）和支持 停止。拟议的研究建立在Emory预防之间建立的合作伙伴关系的基础上 研究中心（EPRC）和CDC资助的国家本地网络的两名成员评估 适应基于证据的干预措施以促进无烟房屋。部落间理事会 密歇根州（ITCM）代表密歇根州的12个联邦认可的部落；大平原部落领导人健康 董事会（GPTLHB）代表一个四州区域内的17个主权美洲印第安国家（北达科他州， 南达科他州，内布拉斯加州和爱荷华州）以及服务区。使用参与过程，EPRC合作 借助ITCM和全国本地网络，适应美国的无烟房屋干预 印度/阿拉斯加本地人（AI/AN）家庭。通过一系列研究评估了原始干预措施 对传播有效性的有效性，并在NCI基于证据的癌症控制计划上列出 网站。改编涉及系统的过程，其中包括10个焦点小组创建无烟 AI/A/A家族的房屋，并投入适当的无烟房屋消息和传统使用 烟草在密歇根州，加利福尼亚，俄克拉荷马州和阿拉斯加有部落。我们现在有很好的位置来测试 改编干预的有效性。使用通过转向进行操作的参与方法 委员会通过共同的决策，我们的目标是：1）预测试和完善适应的无烟 家庭：尊重我们的过去，保护我们未来的干预措施，以确保特定部落的文化适当性 合作伙伴； 2）评估改编的干预措施对建立无烟家庭规则的影响 美洲印第安人家庭使用随机等待名单对照试验进行三个月和六个月的随访， 并探索其对无烟车辆的影响，戒烟尝试，戒烟以及支持烟雾的影响 - 免费部落住房； 3）对干预措施进行混合方法处理评估以评估覆盖范围， 从部落，组织和 参与者的观点和4）评估社区准备的变化，以解决无烟多单位 部落住房。这项研究以成功的合作为基础，有可能创造创新和 有效的模型，用于在粗糙地区促进无烟房屋，并减少美洲印第安人的SH 非吸烟者和儿童以及相关的癌症差异。我们合作伙伴关系的重要能力很棒 如果证明有效，则可能会进行宽度传播。