Modeling the equity impact of age restricted in-person location policies for youth tobacco use

模拟年龄限制的现场政策对青少年烟草使用的公平影响

基本信息

批准号：
10660348
负责人：
Megan Eleanor Roberts
金额：
$ 67.44万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-01 至 2028-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10660348
关键词：
21 year old Address Adolescent and Young Adult Adult Age Alcohols Behavior Behavioral California Censuses Communities Complex Connecticut Data Disparity Ecological momentary assessment Enrollment Ensure Environment Equity Ethnic Origin Evaluation Exposure to Focus Groups Geography Goals Income Learning Location Low Prevalence Low income Marketing Mission Modeling Neighborhoods North Carolina Ohio Persons Policies Policy Maker Population Poverty Process Public Health Qualitative Methods Race Reaction Research Research Personnel Role Rural Rural Appalachia Sales Source Statistical Methods Subgroup Survey Methodology Surveys Time Tobacco Tobacco use United States Youth cohort density discount disparity reduction ethnic minority follow-up health disparity health equity promotion high risk innovation marginalization marginalized population negative affect non-cigarette tobacco product novel prevent racial minority reduce tobacco use residence response rurality stem tobacco advertising tobacco control tobacco prevention tobacco products tobacco user vaping willingness

21 year old Address Adolescent and Young Adult Adult Age Alcohols Behavior Behavioral California Censuses Communities Complex Connecticut Data Disparity Ecological momentary assessment Enrollment Ensure Environment Equity Ethnic Origin Evaluation Exposure to Focus Groups Geography Goals Income Learning Location Low Prevalence Low income Marketing Mission Modeling Neighborhoods North Carolina Ohio Persons Policies Policy Maker Population Poverty Process Public Health Qualitative Methods Race Reaction Research Research Personnel Role Rural Rural Appalachia Sales Source Statistical Methods Subgroup Survey Methodology Surveys Time Tobacco Tobacco use United States Youth cohort density discount disparity reduction ethnic minority follow-up health disparity health equity promotion high risk innovation marginalization marginalized population negative affect non-cigarette tobacco product novel prevent racial minority reduce tobacco use residence response rurality stem tobacco advertising tobacco control tobacco prevention tobacco products tobacco user vaping willingness

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项目摘要

PROJECT SUMMARY/ABSTRACT This proposal concerns age restricted in-person location policies (ARLPs), a novel tobacco control strategy that could have a critical impact on reducing youth tobacco use. Under an ARLP, tobacco sales would only be allowed in tobacco shops or other adult-only retailers. As the majority of tobacco retailers are convenience stores and discount stores, ARLPs could drastically reduce tobacco retailer density, and thereby reduce adolescent and young adult (“youth”) tobacco access and marketing exposure. Moreover, as convenience and discount stores are often disproportionately prevalent in historically marginalized neighborhoods, ARLPs may reduce disparities in tobacco retailer density. Evidence is badly needed to support the introduction of ARLPs to the United States. Data are needed from models of the potential reduction in tobacco retailer density, the potential reduction in youths’ “focal retailers” (i.e., the retailers that youth frequently encounter or use the most for tobacco purchases), the potential impact on youth behavior, and the potential compensatory behaviors by youth (e.g., obtaining tobacco through alternative sources). Woven into these questions is the critical concern of equity impact: Will an ARLP reduce current disparities in retailer density and youth tobacco use? The goal of this project is to model the potential impact of ARLPs on youth tobacco use, both overall and for different priority populations (defined by residence in low-income, racial/ethnic minority, or rural neighborhoods). Aim 1 will use spatial statistical methods to model the potential impact of an ARLP on tobacco retailer density. Across four states (California, Connecticut, North Carolina, and Ohio), investigators will geocode the locations of all current tobacco retailers to model an ARLP’s impact on the retailer landscape. Pairing this environmental data with behavioral data from a diverse cohort of young people living in those states, Aim 2 will use geographic ecological momentary assessment (EMA) to (a) identify young people’s most focal retailers and (b) model the extent to which exposure, access, and use stemming from these focal retailers would be impacted by an ARLP. Investigators will enroll 480 youth (120 per state; ages 16-25; 80% tobacco users; 50% priority population) to collect this real-world, close-to-real-time geographic EMA data. Analyses will model whether an ARLP would have prevented purchases and marketing exposures to a significant extent—particularly among the priority population youth. Finally, Aim 3 will use survey and qualitative methods to determine potential compensatory behaviors by youth. Subgroups of tobacco users will participate in focus groups and all tobacco users from the cohort will be asked to complete an online survey. Analyses will assess whether obtaining tobacco from alternative sources will be harder for priority (vs. non-priority) youth. An external advisory board of key partners will inform all stages of the project, particularly dissemination. Successful completion of this project will provide much-needed information to support equity- enhancing state and local ARLPs. In the long-term, such efforts will contribute to reducing and eventually eliminating tobacco-related health disparities by promoting health equity among all populations.

项目摘要/摘要该提案涉及年龄受到限制的面对面位置政策（ARLP），这是一种新颖的烟草控制策略，可能会对减少青年烟草的使用产生关键影响。在ARLP下，只允许烟草销售在烟草商店或其他仅成人零售商中。由于大多数烟草零售商是便利店，折扣店，ARLP可以大大降低烟草零售商的密度，从而减少青少年和年轻成人（“青年”）烟草访问和营销暴露。而且，作为便利和折扣商店 ARLP通常在历史边缘化的社区中普遍不成比例，可能会降低差异在烟草零售商密度中。很难支持向美国引入ARLP的证据。从烟草零售商密度的潜在降低模型中需要数据，潜在的降低青年的“重点零售商”（即，青年经常遇到或最多使用烟草购买的零售商），对青年行为的潜在影响以及青年的潜在补偿行为（例如，获得烟草通过替代来源）。编织到这些问题是公平影响的关键问题： ARLP降低了零售商密度和青年烟草使用中的当前分布？该项目的目的是建模 ARLP对整体和不同优先人群的青年烟草使用的潜在影响（定义由低收入，种族/族裔少数民族或粗糙社区的居住。 AIM 1将使用空间统计数据建模ARLP对烟草零售商密度的潜在影响的方法。在四个州（加利福尼亚州）康涅狄格州，北卡罗来纳州和俄亥俄州），调查人员将地理位置所有当前烟草零售商的位置建模ARLP对零售商景观的影响。将这些环境数据与来自的行为数据配对 AIM 2多样性的年轻人将使用地理生态瞬间评估（EMA）（a）确定年轻人最重点的零售商，（b）建模曝光程度， ARLP的访问并使用这些重点零售商的使用将受到ARLP的影响。调查人员将注册 480名青年（每个州120岁； 16-25岁； 80％的烟草使用者； 50％优先人口），以收集这一现实世界，接近实时的地理EMA数据。分析将建模ARLP是否会阻止购买市场营销在很大程度上是在优先人群青年中的尤其是。最后，目标3 将使用调查和定性方法来确定青年的潜在补偿行为。子组烟草用户将参加焦点小组，并要求该队列的所有烟草用户完成在线调查。分析将评估从替代来源获得烟草是否更难优先（与非优先级）青年。主要合作伙伴的外部顾问委员会将为项目的所有阶段提供信息，特别是传播。该项目的成功完成将提供急需的信息，以支持权益 - 增强状态和本地ARLP。从长远来看，这种努力将有助于减少并最终通过促进所有人群的健康公平性来消除与烟草相关的健康差异。