Using systems science to advance health equity in tobacco control: a causal loop diagram of smoking.
Using systems science to advance health equity in tobacco control: a causal loop diagram of smoking.
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DOI：
10.1136/tobaccocontrol-2021-056695
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发表时间：
2023-05
期刊：
影响因子：
5.2
通讯作者：
Lich, Kristen Hassmiller
中科院分区：
文献类型：
--
作者：
Mills, Sarah D.;Golden, Shelley D.;O'Leary, Meghan C.;Logan, Paige;Lich, Kristen Hassmiller
制定并使用少数种族/族裔和低收入群体吸烟的随意循环图 (CLD)，以预测烟草控制政策的预期和非预期影响。我们开发了 CLD 来阐明吸烟的种族/民族和社会经济差异的个人、环境和结构原因之间的联系。 CLD 通过对吸烟的概念和实证模型、根本原因和社会压力理论的审查以及对烟草控制利益相关者的 19 次定性访谈而获得信息。然后使用 CLD 来检查三项烟草控制政策的潜在影响。 CLD 包括 24 个结构，涵盖与吸烟相关的个人（例如风险认知）、环境（例如营销）和结构（例如系统性种族主义）因素。使用 CLD 对烟草控制政策进行的评估发现了可能维持吸烟差异的潜在意外后果。例如，公共住房无烟政策的目的是减少居民吸烟。我们的 CLD 表明，该政策可以通过减少家人/朋友吸烟来减少居民吸烟，从而减少支持吸烟的规范和对烟草使用低风险的看法。另一方面，一些吸烟的居民可能会违反政策。违反政策可能会导致财务紧张和/或住房不稳定，从而增加压力并降低控制感，从而产生吸烟增加的意外后果。 CLD 可用于支持利益相关者参与行动规划并确定非传统合作伙伴和烟草控制方法。
Develop and use a casual loop diagram (CLD) of smoking among racial/ethnic minority and lower-income groups to anticipate the intended and unintended effects of tobacco control policies. We developed a CLD to elucidate connections between individual, environmental, and structural causes of racial/ethnic and socioeconomic disparities in smoking. The CLD was informed by a review of conceptual and empirical models of smoking, fundamental cause and social stress theories, and 19 qualitative interviews with tobacco control stakeholders. The CLD was then used to examine the potential impacts of three tobacco control policies. The CLD includes 24 constructs encompassing individual (e.g., risk perceptions), environmental (e.g., marketing), and structural (e.g., systemic racism) factors associated with smoking. Evaluations of tobacco control policies using the CLD identified potential unintended consequences that may maintain smoking disparities. For example, the intent of a smoke-free policy for public housing is to reduce smoking among residents. Our CLD suggests that the policy may reduce smoking among residents by reducing smoking among family/friends, which subsequently reduces pro-smoking norms and perceptions of tobacco use as low risk. On the other hand, some residents who smoke may violate the policy. Policy violations may result in financial strain and/or housing instability, which increases stress and reduces feelings of control, thus having the unintended consequence of increasing smoking. The CLD may be used to support stakeholder engagement in action planning and to identify non-traditional partners and approaches for tobacco control.
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影响因子：
37.8
作者：
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通讯作者：
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影响因子：
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