Community-led Policies and Leadership to Eliminate Disparities for Asian Ame

描述（由申请人提供）：烟草控制政策的变化对减少烟草使用做出了巨大贡献，是 20 世纪公共卫生十大成就之一。尽管烟草政策变革取得了巨大成功，但烟草使用流行率的下降速度仍然很高，特别是在有色人种边缘化社区中，亚裔美国人和太平洋岛民（AA和NHPI）是美国增长最快的人口之一，但我们对让AA和NHPI参与政策变革的最有效流程和途径知之甚少，从而导致成功遵守并最终改变烟草社区规范。我们建议开展一项为期三年的基于社区的参与性研究 (CBPR)，题为“社区主导的政策和领导力，消除亚裔美国人和太平洋岛民在烟草方面的差异”(Com-PLEAT)。本研究的总体目标是确定和了解两个 AA 和 NHPI 社区（长滩县的柬埔寨人和圣地亚哥县的太平洋岛民（包括夏威夷原住民、萨摩亚人和查莫罗人））成功改变烟草控制政策的途径。本研究的具体目标有两个：1) 使用关键知情人访谈、社区准备指数和格特曼尺度图分析，开发和测试四管齐下的政策变革框架及其在帮助动员亚裔美国人和太平洋岛民（AA 和 NHPI）（柬埔寨和查莫罗）社区进行烟草控制方面的效果； 2) 研究 AA 和 NHPI 成功改变烟草政策的途径，包括能力建设的作用。这项拟议的 Com-PLEAT 研究将包括关键知情人访谈、社区准备度评估和格特曼尺度图分析方法，并将通过确定 AA 和 NHPI 政策变革的替代且更成功持续的途径，为烟草预防和控制领域做出重大贡献。拟议的 Com-PLEAT 研究旨在挑战当前的框架，即政策变化将平等地惠及所有社区，并逐步淘汰针对文化定制的战略，以消除健康差异。本研究采用基于社区的参与方法，让社区参与研究设计、数据收集、分析和传播的各个方面，使社区了解对政策和充分参与广泛政策干预至关重要的要素的看法和动机。 相关性（参见说明）：拟议的 Com-PLEAT 研究不仅有助于更好地了解亚裔美国人、夏威夷原住民和太平洋岛民 (NHPI) 社区烟草控制政策变革的有效途径，而且有助于在美国其他 AA 和 NHPI 社区复制这项研究。通过使用创新的研究方法，Com-PLEAT 研究有望转化为更有效和可持续的政策举措实施，包括并为 AA 和 NHPI 社区提供服务，并帮助减少健康差距。

DESCRIPTION (provided by applicant): Tobacco control policy change has contributed tremendously to decreasing tobacco use and represents one of public health's top 10 achievements in the 20th century. Despite the great success of tobacco policy change, the decline in tobacco use prevalence has stalled with still high rates particularly among marginalized communities of color, Asian Americans and Pacific Islanders (AA and NHPIs) are one of the fastest growing populations in the U.S., yet we understand very little about the most effective processes and pathways for engaging AAs and NHPIs in policy change that result in successful compliance and eventual community norm change on tobacco. We propose to conduct a three-year community-based participatory research (CBPR) study titled Community-led Policies and Leadership to Eliminate Disparities for Asian Americans and Pacific Islanders on Tobacco (Com-PLEAT). The overall goal of this research is to identify and understand the pathways to successful tobacco control policy change among two AA and NHPI communities: Cambodians in Long Beach County and Pacific Islanders (including Native Hawaiians, Samoans and Chamorros) in San Diego County. The specific aims of this study are twofold: 1) to develop, and test a 4-prong policy change framework and its effect in helping to mobilize Asian American and Pacific Islander (AA and NHPI) (Cambodian and Chamorro) communities on tobacco control using key informant interviews, community readiness indices and Guttman scalogram analysis; and 2) to study the pathways to successful policy change on tobacco for AAs and NHPIs including the role of capacity building. This proposed Com-PLEAT Study will include key informant interviews, community readiness assessments and Guttman scalogram analysis methodologies and will make a significant contribution to the field of tobacco prevention and control by identifying alternative and more successfully sustained pathways to policy change for AAs and NHPIs. The proposed Com-PLEAT Study seeks to challenge the current framework that policy change will trickle down to all communities equally and the phasing out of culturally-tailored strategies to eliminate health disparities. Using a community-based participatory approach that involves communities in every aspect of the research design, data collection, analysis and dissemination, this study will engage communities to understand perception and motivation about policies and elements critical for full participation in a wide-range of policy interventions. RELEVANCE (See instructions): The proposed Com-PLEAT Study will contribute not only to the better understanding of effective pathways for tobacco control policy change for Asian American, Native Hawaiian and Pacific Islander (NHPI) communities, but also to the replication of this study in other AA and NHPI communities across the U.S. By using innovative research methods, the Com-PLEAT Study will hopefully translate into more effective and sustainable implementation of policy initiatives that include and serve AA and NHPI communities and help reduce health disparities.