Development of a Tobacco Health Literacy Instrument

 描述(由申请者提供)：美国印第安人(AI)的吸烟率是美国所有种族/民族中最高的(41%，白人和黑人为23%)。因此，他们死于与烟草有关的疾病是所有种族/民族中最高的；每五个人工智能中就有两个死于与烟草有关的疾病。人工智能青少年的烟草使用率也很高，据报道，11-18岁的青少年吸烟率略低于37%。预防烟草的努力包括教育材料和方案，以阻止个人开始吸烟或鼓励个人戒烟。然而，正如人工智能人群的高流行率所表明的那样，我们不知道教育努力是否得到了充分的理解，并与目标人群产生了共鸣。这可能部分是因为烟草对许多人工智能来说是一种神圣的植物，因此不能像大多数一级和二级预防计划那样完全消极对待。我们建议创建专门针对烟草知识和风险的健康素养(HL)工具。我们认为，这是一级和二级预防工作中的必要步骤，以便确定适当的方式来干预尚未开始吸烟的人、吸烟并想要戒烟的人以及吸烟但不想戒烟的人的行为。因此，我们的长期目标是改善烟草教育和规划，从而在人工智能社区中更好地开展烟草预防工作。自2003年以来，我们的团队成功地使用基于社区的参与性研究(CBPR)与人工智能社区一起解决烟草使用问题。我们的社区合作伙伴要求我们研究改善烟草预防工作的其他方法。我们将解决以下具体目标：(1)开发一种针对人工智能人群中烟草使用的HL测量，方法是使用CBPR创建一个与文化相关的工具，检查烟草HL知识和风险；(2)通过对人工智能成年人(长式，250；短式，n=100)进行测试，确定烟草HL测量在人工智能人群中的可靠性和有效性。我们将使用专家来估计内容效度，并对参与者的反应进行因子分析，以估计工具的维度和信度。我们开展这一项目的理由是，使用烟草HL工具将导致设计出更好的一级和二级预防工具，从而减少与烟草有关的差异。

 DESCRIPTION (provided by applicant): American Indians (AI) have the highest rates of smoking of any racial/ethnic group in the US (41% versus 23% for whites and blacks). Consequently, they suffer the highest mortality from tobacco-related illnesses of any racial/ethnic group; two of every five AI die from a tobacco-related illness. AI youth have a high prevalence of tobacco use as well, where cigarette smoking is reported just below 37% for youth aged 11-18. Tobacco prevention efforts include education materials and programming that deter individuals from starting smoking or encourage individuals to quit smoking. However, we do not know if education efforts are fully understood and resonate with target populations, as indicated by high prevalence rates among AI populations. This may be explained, in part, because tobacco is a sacred plant to many AI and, as such, cannot be treated completely negatively, as most primary and secondary prevention programs do. We propose to create health literacy (HL) instrument that is specific to tobacco knowledge and risk. We believe this is a necessary step in primary and secondary prevention efforts in order to determine the appropriate way to intervene upon behaviors among those who have yet to start smoking, those who smoke and want to quit, and those that smoke and do not want to quit. Therefore, our long-term goal is to improve tobacco education and programming that will lead to better tobacco prevention efforts among AI communities. Our team has successfully used community-based participatory research (CBPR) to address tobacco use with AI communities since 2003. Our community partners requested that we examine additional ways to improve tobacco prevention efforts. We will address the following specific aims: (1) Develop a HL measure that is specific to tobacco use among AI populations by using CBPR to create a culturally relevant instrument that examines tobacco HL knowledge and risk; (2) Determine the reliability and validity of a tobacco HL measure among AI populations by testing it with AI adults (long form, n=250; short form, n=100). We will use experts to estimate content validity and factor analysis on participants' responses to estimate instrument's dimension and reliability. Our rationale for this project is tha the use of a tobacco HL instrument will lead to the design of better primary and secondary prevention tools, thus reducing tobacco-related disparities.