Building GIS Capacity into Tobacco Control Research Programs of East Asia

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Loma Linda University (LLU) conducted the FIC funded (R01 TW05964-05; R03 TW007345-03) “Asia Tobacco Control Leadership Training (TCLT)” program in East Asia during 2002-2012. Under TCLT, LLU mentored personnel in the Ministries of Health and NGOs of Cambodia and Lao PDR to complete the first national prevalence surveys of tobacco use. TCLT produced numerous scientific publications, policy documents used in successful advocacy for tobacco control legislation, and a sustainable national tobacco survey model with data collection on a handheld mobile technology platform. This R01 renewal application builds upon TCLT survey technology by adding an innovative, research program of “Building Geographic Information System Capacity into the Tobacco Control Research (GIS-TOBCR)” workforce of Cambodia, Lao PDR, and Mongolia. In each nation, the ratified WHO Framework Convention on Tobacco Control (FCTC) treaty is now in implementation phase for policies on taxation, pricing, branding, health labeling, advertising, and smoke-free areas. Our preliminary data indicate, however, that the efficacy of policy implementation exhibits marked geographic variation as evidenced by low cost, illicit tobacco sales in border regions, near schools, and in hard-to-access rural communities (i.e. ethno-religious minorities, traditional medicine vendors). The scientific premise for GIS- TOBCR research in each nation is the gap in published spatial research that can identify – for intervention purposes – community level, geographic targets where tobacco policies are not being implemented. The overall objective of the GIS-TOBCR program is to build GIS research capacity into the tobacco control workforce of Cambodia, Lao PDR, and Mongolia to monitor and improve the progress of implementing tobacco control policies at the community level. Our specific aims use GIS analytics and innovate mobile GIS applications to identify variables that are spatially associated with: 1) Points-of-sale of cigarettes that are non- compliant with WHO FCTC policies on packaging (tax stamps, health warnings, brands for women, single cigarette sales) and pricing, 2) Points-of-sale of loose tobacco (in smokeless products, pipes, roll-your-own) that are non-compliant with WHO FCTC, and 3) Tobacco ads-promotions-placements that are non-compliant with WHO FCTC. Our research capacity building plan is fully integrated into the aims by building GIS research capacity into the multi-sectoral (Ministry of Health, NGO, academia) tobacco control workforce that monitors implementation of WHO FCTC. We use both degree training (MPH) of scientists and workforce training (30 GIS certificates) of their staff to accomplish institutional capacity strengthening in spatial research. Training is administered by: 1) a US investigator team (epidemiology of tobacco control, health GIS, spatial statistics, and health policy) from LLU and UCLA, and 2) LLU-US industry partnerships with ESRI (pioneers of ArcGIS) and Fulcrum Mobile Solutions (mHealth App Innovators). GIS-TOBCR produces a sustainable cadre of 33 spatial research personnel to improve the progress of implementing tobacco control policies in East Asia.