Promoting Smoke-Free Homes in Rural American Indian Households

在美国印第安农村家庭推广无烟家庭

• 批准号: 10371944
• 负责人: MICHELLE C KEGLER
• 金额: $ 88.79万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-10 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10371944
• 关键词: Address; Adoption; Adult; Advocate; Alaska; Alaska Native; American Indians; Area; California; Cancer Control; Centers for Disease Control and Prevention (U.S.); Child; Collaborations; Communities; Education; Effectiveness; Effectiveness of Interventions; Ensure; Ethnic group; Evidence based intervention; Family; Focus Groups; Funding; Future; General Population; Great Plains; Health; Health Service Area; Health system; Home; Household; Housing; Intervention; Iowa; Low income; Maintenance; Malignant Neoplasms; Methods; Michigan; Mission; Modeling; National Cancer Institute; Native Americans; Nebraska; North Dakota; Oklahoma; Outcome; Participant; Performance; Peripheral; Persons; Phase; Policies; Population; Positioning Attribute; Prevalence; Prevention Research; Process; Program Development; Public Health; Quality of life; Randomized; Readiness; Research; Risk; Rural; Rural Community; Series; Smoke; Smoke-free home; Smoker; Smoking; Source; South Dakota; Structure; Testing; Tobacco; Tobacco Control Research; Tobacco use; Tribes; United States Indian Health Service; Waiting Lists; cancer health disparity; cancer prevention; dissemination trial; effectiveness evaluation; effectiveness testing; effectiveness trial; efficacy trial; environmental tobacco smoke; environmental tobacco smoke exposure; evidence base; follow-up; health disparity; improved; indexing; innovation; intertribal; member; non-smoker; non-smoking; northern plains; process evaluation; programs; racial and ethnic; rural Americans; rural area; rural residence; scale up; shared decision making; smoking cessation; tribal community; tribal leader; tribal member; tribal organization; web site

ABSTRACT Smoke-free homes are an innovative and relatively untapped strategy for cancer prevention in rural American Indian communities. Smoking rates are not only higher among rural than urban residents, but also higher among American Indians relative to other major racial/ethnic groups in the U.S. Smoke-free homes, less common in homes with adults who smoke, can reduce exposure to secondhand smoke (SHS) and support cessation. The proposed research builds on an established partnership between the Emory Prevention Research Center (EPRC) and two members of the CDC-funded National Native Network to evaluate the adaptation of an evidence-based intervention to promote smoke-free homes. The Inter-Tribal Council of Michigan (ITCM) represents 12 federally recognized tribes in Michigan; the Great Plains Tribal Leaders Health Board (GPTLHB) represents 17 sovereign American Indian nations within a four-state area (North Dakota, South Dakota, Nebraska and Iowa), plus a service area. Using a participatory process, the EPRC partnered with the ITCM and the National Native Network to adapt a smoke-free homes intervention for American Indian/Alaska Native (AI/AN) families. The original intervention was evaluated through a series of studies, from efficacy to effectiveness to dissemination, and is listed on NCI’s Evidence-Based Cancer Control Programs website. The adaptation involved a systematic process, including 10 focus groups on creating smoke-free homes in AI/AN families and input on appropriate messaging for smoke-free homes and traditional use of tobacco with tribes in Michigan, California, Oklahoma and Alaska. We are now well-positioned to test the effectiveness of the adapted intervention. Using a participatory approach operationalized through a Steering Committee with shared decision-making, our aims are to: 1) pre-test and refine the adapted Smoke-Free Homes: Respect our Past, Protect our Future intervention to ensure cultural appropriateness for specific tribal partners; 2) evaluate the impact of the adapted intervention on establishment of smoke-free home rules among American Indian households using a randomized wait-list controlled trial with three and six month follow-up, and explore its impact on smoke-free vehicles, cessation attempts, smoking cessation, and support for smoke- free tribal housing; 3) conduct a mixed methods process evaluation of the intervention to assess reach, adoption, implementation, contextual influences, and maintenance potential from tribal, organizational and participant perspectives, and 4) assess changes in community readiness to address smoke-free multi-unit tribal housing. This research builds on a successful collaboration with the potential to create an innovative and effective model for promoting smoke-free homes in rural areas, and for reducing SHS among American Indian nonsmokers and children and related cancer disparities. The significant capacity of our partnership has great potential for widespread dissemination of the intervention should it prove effective.

抽象的 无烟家庭是美国农村地区癌症预防的一项创新且相对尚未开发的策略 印度社区。农村居民的吸烟率不仅高于城市居民，而且也高于城市居民。 相对于美国其他主要种族/族裔群体，美洲印第安人的无烟家庭比例较低 在有吸烟成年人的家庭中很常见，可以减少接触二手烟 (SHS) 并提供支持 停止。拟议的研究建立在埃默里预防中心之间已建立的伙伴关系的基础上 研究中心 (EPRC) 和 CDC 资助的国家本土网络的两名成员来评估 采取循证干预措施来促进无烟家庭。部落间理事会 密歇根州 (ITCM) 代表密歇根州 12 个联邦认可的部落；大平原部落领袖健康 委员会 (GPTLHB) 代表四个州区域内的 17 个美洲印第安人主权国家（北达科他州、 南达科他州、内布拉斯加州和爱荷华州），以及一个服务区。通过参与式流程，EPRC 与 与 ITCM 和国家本土网络合作，为美国人制定无烟家庭干预措施 印第安/阿拉斯加原住民 (AI/AN) 家庭。最初的干预措施是通过一系列研究进行评估的， 功效、有效性和传播，并被列入 NCI 循证癌症控制计划 网站。此次调整涉及一个系统化的过程，其中包括 10 个关于创建无烟的焦点小组 AI/AN 家庭中的家庭，并就无烟家庭的适当信息传递和传统使用 密歇根州、加利福尼亚州、俄克拉荷马州和阿拉斯加州的部落都种植烟草。我们现在已经准备好测试 调整后的干预措施的有效性。使用通过指导实施的参与式方法 委员会共同决策，我们的目标是：1）预测试和完善适应的无烟 家园：尊重我们的过去，保护我们的未来干预措施，以确保特定部落的文化适宜性 合作伙伴； 2) 评估调整后的干预措施对建立无烟家庭规则的影响 美国印第安家庭使用随机等待名单对照试验进行三个月和六个月的随访， 并探讨其对无烟车辆、戒烟尝试、戒烟和对吸烟的支持的影响 免费部落住房； 3) 对干预措施进行混合方法过程评估以评估达到的程度， 部落、组织和组织的采用、实施、环境影响和维护潜力 参与者的观点，以及 4) 评估社区为解决无烟多单位问题做好准备的变化 部落住房。这项研究建立在成功合作的基础上，有潜力创造一个创新和 促进农村地区无烟家庭和减少美洲印第安人二手烟的有效模式 非吸烟者和儿童以及相关的癌症差异。我们的合作伙伴关系具有巨大的能力 如果干预措施有效，则有可能广泛传播。