Smoke-free Air Coalitions in Georgia and Armenia: A Community Randomized Trial

格鲁吉亚和亚美尼亚的无烟空气联盟：社区随机试验

• 批准号: 9372431
• 负责人: Carla J Berg
• 金额: $ 33.12万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-22 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9372431
• 关键词: Adoption; Adult; Advocate; Air; American; Armenia; Attention; Centers for Disease Control and Prevention (U.S.); Chronic Disease; Communicable Diseases; Communities; Community Health; Country; Disease; Education; Effectiveness; Environment; Environmental Health; Evaluation; Evidence based practice; Exposure to; Future; Goals; Government; Grant; Healthcare; Home environment; Individual; Influentials; Institution; Lead; Literature; Medical; Methods; Modeling; Movement; Municipalities; Play; Policies; Population; Positioning Attribute; Process; Public Health; Public Health Practice; Randomized Controlled Trials; Readiness; Recording of previous events; Reporting; Research; Research Infrastructure; Research Personnel; Research Training; Resources; Restaurants; Risk Factors; Science; Smoke; Smoking; Surveys; Talents; Testing; Time; Tobacco; Tobacco Control Research; Tobacco use; Training; United States National Institutes of Health; Universities; Woman; Work; Workplace; base; catalyst; civil society; environmental tobacco smoke exposure; evidence base; experience; low and middle-income countries; men; model building; primary outcome; public policy on tobacco; randomized trial; research data dissemination; sex disparity; smoke-free policy; smoking prevalence; social norm; success; theories; tobacco control

SUMMARY/ABSTRACT Public health efforts in low- and middle-income countries (LMICs) could be catalyzed by bolstering ways to optimally leverage local talents and resources, such as civil society. Developing effective models for aligning civil society and governmental public health at the local level in LMICs has the potential to impact a range of chronic diseases and risk factors, including tobacco. Local coalitions have been a dominant strategy in tobacco control in the US, with well-documented success in establishing smoke-free policies specifically. However, this approach has not been widely leveraged or well-studied in LMICs or those with less democratic traditions than the US. Instead, in many LMICs, smoke-free policy progress is largely initiated at the national level. Parallel civil society movements at the local level may be needed to build support for and compliance with policies. Given their sociopolitical histories and high tobacco use and secondhand smoke exposure (SHSe) rates, Georgia (GE) and Armenia (AM) are two strategic settings for the proposed work. The smoking prevalence is 57.7% and 52.3% in men (6th and 11th highest in the world) and 5.7% and 1.5% in women, respectively. Moreover, our findings indicate extremely high rates of SHSe. However, we also documented high receptivity to public smoke-free policies despite high use rates, particularly in worksites and restaurants. This proposal is a well-justified extension of the literature and our prior work. We will build the capacity of GE and AM researchers to conduct high-quality mixed methods tobacco research and test the Community Coalition Action Theory as a framework for impacting local community-driven policy change. Researchers from the GE National Center for Disease Control (NCDC) and AM National Institute of Health (NIH) will collaborate with Emory to execute the proposed research, train tobacco control researchers within their organizations and partnering universities, and train practitioners within local communities to build local coalitions for tobacco control policy. We aim to: 1) conduct a matched-pair community randomized controlled trial in 28 municipalities in GE and AM to examine the impact of local coalitions promoting the adoption of smoke-free policies in worksites and restaurants, with the primary outcome of changes in SHSe over time; 2) assess how community context and coalition factors influence adoption of organizational and municipal smoke-free policies to provide an evidence- base for public health practice; 3) disseminate research findings regarding both the effectiveness and the process of establishing and maintaining coalitions, and consequently increasing smoke-free policies and reducing SHSe, to key stakeholders in GE and AM; and 4) capitalize on the proposed research and dissemination opportunities to build tobacco control research capacity within the GE NCDC, AM NIH, and partnering universities, as well as practice capacity within local public health centers and their civil society partners. Ultimately, the activities outlined in this proposal will serve as a catalyst for future action-oriented science and evidence-based practice to support tobacco control progress in this region more broadly.

摘要/文摘