Reducing Cancer Disparities within the Black community in Jackson, MS through Community-Led Tobacco-Related Social Norm Change

摘要 这项提案涉及A部分，通过以社区为基础减少癌症结果中的不平等 通过对BAT项目的评估，对健康的社会决定因素进行干预 烟草)，一个社区主导的干预措施，赋予低收入非裔美国人(AA)和黑人社区权力 改变烟草使用的社会规范，促进最佳健康和癌症预防 在整个社区。在密西西比州杰克逊市实施的BAT计划的总体目标是改变 普遍的社会规范认为吸烟是一种应对机制，用于应对系统性的种族主义、贫困和 慢性压力，通过与社区行动小组(CAG)和 当地的锚定组织，我兄弟的守护者(MBK)。在全国，特别是在南方， AA/黑人背负着数百年来制度性种族主义的普遍影响。不仅有 吉姆·克罗和红线等政策创造了致命的社会经济环境，但它们的存在是 被历史创伤和世世代代持续的创伤所支撑。传统的和“局外人驱动的” 戒烟计划通常针对个人层面的行为，但对 贫困程度高，并经历系统性种族主义、种族隔离和长期压力的人口。最新 相反，研究认识到使用社区发起和参与的方法来确保 地方文化和背景是项目的中心组成部分，以促进有意义的地方社会 规范改变和强化政策。为实现这些目标，计算机辅助教学将开展能力建设活动。 在CAG成员和MBK领导层中支持他们确定和实施一系列 分阶段行动以增加：获得服务的机会；关于戒烟和健康的资源 ；社交媒体营销以提供教育信息；以及政策倡导以促进健康 无烟环境。评估方法将包括同时进行的混合方法研究设计，以 对实施情况进行强有力的形成性和过程评估，并评估障碍和促进者 利用社区参与应对社会规范的变化，并进行了一项横断面调查 每年在干预和对照社区中使用家庭的概率样本来衡量 社区一级干预措施在一般人口群体中的影响。衡量的结果将包括 改善社会、健康和环境条件，以改变社会规范，包括社交媒体 和营销信息、政策变化以及更多地获得促进健康的支持性服务 以及社区的福祉。随着时间的推移，随着社会规范的变化，杰克逊的社区将 看到与烟草相关的行为的改善结果，包括戒烟尝试、使用情况、二手烟 与烟草使用有关的长期健康后果。

Abstract This proposal addresses Component A to Reduce Inequities in Cancer Outcomes through Community-Based Interventions on Social Determinants of Health, through an evaluation of Project BAT (Black people Against Tobacco), a community-led intervention to empower low-income African American (AA) and Black communities to change social norms around tobacco utilization and promote optimal health and cancer prevention throughout the community. The overall goal of Project BAT, implemented in Jackson, MS, is to change the pervasive social norm that smoking is a coping mechanism used to cope with systemic racism, poverty, and chronic stress, by conducting authentic community engagement with Community Action Groups (CAG) and a local anchor organization, My Brother’s Keeper (MBK). Across the nation, and in the South particularly, AA/Black people are burdened with the pervasive effects of centuries of institutional racism. Not only have policies such as Jim Crow and redlining created deadly socio-economic environments, but their existence is upheld by historical trauma and persistent wounds across generations. Traditional and ‘‘outsider driven’’ smoking cessation programs that generally target behaviors at the individual-level have not been effective for populations with high poverty and who experience systemic racism, segregation, and chronic stress. Latest research instead recognizes the importance of using community-initiated and engaged approaches to ensure that local culture and context are central components of programs in order to catalyze meaningful local social norms change and strengthen policies. To achieve these goals, CAI will conduct capacity building activities among CAG members and MBK leadership to support their identification and implementation of a series of phased actions to increase: access to services; resources regarding tobacco cessation and health and well- being; social media marketing to provide educational messages; and policy advocacy to promote a healthy tobacco-free environment. Evaluation methods will include a concurrent mixed-methods study design to conduct a robust formative and process evaluation on implementation and to assess barriers and facilitators of using community engagement to address social norms change, and a cross-sectional survey conducted annually using a probability sample of households in intervention and comparison communities to measure the impact of community-level interventions within general population groups. Measured outcomes will include the improved social, health, and environmental conditions to allow for social norms change, including social media and marketing messages, policy changes, and increased access to supportive services that promote health and well-being in the community. Over time, as social norms change occurs, the community of Jackson will see improved outcomes in tobacco-related behaviors, including quit attempts, usage, secondhand smoke exposure, and long-term health outcomes associated with tobacco use.