Using Differences in Perceived Legitimacy and Resident Compliance to Promote Fair and Effective Implementation of Smoke Free Housing

项目摘要 无烟住房(SFH)最近被美国住房和城市部授权 保护公屋居民免受二手烟(SHS)影响。 然而，我们的初步工作表明，SFH可能并不有效。在焦点小组中，吸烟者在 低收入住房向我们报告说，他们的主要动机是害怕惩罚，而不是 而不是遵守SFH的义务，他们认为这是不公平的。他们描述了一种情况 许多吸烟者的反应是将吸烟藏在公寓里--他们认为自己会在那里吸烟 不太可能被看到-当遵守SFH被认为是不便，甚至是 不安全(例如，如果他们必须在晚上穿过社区才能在物业外吸烟)。这 表明SFH的正当性很低--居民们对它的不公平感觉如此强烈，以至于 他们不太可能自己遵守这项规定。这意味着提高居民遵从性的努力 依靠惩罚威胁可能会适得其反。居民还报告说，有几个障碍 遵守他们也认为不公平的SFH(例如，禁止在公共房屋内吸烟，但 允许在其他类型的属性上使用它)。这些障碍在住房当局之间有所不同，代表着 SFH实施战略方面的重要差异。 以社区为基础的参与性研究的原则和方法指导了本研究。在目标1中，我们 评估与六个住房当局感知的合法性和合规性相关的因素。我们 将使用混合方法来确定：(1)谁表现出较低的SFH正当性，以及 在什么情况下，以及(2)和之间有哪些财产和组织因素不同 在住房当局内部，可能会影响SFH的实施和居民的遵从性。在目标2中，我们测试 感知合法性、SFH实施策略与SHS的几个标志物之间的关联 (细颗粒物、空气中尼古丁和呼出的CO)。我们假设：(A)认为 合法性将与SFH实施方面的差异有关，(B)SFH实施方面的差异 战略将影响SHS衡量的SFH合规性，以及(C)SFH的低感知正当性将 协调实施战略对SFH合规的影响。在目标3中，我们开发了一个可扩展的 SFH的实施战略，以改善居民的合规性和感知的合法性。 将使用社区咨询委员会为这一过程提供信息，以确保解决方案植根于 真实世界的体验。

Project Summary Smoke-free housing (SFH) has recently been mandated by the U.S. Department of Housing and Urban Development (HUD) to protect public housing residents from secondhand smoke (SHS) exposure. However, our preliminary work suggests that SFH might not be effective. In focus groups, smokers in low-income housing have reported to us that they are primarily motivated by fear of punishment, rather than an obligation to comply with SFH, which they perceive to be unfair. They describe a situation in which many smokers respond by hiding their smoking inside their apartments—where they think they will be less likely to be seen—when compliance with SFH is perceived to be an inconvenience or even unsafe (e.g., if they would have to walk across their community at night to smoke off the property). This suggests that the perceived legitimacy of SFH is low—residents feel so strongly about its unfairness that they are unlikely to comply with it on their own. This means that efforts to increase resident compliance by relying on threats of punishment could be counterproductive. Residents also report several barriers to compliance with SFH that they also perceive to be unfair (e.g., banning smoking in public housing but allowing it on other types of properties). These barriers vary between housing authorities and represent important differences in SFH implementation strategy. Principles and approaches from community-based participatory research guide this study. In Aim 1 we assess factors associated with perceived legitimacy and compliance across six housing authorities. We will use a mixed methods approach to establish: (1) who exhibits lower perceived legitimacy of SFH, and under what circumstances, and (2) what property and organizational factors that differ between and within housing authorities could affect SFH implementation and resident compliance. In Aim 2 we test associations between perceived legitimacy, SFH implementation strategy, and several markers for SHS (fine particulate matter, airborne nicotine, and exhaled CO). We hypothesize that: (a) perceived legitimacy will be related to differences in SFH implementation, (b) differences in SFH implementation strategy will affect SFH compliance, as measured by SHS, and (c) low perceived legitimacy of SFH will mediate the impact of implementation strategy on SFH compliance. In Aim 3 we develop a scalable implementation strategy for SFH that to improve resident compliance and perceived legitimacy. Community advisory boards will be used to inform this process to ensure that solutions are grounded in real-world experiences.