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

项目概要 美国住房和城市部最近强制要求实行无烟住房 (SFH) 旨在保护公共住房居民免受二手烟 (SHS) 暴露的开发 (HUD)。 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 低收入住房向我们报告说，他们的动机主要是害怕受到惩罚，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自己的公寓内——他们认为在那里会吸烟 不太可能被发现——当遵守 SFH 被认为带来不便，甚至被认为是 不安全（例如，如果他们必须在晚上穿过社区才能在房产外吸烟）。这个 表明 SFH 的合法性较低——居民对其不公平感强烈，以至于 他们不太可能自行遵守该规定。这意味着提高居民合规性的努力 依靠惩罚威胁可能会适得其反。居民们还反映了一些障碍 遵守 SFH 的规定，但他们也认为这是不公平的（例如，公共住房内禁止吸烟，但 允许在其他类型的属性上使用）。这些障碍因住房当局而异，并代表 SFH 实施策略的重要差异。 本研究以社区参与性研究的原则和方法为指导。在目标 1 中，我们 评估与六个住房当局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 合法性，以及 在什么情况下，以及 (2) 和之间有哪些不同的财产和组织因素 住房当局内部可能会影响 SFH 的实施和居民的合规性。在目标 2 中我们测试 感知合法性、SFH 实施策略和 SHS 的几个标记之间的关联 （细颗粒物、空气中的尼古丁和呼出的二氧化碳）。我们假设：（a）感知 合法性将与 SFH 实施的差异相关，(b) SFH 实施的差异 战略将影响 SFH 的合规性（如 SHS 所衡量），并且 (c) SFH 的合法性较低将 调解实施策略对 SFH 合规性的影响。在目标 3 中，我们开发了一个可扩展的 SFH 的实施策略，以提高居民的合规性和合法性。 社区咨询委员会将用于告知这一过程，以确保解决方案扎根于 真实世界的经历。

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.