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

利用合法性感知和居民合规性差异促进无烟住房的公平有效实施

• 批准号: 10626729
• 负责人: Kelli England
• 金额: $ 59.83万
• 依托单位: EASTERN VIRGINIA MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-07 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10626729
• 关键词: Affect; Air; Area; Attitude; Authorization documentation; Biological Markers; Communities; Disease; Effectiveness; Environment; Exhalation; Exhibits; Focus Groups; Fright; Goals; Group Interviews; Health; Housing; Individual; Institution; Intervention; Interview; Justice; Laws; Left; Legitimacy; Low income; Measures; Mediating; Methods; Modeling; Monitor; Nicotine; Outcome; Perception; Persons; Policies; Process; Property; Proxy; Public Housing; Punishment; Recommendation; Reporting; Rights; Risk; Sampling; Smoke; Smoke-free home; Smoker; Smoking; Surveys; Testing; Tobacco; Trust; U.S. Department of Housing and Urban Development; Walking; Work; authority; community based participatory research; environmental tobacco smoke; environmental tobacco smoke exposure; experience; fine particles; health disparity populations; implementation framework; implementation strategy; improved; member; metropolitan; prevent; response; soda tax; theories; willingness

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.

项目摘要 无烟住房（SFH）最近被美国住房和城市部授权 保护公共住房居民免受二手烟（SHS）暴露。 然而，我们的初步工作表明，SFH可能不是有效的。在焦点小组中， 低收入住房向我们报告说，他们的动机主要是害怕惩罚，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把烟藏在他们的公寓里--他们认为他们会的地方 不太可能被看到-当遵守SFH被认为是一个不便，甚至 不安全的（例如，如果他们不得不在晚上穿过他们的社区去吸烟的话）。这 表明SFH的合法性很低-居民对它的不公平性感到非常强烈， 他们不太可能自己遵守它。这意味着提高居民遵守情况的努力 可能会适得其反居民还报告了几个障碍， 遵守SFH，他们也认为是不公平的（例如，禁止在公共房屋内吸烟， 允许它在其他类型的属性上）。这些障碍因住房当局而异， SFH实施策略的重要区别。 基于社区的参与性研究的原则和方法指导这项研究。在目标1中， 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感知合法性，以及 在什么情况下，以及（2）什么属性和组织因素，不同的， 住房当局内部可能会影响SFH的实施和居民的遵守。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 (fine颗粒物、空气中的尼古丁和呼出的CO）。我们假设：（a）感知 合法性将与SFH实施的差异有关，（B）SFH实施的差异 根据SHS的衡量，战略将影响SFH的合规性，以及（c）SFH的合法性较低， 调解实施策略对SFH合规性的影响。在Aim 3中，我们开发了一个可扩展的 为改善居民遵守情况和合法性而制定的SFH实施战略。 社区咨询委员会将被用来告知这一过程，以确保解决方案的基础是 真实世界的体验。