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

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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.