TEXAS MULTI CULTURAL REGIONAL COMMUNITY TOBACCO STUDIES

德克萨斯州每年有超过2.6万人死于烟草使用。为了减轻烟草的健康负担，迫切需要创新和密集的干预措施。德克萨斯州的烟草诉讼和解协议导致了每年约1000万美元的拨款。为州级烟草控制。为了与似乎影响其他主要州举措行为的人均支出相匹配，这些资金将集中在单个地区的媒体、社区和政策活动中，涉及大约五分之一的州人口，形成一种“自然”的准实验设计。德克萨斯大学公共卫生学院、贝勒医学院和德克萨斯州卫生部将对这些地区性活动进行评估，并调查其在德克萨斯州三个主要文化群体(盎格鲁裔、西班牙裔和非裔美国人)中的过程和影响。数据来源将包括对成年人的年度电话调查(约通过对中学生的半年期调查(n=15 000/2年)，对医生、其他提供者、学校、其他组织和关键个人的调查，媒体内容跟踪和其他定性和定量研究，以记录和评价媒体、社区和政策活动的执行情况。在准试验性区域研究中，将在全州范围和区域组中比较成人和青年患病率的趋势和相关因素。将通过比较小组研究评估密集地区的戒烟效果。在一项仅限于随机选择的小组参与者的实验研究中，一些吸烟者及其家人将收到同行外展工作人员的邮件电话联系，以增加对媒体和社区活动的接触和反应。这些研究中采用的研究设计将使我们能够回答以下问题：不同强度的区域干预措施对烟草使用流行率和戒烟的影响，以及与不同种族和社会经济地位群体中不同干预措施成败相关的过程和定性因素。为提高解决基金支持的密集区域活动的质量，将通过为TDH及其合作伙伴和承包商举办培训讲习班提供技术援助，重点是有效的多文化行动和利用创新媒体、社区和政策干预措施，以解决与戒毒和预防有关的具体理论变量。开展宣传和同行示范活动，促进个人行为改变和组织方案和政策创新。德克萨斯州的这一区域项目旨在收集禁烟支出影响的证据，并提供能力发展，以证明以后为全州类似密集的烟草控制活动提供资金是合理的。

More than 26,000 people die each year as a result of tobacco use in Texas. To lessen the health burden of tobacco, innovative and intensive interventions are urgently needed. The tobacco suit settlement in Texas has led to an allocation of approximately $10 million/yr. for state-level tobacco control. To match per-capita expenditures that have appeared to influence behavior in other major state initiatives, the funds will be concentrated in media, community and policy activities for a single region, involving approximately one-fifth of the state population and forming a "natural" quasi-experimental design. The University of Texas School of Public Health, the Baylor College of Medicine and the Texas Department of Health (TDH) will evaluate these regional activities and investigate their processes and effects in the three major cultural groups in Texas (Anglo-, Hispanic- and African-American). Data sources will include annual telephone surveys of adults (approx. 10,000 year/with 2,200 smokers), biannual surveys of secondary school students (n=15,000/2 years), surveys of physicians, other providers, schools, other organizations and key individuals, media content tracking and other qualitative and quantitative studies to document and evaluate the implementation of media, community and policy activities. In the quasi-experimental regional studies, trends in adult and youth prevalence and related factors will be compared in statewide and regional groups. Tobacco use cessation effects in the intensive regions will be evaluated through comparative panel studies. In an experimental study limited to randomly selected panel participants, some smokers and their families will receive mail-telephone contacts from peer outreach workers to increase exposure and response to media and community activities. The research designs employed in these studies will allow us to answer questions about the effects of different intensive regional interventions on tobacco use prevalence and smoking cessation and the processes and qualitative factors that are associated with the success or failure of different interventions in different ethnic and SES groups. To enhance the quality of intensive regional activities supported by the settlement funds, technical assistance will be provided through training workshops for TDH and its partners and contractors, focusing on effective multi-cultural action and the use of innovative media, community and policy interventions to address specific theoretical variables related to cessation and prevention. A publicity and peer modeling campaign will be conducted to promote individual behavior change and organizational program and policy innovation. This regional project within Texas is designed to gather evidence of effects of anti-smoking expenditures and to provide capacity development to justify later funding of similarly intensive tobacco control activities for the entire state.