A Community Trial to Speed the Diffusion of Smoke Free Multiunit Housing Policies

描述（由申请人提供）：美国约有8000万人居住在多单元住房（MUH）中，在这些住房中，存在因吸烟而非自愿暴露于SHS的可能性。美国卫生局局长报告称，SHS暴露没有安全水平。根据我们的初步数据，这可能部分是由于对SHS危险性的了解程度较低，缺乏对MUH单位之间转移程度的了解，实施政策的障碍，如损失的租金收入和无烟建筑政策的合法性，以及租户对要求建筑物无烟环境的普遍冷漠。使用罗杰斯的扩散理论作为指导框架，我们的目标是进行随机的社区干预，以测试是否可以通过向适当的目标受众（即，房东/业主和租户）。主要假设是，这种无烟MUH教育活动将以比没有这种干预的情况下观察到的更快的速度增加居住在具有100%无烟政策的建筑物中的租户的比例。为了验证这一假设，我们建议进行一项随机配对的社区干预试验，以衡量有关SHS的知识变化，对无烟MUH政策的支持，以及租户和房东/业主之间的实际政策执行情况。我们将与美国非吸烟者权利组织（ANR）合作，实施为期12个月的干预措施，并在美国的8对中小型社区提供技术援助。干预措施将包括收集和传播从租户和房东/业主处获得的基线科学调查数据，以及记录MUH综合体单元之间SHS传输程度的空气质量数据。无烟MUH教育干预将针对从基线数据收集中确定的具体问题和障碍进行定制。干预措施将传递给目标受众（例如，通过与房东/业主和房地产经纪人协会的会议、新闻发布会和宣传无烟MUH政策的活动等渠道，向租户和房东/业主提供禁烟服务。检查的结果包括对SHS危险的认识的变化，对无烟政策的支持，以及居住在无烟MUH的租户的百分比。 公共卫生相关性：尽管美国有8000万租房者，二手烟暴露的危险性很大，但几乎没有关于租户和房东/管理人员对此问题的看法的文献，也没有太多数据来记录二手烟可能从吸烟区转移到同一建筑物内的非吸烟区的程度。我们的目标是进行一项基于社区的随机干预，以测试SHS知识的增加，对无烟MUH政策的支持以及实际政策的实施是否可以通过向适当的目标受众提供可靠的科学信息的教育干预来实现（即，房东/业主和租户）。

DESCRIPTION (provided by applicant): There are approximately 80 million people in the US that live in multiunit housing (MUH) where the potential exists for involuntary exposure to SHS from smoking occurring in other parts of their building. The US Surgeon General has reported that there is no safe level of exposure to SHS. Based on our preliminary data, this could be in part due to low levels of knowledge about the dangers of SHS, the lack of understanding the extent to which it transfers between units in MUH, perceived barriers to implementing policies such as lost rental income and the legality of smoke free building policies, and a general apathy among tenants to request a smoke free environment in their building. Using Rogers' Theory of Diffusion as a guiding framework, we aim to conduct a randomized community-based intervention to test whether increases in SHS knowledge, support for smokefree MUH policies, and actual policy implementation can be achieved through an educational intervention that delivers credible scientific information to the appropriate target audiences (i.e., landlords/owners and tenants). The primary hypothesis is that this smokefree MUH educational campaign will increase the fraction of tenants that live in a building that has a 100% smokefree policy at a faster rate than that observed without such an intervention. To test this hypothesis, we propose to conduct a randomized matched-pair community-based intervention trial to measure changes in knowledge about SHS, support for smokefree MUH policies, and actual policy implementation among tenants and landlords/owners. We will work with Americans for Non- smokers' Rights (ANR) to implement the 12 month intervention and to provide technical assistance in 8 pairs of small to mid-sized communities in the US. The intervention will involve the collection and dissemination of scientific survey data obtained at baseline from tenants and landlord/owners as well as air quality data documenting the extent to which SHS transfers between units in a MUH complex. The smokefree MUH educational intervention will be tailored to the specific issues and barriers identified from this baseline data collection. The intervention will be delivered to the target audience (e.g., tenants and landlords/owners) through channels, such as meetings with landlords/owners' and realtors' associations, press conferences, and events to promote smokefree MUH policies. Outcomes examined include changes in knowledge about the dangers of SHS, support for smokefree policies, and the percent of tenants that live in a smokefree MUH. PUBLIC HEALTH RELEVANCE: Despite the fact that there are 80 million renters in the US and the dangers of secondhand smoke exposure, there is little literature about what tenants and landlords/managers believe on this issue, nor is there much data to document the extent to which secondhand smoke may transfer from smoking to non-smoking areas within the same building. We aim to conduct a randomized community-based intervention to test whether increases in SHS knowledge, support for smokefree MUH policies, and actual policy implementation can be achieved through an educational intervention that delivers credible scientific information to the appropriate target audiences (i.e., landlords/owners and tenants).