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Addressing Candy-Coated Dangers in
Rural Communities: A Guide to Using
the 7 Strategies for Effective
Community Change to Reduce
Smokeless Tobacco Use

Alicia Smith, MPH, Project Manager, CADCA
November 29, 2012
Topics for Today
• CADCA Overview
• Environmental Strategy of Choice: The
  Coalition Model
• Trending Threat: Smokeless Tobacco
• 7 Strategies for Community Change
About CADCA
• Founded in 1992 as a recommendation from the President’s Drug
  Advisory Council, CADCA is the only membership organization
  representing community anti-drug coalitions.
• A leading international not-for-profit organization involved in the
  demand reduction of alcohol, tobacco and other drug problems.
• Represents more than 5,000 community coalitions across the
  United States and, now, internationally.


   Our Mission: To build and strengthen the capacity of community
     coalitions to create and maintain safe, healthy and drug-free
                     communities around the world.
Top Benefits of CADCA
               Membership
•   Receive free web publications (The Members’ Edge, Coalitions Online) and
    discounted print publications (Strategizer, Practical Theorist, Coalitions)

•   Discounted rates of 30% for members and their youth to attend CADCA’s
    National Leadership Forum and Mid-Year Training Institute

•   Discounted rates on Masters of Prevention Programs at University of
    Oklahoma, College of Liberal Studies, and College of Continuing
    Education’s Southwest Prevention Center

•   Use of CADCA logo for branding purposes

•   Eligibility to enter CADCA contests and apply for scholarship opportunities
Membership Fee Structure
       CADCA Membership Categories                        Annual Dues
       Community Coalition/Community-Based Organization
       Annual budget:
       • $ 500,000 and above…………………………………………….            $500
       • $ 300,000 - $499,999……………………………………………            $400
       • $ 100,000 - $299,999……………………………………………            $300
       • $ 0 - $99,999…………………………………………………………              $200
       Individual Member                                  $50



The membership team is here to help! Please contact the Membership
team with any questions or concerns about individual or organizational
membership:

Na’Denna Colbert, Membership Manager, ncolbert@cadca.org
Dana Landers, Membership Associate, dlanders@cadca.org
CADCA Core Services
• Public Policy and Advocacy
• Membership and Communications
• Special Events and Conferences
• International Programs
• Youth Programs
• Training and Technical Assistance
• Research Dissemination and Evaluation
CADCA’s Reach
      •   E-newsletter Coalitions Online
          reaches 23,000 subscribers weekly.
      •   CADCA TV series –satellite and web
          broadcasts that reach approximately
          7 million households per program.
      •   Library of 74 publications developed
          for coalitions.
      •   Connected Communities, an online
          peer-to-peer network for coalitions
          has 1871 members
      •   2069 Like us on FacebookCADCA
      •   935 Follow us on Twitter @CADCA
      •   YouTube channel: cadca09
CADCA’s Youth Program
The National Youth Leadership Initiative
   – Trains over 500 youth a year who are
     connected to local coalitions
   – Fosters youth leadership in the design,
     implementation, and evaluation of action
     strategies addressing community
     problems
   – Geared to prepare the community
     coalition workforce of tomorrow
   – Allows for youth to be trained to be
     effective and meaningful members of
     their local coalitions
   – State trainings in West Virginia,
     Michigan; Cherokee Nation
CADCA’s International Program
•   International training program sponsored by
    the U.S. Department of State began in
    2004.
•   In 2006, received special consultative
    status to the Economic and Social Council
    (ECOSOC) of the UN.
•   Helps community leaders develop anti-drug
    coalitions through training and technical
    assistance to local non-governmental
    organizations in foreign countries.
•   Currently assisting communities in Mėxico,
    Bolivia, Brazil, Perú, Colombia, Guatemala,
    Honduras, South Africa and Kenya.             There are over 50 coalitions in
                                                  Peru and 11 in Brazil.
CADCA Supports Veterans and
         Military Families
•   CADCA has been selected by the Corporation for National
    and Community Service (CNCS) to conduct a national
    program to involve CADCA coalitions in addressing the
    needs of veterans and military.
•   Over the next year, CADCA will place 100 AmeriCorps and
    VISTA members in coalitions in 28 states with an additional
    78 members to come on board the following year in the
    remaining states and territories
•   Focus on helping veterans and military families access a
    whole host of services, including substance abuse and
    mental health services
CADCA's National Coalition Institute
•   Drug Free Communities Act reauthorization of 2002 provided for a National Coalition
    Institute.
•   CADCA participated in a competitive RFA and was selected to create the Institute and
    deliver services to the field.
•   Federal Partners: ONDCP and SAMHSA/CSAP
•   Funding started at $2M and remains at this level
•   As per the DFC Act, the National Community Coalition Institute shall:
      – “(1.) Provide education, training and technical assistance for coalition leaders and
         community teams, with emphasis on the development of coalitions serving
         economically disadvantaged areas;
      – (2.) develop and disseminate evaluation tools, mechanisms and measures to better
         assess and document coalition performance measures and outcomes; and
      – (3.) bridge the gap between research and practice by translating knowledge from
         research into practical information.”
•   An independent evaluation by Michigan State University found that coalitions who
    receive support from CADCA’s Institute demonstrate higher levels of effectiveness
    than those who do not.
CADCA Awarded CTG Funding
• Two-prong approach to support,
  disseminate, and amplify the evidence-
  based strategies of the CTG tobacco-free
  living strategies
   – Targeted group of coalitions; based on
     our 2011 Annual Survey of Coalitions

   – National CADCA partners; building
     on our current partnerships as well
     as forming new ones
CADCA Members Focus on Tobacco
    Prevention and Smoking Cessation
•    59% of coalitions are addressing tobacco directly
      – 66% are directly involved or connected to another collaborative addressing
        tobacco prevention

•    35% of coalitions are directly involved or connected to another collaborative
     addressing smoking cessation

•    77% of coalition respondents collect data on tobacco

•    In the last 12 months, 35% of coalitions have
     been involved in smoking cessation activities
     for youth and 30% of coalitions have been
     involved in smoking cessation activities for adults
Environmental Strategy of Choice
A coalition is a formal arrangement for cooperation and
collaboration between groups
or sectors of the community,
in which each group
retains its identity but all
agree to work together
towards a common goal
of building a safe, healthy
and drug-free community.
Important to Note:
 A coalition is not a program,
although partners often carry out
   programs as a “piece” of the
 community-wide strategic plan.
Key Sectors
Coalitions convene and combine talent and
resources to address local substance abuse
issues:
Law enforcement               Faith based community
Youth                         Civic and volunteer groups
Parents                       Health care professionals
Businesses                    State, local or tribal
Media                          agencies
Schools                       Other organizations
Youth serving organizations    involved in reducing
                                substance abuse
The relationship between SAMHSA’s Strategic Prevention Framework and the Core Competencies* supported by

    1. Create and maintain coalitions and partnerships                        2. Assess community needs and resources



                                                                                                       3. Analyze problems and goals
                                   A. Assessment
                                                                                                            4. Develop a framework or model of change
                  15. Sustain projects and initiatives



                   14. Evaluate initiatives
                                                                                                                    B. Capacity

                                                                                                               5. Increase participation and membership

               E. Evaluation
                                                                                                                       6. Build leadership
    13. Write grant applications for funding


                                                                                                            7. Enhance cultural competence
      12. Influence policy development


                                                                                            8. Improve organizational mgt. and development
             11. Advocate for change



                  10. Develop interventions
                                                                                               C. Planning
                                                                                   9. Develop strategic and action plans
                          D. Implementation

                                              *Core Competencies 2004 © University of Kansas. Used by permission.           17
Products Your Community Needs to Create
               A. Community
                Assessment

                                   B. Logic Model



    E. Evaluation
        Plan




      D. Sustainability       C. Strategic & Action
           Plan                       Plan
Coalition Essentials
So, what’s the trending threat?
What Do We All Have in Common?
Big tobacco keeps up with the times.
US Smokeless Tobacco #1 in Spit
Project goal was to over come three
problems kids have when starting spit
tobacco:
1) Normal nicotine level burns tender
   young mouths.

Lower nicotine – “starter” product


2) “Float” – new users do not know how
    to keep a pinch in one spot
Pouch keeps it in place


3) Bad / unfamiliar taste
Add sweet candy flavoring
Snus
• Candy and liqueur-flavored
  tobacco mask the initial harsh
  reactions when using tobacco
  products
• Advertising used to market
  these products downplay their
  potential for addiction and
  mislead users, often the young
  and novice, into believing they
  are experimenting with a less
  harmful tobacco product.
Big Tobacco’s Sweet Plan
  According to the industry, adding flavors is
 associated with increasing their market share
 among target populations—young adults and
                novice smokers
“Growing interest in new flavor sensations (i.e.
Soft drinks, snack foods) among younger adult
consumers may indicate new opportunities for
 enhanced flavor tobacco products” Lorillard,
                     1993
Conducting Community Assessment

•   Who is most affected by tobacco?
•   Where the problem is occurring?
•   When it is occurring?
•   What are perceptions of harm by
    youth and adults?
How Do We Do That?
                 Action Plan
•   Collect Local Data
•   Contact attorney for draft review
•   Train youth and adult advocates
•   RAISE AWARENESS
•   Gain Local Support- individual & groups
•   Resolution
•   Ordinance
Sample Logic Model Template

                                                                        Theory of Change

                Problem Statement                         Strategies              Activities                            Outcomes

      Problem       But why?         But why here?                                                         Short Term       Intermediate   Long-Term
                    Root Cause       Local Condition                                                                                       [1]




                                                                            DATA


                                                                            DATA



                                                                             DATA

[1]   The long-term outcomes are affected not by any single strategy but by ALL of the strategies and activities.
Recruiting and Engaging Partners
•   Families
•   Youth
•   Law enforcement
•   Educators
•   Public Health professionals
•   Healthcare Providers
•   Treatment and Recovery professionals
•   Non-traditional Messengers
Using the 7 Strategies for
   Community Change:
  Tobacco Interventions
Coalitions Pursuing Comprehensive
               Environmental Strategies
1. Provide information
                                                                   Individually-
2. Build skills                                                      focused

3. Provide social support
4. Reduce barriers / enhance access
5. Change consequences / incentives
                                                                    Environmentally-
6. Alter the physical design of the environment                         focused

7. Change policy and rules
                             Source: KU Work Group for Community Health and Development, 2007
1. PROVIDING INFORMATION
 Educational presentations, workshops or seminars
 or other presentations of data.
The Coalition Model:
•   Be aware of new tobacco products
•   Current tobacco laws
•   Gather data about tobacco use in current community
•   Promote effective tobacco cessation services
•   Ex: Van Buren County SAFE Coalition, Iowa
    – Engaged schools, health department, etc. in data
      collection process
    – Data revealed a need to focus on youth alcohol and
      tobacco use
    – Enhance school and community policies, disseminate
      accurate information and increase local awareness
                                       http://www.cadca.org/files/SevenStrategies4CommunityChange.pdf
2. ENHANCING SKILLS
 Activities designed to increase the skills of
 participants to achieve population-level outcomes
The Coalition Model:
• Participate in CADCA tobacco-prevention trainings
   –   Ways to implement CTG tobacco-free living strategies
   –   New products and the retail/contract environment
   –   Faith and historically-based perspective to cessation
   –   National Forum & Mid-Year training opportunities
• Attend national conferences on tobacco
  prevention
   –   Webinars hosted by: CADCA, SCLC, Legacy, ALA
   –   Breakfree Alliance
   –   National Networks for Tobacco Control
   –   National Conference on Tobacco or Health
                                          http://www.cadca.org/files/SevenStrategies4CommunityChange.pdf
“Newusers of smokeless tobacco . . . are
  most likely to begin with products that
    are milder tasting, more flavored
  and/or easier to control in the mouth.
After a period of time, there is a natural progression of product
   switching to brands that are more full-bodied, less flavored,
      have more concentrated ‘tobacco taste’ than the entry
                                brand.”


              (UST document, “The Graduation Theory”)
3. PROVIDING SUPPORT
 Creating opportunities to support activities that
 reduce risk or enhance protection
The Coalition Model:
    • Policy enforcement + support = sustainability
       – Ex: Campus Wellness Coalition & Oklahoma City
         Community College
          • Established on-campus taskforce: students & faculty
          • Announced available cessation services along with the
            upcoming policy
          • Announced policy 18 months in advance
          • Provided free on-campus counseling services for students,
            faculty and employees
              – Partnered with local treatment centers; Co-op program for students
          • Provided information and feedback; campus newsletter

                                            http://www.cadca.org/files/SevenStrategies4CommunityChange.pdf
4. ENHANCING ACCESS/REDUCING
   BARRIERS
 Improving systems and processes to increase the
 ease, ability and opportunity to utilize those
 systems and services.
The Coalition Model:
        • Making the healthier choice the easiest choice to
          make
           – Ex: Gwinnett County in Georgia, CADCA coalition
             member
              • High rate of smoking
              • Built a network of supporters
              • Orchestrated education campaigns: smoke free homes,
                restaurants
              • Partnered with local retailers to educate them about the
                need to place tobacco products behind the counter
              • Provided incentives and recognition to those business
                advocates

                                   http://www.cadca.org/files/SevenStrategies4CommunityChange.pdf
5. CHANGING CONSEQUENCES
 Incentives/Disincentives: Increasing or decreasing
 the probability of a specific behavior by altering the
 consequences of that behavior
The Coalition Model:
  • Business Rewards
     – Placing tobacco products behind the counter
     – Reducing tobacco signage & advertising
     – Working with local law enforcement to ensure retailers
       abiding by state laws; fines
  • Influence of nontraditional partners
     – Ex: Oklahoma County Tobacco Use
       Prevention Coalition
         •   Partnered with Tinker Federal Credit Union
         •   Empowerment Zone
         •   Free financial counseling
         •   Worked with smokers who quit to build a budget;
             create a new goal with the savings
                                               http://www.cadca.org/files/SevenStrategies4CommunityChange.pdf
6. PHYSICAL DESIGN
 Changing the physical design or structure of the
 environment to reduce risk or enhance protection
The Coalition Model:
  • Notice of policy
  • Removing ash trays
  • Eliminate tobacco litter
     – Ex: Community Connections Coalition in
       West Virginia, CADCA coalition member
        • High rate of smoking/chew tobacco (24%)
        • Large event draws most of the community
          together
        • Designated outdoor smoking areas at 9-
          day state fair


                                       http://www.cadca.org/files/SevenStrategies4CommunityChange.pdf
7. MODIFYING POLICIES
  Formal change in written procedures, by-laws,
  proclamations, rules or laws with written
  documentation, and/or voting procedures
The Coalition Model:
   •   Smokefree State Policy
   •   Tobacco Free Worksite policies
   •   Clean Indoor Air Ordinances (city/county/state)
   •   Tobacco Free Congregation policy (faith-based approach)
   •   24-hour, 100% Tobacco Free Schools policy
                   – Ex: Gwinnett County’s worked let to the formation of
                     the Youth Advisory Board “Why Smoke? youth tobacco
                     prevention campaign
                   – Established 100% tobacco free schools
                   – Signage posted at every school
                   – Postcards announcing the policy sent to over 10,000
                     homes

                                        http://www.cadca.org/files/SevenStrategies4CommunityChange.pdf
Problem: Smokeless tobacco use among teens and
    young adults living in rural and frontier communities
                is disproportionately high.
But Why? Smokeless tobacco promotions have increased dramatically
  and a new generation of smokeless tobacco products has hit the
  market.

•   Reducing Access / Enhancing Barriers

•   Changing Consequences

•   Changing Physical Design

•   Modifying Laws and Policies
Join us in Washington, D.C.!
•   National Leadership Forum
     – The nation’s largest training, networking and
        advocacy event for substance abuse prevention
        and treatment professionals and researchers.
     – Attendance: nearly 3500
     – February 4 – 7, 2012 at the Gaylord National
        Harbor Hotel, Fort Washington, MD.
Contact Information
             Alicia Smith, MPH
   Project Manager, Tobacco Programs
          (703) 706-0560 ext. 273
       or 1-800-54-CADCA ext. 273
             asmith@cadca.org


              Join CADCA’s
Weekly email updates and the Tobacco Use
       Prevention Strategies Group
       on Connected Communities:
  www.connectedcommunities.ning.com
QUESTIONS?

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Cadca candy coateddangers7strategies - alicia smith

  • 1. Addressing Candy-Coated Dangers in Rural Communities: A Guide to Using the 7 Strategies for Effective Community Change to Reduce Smokeless Tobacco Use Alicia Smith, MPH, Project Manager, CADCA November 29, 2012
  • 2. Topics for Today • CADCA Overview • Environmental Strategy of Choice: The Coalition Model • Trending Threat: Smokeless Tobacco • 7 Strategies for Community Change
  • 3. About CADCA • Founded in 1992 as a recommendation from the President’s Drug Advisory Council, CADCA is the only membership organization representing community anti-drug coalitions. • A leading international not-for-profit organization involved in the demand reduction of alcohol, tobacco and other drug problems. • Represents more than 5,000 community coalitions across the United States and, now, internationally. Our Mission: To build and strengthen the capacity of community coalitions to create and maintain safe, healthy and drug-free communities around the world.
  • 4. Top Benefits of CADCA Membership • Receive free web publications (The Members’ Edge, Coalitions Online) and discounted print publications (Strategizer, Practical Theorist, Coalitions) • Discounted rates of 30% for members and their youth to attend CADCA’s National Leadership Forum and Mid-Year Training Institute • Discounted rates on Masters of Prevention Programs at University of Oklahoma, College of Liberal Studies, and College of Continuing Education’s Southwest Prevention Center • Use of CADCA logo for branding purposes • Eligibility to enter CADCA contests and apply for scholarship opportunities
  • 5. Membership Fee Structure CADCA Membership Categories Annual Dues Community Coalition/Community-Based Organization Annual budget: • $ 500,000 and above……………………………………………. $500 • $ 300,000 - $499,999…………………………………………… $400 • $ 100,000 - $299,999…………………………………………… $300 • $ 0 - $99,999………………………………………………………… $200 Individual Member $50 The membership team is here to help! Please contact the Membership team with any questions or concerns about individual or organizational membership: Na’Denna Colbert, Membership Manager, ncolbert@cadca.org Dana Landers, Membership Associate, dlanders@cadca.org
  • 6. CADCA Core Services • Public Policy and Advocacy • Membership and Communications • Special Events and Conferences • International Programs • Youth Programs • Training and Technical Assistance • Research Dissemination and Evaluation
  • 7. CADCA’s Reach • E-newsletter Coalitions Online reaches 23,000 subscribers weekly. • CADCA TV series –satellite and web broadcasts that reach approximately 7 million households per program. • Library of 74 publications developed for coalitions. • Connected Communities, an online peer-to-peer network for coalitions has 1871 members • 2069 Like us on FacebookCADCA • 935 Follow us on Twitter @CADCA • YouTube channel: cadca09
  • 8. CADCA’s Youth Program The National Youth Leadership Initiative – Trains over 500 youth a year who are connected to local coalitions – Fosters youth leadership in the design, implementation, and evaluation of action strategies addressing community problems – Geared to prepare the community coalition workforce of tomorrow – Allows for youth to be trained to be effective and meaningful members of their local coalitions – State trainings in West Virginia, Michigan; Cherokee Nation
  • 9. CADCA’s International Program • International training program sponsored by the U.S. Department of State began in 2004. • In 2006, received special consultative status to the Economic and Social Council (ECOSOC) of the UN. • Helps community leaders develop anti-drug coalitions through training and technical assistance to local non-governmental organizations in foreign countries. • Currently assisting communities in Mėxico, Bolivia, Brazil, Perú, Colombia, Guatemala, Honduras, South Africa and Kenya. There are over 50 coalitions in Peru and 11 in Brazil.
  • 10. CADCA Supports Veterans and Military Families • CADCA has been selected by the Corporation for National and Community Service (CNCS) to conduct a national program to involve CADCA coalitions in addressing the needs of veterans and military. • Over the next year, CADCA will place 100 AmeriCorps and VISTA members in coalitions in 28 states with an additional 78 members to come on board the following year in the remaining states and territories • Focus on helping veterans and military families access a whole host of services, including substance abuse and mental health services
  • 11. CADCA's National Coalition Institute • Drug Free Communities Act reauthorization of 2002 provided for a National Coalition Institute. • CADCA participated in a competitive RFA and was selected to create the Institute and deliver services to the field. • Federal Partners: ONDCP and SAMHSA/CSAP • Funding started at $2M and remains at this level • As per the DFC Act, the National Community Coalition Institute shall: – “(1.) Provide education, training and technical assistance for coalition leaders and community teams, with emphasis on the development of coalitions serving economically disadvantaged areas; – (2.) develop and disseminate evaluation tools, mechanisms and measures to better assess and document coalition performance measures and outcomes; and – (3.) bridge the gap between research and practice by translating knowledge from research into practical information.” • An independent evaluation by Michigan State University found that coalitions who receive support from CADCA’s Institute demonstrate higher levels of effectiveness than those who do not.
  • 12. CADCA Awarded CTG Funding • Two-prong approach to support, disseminate, and amplify the evidence- based strategies of the CTG tobacco-free living strategies – Targeted group of coalitions; based on our 2011 Annual Survey of Coalitions – National CADCA partners; building on our current partnerships as well as forming new ones
  • 13. CADCA Members Focus on Tobacco Prevention and Smoking Cessation • 59% of coalitions are addressing tobacco directly – 66% are directly involved or connected to another collaborative addressing tobacco prevention • 35% of coalitions are directly involved or connected to another collaborative addressing smoking cessation • 77% of coalition respondents collect data on tobacco • In the last 12 months, 35% of coalitions have been involved in smoking cessation activities for youth and 30% of coalitions have been involved in smoking cessation activities for adults
  • 14. Environmental Strategy of Choice A coalition is a formal arrangement for cooperation and collaboration between groups or sectors of the community, in which each group retains its identity but all agree to work together towards a common goal of building a safe, healthy and drug-free community.
  • 15. Important to Note: A coalition is not a program, although partners often carry out programs as a “piece” of the community-wide strategic plan.
  • 16. Key Sectors Coalitions convene and combine talent and resources to address local substance abuse issues: Law enforcement Faith based community Youth Civic and volunteer groups Parents Health care professionals Businesses State, local or tribal Media agencies Schools Other organizations Youth serving organizations involved in reducing substance abuse
  • 17. The relationship between SAMHSA’s Strategic Prevention Framework and the Core Competencies* supported by 1. Create and maintain coalitions and partnerships 2. Assess community needs and resources 3. Analyze problems and goals A. Assessment 4. Develop a framework or model of change 15. Sustain projects and initiatives 14. Evaluate initiatives B. Capacity 5. Increase participation and membership E. Evaluation 6. Build leadership 13. Write grant applications for funding 7. Enhance cultural competence 12. Influence policy development 8. Improve organizational mgt. and development 11. Advocate for change 10. Develop interventions C. Planning 9. Develop strategic and action plans D. Implementation *Core Competencies 2004 © University of Kansas. Used by permission. 17
  • 18. Products Your Community Needs to Create A. Community Assessment B. Logic Model E. Evaluation Plan D. Sustainability C. Strategic & Action Plan Plan
  • 20. So, what’s the trending threat?
  • 21. What Do We All Have in Common?
  • 22. Big tobacco keeps up with the times.
  • 23. US Smokeless Tobacco #1 in Spit Project goal was to over come three problems kids have when starting spit tobacco: 1) Normal nicotine level burns tender young mouths. Lower nicotine – “starter” product 2) “Float” – new users do not know how to keep a pinch in one spot Pouch keeps it in place 3) Bad / unfamiliar taste Add sweet candy flavoring
  • 24. Snus
  • 25. • Candy and liqueur-flavored tobacco mask the initial harsh reactions when using tobacco products • Advertising used to market these products downplay their potential for addiction and mislead users, often the young and novice, into believing they are experimenting with a less harmful tobacco product.
  • 26. Big Tobacco’s Sweet Plan According to the industry, adding flavors is associated with increasing their market share among target populations—young adults and novice smokers “Growing interest in new flavor sensations (i.e. Soft drinks, snack foods) among younger adult consumers may indicate new opportunities for enhanced flavor tobacco products” Lorillard, 1993
  • 27. Conducting Community Assessment • Who is most affected by tobacco? • Where the problem is occurring? • When it is occurring? • What are perceptions of harm by youth and adults?
  • 28. How Do We Do That? Action Plan • Collect Local Data • Contact attorney for draft review • Train youth and adult advocates • RAISE AWARENESS • Gain Local Support- individual & groups • Resolution • Ordinance
  • 29. Sample Logic Model Template Theory of Change Problem Statement Strategies Activities Outcomes Problem But why? But why here? Short Term Intermediate Long-Term Root Cause Local Condition [1] DATA DATA DATA [1] The long-term outcomes are affected not by any single strategy but by ALL of the strategies and activities.
  • 30. Recruiting and Engaging Partners • Families • Youth • Law enforcement • Educators • Public Health professionals • Healthcare Providers • Treatment and Recovery professionals • Non-traditional Messengers
  • 31. Using the 7 Strategies for Community Change: Tobacco Interventions
  • 32. Coalitions Pursuing Comprehensive Environmental Strategies 1. Provide information Individually- 2. Build skills focused 3. Provide social support 4. Reduce barriers / enhance access 5. Change consequences / incentives Environmentally- 6. Alter the physical design of the environment focused 7. Change policy and rules Source: KU Work Group for Community Health and Development, 2007
  • 33. 1. PROVIDING INFORMATION Educational presentations, workshops or seminars or other presentations of data.
  • 34. The Coalition Model: • Be aware of new tobacco products • Current tobacco laws • Gather data about tobacco use in current community • Promote effective tobacco cessation services • Ex: Van Buren County SAFE Coalition, Iowa – Engaged schools, health department, etc. in data collection process – Data revealed a need to focus on youth alcohol and tobacco use – Enhance school and community policies, disseminate accurate information and increase local awareness http://www.cadca.org/files/SevenStrategies4CommunityChange.pdf
  • 35. 2. ENHANCING SKILLS Activities designed to increase the skills of participants to achieve population-level outcomes
  • 36. The Coalition Model: • Participate in CADCA tobacco-prevention trainings – Ways to implement CTG tobacco-free living strategies – New products and the retail/contract environment – Faith and historically-based perspective to cessation – National Forum & Mid-Year training opportunities • Attend national conferences on tobacco prevention – Webinars hosted by: CADCA, SCLC, Legacy, ALA – Breakfree Alliance – National Networks for Tobacco Control – National Conference on Tobacco or Health http://www.cadca.org/files/SevenStrategies4CommunityChange.pdf
  • 37. “Newusers of smokeless tobacco . . . are most likely to begin with products that are milder tasting, more flavored and/or easier to control in the mouth. After a period of time, there is a natural progression of product switching to brands that are more full-bodied, less flavored, have more concentrated ‘tobacco taste’ than the entry brand.” (UST document, “The Graduation Theory”)
  • 38. 3. PROVIDING SUPPORT Creating opportunities to support activities that reduce risk or enhance protection
  • 39. The Coalition Model: • Policy enforcement + support = sustainability – Ex: Campus Wellness Coalition & Oklahoma City Community College • Established on-campus taskforce: students & faculty • Announced available cessation services along with the upcoming policy • Announced policy 18 months in advance • Provided free on-campus counseling services for students, faculty and employees – Partnered with local treatment centers; Co-op program for students • Provided information and feedback; campus newsletter http://www.cadca.org/files/SevenStrategies4CommunityChange.pdf
  • 40. 4. ENHANCING ACCESS/REDUCING BARRIERS Improving systems and processes to increase the ease, ability and opportunity to utilize those systems and services.
  • 41. The Coalition Model: • Making the healthier choice the easiest choice to make – Ex: Gwinnett County in Georgia, CADCA coalition member • High rate of smoking • Built a network of supporters • Orchestrated education campaigns: smoke free homes, restaurants • Partnered with local retailers to educate them about the need to place tobacco products behind the counter • Provided incentives and recognition to those business advocates http://www.cadca.org/files/SevenStrategies4CommunityChange.pdf
  • 42. 5. CHANGING CONSEQUENCES Incentives/Disincentives: Increasing or decreasing the probability of a specific behavior by altering the consequences of that behavior
  • 43. The Coalition Model: • Business Rewards – Placing tobacco products behind the counter – Reducing tobacco signage & advertising – Working with local law enforcement to ensure retailers abiding by state laws; fines • Influence of nontraditional partners – Ex: Oklahoma County Tobacco Use Prevention Coalition • Partnered with Tinker Federal Credit Union • Empowerment Zone • Free financial counseling • Worked with smokers who quit to build a budget; create a new goal with the savings http://www.cadca.org/files/SevenStrategies4CommunityChange.pdf
  • 44. 6. PHYSICAL DESIGN Changing the physical design or structure of the environment to reduce risk or enhance protection
  • 45. The Coalition Model: • Notice of policy • Removing ash trays • Eliminate tobacco litter – Ex: Community Connections Coalition in West Virginia, CADCA coalition member • High rate of smoking/chew tobacco (24%) • Large event draws most of the community together • Designated outdoor smoking areas at 9- day state fair http://www.cadca.org/files/SevenStrategies4CommunityChange.pdf
  • 46. 7. MODIFYING POLICIES Formal change in written procedures, by-laws, proclamations, rules or laws with written documentation, and/or voting procedures
  • 47. The Coalition Model: • Smokefree State Policy • Tobacco Free Worksite policies • Clean Indoor Air Ordinances (city/county/state) • Tobacco Free Congregation policy (faith-based approach) • 24-hour, 100% Tobacco Free Schools policy – Ex: Gwinnett County’s worked let to the formation of the Youth Advisory Board “Why Smoke? youth tobacco prevention campaign – Established 100% tobacco free schools – Signage posted at every school – Postcards announcing the policy sent to over 10,000 homes http://www.cadca.org/files/SevenStrategies4CommunityChange.pdf
  • 48. Problem: Smokeless tobacco use among teens and young adults living in rural and frontier communities is disproportionately high. But Why? Smokeless tobacco promotions have increased dramatically and a new generation of smokeless tobacco products has hit the market. • Reducing Access / Enhancing Barriers • Changing Consequences • Changing Physical Design • Modifying Laws and Policies
  • 49.
  • 50. Join us in Washington, D.C.! • National Leadership Forum – The nation’s largest training, networking and advocacy event for substance abuse prevention and treatment professionals and researchers. – Attendance: nearly 3500 – February 4 – 7, 2012 at the Gaylord National Harbor Hotel, Fort Washington, MD.
  • 51. Contact Information Alicia Smith, MPH Project Manager, Tobacco Programs (703) 706-0560 ext. 273 or 1-800-54-CADCA ext. 273 asmith@cadca.org Join CADCA’s Weekly email updates and the Tobacco Use Prevention Strategies Group on Connected Communities: www.connectedcommunities.ning.com