York Nancy L, Hahn Ellen J, Rayens Mary Kay, Talbert Jeff
University of Nevada Las Vegas, School of Nursing, 4505 Maryland Parkway, Box 453018, Las Vegas, NV 89154-3018, USA.
Am J Health Promot. 2008 Nov-Dec;23(2):112-20. doi: 10.4278/ajhp.07021615.
The purpose of this study was to use the Community Readiness Model to examine local smoke-free policy development.
DESIGN, SETTING, AND SUBJECTS: A descriptive, cross-sectional design was used to assess 64 Kentucky communities. Dimensions of readiness included a community's knowledge of the problem and existing voluntary smoke-free policies; leadership for policy development; resources for policy development; climate surrounding policy development; existing voluntary policy efforts; and political climate for policy development. Dimension scores were summed to identify one of six overall readiness stages: (1) unawareness; (2) vague awareness; (3) preplanning; (4) preparation; (5) initiation; and (6) endorsement.
Correlations between dimensions and overall readiness scores were evaluated. One-way analysis of variance was used to evaluate regional trends, and multiple regression was used to assess the influence of sociodemographic/political variables on policy readiness.
The knowledge dimension rated highest, and community climate rated lowest. Most communities were in the lower stages of readiness. No relationship was found between overall readiness and region (F [4,59] = 1.17; p > .05); nor were there regional differences among dimension scores. Smaller communities were less ready for local policy development than larger ones (adjusted R2 = .25; p = .003).
The Community Readiness Model is appropriate for understanding local policy development, and it provides advocates with information that may prove helpful in advancing smoke-free policy.
本研究旨在运用社区准备度模型来审视地方无烟政策的制定情况。
设计、地点与研究对象:采用描述性横断面设计对肯塔基州的64个社区进行评估。准备度的维度包括社区对问题的认知以及现有的自愿性无烟政策;政策制定的领导力;政策制定的资源;政策制定的氛围;现有的自愿性政策努力;以及政策制定的政治氛围。将各维度得分相加,以确定六个总体准备度阶段之一:(1)无认知;(2)模糊认知;(3)预规划;(4)准备;(5)启动;以及(6)认可。
评估各维度与总体准备度得分之间的相关性。采用单因素方差分析来评估区域趋势,采用多元回归来评估社会人口统计学/政治变量对政策准备度的影响。
知识维度得分最高,社区氛围得分最低。大多数社区处于较低的准备度阶段。未发现总体准备度与区域之间存在关联(F[4,59]=1.17;p>.05);各维度得分在区域之间也无差异。较小的社区相比大社区对地方政策制定的准备度更低(调整后的R2=.25;p=.003)。
社区准备度模型适用于理解地方政策制定情况,它为倡导者提供了可能有助于推进无烟政策的信息。