Leung Emily, Yazdi Hanaan, Drayton Maisha, Davis David, Middleton Dawn, Senter Lindsay
CAI (Cicatelli Associates Inc.), 505 Eighth Ave., Suite 1900, New York, NY, 10018, USA.
J Racial Ethn Health Disparities. 2024 Jul 5. doi: 10.1007/s40615-024-02066-1.
Although smoking has decreased dramatically over the last 50 years, reductions are uneven by race and income, specifically in the Southern United States. There is a need for intentional collaboration with communities located where large tobacco disparities exist to make lasting change. Using community-based participatory research principles, we provided intensive capacity building to a community advisory group (CAG) of 14 Jackson, MS, residents to conduct a community-led needs assessment. The aim of the community-led needs assessment was to investigate firsthand why the community smokes and the impacts of smoking-giving the CAG voice and choice to work towards reducing tobacco-related harms and inequities.
From October 2020 to September 2021, CAG members conducted thirteen interviews and nine focus groups, reaching 54 residents. We analyzed the data using a thematic and in vivo approach.
Participants reported smoking is used to cope with systemic socio-economic issues (e.g., racism, poverty). Smoking is normalized in the community through continued use, ease of purchase, visibility of tobacco retailers, and lack of conversations or questioning surrounding smoking. Participants felt that peer and family use, addiction, and inaccessible smoking resources were the most influential factors driving smoking behaviors.
This community engagement approach empowered residents to design and implement a comprehensive needs assessment resulting in rich data-a needed approach for a community experiencing enduring health inequities. Communities need to be engaged and invested in from the beginning as equal partners to learn, investigate, and develop community-relevant and innovative solutions to address tobacco social norms.
尽管在过去50年里吸烟率大幅下降,但按种族和收入划分,降幅并不均衡,在美国南部地区尤为明显。有必要与存在巨大烟草差异的社区进行有针对性的合作,以实现持久改变。我们运用基于社区的参与性研究原则,为密西西比州杰克逊市一个由14名居民组成的社区咨询小组(CAG)提供了强化能力建设,以开展一项由社区主导的需求评估。由社区主导的需求评估旨在直接调查该社区吸烟的原因以及吸烟的影响,让社区咨询小组有发言权和选择权,致力于减少与烟草相关的危害和不平等现象。
2020年10月至2021年9月,社区咨询小组成员进行了13次访谈和9次焦点小组讨论,共涉及54名居民。我们采用主题分析和现场分析的方法对数据进行了分析。
参与者报告称,吸烟被用于应对系统性的社会经济问题(如种族主义、贫困)。通过持续吸烟、购买便利、烟草零售商随处可见以及缺乏关于吸烟的讨论或质疑,吸烟在社区中变得正常化。参与者认为,同伴和家人吸烟、成瘾以及难以获得戒烟资源是推动吸烟行为的最具影响力的因素。
这种社区参与方式使居民能够设计并实施全面的需求评估,从而获得丰富的数据,这是一个长期面临健康不平等问题的社区所需的方法。社区需要从一开始就作为平等伙伴参与进来并投入其中,以便学习、调查并制定与社区相关的创新解决方案,以解决烟草社会规范问题。