Gonzalez Nathaniel J, Nippoldt Lauren, Nielsen Kelly, Lowry Chag, Casanova Alexxa R, Kovacs Georgia C, Al-Delaimy Wael K
Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, San Diego, CA, USA.
Center for Research and Evaluation, University of California San Diego, San Diego, CA, USA.
J Racial Ethn Health Disparities. 2025 Sep 15. doi: 10.1007/s40615-025-02643-y.
Commercial tobacco-related health disparities persist for American Indian and Alaska Natives in the USA despite widespread reductions in commercial tobacco use in the general population. Addressing these disparities requires a culturally relevant approach but the diversity of Tribal communities, including historical, cultural, social, and economic differences, can make uniform public health interventions that are culturally relevant challenging to design. The California Tribal Initiative to Reduce Tobacco-Related Disparities, launched in 2019 by the California Department of Public Health and the California Tobacco Prevention Program, uniquely addresses these disparities by directly funding Tribal governments and American Indian Serving Community Organizations to develop tailored commercial tobacco prevention projects that will work for them. This article presents the results from the California American Indian Tobacco Initiative Evaluation, tasked with assessing the initiative's success. The study used a longitudinal and mixed-methods approach between 2019 and 2024, employing surveys, key informant interviews, and talking circles to assess the initiative through progress in three areas: enhancing community engagement, advancing and adhering to commercial tobacco prevention policies, and building Tribal capacities to sustain these efforts. Findings indicate significant improvements across all areas, underscoring the efficacy of empowering Tribes to lead health interventions. This approach not only advances public health but also fosters greater trust and collaboration between Tribes and public health entities.
在美国，尽管普通人群中商业烟草使用量普遍下降，但美国印第安人和阿拉斯加原住民在与商业烟草相关的健康差距依然存在。解决这些差距需要一种与文化相关的方法，但部落社区的多样性，包括历史、文化、社会和经济差异，可能会使设计出与文化相关的统一公共卫生干预措施具有挑战性。加利福尼亚州减少烟草相关差距部落倡议由加利福尼亚州公共卫生部和加利福尼亚州烟草预防项目于2019年发起，通过直接资助部落政府和为美国印第安人服务的社区组织来制定适合他们的商业烟草预防项目，独特地解决了这些差距。本文介绍了加利福尼亚州美国印第安烟草倡议评估的结果，该评估的任务是评估该倡议的成效。该研究在2019年至2024年间采用了纵向和混合方法，通过调查、关键信息提供者访谈和交流圈，从三个方面的进展来评估该倡议：加强社区参与、推进和坚持商业烟草预防政策以及建设部落维持这些努力的能力。研究结果表明，所有领域都有显著改善，突出了赋予部落主导健康干预措施的有效性。这种方法不仅推进了公共卫生，还促进了部落与公共卫生实体之间更大的信任与合作。
