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Por La Vida taking action for tobacco free communities

Institution: University of California, San Diego
Investigator(s): Ana Navarro, Ph.D. Beatriz Barraza-Roppe, B.S.
Award Cycle: 2000 (Cycle 9) Grant #: 9AT-1501 Award: $795,633
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Full CARA

Initial Award Abstract
The recent California Tobacco Surveys provide mixed information about tobacco control in Latinos. Most encouraging is that cigarette smoking prevalence and nicotine dependence is lower among Latinos compared to non-Latino whites. This difference in tobacco use is primarily due to lower smoking rates by Latinas compared to non-Latina whites. However, exposure to environmental tobacco smoke is higher among Latino non-smokers than among other ethnic groups. Also suggesting gaps in the tobacco control program in Latinos is the fact that susceptibility to smoking among 12-14 year old teenagers has increased and is highest in Latinos compared to other ethnic groups.

It is widely recognized that improving health promotion of special populations requires community-based interventions in the target community. In recent years, a variety of community agencies have increasingly utilized interventions in which community lay health advisors have been central. The proposed Por La Vida project capitalizes on the use of existing social networks in the Latino community. In the past, health promotion Por La Vida projects have successfully reached out to the Latino population of low socioeconomic level and low level of acculturation. This proposal builds on the success of previous Por La Vida programs and aims at further enhancing the empowerment of the Latino community to build for themselves smokefree environments.

The goal of this study is to develop, implement, and evaluate an innovative Por La Vida community-based intervention to foster tobacco-free communities. Consistent with the California Tobacco Control program, the intervention aims at changing community norms around the use of tobacco. The proposed study examines the feasibility and the effectiveness of the intervention in the Latino community in San Diego. Specifically, this project proposes: (1) To develop the Por La Vida Taking Action for Tobacco-Free Communities intervention to foster tobacco free environments and to counter the effects of the tobacco industry in the Latino community; (2) To recruit and train 30 Latinas from the community to serve as consejeras for conducting either the tobacco-free communities educational group sessions or the comparison nutrition educational sessions in their respective communities; (3) To recruit approximately 300 Latinas to participate in either the tobacco-free communities intervention or in the comparison nutrition program conducted by trained consejeras.; and (4) To implement evaluation strategies to estimate the extent to which the program is implemented as intended and the short-term impact of the intervention on knowledge, attitudes, and behaviors relevant to tobacco control in the communities that are targeted by the intervention.

The impact evaluation relies on a randomized experimental-control group design with pretest and posttest measures. Experimental group participants will participate in a series of 14 educational sessions to prepare and conduct activities to foster tobacco-free communities in their own neighborhoods. The activities include: (1) Awareness of Needs and Assets, (2) Responsible Sales Practices, (3) Parent-Child Communication Workshop, and (4) Tobacco-Free Communities Celebration. Individuals in the control group will participate in equally engaging educational sessions focusing on nutrition. Outcome measures will include self-report of knowledge, attitudes and behaviors relevant to (1) tobacco use, (2) exposure to environmental smoke, (3) countering the tobacco industry, and (4) involvement in activities to foster tobacco-free communities. We expect this study to provide evidence of effective strategies to empower the Latino community to actively plan and participate in the fight against tobacco. The proposed intervention seeks to enhance existing tobacco control efforts to make tobacco less desirable, less acceptable, and less accessible. If successful, the intervention could be disseminated to other Latino communities in the state of California to enhance the Tobacco Control Program.