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This Integrated Research Project (IRP) proposal comprises four interwoven studies, addressing aspects of tobacco use and control in Latino communities (TCLC). The TCLC core will provide logistical support to the individual projects (IP) as appropriate, by providing common recruiting, training and reinforcement, and process evaluation of the three studies that have face-to-face interventions as key elements of the study. The four projects are described below.
Smoking Cessation in Latinos Using Community Health Advisors. Latino community recruiters will use their existing social networks to recruit 500 adult, Latino smokers. Half the participants will be randomly assigned to the intervention, and half to a comparison condition. Intervention subjects will receive a 4-month smoking cessation program delivered in the home by Community Health Advisors (CHAs). Intervention components I,clude video, brochures, scripted discussion of key topics, and referral to more formal cessation support, all designed to be l linguistically- and culturally-relevant. This study will include 3 repeated assessments over a 16-month period.
Reducing Environmental Tobacco Smoke in Latino Children. Researchers will develop, implement and evaluate an intervention to reduce exposure to ETS among low income Latino children and families recruited through local Head Start programs. The intervention will incorporate a strategy to lower ETS exposure using a behavioral problem-solving approach that includes face-to-face and telephone contacts by CHAs. CHAs will work with a primary household member to identify specifics about children's exposure to household ETS. Behavior modification techniques, such as behavioral contracts, contingency management, cues, and shaping will be developed to modify the environment thereby reducing children's exposure to ETS. Participants in the intervention will be compared to a measurement-only control group.
Anti-tobacco Advocacy in Latinos Via Por La Vida Consejeras. Researchers will identify, recruit and train 20 Latinas as CHAs to serve as group leaders who will recruit 200 Latinas to participate in educational advocacy sessions and activities. Objectives of the program are to minimize ETS exposure, counter pro-tobacco influences, relocate tobacco ads in stores, survey and enforce youth tobacco purchasing laws, and restrict smoking in workplaces and public places. Researchers will develop a curriculum to train CHAs to become active anti-tobacco advocates in their communities. It will address topics such as: conducting local tobacco control needs assessments, role of CHAs, current tobacco legislation, attracting media interest, forming coalitions/partnering, making presentations, and local worksite advocacy. Evaluation strategies will estimate 1) the extent to which the program is implemented as intended, and 2) the impact of the intervention. A randomized waiting list control study has been designed.
Effect of Tobacco Taxation Upon Latino Health Status. This project will use a combined index of morbidity and mortality to demonstrate the relationship between increased taxation and changes in quality of adjusted life years (QALY) specific to Latinos and estimate the effects of changes in tobacco excise tax policies upon tobacco use and health status in Latino and other low income communities. Researchers will first evaluate the effects of inflation-adjusted price per pack and consumption using a file maintained by the UCSD Cancer Center. The data include monthly cigarette sales, average price and State and Federal tax data for each state since 1983. Data from the National Health Interview Survey and from Behavioral Risk Factors Surveys will be used to estimate consumption of cigarettes by ethnic and racial status and by income level. Special attention will be devoted to the California Tobacco Survey to determine if recent changes in tobacco pricing in California affected consumption differentially for Latino and non-Latino California residents. Time trend analyses on these data will be conducted. |
