Tobacco control policy change has contributed tremendously to decreasing tobacco use and represents one of public health's top 10 achievements in the 20th century. Despite the great success of tobacco policy change, the decline in tobacco use prevalence has stalled with still high rates particularly among marginalized communities of color, Asian Americans and Pacific Islanders (AA and NHPIs) are one of the fastest growing populations in the U.S., yet we understand very little about the most effective processes and pathways for engaging AAs and NHPIs in policy change that result in successful compliance and eventual community norm change on tobacco. We propose to conduct a three-year community-based participatory research (CBPR) study titled Community-led Policies and Leadership to Eliminate Disparities for Asian Americans and Pacific Islanders on Tobacco (Com-PLEAT). The overall goal of this research is to identify and understand the pathways to successful tobacco control policy change among two AA and NHPI communities: Cambodians in Long Beach County and Pacific Islanders (including Native Hawaiians, Samoans and Chamorros) in San Diego County.
The specific aims of this study are twofold: 1) to develop, and test a 4-prong policy change framework and its effect in helping to mobilize Asian American and Pacific Islander (AA and NHPI) (Cambodian and Chamorro) communities on tobacco control using key informant interviews, community readiness indices and Guttman scalogram analysis; and 2) to study the pathways to successful policy change on tobacco for AAs and NHPIs including the role of capacity building. This proposed Com-PLEAT Study will include key informant interviews, community readiness assessments and Guttman scalogram analysis methodologies and will make a significant contribution to the field of tobacco prevention and control by identifying alternative and more successfully sustained pathways to policy change for AAs and NHPIs. The proposed Com-PLEAT Study seeks to challenge the current framework that policy change will trickle down to all communities equally and the phasing out of culturally-tailored strategies to eliminate health disparities. Using a community-based participatory approach that involves communities in every aspect of the research design, data collection, analysis and dissemination, this study will engage communities to understand perception and motivation about policies and elements critical for full participation in a wide-range of policy interventions.
The proposed Com-PLEAT Study will contribute not only to the better understanding of effective pathways for tobacco control policy change for Asian American, Native Hawaiian and Pacific Islander (NHPI) communities, but also to the replication of this study in other AA and NHPI communities across the U.S. By using innovative research methods, the Com-PLEAT Study will hopefully translate into more effective and sustainable implementation of policy initiatives that include and serve AA and NHPI communities and help reduce health disparities.
