Internet, web-based communications technology has the potential to improve technical assistance to local coalitions working on health promotion and disease control. A collaborative project between the AMC Cancer Research Center, Colorado ASSIST Study, and the Coalition for Tobacco-Free Colorado is proposed. It will test whether a web-based technical assistance program on community tobacco control can be used effectively by state tobacco control professionals and local tobacco control coalition members to achieve gains in community tobacco control. The two-phase project will involve communities throughout Colorado. In Phase I, we will (a) conduct a community needs analysis of eligible Colorado cities to identify current tobacco control plans and activities, and technical assistance needs; (b) produce the web-based technical assistance program containing on-line training courses, an on-line resource center, an on-line self- assessment for local coalitions, and interactive communication features to link local coalitions and state tobacco control professionals; (c) test the website for usability; and (d) identify six existing local tobacco control coalitions funded by ASSIST and form 14 new coalitions for the randomized trial. In Phase II, the web-based technical assistance program will be evaluated in a randomized, controlled trial, in 20 matched pairs of cities in Colorado. The primary outcome will be changes in local tobacco control policy by government, business, and homes. A multi-level composite policy score will be based on interviews with samples of elected officials, business owners/managers, and residents and analysis of written tobacco control policies in participating cities. Secondary outcomes will include measures of support for tobacco control policies and assessments of coalition functioning, including analysis of newspaper articles/editorials on tobacco control. The tertiary outcome will be changes in prevalence of tobacco use (smoking and smokeless tobacco). All interviews will be conducted by telephone. In addition, we will test whether changes in intervention cities are associated with baseline readiness to adopt tobacco control policies and whether secular changes in tobacco control policies in control cities are predicted by baseline readiness to adopt, similarity, proximity, and contact with intervention cities, and exposure to tobacco control information, including newspaper articles/editorials on tobacco control.
