The purpose of this study is to test the effects of a community intervention on smoke-free policy outcomes in rural underserved communities. The intervention combines assessment of community readiness with tailored, evidence-based dissemination and implementation strategies. Rural residents are more likely to be exposed to secondhand smoke than those living in urban areas, reflecting a major rural-urban disparity in smoke-free laws. The overall goal of the study is to accelerate the 'diffusion-of-innovations curve'in rural communities through tailored, evidence-based dissemination and implementation efforts. The long-term goal is to develop a best practices framework for disseminating scientific knowledge about the effects of secondhand smoke and smoke-free laws and implementing effective community policy change and maintenance strategies in rural underserved communities. A pretest posttest, three-group quasi- experimental design will be used to test the primary hypotheses: Controlling for contextual factors, (a) the overall change in stage of readiness for smoke-free policy will be greater for Treatment than Control communities;(b) media coverage will be more favorable toward smoke-free environments in Treatment than Control communities;and (c) Treatment communities will be more likely than Control communities to demonstrate smoke-free policy outcomes. Guided by a community readiness model, the Intervention will have two components: (1) assessment of community stage of readiness;and (2) stage-specific, tailored dissemination and implementation strategies. The main elements of Component II of the Intervention include translating and disseminating knowledge, and building capacity and demand for smoke-free policy. The Treatment communities (n = 20) will participate in both components of the Intervention. Control I communities (n = 10) will participate in the community assessment of readiness at baseline and annually. The Control II communities (n = 10) will participate in community assessment of stage of readiness at the end of the study only. Community stakeholders will participate in key informant telephone interviews to assess community readiness for smoke-free policy. Print media clippings from all 51 daily and non-daily newspapers in study counties will be evaluated for pro/con slant related to smoke-free environments. Initial, intermediate, and final smoke-free policy outcomes will be measured. The potential influence of secular trends on the impact of this community intervention will be analyzed. The proposal is directly relevant to public health in that it has the potential to protect residents in rural, underserved communities from premature death and disease from exposure to secondhand smoke.
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| Rayens, Mary Kay; Butler, Karen M; Wiggins, Amanda T et al. (2016) Recall and Effectiveness of Messages Promoting Smoke-Free Policies in Rural Communities. Nicotine Tob Res 18:1340-7 |
| Hahn, Ellen J; Rayens, Mary Kay; Adkins, Sarah et al. (2015) A controlled community-based trial to promote smoke-free policy in rural communities. J Rural Health 31:76-88 |
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| Fallin, Amanda; Zuercher, Robert; Rayens, Mary Kay et al. (2012) A short online community readiness survey for smoke-free policy. Nicotine Tob Res 14:1494-8 |
| Helme, Donald W; Rayens, Mary Kay; Kercsmar, Sarah E et al. (2012) Rural print media portrayal of secondhand smoke and smoke-free policy. Health Promot Pract 13:848-56 |
| Rayens, Mary Kay; York, Nancy L; Adkins, Sarah M et al. (2012) Political climate and smoke-free laws in rural Kentucky communities. Policy Polit Nurs Pract 13:90-7 |
| Fallin, Amanda; Parker, Lindsay; Lindgreen, Janine et al. (2011) Secular trends and smoke-free policy development in rural Kentucky. Health Educ Res 26:711-21 |
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