Monday, January 10, 2011

Report for the Legislature - January 2011 Report

Empowerment Evaluation Report - January 2011.  The January 2011 MISRGO Empowerment Evaluation report was issued.  It was prepared for MISRGO, ADH, and the State Legislature.

The front cover highlights one of MISRGO's achievements - securing smoke free parks in Arkansas.  (The cover highlights Elroy Brown's effective work in Gosnell.)

The report is available at this site, just download it at your leisure.  A few points drawn from the report are presented below:

Tobacco Use in Arkansas (with a national comparison)

There are over 480,000 individuals who smoke cigarettes in the State of Arkansas.  That is approximately 22.3% of the population.  Arkansas ranks 44th among all states concerning the prevalence of cigarette smoking among adults.  Smoking attributable mortality among adults is 45th in the nation.[i]




Arkansas ranks 49th among the states concerning youth consumption of tobacco.




MISRGO Grantee Counties (smoking prevalence rates)

Tobacco use in MISRGO grantee counties range from 16% to 37%.  The average tobacco use is 24% across MISRGO serviced counties.  The number of grantees working in the same counties ranges from 1 to 7, depending on the grantees’ specific capacities and the types of intervention or assistance needed.



Public Support (State-wide)

There is State-wide support for the use of public funds for MISRGO tobacco prevention programs. 99% of the 929 people surveyed throughout the state (who were familiar with MISRGO grantee programs), stated they thought that tobacco prevention and education programs were a good use of public money.



 Similarly, 99% reported that they would recommend their local MISRGO-related tobacco prevention & education agency to their friends or family members if they smoked or were thinking about smoking.


Community members throughout the State also thought that the MISRGO-related programs have been effective in preventing people from using tobacco and stopping them from using tobacco (95-96% of those surveyed). 



Community members rated MISRGO-related tobacco prevention programs effective or very effective (94%).



The majority of community members surveyed thought MISRGO-related tobacco prevention agencies were effective or very effective concerning the following activities:

90%    Sending out educational literature
92%    Letting people know about the dangers of second hand smoke
91%    Telling people about the QUIT Line
86%    Educating retailers to not sell tobacco products to minors
84%    Getting perimeter laws
86%    Getting smoke free parks
79%    Getting advertisers to reduce their advertising of tobacco products
90%    Building coalitions with other anti-tobacco agencies
88%    Helping minorities stop smoking (or not begin)

Highlighted Accomplishments

Tobacco-free policy

MISRGO grantees have been effective in creating tobacco free environments.  According to the Centers for Disease Control and Prevention (Starr, et al, 2005), “Creating tobacco-free policies in workplaces, other public places, and homes and vehicles not only protects nonsmokers from involuntary exposure to toxins in tobacco smoke, but also may have the added benefit of reducing tobacco consumption by smokers and increasing the number of smokers who quit” (p. 147).

MISRGO grantees adhere to CDC recommendations in this regard.   They have helped to establish 6 smoke free parks.  They have also helped to convince local industry to adopt smoke free policies, including Nibco of Blytheville and American Greeting and Denso, both in Osceola.  They have also persuaded 4 churches to adopt smoke-free policies, a well as Sweet Home Community Park and the Charles Strong Recreation Center.

MISRGO grantees have used local newspapers and media to extend the impact of their work.  They have sparked the debate about tobacco use and prevention in the press. This is important in itself, as the CDC points out:  “Experience shows that the education that occurs when a community debates whether it wants a local tobacco-free law – a debate that typically generates extensive media coverage – can greatly facilitate enforcement of the law, sometimes making it largely self-enforcing” (p. 147).  MISRGO grantees have also used the press (including television[i], radio[ii], and newspapers) to highlight their accomplishments, another useful tool in educating the public to adhere to tobacco-free policies.


[i] 3 television spots aired concerning the ills of tobacco use.
[ii] 35,000 people were exposed to radio adds about tobacco consumption.


Quit Line

The Quit Line is an important tool in the fight against tobacco consumption.  According to the CDC “Tobacco control programs need to foster the motivation to quit through policy changes and media campaigns and promote their quitline services” (2007, p. 41).   MISRGO grantees have submitted 948 fax referrals to the Quitline this year.  In total MISRGO grantees have submitted over 3,217 fax referrals to the Quitline, excluding grantees no longer funded.

Pledges & Successes

There are many steps needed to convince people not to begin smoking and to promise to stop smoking.  MISRGO grantees have been effective in convincing minority members of the communty to take one of the first significant steps in this direction, pledging to quit.  Although a pledge is not as compelling as a referral to the Quitline or larger community-based change, such as creating tobacco free environments, a pledge is an important stepping-stone.  According to the CDC “Attempting to quit is an essential step in the process of becoming tobacco-free” (Starr, et al, 2005, p. 246). A pledge can help prevent or stop a person from using tobacco. 

MISRGO grantees have convinced 1448 youth to pledge to be smoke free this year.  They have also convinced 200 parents to pledge not to use tobacco in their homes or in their cars. 

Currently funded MISRGO grantees have helped approximately 2,710 members of their communities throughout the state to stop using tobacco.

Education

The type of success described in this report is predicated on a number of factors.  One of the most important contributing factors is education.  Education may range from disseminating educational information at health fairs and in schools to measuring knowledge retention using pre- and post-tests.  Most MISRGO educational interventions preclude extensive testing due to the nature of the informal community and home settings.  However, there is no single educational intervention that works for everyone and thus multiple educational approaches are used to convince people not to use tobacco, including youth performances.  According to the CDC,  “State program involvement in community-level interventions should include:  Supporting local strategies or efforts to educate the public and media not only about the health effects of tobacco use and exposure to secondhand smoke, but also about available cessation services” (2007, p. 23).  Education in its various forms represents the backbone or foundation of any effective tobacco prevention program.

MISRGO grantee educational efforts resulted in:

66,766   receiving information about dangers of tobacco use
1,177      receiving information about Acts 8 & 13
2,400      receiving information about smoke-free ordinances

In addition, pregnant, low-income, homeless, and Hispanics or Latinos received tobacco prevention educational materials from MISRGO grantees.

318         pregnant, low-income & homeless people received tobacco prevention information
300          Hispanics received tobacco prevention information

Grantee Activities

MISRGO accomplishments are the result of many activities, monitoring tools, and administrative oversight and technical assistance.

An abbreviated list of grantee activities is provided below to highlight the wide-spectrum of work required to produce MISRGO outcomes.


  • ·      Working to establish ordinances in parks
  • ·      Promoting organizations in the community that review tobacco policies (e.g., restaurants and facilities)
  • ·      Helping to increase compliance rates among retailers
  • ·      Identifying disparities concerning sales to minors
  • ·      Providing tobacco education through surveys and media outreach
  • ·      Providing AHDC Workshops on ACTs 8 and 13
  • ·      Distributing educational materials & providing tobacco prevention sessions
  • ·      Promoting the Arkansas Tobacco Quitline
  • ·      Promoting the fax back referral program
  • ·      Helping to decrease tobacco advertising
  • ·      Helping to increase collaboration with other organizations (e.g., organizations serving minorities, clinics/physicians, schools) to promote a tobacco free message
  • ·      Helping to encourage smoke free households and cars
  •      Training youth advocates or FAST teams in tobacco prevention

Monitoring Progress

MISRGO has implemented a useful tool to monitor grantee progress and performance.  It is designed to help grantees establish their own goals and monitor their own efforts.  The tool also enables MISRGO to determine if grantees are making satisfactory progress or if assistance is needed.

Baseline.  Grantees established a baseline, such as the number of minority members of the community already receiving educational materials about second hand smoke.  In the example below, the baseline was 0.

Goal.  Grantees then established a goal or multiple goals, the number of minority community members they would like to receive educational materials about second hand smoke by the end of the year.  In this case the number is 1000 for this year and 5,000 over a 5-year period.

Benchmarks.  Grantees created benchmarks, or steps toward their goal.  This helped them measure their progress toward their goals.  In this case the grantee created the following benchmarks for this year:  250 in the 1st quarter, 500 in the 2nd quarter, 750 in the 3rd quarter, and 1000 in the 4th quarter or end of year goal.  



A review of grantee performance based on this data suggests that they are making satisfactory progress toward end-of-the-year goals. (See Appendix B for an example.)

Capacity Building

MISRGO has provided numerous workshops, lectures, and technical assistance sessions to improve grantee performance.  (See Appendix C.) The MISRGO evaluation team has also provided lectures, demonstrations, exercises, and workshops to enhance evaluation capacity.  Workshops focused on tools to conduct both process and outcome evaluations.  Technology training was embedded in the evaluation training, ranging from online survey deployment to the use of digital photography to document and disseminate accomplishments.  (See Fetterman and Wandersman, 2005 for a detailed discussion about evaluation capacity building.)  A detailed presentation of MISRGO evaluation capacity building efforts is available on the web at:  http://tobaccoprevention.blogspot.com

Conclusion

MISRGO grantees have had a significant impact on minority populations in Arkansas.  They have established a strong rapport with African American, Latino or Hispanic, and Asian communities in the State.  This relationship has enabled them to disseminate tobacco prevention literature to youth and adults in these communities.  It has also been instrumental in encouraging minorities in these communities to establish tobacco-free environments, particularly in public parks.  MISRGO grantees have also been effective in encouraging community members to call the QUIT line. 

Minority community members throughout the State support the use of public funds to support MISRGO-based tobacco prevention programs.  This support is based in part on their perception of the grantees’ effectiveness in preventing and stopping people from using tobacco in their communities.

MISRGO grantees are making progress toward their stated goals and objectives.  Continued support will only enhance their capacity to reduce tobacco consumption in minority communities throughout the State of Arkansas.

[See the MISRGO Empowerment Evaluation Report for additional details, January 2011].