in Commercial Tobacco Policy Work Presentation by: Jodi Broadwell - - PowerPoint PPT Presentation

Building Leaders and Sharing Stories in Commercial Tobacco Policy Work

Presentation by: Jodi Broadwell Monday, February 27th at 1:45-3PM Room 42A

 Industry targeting and the Inequitable Distribution of Funding, Training, and Resources from the Tobacco Control Movement contributes to the Disparities we see for Priority Populations compared to the significant declines in Commercial Tobacco use seen in the General Population.

Commercial Tobacco-Related Disparities in Priority Populations

 In 2012 and 2013 LGBTQ Community Members were smoking at Twice the Rate of the General Population.

 One of the Best Practices to Support Equity and Eliminate Health Disparities is to Fund Programs that can effectively Reach, Educate, and Build Leadership in Communities experiencing Commercial Tobacco-Related Disparities.

Commercial Tobacco-Related Disparities in Priority Populations

 One of the Best Practices to Support Equity and Eliminate Health Disparities is to Fund Programs that can effectively Reach, Educate, and Build Leadership in Communities experiencing Commercial Tobacco-Related Disparities.

Commercial Tobacco-Related Disparities in Priority Populations

The Leadership and Advocacy Institute to Advance Parity for Minnesota’s Priority Populations (LAAMPP)

The Leadership and Advocacy Institute to Advance Parity for Minnesota’s Priority Populations (LAAMPP)

 Cross-Cultural Leadership Development Institute  Intentionally Recruits Potential Leaders from Minnesota’s Priority Populations  Develop cadres of Commercial Tobacco Control Leaders within Minnesota Communities that Experience Disproportionate Harm from Commercial Tobacco.

 Aims to Build Leadership & Develop Skills and Capacity of the Fellows who Participate  Support Fellows in Developing Relationships and Networks within their communities, cross culturally, and within the Commercial Tobacco Control Movement  Enact Policies, Systems, and Environmental Change

LAAMPP Theory of Change

LAMMPP III Institute Components

• 18 Months

(September 2012- March 2014)

• 18 Days of

Training

• Group projects by

each Cohort

LAAMPP Core Competencies

 AAA: African-African American (n=6)  AI: American Indian (n=3)  AAPI: Asian American Pacific Islander (n=5)  Latino (n=6)  LGBTQ: (n=3)

Five LAAMPP III Cohorts (23 Fellows)

 A LAAMPP Evaluation was recently published in the Journal of Health Disparities Research and Practice.  Findings were consistent across evaluation methods: the program’s Theory of Change successfully trained commercial tobacco control leaders from priority populations and supported them in developing the networks necessary to successfully undertake policy initiatives.  Fellows passed policy changes in the Twin Cities Metro area, as well as Greater Minnesota cities of Duluth, Mankato, and Willmar and are more likely to be seen as leaders by their communities.

LAAMPP III Evaluation

Acknowledgements

 Linda Bosman: linda@bosmaconsulting.com  Raffaele Vacca, University of Florida  José Luis Molina González, Universitat Autònoma de Barcelona  ClearWay MinnesotaSM  Minnesota Department of Health  APPEAL  LAAMPP III Fellows  LAAMPP III Evaluation Advisory Panel

1. To what extent did LAAMPP III confirm the Theory

• f Change by developing the necessary skill &

capacity among Fellows? 2. To what extent did LAAMPP III Fellows develop social relationships & networks within their own and across priority populations, and in the broader (mainstream) tobacco control movement to undertake tobacco control work? 3. To what extent did LAAMPP III Fellows impact systems & community level change?

LAAMPP III Evaluation Questions

 Key Informant Interviews

 Fellows (23 pre & 22 post)  Community Contacts (22 post)  Projects Contacts (17 post)

 Skills assessments questionnaires

 (23 pre & 23 post)

 Social Network Analysis

 (23 pre, 22 post)

 Lessons Learned Reflection Session  Participant observations: trainings & events  Case studies of 5 Fellows’ projects

Mixed Methods Evaluation Design

 Qualitative analysis of themes & key elements

 Atlas ti qualitative software

 Quantitative analysis of Fellows’ assessments, using a scale of 0 to 4, and averaging across Fellows  Social Network Analysis

 Personal network analysis approach  EgoNet software  Aggregated across Fellows

 Triangulation of data across methods & evaluation questions

Analysis

Core Competencies/Capacity Using LAAMPP Skills

Fellows’ knowledge & Frequency of Implementing Skills Increased:

• Commercial tobacco

control

• Advocacy & policy
• Cultural & Community

Competency

• Collaboration
• Facilitation

Pre Post …The harm caused by commercial tobacco in your culture/priority population group? 3.17 3.91 …The harm caused by commercial tobacco in other cultures/priority population groups? 2.61 3.87 …Tobacco industry marketing strategies that target your priority population group? 2.65 3.83 …Tobacco industry marketing strategies that target other priority populations? 2.7 3.78 0.5 1 1.5 2 2.5 3 3.5 4

Scale 0 to 4

Increased Individual Knowledge: Tobacco (pre/post)

Pre Post …Advocacy work such as how to advocate for change in a policy or practice? 2.52 3.61 …How to conduct policy work at the community level? 2.39 3.64 …How to conduct policy work in mainstream settings that supports parity (outcomes that support priority populations’ health, not just mainstream society)? 1.95 3.13 …How to conduct policy work in legislative settings? 1.35 3.13 …How to conduct policy work that focuses on Tobacco Industry practices? 1.52 3.17 0.5 1 1.5 2 2.5 3 3.5 4

Scale 0 to 4

Increased Individual Knowledge: Advocacy/Policy (pre/post)

Educated tobacco harms Educated tobacco industry targeting priority pops Policy change at state level Policy change in

• wn community

Policy change regulate tobacco sales Policy change regulate ads/marketing Info on cessation services in community Educated on sacred tobacco Pre Average Score 2.13 2.00 0.57 1.17 0.26 0.17 1.87 1.57 Post Average Score 3.00 2.96 1.61 2.43 1.39 1.13 2.78 2.13

0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 Frequency that Fellows undertook Activity (Scale 0 to 4)

Tobacco Prevention & Control Activity

Frequency Pre & Post LAAMPP III

Developed advocacy strategies/m y cmty Contacted elected

• fficial/

leader Wrote letter to policy makers Worked policy change in my cmty Met w/policy makers to develop relation- ship & educate them Met w/policy makers to lobby for policy change Spoken publicy about cmty issues Testified before decision- making body Mobilized

• thers to

support policy change Conducted

• utreach to

mobilize support Pre Average Score 1.09 0.70 0.57 1.30 0.65 0.57 1.09 0.22 0.91 1.30 Post Average Score 2.04 1.78 1.43 2.39 1.74 1.48 1.57 0.78 2.13 1.57 0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 Frequency that Fellows undertook Activity (Scale 0 to 4)

Policy/Advocacy Activity Frequency Pre & Post LAAMPP III

Fellows developed, expanded and strengthened their tobacco control networks: Within their own priority population Across other priority populations In the broader tobacco control movement

Social Network Analysis (SNA)

 Pre/post interview with each Fellow to collect data to analyze each Fellows’ personal networks in tobacco control  Fellows individual network data aggregated for full LAMPP III Institute  Use EgoNet Software

SNA Methodology

Highlights of SNA Findings

 Alter Average Degree Increased (ADI) was lower than Average Size Increase (ASI)  Average Density decreased  Average Closeness decreased  Average Betweenness increased  Average number of cliques increased  Average Diversity of sectors increased  Average composition of influential tobacco control contacts in networks increased

 Larger (more tobacco control people in them)  More dispersed (not all know each other)  More extensive (people outside their circle)  Include more ‘influentials’/brokers  Less concentrated in fewer professional circles/more diversity of sectors  Include more individuals perceived to be influential in tobacco control

What these measures tell us about Fellows’ Tobacco Control Networks:

Fellows’ tobacco control networks are more diverse & less concentrated in few professional circles (example #1)

Baseline (Fellow #118)

Follow-up (Fellow #118)

Baseline (Fellow #118) Follow-Up (Fellow #118)

Fellows’ tobacco control networks are more diverse & less concentrated in few professional circles (example #2)

Baseline (Fellow #107) Follow-up (Fellow #107)

Baseline (Fellow #107 Follow-Up (Fellow #107)

Fellows’ networks contain more individuals perceived to be influential in tobacco control

Baseline (Fellow #108) Follow-up (Fellow #108)

Baseline (Fellow #108 Follow-Up (Fellow #108)

 AAA cohort: Smoke Free Foster Care ordinance passed in Ramsey County  Latino cohort: Smoke Free Housing & Smoke Free Churches  AAPI cohort: Education at Hmongtown Market working towards Smoke Free Policy  AI cohort: AI “Unfiltered Report”-culturally tailored Advocacy Tool  LGBTQ cohort: Duluth-Superior Pride Festival Commercial Tobacco Free Sponsorship, Events and Grounds Policy

Applying LAAMPP Components

Questions?

to make change in community norms around corporate tobacco in Duluth LGBTQ communities Duluth Superior Pride Commercial Tobacco-Free Sponsorship, Events, and Grounds Policy

LGBTQ Cohort Project Goals

Duluth-Superior Pride Sponsorship

QUITPLAN Services Tobacco Free Zone

Duluth-Superior Pride Festival

Tabling at the Festival

Tabling at the Festival: Educational Materials

We talked to 235 people!!! about

Interactive Survey at Duluth-Superior Pride Festival

Survey Questions and Results

• 1. Do you think Duluth-Superior

Pride should be a corporate tobacco-free event?

Yes: 195 No: 47 81% of people who voted are in favor of a tobacco- free pride festival!

• 2. Do you think Duluth-Superior

Pride should accept sponsorship money from corporate tobacco companies?

No: 194 Yes: 40 83% of people who voted do not think DS Pride should accept corporate tobacco sponsorship! *10 people that voted No on Question #1 said they would support a designated smoking area at the festival.

Community Heroes

Community Heroes

Community Heroes

Community Heroes

Community Heroes

Free Cessation Resources

Visibility: Duluth-Superior Pride Parade

Duluth-Superior Pride Policy and Implementation Plan Passes

Duluth-Superior Pride Policy Signing

2014 Pride Guide Ad

Community Hero/Policy Display

Tabling at 2014 Pride Festival

Signage at DS Pride Festival

2015 and 2016 Pride Guide Ads

2015 and 2016 Updates

 Fellows from LAAMPP have successfully advocated for and passed policies regarding commercial tobacco that are changing social norms.  Leaders from priority populations bring unique and important perspectives to the commercial tobacco control movement and ensure policies that will help reduce health disparities are supported in communities.

Changing Social Norms

Cessation Counseling

• Became a

Certified Tobacco Treatment Specialist in 2016

LGBTQ Smoking Rates

*data collected annually from Rainbow Health Initiative and published in their Voices

• f Health: A Survey of LGBTQ Health in MN found @ www.rainbowhealth.org

Questions?

 LAAMPP follow-up program meant to provide LAAMPP Alumni, as well as other leaders from priority populations, with an opportunity to continue work from LAAMPP, learn additional skills, and apply them to tobacco control policy efforts, both locally and statewide  Current ClearWay MN grant is managed by Association of NonSmokers-Minnesota (ANSR)

Policy Champions

 LAAMPP Alumni were involved in the Raise it for Health coalition’s efforts to increase the price of tobacco during the 2013 Legislative Session.  Policy Champions countered the tobacco industry’s efforts to frame increased cigarette taxes as unfair and regressive. We spoke to the proven health benefits tobacco taxes have for priority populations.

Policy Champions

Policy Champions

Mock Tobacco Tax Signing with Governor Dayton

Policy Champions

Minnesotans for a Smoke-Free Generation Coalition

 Minnesotans for a Smoke-Free Generation is a coalition of Minnesota's leading health and other interested

• rganizations.

 We share a common goal of saving Minnesota youth from a lifetime of addiction to tobacco. Each year in Minnesota, tobacco use is responsible for more than 5,100 deaths and almost $3 billion in preventable health care costs — and 90 percent of adult smokers started before the age of 18.  Minnesotans for a Smoke-Free Generation supports policies that reduce youth smoking and help end the death and disease associated with tobacco use.

Minnesotans for a Smoke-Free Generation Coalition Mission:

Issues:

Age Flavoring Funding Price Minnesotans for a Smoke-Free Generation Coalition

 A national consensus is growing to raise the minimum age to purchase tobacco products to 21 – a move that will prevent addictions and future health problems.  Hawaii was the first state to raise the age to purchase tobacco to 21 in 2016.  At least 80 municipalities in the United States have raised the age to purchase

Minnesotans for a Smoke-Free Generation Coalition

Age:

Minnesotans for a Smoke-Free Generation Coalition

 Restricting the sale of flavored tobacco products protects kids and creates a healthier future.  The tobacco industry knows the power of these products, and uses them to target young people, African Americans and LGBTQ communities.

Minnesotans for a Smoke-Free Generation Coalition

Flavoring:

Minneapolis Flavoring Case Study

Produced by ClearWay Minnesota in May of 2016

 Big Tobacco continues to target youth and diverse communities  Minnesotans for a Smoke-Free Generation supports increasing public funding for tobacco control efforts as a proven way to reduce tobacco use, especially among populations targeted by the tobacco industry, including youth and diverse communities.

Minnesotans for a Smoke-Free Generation Coalition

Funding:

 Keeping tobacco prices high is the most effective way to prevent kids from becoming addicted to tobacco

• products. The 2013 Tobacco Tax increase is working in
• MN. Fewer young people are starting to smoke.

Minnesotans for a Smoke-Free Generation Coalition

Price:

 info@smokefreegenmn.org  www.smokefreegenmn.org  www.twitter.com/smokefreegenMN  www.facebook.com/smokefreegenMN  www.Instagram.com/smokefreegenmn

Minnesotans for a Smoke-Free Generation Coalition Connect:

www.stopthestartmn.com

We’ve come a long way in reducing the harm of smoking in Minnesota. If we can stop kids from starting, we can end smoking for good.

 The Menthol Coalition was formed by NorthPoint Health & Wellness, the Association for Nonsmokers-Minnesota (ANSR), and ClearWay Minnesota as a coalition of organizations interested in reducing the harm caused by menthol-flavored cigarettes and tobacco.  The Menthol Coalition meets on a regular basis to share information, provide updates about on-going projects, coordinate efforts around community education and advocate for policy change. We hope that you will join us to help reduce the harm caused by menthol-flavored tobacco.

Minnesota Menthol Coalition

Beautiful Lie Ugly Truth Campaign

www.beautifullieuglytruth.org

 The Beautiful Lie Ugly Truth campaign exposes how the tobacco industry targets youth, African American, women, and LGBTQ populations with menthol tobacco.  Our goal is to increase awareness that menthol tobacco is a problem in our communities and motivate leaders to recognize the health impact of menthol tobacco use.

LQBTQ Menthol Use in Minnesota

Questions?