The Impact of Anchorage's 2000 and 2007 Smoke-Free Policies on Select Restaurants and Bars

The American Lung Association in Alaska (ALAA) asked the Institute of Social and Economic Research (ISER) to investigate the impact of the Anchorage 2000 and 2007 Clean Indoor Air (CIA) municipal ordinances on selected restaurants and bars. As previous U.S. studies have been conducted that speak to the economic and health impacts of CIA laws, ALAA also requested that ISER synthesize results of these existing studies and conduct a survey on restaurant and bar representatives’ perceptions of the impact of the ordinances.The American Lung Association in AlaskaExecutive Summary / Introduction / Anchorage Municipal Ordinances / Policy Enforcement / Literature Review: Impact of Smoke-Free Laws on Employment and Air Quality / Methodology / Key Informant Interview Findings / Survey Findings / Limitations / References / Appendice

Cancer Education for High School Students in the Northwest Arctic Increases Knowledge and Inspires Intent to Share Information and Reduce Cancer Risk

Culturally appropriate cancer education is an opportunity to reduce health inequities in cancer. This manuscript describes the outcomes of piloting cancer education for youth in the Northwest Arctic region of Alaska. The project began due to community concerns, was focused through sharing circles conducted in the region, and was guided by a community advisory board. The project was based on the principles of Community Based Participatory Action Research (CBPAR), honored Indigenous Ways of Knowing, and was grounded in Empowerment Theory. In response to community requests, eleven cancer education lessons were developed for young people in the Northwest Arctic. Several lessons were piloted in spring 2022. Each participant was invited to complete a pre-lesson and a post-lesson survey. A total of 113 surveys were completed from five different lessons: 66 pre-lesson surveys and 47 post-lesson surveys. Respondents' mean cancer knowledge scores were significantly higher after the Cancer Basics lesson. On 98% of post-lesson surveys, respondents said they planned to share cancer education messages such as staying tobacco-free and increasing physical activity with others, including their family, friends, and community members. On 93% of the post-lesson surveys, respondents indicated they planned to make changes to reduce their own personal cancer risk, including by staying tobacco-free, eating healthier, and increasing physical activity. "Cancer is serious, and something we should start talking about"

Preventive Screenings Gap Analysis

Prepared for: Alaska Department of Health and Social Services Division of Public Health Chronic Disease Prevention and Health Promotion Sectio

Bridging storytelling traditions with digital technology

Objective. The purpose of this project was to learn how Community Health Workers (CHWs) in Alaska perceived digital storytelling as a component of the “Path to Understanding Cancer” curriculum and as a culturally respectful tool for sharing cancer-related health messages. Design. A pre-course written application, end-of-course written evaluation, and internet survey informed this project. Methods. Digital storytelling was included in seven 5-day cancer education courses (May 2009–2012) in which 67 CHWs each created a personal 2–3 minute cancer-related digital story. Participant-chosen digital story topics included tobacco cessation, the importance of recommended cancer screening exams, cancer survivorship, loss, grief and end-of-life comfort care, and self-care as patient care providers. All participants completed an end-of-course written evaluation. In July 2012, contact information was available for 48 participants, of whom 24 completed an internet survey. Results. All 67 participants successfully completed a digital story which they shared and discussed with course members. On the written post-course evaluation, all participants reported that combining digital storytelling with cancer education supported their learning and was a culturally respectful way to provide health messages. Additionally, 62 of 67 CHWs reported that the course increased their confidence to share cancer information with their communities. Up to 3 years post-course, all 24 CHW survey respondents reported they had shown their digital story. Of note, 23 of 24 CHWs also reported change in their own behaviour as a result of the experience. Conclusions. All CHWs, regardless of computer skills, successfully created a digital story as part of the cancer education course. CHWs reported that digital stories enhanced their learning and were a culturally respectful way to share cancer-related information. Digital storytelling gave the power of the media into the hands of CHWs to increase their cancer knowledge, facilitate patient and community cancer conversations, and promote cancer awareness and wellness

Promoting Culturally Respectful Cancer Education Through Digital Storytelling

Cancer is the leading cause of mortality among Alaska Native people. Over half of Alaska Native people live in rural communities where specially trained community members called Community Health Aides/Practitioners (CHA/Ps) provide health care. In response to CHA/Ps’ expressed desire to learn more about cancer, four 5-day cancer education and digital storytelling courses were provided in 2014. Throughout each course, participants explored cancer information, reflected on their personal experiences, and envisioned how they might apply their knowledge within their communities. Each course participant also created a personal and authentic digital story, a methodology increasingly embraced by Indigenous communities as a way to combine storytelling traditions with modern technology to promote both individual and community health. Opportunities to learn of CHA/Ps’ experiences with cancer and digital storytelling included a 3-page end-of-course written evaluation, a weekly story-showing log kept for 4 weeks post-course, a group teleconference held 1–2 weeks post-course, and a survey administered 6 months post-course. Participants described digital storytelling as a culturally respectful way to support cancer awareness and education. Participants described the process of creating digital stories as supporting knowledge acquisition, encouraging personal reflection, and sparking a desire to engage in cancer risk reduction activities for themselves and with their families and patients. As a result of creating a personalized digital story, CHA/Ps reported feeling differently about cancer, noting an increase in cancer knowledge and comfort to talk about cancer with clients and family. Indigenous digital stories have potential for broad use as a culturally appropriate health messaging tool

Cancer Control Continuum Gap Analysis: Inventory of Current Policy and Environmental Strategies

"Comprehensive cancer control (CCC) is a process through which communities and partner organizations pool resources to reduce the burden of cancer. These combined efforts help to reduce cancer risk, find cancers earlier, improve treatments, and increase the number of people who survive cancer. ”This analysis has explored both current policies that have been enacted in Alaska at the state and federal level, and those that are acknowledged at a national level. The gap analysis is designed to inform the State DHSS as it takes steps to develop a policy agenda for comprehensive cancer control that aims to; reduce the risk of developing cancer, identify cancer earlier, improve cancer treatment, and increase the number of cancer survivors."Alaska Department of Health and Social Service

Addendum to the COVID-19 Panel Survey Report Highlights: Identifying Factors Associated with Risk Behaviors Related to COVID-19

Additional analysis with the panel survey data was conducted to identify which modifiable and demographic factors were independently associated with risk behaviors related to COVID-19 (i.e., demographic groups less likely to practice physical distancing and good hygiene). We found that as the respondents’ level of perceived threat of COVID-19 and age decreased, the COVID-related risk behavior increased. Groups who had lower levels of perceived threat of COVID-19 included people with low socioeconomic status (SES), those who had children in their household, and those who lacked clarity regarding the Municipality’s policies related to COVID-19. These findings suggest that efforts to decrease overall risk of COVID-19 in Anchorage should consider developing education and communication strategies that heighten awareness of the seriousness and threat of COVID-19 to public health. These strategies could be designed to reach out specifically to people from low SES groups, as well as those with children in their households. Additionally, communication strategies could improve the community’s understanding of policies related to COVID-19

COVID-19 Survey in the Municipality of Anchorage, June 16-18: Highlights

An online survey of a panel of 295 Anchorage residents 18 years old and older was conducted June 16-18, 2020. This was the fourth survey since May 2020 conducted by the Municipality of Anchorage (MOA) regarding COVID-19 related knowledge, attitudes, and behaviors. The first survey in the series was a population-based cell phone survey of Anchorage residents conducted May 6-10. The second (May 20-22) third (June 2-4) and fourth (June 16-18) surveys were conducted online with a panel of participants from the first survey. Key findings from the fourth survey included: Most respondents (72%) wore a mask most or all of the time outside their home. Most (90%) spent time outside their home the day before the survey. Most (64%) supported mandating wearing masks either “now” or “later.” Almost half (47%) had physical contact with someone not in their household. Most (76%) came within six feet of someone not from their household. Most (91%) felt somewhat knowledgeable or very knowledgeable about MOA COVID-19 emergency orders. COVID-19 related risk behaviors increased among those who: o Had less than a college degree o Were younger (<45 years) o Had lower perceived threat of COVID-19 o Were less likely to bring a mask when they went out o Were less likely to wash or sanitize hands when touching things touched by others. Compared with previous surveys, more respondents are leaving their homes and coming into physical contact with others. However, most survey respondents also reported wearing masks outside their home, supported a mandate to wear masks, and did not have physical contact with others. KEY MESSAGES As a whole, panel respondents reported positive COVID-19 mitigation behaviors. Messaging could continue to employ the need for personal responsibility to reduce risk, while emphasizing community/societal responsibility and benefit. Integrated communications with key education partners (ASD, UAA, APU, etc.) could also help reach groups associated with COVID-19 related risk behaviors. To encourage increased receptiveness to mitigation behaviors, messaging could try to incorporate affinity group imagery and rhetorical framing

Needs Assessment Related to COVID-19 with Special Populations: Brief Report

A total of 754 adult respondents from the Municipality of Anchorage (MOA) participated in a needs assessment survey conducted between May 25, 2020 and June 30, 2020. The survey aimed to reach out to specific populations: immigrants and refugees (N=246), non-immigrant racial/ethnic minority groups (N=163), and people with disabilities (N=93) each had a large enough sample size to include in this report. The survey also aimed to reach out to LGBTQ+ populations, however, we did not collect enough surveys from people who identified as LGBTQ+ to have reliable information. Key findings from the survey included: Understand Information from MOA • Most (94%) reported being knowledgeable/somewhat knowledgeable about the Municipality’s emergency orders and changes related to COVID-19 • Most (93%) reported that the Municipality’s policies related to COVID-19 are clear/very clear. Less Risk Behaviors • Immigrants and refugees, and people with disabilities, were significantly more likely to engage in COVID-19 related protective behaviors (wearing mask, physical distancing, etc.) compared with other survey respondents. More Worried • In terms of mental health, racial/ethnic minorities and immigrants and refugees reported significantly higher levels of worry in terms of household finances, losing employment, having self or members of their household being infected by coronavirus, and having enough to eat compared with other survey respondents. Information Preferences • All three examined groups preferred receiving information about COVID-19 through Internet, television, texting, and email. • A majority of respondents for each examined demographic group reported that their primary source of information about COVID-19 were general media sources (i.e., KTUU, KTVA, ADN) and official sources of information in Alaska (health departments, Dr. Zink, governor, mayor). A majority of immigrants and refugees in the sample (81%) also got their information from social sources (family, friends, social media)