Learning From Coalitions' Efforts to Promote Equity and Justice.

Coalitions and collaboratives are working to address many of the most pressing contemporary health and social issues. The articles in this special issue provide numerous insights into these complex collaborative processes across different contexts and focal issues. All emphasize and scrutinize the strategies that groups are using in their work. These strategies seek to navigate not only conventional notions of effectiveness but also the challenges of pursuing greater equity and justice. In this concluding article, we distill some of the key insights from these articles as a collective. This special issue on collaborating for equity and justice can serve as a launching point for new efforts by coalitions and researchers pursuing policy, systems, and structural changes, particularly those intent on addressing root causes of health and social disparities

Findings from a National home food Environment Survey: How does Georgia Compare?

Background: Aspects of the home food environment, both social and physical, influence healthy eating and weight management practices. Healthy eating, according to the Dietary Guidelines for Americans, 2015, centers on balancing calories consumed and calories expended for weight management combined with consumption of nutrient-dense foods and drinks. Obesity and excess weight increase the risk of numerous chronic diseases including cancer, diabetes, and heart disease. With this presentation, we will explore how Georgia home food environments and eating behaviors are similar or different from the rest of the nation. Methods: Survey participants (n=4,942) were recruited from a reputable online survey panel service. Eligible participants were English-speaking U.S. adults ages 18-75; the final sample was representative of the U.S. population in terms of age, race/ethnicity, geographic region, and income level. Georgia participants represented 3% of the overall sample (n=158). Incentives for completing the 30-minute online survey were provided by the panel service. Survey measures included sociodemographics, healthy eating behaviors (e.g., fruit, vegetable, and fat intake), social home food environment (e.g., food shopping/preparation, household member support) physical home food environment (e.g., food/drink inventories/placement), household food security and coping strategies, and broader contextual factors (e.g., the community food environment, and community capacity and assets). Results: Descriptive data to be presented will include characteristics of participant households, including levels of social and environmental support for healthy eating. Prevalence estimates for key environmental (food/drink inventories/placement, social support among household members) and behavioral (dietary behavior) variables across the sample and among Georgia participants will also be shared. Statistically significant differences between Georgia and the nation will be highlighted. Conclusions: This study presents a unique opportunity to explore socio-environmental influences on healthy eating behaviors nationwide and specifically among Georgians. Findings may be useful in informing tailored messages, healthy eating interventions, and related public health priorities for the state of Georgia

Prevalence and predictors of home and automobile smoking bans and child environmental tobacco smoke exposure: a cross-sectional study of U.S.- and Mexico-born Hispanic women with young children

BACKGROUND: Detrimental effects of environmental tobacco smoke (ETS) exposure on child health are well documented. Because young children's primary exposure to ETS occurs in homes and automobiles, voluntary smoking restrictions can substantially reduce exposure. We assessed the prevalence of home and automobile smoking bans among U.S.- and Mexico-born Hispanics in the southwestern United States, and examined the influence of mother's country of birth and smoking practices on voluntary smoking bans and on child ETS exposure. METHODS: U.S.- and Mexico-born Hispanic mothers of children aged 2 through 12 years were systematically sampled from health clinics in Albuquerque, New Mexico. In-person interviews were conducted with 269 mothers (75.4% response rate) to obtain information on main study outcomes (complete versus no/partial home and automobile smoking bans; child room and automobile ETS exposure) and risk factors (mother's country of birth, maternal and household smoking behaviors). Data were analyzed with chi square tests and logistic regression models. RESULTS: Three-fourths (74–77%) of U.S.-born and 90–95% of Mexico-born mothers reported complete automobile and home smoking bans. In multivariate analyses, mother's U.S nativity, mother's current smoking, and presence of other adult smokers in the home were associated with significantly increased odds of not having a complete home or automobile smoking ban. Mother's smoking was associated with child ETS exposure both indoors (odds ratio [OR] = 3.31) and in automobiles (OR = 2.97). Children of U.S.-born mothers had increased odds of exposure to ETS indoors (OR = 3.24; 95% confidence interval [CI]: 1.37–7.69), but not in automobiles. Having complete smoking bans was associated with substantially reduced odds of child ETS exposure both indoors (OR = 0.10; 95% CI: 0.04–0.27) and in automobiles (OR = 0.14; 95% CI: 0.05–0.36). CONCLUSION: This study of Hispanic mothers in the southwestern U.S. indicates that there are substantial differences between U.S.- and Mexico-born mothers in the prevalence of home and automobile smoking bans, and resulting child ETS exposure. Tobacco interventions to increase smoke-free environments for U.S. Hispanic children should focus on both home and automobile smoking practices, especially among U.S.-born mothers, and utilize strategies that impact smoking practices of all household members

Knowledge, Attitudes, and Practices Regarding Smoke-Free Policies in Multi-Unit Housing in Georgia

Background: Nonsmokers living in multi-unit housing (MUH) without a smoke-free (SF) policy are vulnerable to secondhand and thirdhand smoke exposure. This study aimed to investigate the presence and type of SF policies in MUH in Georgia. Another aim was to explore knowledge, beliefs, and attitudes of property managers and owners (PM/Os) regarding SF MUH policies, including e-cigarettes. Methods: Throughout 2015 PM/Os of MUH in Savannah and Atlanta were surveyed regarding SF policies in MUH. A list with contact information of PM/Os was obtained from the ASDE Survey Sampler. The participants were mailed an invitation letter and were called one week later to schedule the interview. To be eligible, the participant must have been an English-speaking adult working as a PM/O in MUH. The survey administered was adapted from a survey designed by CDC’s Office on Smoking and Health. All survey data were entered into SPSS and analyzed using SAS. Results: The greatest number of the 91 PM/Os surveyed were female (70.3%) and/or white (48.4%), with an average age of 41.7 years. Most properties were market-rate (71.3%) or were a mix of market-rate and subsidized units (17.2%). Forty-one PM/Os reported some smoking restriction, while 50 had no policy. Properties mainly prohibited smoking in common outdoor areas (n=18) or inside individual apartments (n=13). Policies included bans of non-cigarette combustible products (n=19), hookah (n=12), e-cigarettes (n=7), and smokeless tobacco (n=5). Most PM/Os reported high compliance and positive resident reactions to the policy. Comparing responses by policy status, no differences in knowledge nor support for tobacco control legislation were found, except for SF outdoor seating in restaurants, which was more frequently supported by PM/Os with smoking restrictions. Personal beliefs on restricting use of cigarettes and e-cigarettes in MUH did not differ significantly by policy status, but those with a SF policy were more supportive of prohibiting smokeless tobacco use in MUH. Conclusions: Implementing smoke-free policies in multi-unit housing is feasible and is generally supported by residents

A qualitative examination of home and neighborhood environments for obesity prevention in rural adults

<p>Abstract</p> <p>Background</p> <p>The home and neighborhood environments may be important in obesity prevention by virtue of food availability, food preparation, cues and opportunities for physical activity, and family support. To date, little research has examined how home and neighborhood environments in rural communities may support or hinder healthy eating and physical activity. This paper reports characteristics of rural homes and neighborhoods related to physical activity environments, availability of healthy foods, and family support for physical activity and maintaining an ideal body weight.</p> <p>Methods</p> <p>In-depth interviews were conducted with 60 African American and White adults over 50 years of age in two rural counties in Southwest Georgia. Interviews were transcribed verbatim and coded independently by two members of the research team using standard methods of qualitative analysis. Themes were then identified and data matrices were used to identify patterns by gender or race.</p> <p>Results</p> <p>Neighborhood features that supported physical activity were plenty of land, minimal traffic and living in a safe and friendly neighborhood. The major barrier was lack of recreational facilities. The majority of participants were not physically active with their family members due to schedule conflicts and lack of time. Family member-initiated efforts to encourage physical activity met with mixed results, with refusals, procrastination, and increased activity all reported. Participants generally reported it was easy to get healthy foods, although cost barriers and the need to drive to a larger town for a supermarket with good variety were noted as obstacles. Family conversations about weight had occurred for about half of the participants, with reactions ranging from agreement about the need to lose weight to frustration.</p> <p>Conclusion</p> <p>This study suggests that successful environmental change strategies to promote physical activity and healthy eating in rural neighborhoods may differ from those used in urban neighborhoods. The findings also provide insight into the complexities of family support for physical activity and maintaining a healthy weight. Addressing socio-ecologic factors has the potential to increase healthy behaviors and decrease the prevalence of obesity among rural residents.</p

LILAC Innovative Program for Instruction Librarians

Librarians from Rochester-area colleges worked together to create LILAc -- the Library Instruction Leadership Academy. The aim of the academy was to prepare librarians to be better instructors in their current or future jobs. The program was a huge success and is now being duplicated by other areas in New York State

Assessment of the Building Collaborative Research Capacity Model: Bridging the community-academic researcher divide

Background: Community–based Participatory Research (CBPR) can be challenging when community leaders and academic researchers have not previously co-led research or worked together with established rules guiding their relationships, roles, and respective functions. The objective of this investigation was to assess the processes and outcomes of the Building Collaborative Research Capacity Grant Program, sponsored by the Community Engagement Research Program of The Atlanta Clinical and Translational Science Institute and designed to foster CBPR. Methods: Four competitively selected community-based organizations (CBOs) participated in capacity-building workshops designed to build research skills and receive technical assistance to plan a pilot study with academic researchers. Pre- and postsurveys were used to assess the impact of the training and technical assistance on the CBOs’ knowledge and skills and abilities to plan, implement, and evaluate research. Key informant interviews were conducted with academic researchers and CBO dyads to identify experiences, perceptions, and recommendations related to the program model, and seven identified domains of collaborative research including research skills, attitudes toward collaboration, shared goals, institutional factors, mutual respect, human and fiscal resources, and partnering skills. Results: Areas of research competency increased from pre- to post-survey, with statistically significant increases in Community Assessment (p= 0.046) and Program Planning (p= 0.046). Each partnership had inherent characteristics related to strengths and barriers affecting the research outcomes. Conclusions: The present results contribute to the literature through assessment of processes, outcomes, and partner insights of a model designed to facilitate collaborative community-engaged research partnerships. Future research should examine the model to expand understanding of the dimensions of effective community and academic research collaboration

Factors associated with support for smoke-free policies among government workers in six Chinese cities: a cross- sectional study

Background: A certain level of public support for smoke-free environments is a prerequisite for adoption and enforcement of policies and can be used as an indicator of readiness for legislative action. This study assessed support for comprehensive smoke-free policies in a range of settings such as hotels and colleges among government workers in China and identified factors associated with support for smoke-free policies. Understanding the extent to which government workers, a large segment of the working population in China, report a smoke-free workplace and support for smoke-free policies may be important indicators of readiness for strengthened policies given their role in formulating, implementing and enforcing regulations. Methods: Data were from an evaluation of the Tobacco Free Cities initiative of Emory University’s Global Health Institute-China Tobacco Control Partnership. Self-administered surveys were completed by 6,646 workers in 160 government agencies in six Chinese cities. Multivariate logistic regression was used to identify factors associated with support for smoke-free worksites, bars, hotels, and colleges. Results: Over half (54.6%) of participants were male. A large percentage of the male workers smoked (45.9%,) whereas very few women did (1.9%). Fewer than 50% of government workers reported smoke-free policies at work, with 19.0% reporting that smoking is allowed anywhere. Support for smoke-free policies was generally very high, with the lowest levels of support for smoke-free bars (79.0%) and hotels (82.3%), higher levels of support for restaurants (90.0%) and worksites (93.0%), and above 95% support for hospitals, schools, colleges, public transportation and religious settings. Knowledge of the harmfulness of secondhand smoke was positively associated with support for smoke-free policies. Stricter worksite smoking policies were associated with support for smoke-free workplaces and bars, but not hotels and colleges. Women and nonsmokers were more supportive of smoke-free policies in general. Conclusion: Government workers play important roles in formulating, implementing and enforcing regulations; results suggest support for a more comprehensive approach to smoke-free environments in China among workers across a broad range of agencies