Leveraging Community Partnerships to Enhance Tobacco Prevention Efforts

State: FL Type: Promising Practice Year: 2016

:

The CDC has determined that tobacco use is the single most preventable cause of death in the United States and a leading cause of many long term chronic health conditions. Tobacco addiction is among the leading preventable causes of morbidity and mortality in Florida and in the United States. If the United States continues on its current trajectory of youth tobacco initiation, 5.6 million children alive today who are younger than 18 years of age will die prematurely as a result of smoking. The 2013 Youth Risk Behavior survey reports that 9.7% of Broward County youth use tobacco compared to the state and national averages of 30.4% and 22.4% respectively. Furthermore, 27.8% of Broward youth report ever attempting to smoke a cigarette versus the state and national averages of 39.6% and 41.1%. 

:
Broward County Health Department
:
Leveraging Community Partnerships to Enhance Tobacco Prevention Efforts
Describe public health issue: The CDC has determined that tobacco use is the single most preventable cause of death in the United States and a leading cause of many long term chronic health conditions. Tobacco addiction is among the leading preventable causes of morbidity and mortality in Florida and in the United States. The list of illnesses caused by tobacco use is long and contains many of the most common causes of death, including heart disease, stroke, lung disease, many forms of cancer, and vascular diseases. Cigarette use alone, results in an estimated 480,000 deaths each year in the US, including 32,300 deaths in Florida. Secondhand smoke causes 742,000 deaths each year among adult non-smokers in the United States with 2,520 of those deaths among Floridians. The tobacco industry spends close to $562.6 million in Florida annually to market its products and many of their marketing efforts directly reach kids. Tobacco industry documents, research on the effect of the cigarette companies’ marketing efforts on kids, and the opinions of advertising experts combine to reveal the intent and the success of the industry’s efforts to attract new smokers from the ranks of children. If the United States continues on its current trajectory of youth tobacco initiation, 5.6 million children alive today who are younger than 18 years of age will die prematurely as a result of smoking. The 2013 Youth Risk Behavior survey reports that 9.7% of Broward County youth use tobacco compared to the state and national averages of 30.4% and 22.4% respectively. Furthermore, 27.8% of Broward youth report ever attempting to smoke a cigarette versus the state and national averages of 39.6% and 41.1%.    Goals and objectives of proposed practice The goals of this practice are:1) to increase the number of and sustain current Students Working Against Tobacco (SWAT) clubs in Broward County through community partnerships and advocacy training; 2) increase DOH-Broward presence at local events to promote or attain policy changes; 3) to create tobacco free environments and social norms; and, 4) to de-normalize tobacco use through policy, environmental and systems change through youth advocacy.   How was practice implemented / activities:   The practice was implemented by partnering with local organizations to identify schools and/or organizations with a need for SWAT.  A series of trainings is then implemented along with sustainability visits held with youth and SWAT Advisors. Results/ Outcomes (list process milestones and intended/actual outcomes and impacts.Were all of the objectives met? Yes, the number of SWAT clubs has increased county wide from 15 in 2014, to 31 in 2015; Broward County has the highest number of SWAT clubs in Florida. Community partners were inspired by the accomplishments of SWAT youth.  This resulted in an increase in funding of $185,000 from 2014 to 2015 to establish and operate additional chapters throughout Broward County.  This funding increase will continue for the next 6 years. What specific factors led to the success of this practice? The following factors led to the success of this practice:  SWAT Fest: Annual Youth Training with more than 230 youth and parents participating in 2015, SWAT Advisor training sessions and Coordinator/Advisor sustainability visits. Public Health impact of practice: The 2013 Youth Risk Behavior survey reports that 9.7% of Broward County youth use tobacco compared to the state and national averages of 30.4% and 22.4% respectively. Furthermore, 27.8% of Broward youth report ever attempting to smoke a cigarette versus the state and national averages of 39.6% and 41.1%.  The website for DOH-Broward is http://broward.floridahealth.gov/
Statement of the problem/public health issue:The CDC has determined that tobacco use is the single most preventable cause of death in the United States and a leading cause of many long term chronic health conditions. Tobacco addiction is among the leading preventable causes of morbidity and mortality in Florida and in the United States. The list of illnesses caused by tobacco use is long and contains many of the most common causes of death, including heart disease, stroke, lung disease, many forms of cancer, and vascular diseases. Cigarette use alone, results in an estimated 480,000 deaths each year in the US, including 32,300 deaths in Florida. Secondhand smoke causes 742,000 deaths each year among adult non-smokers in the United States with 2,520 of those deaths among Floridians. The tobacco industry spends close to $562.6 million in Florida annually to market its products and many of their marketing efforts directly reach kids. Tobacco industry documents, research on the effect of the cigarette companies’ marketing efforts on kids, and the opinions of advertising experts combine to reveal the intent and the success of the industry’s efforts to attract new smokers from the ranks of children. If the United States continues on its current trajectory of youth tobacco initiation, 5.6 million children alive today who are younger than 18 years of age will die prematurely as a result of smoking. Despite a decrease in the number of smokers in recent years, more than 18,900 kids (under age 18) in Florida become new cigarette smokers each year. Considering nine out of 10 smokers start by age 18, it’s crucial to prevent kids from using tobacco during these pivotal years. Many youth have the attitude that they can “stop smoking at any time.” Unfortunately, the reality is quite different.Tobacco Free Florida along with Students Working Against Tobacco (SWAT) and local partnerships, are committed to reduce youth smoking and tobacco use rates. We are educating youth and adults about how the tobacco industry targets youth, protecting young people from “starter” products like candy flavored tobacco and little cigars, and working with the community to limit our childrens’ access and exposure to tobacco. Because almost all smokers begin when they are kids, if we are able to eliminate youth smoking, we can end the tobacco epidemic. The 2013 Youth Risk Behavior survey reports that 9.7% of Broward County youth use tobacco compared to the state and national averages of 30.4% and 22.4% respectively. Furthermore, 27.8% of Broward youth report ever attempting to smoke a cigarette versus the state and national averages of 39.6% and 41.1%. What target population is affected by problem:What is target population size? Broward County Middle and High School aged youth (ages 11 – 19; 156,107 Florida CHARTS, 2013 population estimate)What percentage did you reach? SWAT has established clubs in 34% of Broward County public middle and high schools, the sixth largest school district in the nation. This percentage does not include the six SWAT clubs established with community organizations, such as the City of Lauderhill Parks and Recreation Department, which have members from several school sites.What has been done in the past to address the problem? Students Working Against Tobacco (SWAT) was established in 1998 in all 67 counties in Florida in conjunction with the statewide Tobacco Free Florida prevention and cessation program. DOH-Broward did not have a formalized training program for students or advisors. Why is current/proposed practice better? DOH-Broward has been able to sustain and expand youth prevention efforts through community partnerships, strategic planning and targeted trainings more than any other county in the state of Florida. Monthly regional SWAT technical assistance conference calls are held to keep youth engaged. Broward SWAT has received resolutions and proclamations from 84% of municipalities in the county and from the local school board, league of cities and county government. Additionally, SWAT youth initiated the Tobacco Free Schools policy adopted by Broward County Public Schools, the sixth largest school district in the nation, in 2014. This initiative is a creative use of existing tool or practice. The annual SWAT fest allows all Broward County SWAT youth to collaborate and share best practices. SWAT youth continue relationships formed at SWAT fest. Monthly regional SWAT technical assistance conference calls are held to keep youth engaged.Is current practice evidence-based? If yes, provide references: Data from California and Massachusetts show that comprehensive tobacco control programs can substantially reduce tobacco use, and in the case of California, reduce rates of death from lung cancer and cardiovascular disease.  Tools/practices utilized include Centers for Disease Control and Prevention. Youth tobacco surveillance, 2000. MMWR Surveillance Summary 2001;50(SS-4), Hopkins D, Fielding J, Task Force on Community Preventive Services, editors. The Guide to Community Preventive Services: Tobacco use prevention and control-reviews, recommendations, and expert commentary. Am J Prev Med 2000;20(2S).  
Tobacco
Goal(s) and objectives of practice: The goals of this practice are: 1) to increase the number of and sustain current Students Working Against Tobacco (SWAT) clubs in Broward County through community partnerships and advocacy training; 2) increase DOH-Broward presence at local events to promote or attain policy changes; 3) to create tobacco free environments and social norms; and, 4) to de-normalize tobacco use through policy, environmental and systems change through youth advocacy. What did you do to achieve the goals and objectives?Steps taken to implement the program: Recruited SWAT clubs in public and private schools and community based organizations. Partnered with Broward County Public Schools (BCPS), Broward Health Regional Planning Council (BHRPC) and local community organizations to pinpoint locations and Advisors which would best benefit local communities.Established SWAT Advisor per club and provided specific training on club operations and sustainability. Dispensed Scope of Work for Advisors to follow closely.Encouraged Advisors to recruit members at each locationImplemented SWAT Fest: Annual Youth Training and required club Officers and Advisors to attend. Highly encouraged all other members to attend. Solicit community partners to attend SWAT Fest and train youth on local initiatives and effective advocacy. SWAT Fest is an interactive annual youth training for all SWAT youth and Advisors created by DOH-Broward. The objective of this training is to provide SWAT youth with the necessary tools and experience needed to become empowered and work towards the needed changes against tobacco in their distinct communities. The event educates SWAT youth on proper procedures, operating protocols, SWAT’s history and motivates them into action. Additionally, SWAT training teaches advocacy skills that can be utilized in many aspects of life. Trainings are led by contracted vendors, DOH-Broward staff, state DOH staff and community partners (i.e. American Lung Association, Broward Health Regional Planning Council and the Tobacco Free Partnership of Broward County). SWAT Fest is held on the campus of Nova Southeastern University at no charge to DOH-Broward. In previous years, neighboring counties have asked to bring their youth to the event for training including Miami-Dade, Palm Beach, Collier and St. Lucie counties. In 2015, SWAT Fest had a record breaking 231 participants, including parents of SWAT youth that elected to stay to be trained themselves. Visit with each SWAT clubs and advisor for sustainability and technical assistance once per quarter. Follow up on a weekly basis via email and telephone communications. Any criteria for who was selected to receive the practice (if applicable)? Middle and high school aged youth (age 11-19).What was the timeframe for the practice? The timeframe for this practice is the most recent 1 year State of Florida fiscal year, July 1, 2014 – June 30, 2015. Were other stakeholders involved? What was their role in the planning and implementation process? Yes. Broward County Schools, Broward Regional Health Planning Council, the Health Foundation of South Florida, the American Lung Association of the SouthEast, contribute financially to fund and sustain the program, and also assist in providing a social media presence. What does the LHD do to foster collaboration with community stakeholders? Describe the relationship(s) and how it furthers the practice goal(s): DOH-Broward collaborates with local community stakeholders, first by determining how SWAT can be infused into the existing strategic plans of each organization. Additionally, community stakeholders are invited to the Tobacco Free Partnership of Broward County (TFP) Youth Roundtable to meet with SWAT leadership (the President and V. President of each club) on a quarterly basis. These empowering meetings serve as avenues for the youth to voice concerns, create solutions and collaborate with community organizations on local policy initiatives. Any start up or in-kind costs and funding services associated with this practice? Please provideactual data, if possible. Else, provide an estimate of start-up costs/ budget breakdown. The annual cost to establish and maintain a SWAT club totals $1,713.02. This includes providing each Club Advisor a stipend of $1,000; costs to host SWAT Fest training including contracted trainers and food totaling $277.42 per club; SWAT clubs are also given materials to operate and create projects to educate their communities and commemorate Tobacco Control Observances (World No Tobacco Day, Kick Butts Day, Red Ribbon Week etc.); and, costs of club materials totaling $150.30 per club. In addition to operational materials and training costs, clubs are given functional items to recruit new members, promote SWAT at events and for unification. Items include Advisor and Officer polo shirts (for the Advisor and four Officers of each club), SWAT T-shirts for General Body members, two Flash Drives (for Advisor and Secretary to store and maintain club records), padfolios/notebooks and SWAT backpacks. The total costs of functional materials are $285.30.  
What did you find out?  To what extent were your objectives achieved? DOH-Broward Tobacco Prevention staff learned that youth are just as concerned for the health of themselves and their community as adults but needed to be given the tools in creative and fun ways. By changing the name “SWAT Youth Training” to “SWAT Fest”, youth were intrigued about the event and attended repeatedly. SWAT Advisors expressed that their youth returned to their clubs yearly asking for dates to attend the SWAT Fest training. Utilizing creative and interactive techniques not only engaged the youth but also their parents and Advisors. We also learned that given adequate support, teachers and community leaders readily returned to reinstate their clubs on an annual basis. Some Advisors have advised the same clubs for over 5 years. The need for training and information exceeded the need for finances as some clubs continued their work without funding as long as SWAT Coordinators were able to teach them advocacy and leadership skills. Requiring SWAT Coordinators to meet with SWAT clubs on a quarterly basis ensured students and Advisors constantly received training on trending issues and made youth feel empowered to fight Big Tobacco. The goals of this practice were all met as described by the activities above.  They are: 1) to increase the number of and sustain current Students Working Against Tobacco (SWAT) clubs in Broward County through community partnerships and advocacy training; 2) increase DOH-Broward presence at local events to promote or attain policy changes; 3) to create tobacco free environments and social norms; and, 4) to de-normalize tobacco use through policy, environmental and systems change through youth advocacy. Did you evaluate your practice?  Yes. List any primary data sources, who collected the data, and how: DOH-Broward Tobacco Prevention Program utilizes pre and post evaluations at the annual SWAT Fest, beginning in 2011 and at each subsequent annual event through 2015. List any secondary data sources used (if applicable) Youth Risk Behavior Survey, bi-annual survey conducted by the CDC. List performance measures used. Include process and outcome measures as appropriate. The number of SWAT clubs has increased county wide from 15 in 2014, to 31 in 2015; Broward County has the highest number of SWAT clubs in Florida. Community partners were inspired by the accomplishments of SWAT youth.  This resulted in an increase in funding of $185,000 from 2014 to 2015 to establish and operate additional chapters throughout Broward County.  This funding increase will continue for the next 6 years. Describe how results were analyzed. Were any modifications made to the practice as a result of the data findings? No, the project was success  and no modifications  were necessary.  
Lessons learned in relation to partner collaboration: Broward County Public Schools’ Office of Diversity, Prevention and Intervention, SWAT is a school board recognized and supported program. In the absence of assistance from Department of Health, Broward County Public Schools would partially keep a form of the program. Additionally, community partners such as the American Lung Association, Health Foundation of South Florida and the Broward Regional health Planning Council have worked to find funds in their budgets to support the program and will likely continue to do so. Did you do a cost/benefit analysis? If so, describe. No, as costs are minimal. Is there sufficient stakeholder commitment to sustain the practice? Community partners were inspired by the accomplishments of SWAT youth.  This resulted in an increase in funding of $185,000 from 2014 to 2015 to establish and operate additional chapters throughout Broward County.  This funding increase will continue for the next 6 years,therefore the practice  is sustainable with continued funding.  
Colleague in my LHD
 
Processing...


Driving Walking/Biking Public Transit  Get Directions