Partnering with education and job and training programs for sustainable tobacco control among Baltimore african american young adults

Stage-based healthy lifestyles program for non-college young adults

Purpose

The purpose of this paper is to test the feasibility of implementing a healthy lifestyles intervention to maintain or achieve healthy weight for low-income young adults in vocational education.

Design/methodology/approach

Non-randomized, quasi-experimental feasibility test of a ten-week intervention with follow-up assessment designed using PRECEDE-PROCEED. A convenience sample included low-income young adults (n=165), 18-24 years recruited from two vocational training facilities. The intervention had weekly: online educational modules, targeting the non-dieting approach through healthful eating, and physical activity; and messages to promote fruit and vegetable intake, increased physical activity and stress management. Anthropometrics were measured, and an online survey on physical activity and eating behavior (e.g. self-regulation, self-instruction, emotional eating) was administered at baseline, post-, and follow-up.

Findings

At baseline, males were overweight and females were obese based on average BMI; no significant change in BMI, food intake, physical activity, or stress management were noted following the intervention. Eating behavior changed in treatment vs control group; food self-regulation was higher (p=0.025) for high use treatment group compared to the control group.

Practical implications

Lifestyle interventions are critical for low-income young adults who are overweight or obese by 18-24 years of age. Young adults who engage in such interventions can make food behavior changes that can have a mediating effect on healthy weight management. Models like PRECEDE-PROCEED are vital to success when working toward sustainable programs within communities.

Originality/value

Few healthy lifestyle programs have been reported for low-income, non-college young adults, specifically with a largely male population, and none with PRECEDE-PROCEED.

Using PRECEDE to develop a weight management program for disadvantaged young adults

OBJECTIVE

To conduct a needs assessment using the PRECEDE model for the development of a weight management program for low-income young adults.

DESIGN

Four phases were implemented using qualitative (focus groups and interviews) and quantitative (survey) methodologies, with steering committee guidance.

SETTING

Northeastern residential vocational center.

PARTICIPANTS

Convenience sample of low-income young adults, 18-24 years old (total n = 203), who were attending a job training vocational center.

PHENOMENON OF INTEREST

General themes of life satisfaction determinants and issues related to weight, self-reported weight and related behavior, existing environmental supports, and desired changes of behavioral and environmental influences of weight.

ANALYSIS

Content analysis of qualitative data; descriptive analysis and Student t test.

RESULTS

Self-image and discrimination were themes for weight issues. More than half of participants were overweight or obese (57%) and had low levels of physical activity (58%). Self-reported fruit and vegetable intake was inadequate (<2.5 cups/d). Identified environmental factors most needing improvement were accessibility for walking and biking and availability of healthful food. Participants reported exercising, getting adequate sleep, eating healthful snacks, and effectively managing stress as behavior they were willing to change.

CONCLUSIONS AND IMPLICATIONS

The PRECEDE model was useful to identify concerns, priorities, and modifiable factors among a young adult community that can increase the relevancy of a weight management program.

Cigarillo use among high-risk urban young adults

In the U.S., cigar use doubled from 5.0 to 10.6 billion cigars consumed annually between 1997 and 2007, driven in large part by increased sales of cigarette-sized "little cigars" and narrow, mid-sized "cigarillos." The present study examined prevalence of cigarillo use as well as attitudes, knowledge and behaviors related to cigarillo use among a sample of predominantly urban African American young adults 18-24 not in school and not employed. Survey data were collected from 131 young adults attending education and job training centers in Baltimore, Maryland and from 78 young adults attending education, job training, or recreational programs in Washington, D.C. In Baltimore, 22% of young adults had smoked a cigarillo in the past 30 days, compared with nearly 63% in D.C. Both populations were heavily exposed to cigarillo advertising and marketing. Cigarillo use in this urban young adult population is a growing public health problem and undermines the progress made in decreasing cigarette use.

Targeting cessation: understanding barriers and motivations to quitting among urban adult daily tobacco smokers

INTRODUCTION

Many people continue to smoke tobacco products despite known negative health consequences, including increased risk of chronic disease and death. Disparities exist in rates of smoking and chronic disease, underscoring the importance of understanding the barriers and motivations to smoking cessation among vulnerable populations, such as socioeconomically disadvantaged people of color.

METHODS

This study uses data from a cross-sectional randomized household survey conducted in six low-income neighborhoods in New Haven, Connecticut, USA (N=1205). The objectives were to examine barriers and motivations to quitting smoking among daily tobacco smokers (31.6% of respondents) and sociodemographic differences in endorsement of barriers and motivations.

RESULTS

The two most common barriers to quitting were perceiving it to be too difficult and not wanting to quit. Financial costs, social support, and social influence were themes endorsed highly across both barriers and motivations to quitting. Sociodemographic differences were found, such as women and Black participants being more likely to be interested in a free quitline or quit website; women and Latinos being more likely to be afraid of gaining weight; and women, participants with less education, and older participants being more likely to be concerned about the cost of cessation products.

CONCLUSIONS

Understanding barriers and motivations to quitting among disadvantaged populations is crucial. Financial issues, social support, and social norms should be targeted in promoting cessation among disadvantaged, urban populations. Programs, interventions, and policies can also use research about specific barriers and motivations for sociodemographic sub-groups to be tailored, targeted, and more effective.

Mobilizing for policy: using community-based participatory research to impose minimum packaging requirements on small cigars

THE PROBLEM

Cigarette sales have declined in the United States over the past decade; however, small cigar sales have been rapidly increasing. In most urban areas, small cigars are inexpensive and are sold as singles without health warnings.

PURPOSE OF ARTICLE

This paper describes a community- academic-practice partnership's (CAPP) efforts to decrease small cigar use in young adults living in Baltimore, Maryland, through legislative strategies.

KEY POINTS

Survey data among young adults not in school indicated that 20% of individuals reported current small cigar use, often in combination with cigarettes. The community- academic partnership engaged the community in discussion about small cigar use in the fall of 2007. In collaboration with partners, bills were submitted to the legislative bodies for the city and state to impose minimum packaging requirements on small cigars.

CONCLUSION

Collaborative partnerships between community-based organizations, public health agencies, and academic institutions can lead to policy initiatives with the potential to improve public health.