Abstract C55: Assessing the organizational context for implementing tobacco use prevention programs at a Historically Black College/University (HBCU)
Authors: Selove Rebecca , Green Cheryl , Brown Charles , Yousef-Zadeh Nahall , Padgett David 
Published: March 2017

Background: African Americans have substantially higher mortality rates associated with tobacco-related cancers. Tobacco product use begins more commonly among African Americans at age 18-25 than at a younger age. HBCU campuses provide potential opportunities for implementing evidence-based tobacco product use prevention programs to reduce cancer risks among African Americans. The Consolidated Framework for Implementation Research (CFIR) provides a structure for assessing the organizational context for implementation.

Methods: Multiple assessment procedures were piloted as part of planning to implement tobacco product use prevention interventions on an HBCU campus. They included semi-structured staff interviews with key informants (n=7) and students (n=3); a staff focus group (n=7); and four versions of staff and student surveys (n=195). An environmental scan assessment tool using geographic information system (GIS) software was used to map tobacco waste (primarily cigarette butts) at nine sites on campus.

A thematic approach was used to assess qualitative data. Interviews and focus group discussions were recorded and transcribed, and the first author used CFIR domains as a priori codes for the first step of analysis. Next, the coded transcripts were reviewed by the second and third authors, and differences of opinion regarding coding were resolved in discussions among all three authors. Numerical data collected from surveys was summarized with frequency distributions and descriptive analysis.

Some qualitative results include:

Inner Setting: The fact that this University is an HBCU was salient for nearly every informant, as a key reason they are here, and as a point of pride. Some feel strongly that tobacco use on campus is a significant problem in that it contributes to exposure to second-hand smoke and reflects poorly on an HBCU. Some individuals assume there is no tobacco use problem because current policy prohibits tobacco use on campus. Environmental scans demonstrated a high level of tobacco use in some areas.

Outer Setting: Some students want to inform other students about the existing policy, and are receptive to using a compassionate approach rather than shaming students who smoke. Smokers would like areas of the campus to be designated for tobacco use so they can smoke and get to class on time. Tobacco advertising and marketing is highly visible to some students.

Intervention: There is generally little awareness of the availability of evidence-based tobacco use prevention programs or other interventions.

Project staff: Several campus staff are interested in being trained to be providers of cessation services.

Implementation Process: There is strong interest on the part of key staff to undertake a systematic approach to assessing facilitators and barriers to tobacco use, identifying evidence-based tobacco use prevention interventions that could be used at this University, and developing a science-based implementation plan for those interventions.

Quantitative results: 75% of survey respondents were between 18-25 years of age.

Level of knowledge about tobacco was fairly high, although nearly 30% responded incorrectly about nicotine as a toxic substance that is made by tobacco plants; 42% said the stress of quitting is more harmful than smoking; and only 50% responded correctly to an item about lung cancer mortality disparity among African American men.

Conclusion: The selected methods provided information about many facilitators and barriers to tobacco use prevention program implementation on an HBCU campus. Next steps include refining and expanding the data procedures to reach more faculty and students, and using the results to select interventions and develop an implementation plan.

Note: This abstract was not presented at the conference.

Citation Format: Rebecca Selove, Cheryl Green, Charles Brown, Nahall Yousef-Zadeh, David Padgett. Assessing the organizational context for implementing tobacco use prevention programs at a Historically Black College/University (HBCU). [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C55.