in Commercial Tobacco Policy Work Presentation by: Jodi Broadwell - PowerPoint PPT Presentation

Building Leaders and Sharing Stories in Commercial Tobacco Policy Work Presentation by: Jodi Broadwell Monday, February 27 th at 1:45-3PM Room 42A

Commercial Tobacco-Related Disparities in Priority Populations  Industry targeting and the Inequitable Distribution of  In 2012 and 2013 Funding, Training, and Resources from the LGBTQ Community Tobacco Control Movement contributes to the Members were Disparities we see for smoking at Twice Priority Populations the Rate of the compared to the significant declines in Commercial General Population. Tobacco use seen in the General Population.

Commercial Tobacco-Related Disparities in Priority Populations  One of the Best Practices to Support Equity and Eliminate Health Disparities is to Fund Programs that can effectively Reach, Educate, and Build Leadership in Communities experiencing Commercial Tobacco-Related Disparities.

Commercial Tobacco-Related Disparities in Priority Populations  One of the Best Practices to Support Equity and Eliminate Health Disparities is to Fund Programs that can effectively Reach, Educate, and Build Leadership in Communities experiencing Commercial Tobacco-Related Disparities.

The Leadership and Advocacy Institute to Advance Parity for Minnesota’s Priority Populations (LAAMPP)

The Leadership and Advocacy Institute to Advance Parity for Minnesota’s Priority Populations (LAAMPP)  Cross-Cultural Leadership Development Institute  Intentionally Recruits Potential Leaders from Minnesota’s Priority Populations  Develop cadres of Commercial Tobacco Control Leaders within Minnesota Communities that Experience Disproportionate Harm from Commercial Tobacco.

LAAMPP Theory of Change  Aims to Build Leadership & Develop Skills and Capacity of the Fellows who Participate  Support Fellows in Developing Relationships and Networks within their communities, cross culturally, and within the Commercial Tobacco Control Movement  Enact Policies, Systems, and Environmental Change

LAMMPP III Institute Components • 18 Months (September 2012- March 2014) • 18 Days of Training • Group projects by each Cohort

LAAMPP Core Competencies

Five LAAMPP III Cohorts (23 Fellows)  AAA: African-African American (n=6)  AI: American Indian (n=3)  AAPI: Asian American Pacific Islander (n=5)  Latino (n=6)  LGBTQ: (n=3)

LAAMPP III Evaluation  A LAAMPP Evaluation was recently published in the Journal of Health Disparities Research and Practice.  Findings were consistent across evaluation methods: the program’s Theory of Change successfully trained commercial tobacco control leaders from priority populations and supported them in developing the networks necessary to successfully undertake policy initiatives.  Fellows passed policy changes in the Twin Cities Metro area, as well as Greater Minnesota cities of Duluth, Mankato, and Willmar and are more likely to be seen as leaders by their communities.

Acknowledgements  Linda Bosman: linda@bosmaconsulting.com  Raffaele Vacca, University of Florida  José Luis Molina González, Universitat Autònoma de Barcelona  ClearWay Minnesota SM  Minnesota Department of Health  APPEAL  LAAMPP III Fellows  LAAMPP III Evaluation Advisory Panel

LAAMPP III Evaluation Questions 1. To what extent did LAAMPP III confirm the Theory of Change by developing the necessary skill & capacity among Fellows? 2. To what extent did LAAMPP III Fellows develop social relationships & networks within their own and across priority populations, and in the broader (mainstream) tobacco control movement to undertake tobacco control work? 3. To what extent did LAAMPP III Fellows impact systems & community level change ?

Mixed Methods Evaluation Design  Key Informant Interviews  Fellows (23 pre & 22 post)  Community Contacts (22 post)  Projects Contacts (17 post)  Skills assessments questionnaires  (23 pre & 23 post)  Social Network Analysis  (23 pre, 22 post)  Lessons Learned Reflection Session  Participant observations: trainings & events  Case studies of 5 Fellows’ projects

Analysis  Qualitative analysis of themes & key elements  Atlas ti qualitative software  Quantitative analysis of Fellows’ assessments, using a scale of 0 to 4, and averaging across Fellows  Social Network Analysis  Personal network analysis approach  EgoNet software  Aggregated across Fellows  Triangulation of data across methods & evaluation questions

Core Competencies/Capacity Using LAAMPP Skills Fellows’ knowledge & Frequency of Implementing Skills Increased : • Commercial tobacco control • Advocacy & policy • Cultural & Community Competency • Collaboration • Facilitation

Increased Individual Knowledge: Tobacco (pre/post) 4 3.5 3 2.5 Scale 0 to 4 2 1.5 1 0.5 0 Pre Post …The harm caused by commercial tobacco 3.17 3.91 in your culture/priority population group? …The harm caused by commercial tobacco in other cultures/priority population 2.61 3.87 groups? …Tobacco industry marketing strategies 2.65 3.83 that target your priority population group? …Tobacco industry marketing strategies 2.7 3.78 that target other priority populations?

Increased Individual Knowledge: Advocacy/Policy (pre/post) 4 3.5 3 2.5 Scale 0 to 4 2 1.5 1 0.5 0 Pre Post …Advocacy work such as how to advocate for change in a policy or 2.52 3.61 practice? …How to conduct policy work at the 2.39 3.64 community level? …How to conduct policy work in mainstream settings that supports parity (outcomes that support priority 1.95 3.13 populations’ health, not just mainstream society)? …How to conduct policy work in 1.35 3.13 legislative settings? …How to conduct policy work that 1.52 3.17 focuses on Tobacco Industry practices?

Tobacco Prevention & Control Activity Frequency Pre & Post LAAMPP III 4.00 3.50 Frequency that Fellows undertook Activity 3.00 2.50 (Scale 0 to 4) 2.00 1.50 1.00 0.50 0.00 Educated Policy change Policy change Info on cessation Educated tobacco industry Policy change at Policy change in Educated on regulate tobacco regulate services in tobacco harms targeting priority state level own community sacred tobacco sales ads/marketing community pops Pre Average Score 2.13 2.00 0.57 1.17 0.26 0.17 1.87 1.57 Post Average Score 3.00 2.96 1.61 2.43 1.39 1.13 2.78 2.13

Policy/Advocacy Activity Frequency Pre & Post LAAMPP III 4.00 3.50 Frequency that Fellows undertook Activity 3.00 2.50 (Scale 0 to 4) 2.00 1.50 1.00 0.50 0.00 Met w/policy Met Testified Mobilized Developed Contacted Worked makers to w/policy Spoken Conducted Wrote letter before others to advocacy elected policy develop makers to publicy outreach to to policy decision- support strategies/m official/ change in relation- lobby for about cmty mobilize makers making policy y cmty leader my cmty ship & policy issues support body change educate change them Pre Average Score 1.09 0.70 0.57 1.30 0.65 0.57 1.09 0.22 0.91 1.30 Post Average Score 2.04 1.78 1.43 2.39 1.74 1.48 1.57 0.78 2.13 1.57

Social Network Analysis (SNA) Fellows developed, expanded and strengthened their tobacco control networks:  Within their own priority population  Across other priority populations  In the broader tobacco control movement

SNA Methodology  Pre/post interview with each Fellow to collect data to analyze each Fellows’ personal networks in tobacco control  Fellows individual network data aggregated for full LAMPP III Institute  Use EgoNet Software

Highlights of SNA Findings  Alter Average Degree Increased (ADI) was lower than Average Size Increase (ASI)  Average Density decreased  Average Closeness decreased  Average Betweenness increased  Average number of cliques increased  Average Diversity of sectors increased  Average composition of influential tobacco control contacts in networks increased

What these measures tell us about Fellows’ Tobacco Control Networks:  Larger (more tobacco control people in them)  More dispersed (not all know each other)  More extensive (people outside their circle)  Include more ‘influentials’/ brokers  Less concentrated in fewer professional circles/ more diversity of sectors  Include more individuals perceived to be influential in tobacco control

Fellows’ tobacco control networks are more diverse & less concentrated in few professional circles (example #1) Follow-up (Fellow #118) Baseline (Fellow #118) Baseline (Fellow #118) Follow-Up (Fellow #118)

Fellows’ tobacco control networks are more diverse & less concentrated in few professional circles (example #2) Baseline (Fellow #107) Follow-up (Fellow #107) Baseline (Fellow #107 Follow-Up (Fellow #107)

Fellows’ networks contain more individuals perceived to be influential in tobacco control Baseline (Fellow #108) Follow-up (Fellow #108) Baseline (Fellow #108 Follow-Up (Fellow #108)