Application of a CBPR Framework to Inform a Multi-level Tobacco Cessation Intervention in Public Housing Neighborhoods
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African American women in urban, high poverty neighborhoods have high rates of smoking, difficulties with quitting, and disproportionate tobacco-related health disparities. Prior research utilizing conventional “outsider driven” interventions targeted to individuals has failed to show effective cessation outcomes. This paper describes the application of a community-based participatory research (CBPR) framework to inform a culturally situated, ecological based, multi-level tobacco cessation intervention in public housing neighborhoods. The CBPR framework encompasses problem identification, planning and feasibility/pilot testing, implementation, evaluation, and dissemination. There have been multiple partners in this process including public housing residents, housing authority administrators, community health workers, tenant associations, and academic investigators. The advisory process has evolved from an initial small steering group to our current institutional community advisory boards. Our decade-long CBPR journey produced design innovations, promising preliminary outcomes, and a full-scaled implementation study in two states. Challenges include sustaining engagement with evolving study partners, maintaining equity and power in the partnerships, and long-term sustainability of the intervention. Implications include applicability of the framework with other CBPR partnerships, especially scaling up evolutionary grassroots involvement to multi-regional partnerships.
KeywordsCommunity-based participatory research Partnerships Smoking cessation Multi-level interventions RCT
This study received funding/support from: National Institutes of Health/National Heart Lung & Blood Institute, 5R01HL090951-03. South Carolina Clinical & Translational Research Institute, Medical University of South Carolina’s CTSA, NIH/NCRR Grant Number UL1RR029882. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH or NCRR.” The authors wish to thank Dr. Mary Ellen Wewers, Ashley Stevenson, Kendra Piper, Kelora Myles, Tammy McCottry Brown, Sheree Cartee, Matthew Humpries, Toni Ravenell, Erin Crawford, Augusta Housing Authority, Aiken Housing Authority, Charleston County Housing Authority, Housing Authority for the City of Charleston, and North Charleston Housing Authority for their contributions to this project.
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