Elba C. Díaz-Toro, DMD, MSD, MPH1, Maria E. Fernández, PhD2, Virmarie Correa- Fernández, PhD3, William A. Calo, JD, MPH4, Ana Patricia Ortiz, MPH, PhD5, Luz M. Mejía, MA3, Carlos A. Mazas, PhD3, María del Carmen Santos-Ortiz, MA, MPHE, CHES, PhD5, David W. Wetter, PhD3
1 School of Dental Medicine and Puerto Rico Comprehensive Cancer Center, University of Puerto Rico, Medical Sciences Campus; 2 Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health;3Department of Health Disparities Research, University of Texas MD Anderson Cancer Center;4 Institute for Health Policy, University of Texas Health Science Center at Houston, School of Public Health;5 Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus
WHAT IS THE PURPOSE OF THE STUDY?
To create a sustainable, community-based partnership (the Outreach Pilot Program; OPP) to promote tobacco control and decrease tobacco use in Puerto Rico through community-based participatory research.
WHAT IS THE PROBLEM?
The public health burden of smoking in Puerto Rico is substantial as the five leading causes of death in Puerto Rico are associated with smoking (heart disease, malignant neoplasm, stroke, hypertension, and chronic pulmonary disease).
Despite the clear need for tobacco control interventions, the availability of treatment in Puerto Rico is low.
WHAT ARE THE FINDINGS?
The OPP carried out activities which fell under the following broad categories: 1) network development, 2) research activities, 3) training and education, and 4) community awareness. Eighty (80) organizations participated in the OPP.
OPP activities increased the number of callers to the Puerto Rico Quitline and created a shift in the source of callers away from costly mass media promotion towards a higher proportion of callers referred through health care providers and via low cost print materials promoted by the network outreach activities. Physicians’ referrals to the PRQ increased from 2.6% to 7.2% and brochure referrals from 1.4% to 4.6%. The number of annual smokers receiving cessation services increased from 703 in 2005 to 1,086 in 2008.
Utilizing a community-based participatory approach, outreach programs can empower community organizations to take action via networking, education, research, and the provision of tangible solutions for service provision. These efforts can bring organizations together under a common goal, influence public policy, provide critical training in tobacco control, and increase the utilization of treatment programs in a manner that is culturally sensitive and relevant for the local community.
WHO SHOULD CARE MOST?
Community-based organizations and community health centers.
Educators responsible for training health professionals.
RECOMMENDATION FOR ACTION
The description of the development and implementation of the OPP provides an example of how community networking is feasible, sustainable, and can contribute to tobacco control.
Challenges will occur; thus, should be expected and addressed. Challenges identified by OPP network members: tobacco control was not always perceived as a priority by their managers, time constraints and limited funding to implement outreach activities, and perceived lack of professional competence in tobacco-related topics.
Network participants suggested the following: continue providing information regarding tobacco-related research and other accomplishments by collaborators, integrate tobacco awareness within other chronic diseases campaigns throughout the year, and continue trainings on evidence-based practices for tobacco control.
Network members noted that an outreach program's sustainability relies on building of capacity of its members, and this should be a key component of network activities.
Community networks such as the OPP should continue to be analyzed in terms of their governance, accountability, operations, risks and benefits.