improving health and reducing tobacco use of lgbt missourians
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Improving Health and Reducing Tobacco Use of LGBT Missourians Kevin D. Everett, PhD & Jane A. McElroy, PhD Family & Community Medicine University of Missouri August 16, 2012 NCTOH Kansas City, Missouri. Tobacco and Health Disparities. Tobacco is a powerful and pervasive cause - PowerPoint PPT PresentationTRANSCRIPT
Improving Health and Reducing Tobacco Use of LGBT Missourians
Kevin D. Everett, PhD & Jane A. McElroy, PhDKevin D. Everett, PhD & Jane A. McElroy, PhDFamily & Community MedicineFamily & Community Medicine
University of Missouri University of Missouri
August 16, 2012August 16, 2012NCTOHNCTOH
Kansas City, MissouriKansas City, Missouri
Tobacco is a powerful and pervasive causeof health disparities.
Some groups appear more vulnerable to the harm caused by tobacco use and exposure than others.
Tobacco and Health Disparities
LGBT Missourians and Tobacco Use
Funding announcement:
Address tobacco caused health disparities in Missouri.
Funding in three phases: Assessment, Planning, & Implementation
Phase I: Assessment (2008-2009)
Phase II: Planning (2010-2011)
Phase III: Implementation (2011-2013)
No statewide Missouri data on LGBT tobacco use THE PULSE (2003;2006) - a health assessment
of SGM in the Kansas City area. Both years of assessment found higher rates of smoking than general population (state and national).
LGBT Missourians and Tobacco Use
(Prior to 2008)
Reviewed published literature on LGBT tobacco issues
Project to be guided by community-based participatory research (CBPR) principles.
Selected a project advisory board Leaders in LGBT community, not necessarily tobacco
control experts . Initial task for advisory board and research team:
Discuss strategies for gathering data from this ‘hard to reach population.’
Phase1: Assessment Project
The Check-Out Project
Develop survey instrument for Pride Festivals and interview guides for focus groups
Data collection plan for Pride Festivals
Recruitment plan for focus groups
http://www.mffh.net/mm/files/LGBT2009.pdf
SGMCurrent Smoker
Former Smoker
Never Smoker
Lesbian (n=949) 38% 20% 43%
Gay (n=891) 34% 17% 49%
Bisexual (n=367) 36% 13% 52%
Transgender (n=29) 38% 14% 48%
Transsexual (n=14) 43% 21% 36%
Queer (n=70) 41% 19% 40%
SGM Total (n=2320) 36% 18% 46%
Smoking Status by Sexual and Gender Minority
(SGM)
Check Out Project 2008
Smoking Status by Sexual and Gender Minority
(SGM)SGM Groups
(2008, 2010, 2011 unique participants)
Current Smoker
Former Smoker
Never Smoker
Lesbian (n=1,713) 38% 14% 48%
Gay (n=1,890) 36% 15% 49%
Bisexual Male (n=240) 39% 10% 51%
Bisexual Female (n=608) 42% 12% 46%
Transgender/transsexual (n=284) 41% 11% 48%
Other (n=397) 35% 14% 51%
SGM Male Total (n=2165) 36% 14% 49%
SGM Female (2874) 39% 13% 48%
“There is a certain dependency that I have upon cigarettes --- to go to if something’s wrong.”
“Judgment by ex-smokers is more negative because they seem to be so grossed out now by smoking that they are more judgmental than nonsmokers.”
“If I were a nonsmoker just magically, that would be wonderful…”
Focus Group: Current LGBT Smokers
“Quitting smoking doesn’t change social life as much as one fears it will.”
“…now I don’t eat candy or drink soda. Eat lots of vegetables. Not sure if it is a result of quitting, but feel it is only possible because I quit.”
Focus Group: Former Smokers
Check Out Project 2008
High rates of smoking within the LGBT community
Lower rates of quitting smoking Lack of awareness of evidence-based
cessation methods Lower support for tobacco control best
practices Excellent project performance --- exceeded
expectation regarding survey collection
Phase I: Conclusions
Develop a plan for interventions to reduce exposure to tobacco use and increase cessation attempts of current smokers.
Approach: Advisory Board meetings Utilized facilitators to enhance Advisory Board’s
appreciation for tobacco control best practices Interviewed leaders across the country who had success
with LGBT community addressing tobacco issues Continued collecting data at Pride Festivals
Phase II: Planning Phase
2008 (n=3,138) Initial survey tobacco use and opinions about tobacco control
2009 (n= 600) – addressed preferred cessation locations
2010 (n = 3,199)– assessed preferred health information sources, use of new media, and current smokers rated strategies for quitting
2011 (n= 4038) – broader assessment of health issues
2012 (n = 5,000+)– ratings of stress and resilience
Pride Festival Surveys
Pride Festivals survey, all years
N= 956N=3,237
N=727
N=5919
Total=11,392
2008-2011 Pride Festivals Adult Participants
MISSOURI
Online=553
Launch a SGM-tailored, Missouri-grounded website that promotes a healthy and smoke-free lifestyle.
Create and disseminate effective tobacco control messaging throughout the project period.
Promote evidence-based smoking cessation treatment for the SGM community beginning January 2012.
Support leadership development of SGM young adults.
Phase III: Intervention
Three partner organizations offering evidence-based treatment cessation treatment (trained coaches, free NRT, and culturally adapted self-help materials): LGBT Center of St Louis SAGE of Metro St Louis The Spot
Missouri Tobacco Quitline – now asks sexual orientation questions (as of April 2012) at intake and promotes the three organizations if calls come from LGBT individual.
Cessation Initiative
Coming Soon:www.outproudandhealthy.or
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Funders: Missouri Foundation for Health; St Louis County Health Department ARRA funds
Staff: Dean Andersen, MEd; Kimmie Nolte; Sue
McDaniel, PhD; Jenna Jordan, MS; Angie Bunge Our National Consultants Kitty Jerome, MEd – The Robert Wood Johnson
Foundation Dr. Scout -The Network for Health Equity,
Fenway Institute
Aknowledgments: