SmokeBusters

Group 17

PBHL 550

Final Grant Proposal

Asha Dorsey Oluwatoyin Fadeyibi

Phillip Hall Yves Helou

Bhavika Patel

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Table of Contents

Program Abstract.............................................................................................................................2

Program Narrative

Needs Statement..............................................................................................................................3

Introduction..........................................................................................................................3

Service Area.........................................................................................................................3

Priority Population...............................................................................................................4

Causal and Contributing Factors..........................................................................................5

Consequences of the Problem..............................................................................................7

Existing Resources and Assets.............................................................................................8

Barriers to Services............................................................................................................10

Community Engagement...................................................................................................11

Linking Needs to Proposed Program.................................................................................12

Goals and Objectives.....................................................................................................................14

Program Plan

Program Description..........................................................................................................16

Overall Strategy.................................................................................................................16

Recruitment........................................................................................................................18

Promotion...........................................................................................................................20

Program Availability and Accessibility.............................................................................20

Community Engagement...................................................................................................21

Partnerships and Collaboration..........................................................................................21

Cultural Competence.........................................................................................................22

Management and Staffing Plan

Key Personnel and Staffing Plan.......................................................................................24

Management Plan...............................................................................................................26

Quality Assurance Protocols..............................................................................................27

Logic Model...................................................................................................................................28

References......................................................................................................................................29

Budget

Line-Item............................................................................................................................33

Budget Justification...........................................................................................................32

Attachments

Attachment 1: Detailed Year 1 Work Plan........................................................................36

Attachment 2: Organizational Chart..................................................................................39

Attachment 3: Planning Team Bios...................................................................................40

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ABSTRACT

Philadelphia, Pennsylvania ranks the second highest in terms of mortality rates due to

CVD. Furthermore, the risk of CVD is doubled for those who have a history of smoking.

Philadelphia is afflicted with a 25% adult smoking prevalence rate, which is higher than the

national average of 17.3%. The 19121 area of Lower North Philadelphia has one of the highest

rates of smoking related deaths associated with heart disease. Although sales to youth have

decreased to 7.1%, the rate of smoking amongst adults continues to escalate.

SmokeBusters is a multi-strategic public health program focused on the secondary

prevention of CVD, which targets smoking as a risk factor amongst 25-44 year old low-and

middle-income African-American residents in the 19121 zip code. SmokeBusters targets this

particular underserved population because of the lack of access to quality smoking cessation

services. This program is designed to recruit and retain 45 individuals at a time by engaging

them in a series of 12-week educational sessions to strengthen behaviors associated with

smoking cessation. Through a partnership with SmokeFree Philly and an affiliation with corner

stores in the zip code, SmokeBusters will also provide smoking cessation aids such as nicotine

patches and nicotine gum, access to free support, and a 24-hour hotline. By the end of year one

SmokeBusters intends to decrease the risk for CVD for its participants by 50% through smoking

cessation.

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PROGRAM NARRATIVE

NEEDS STATEMENT

Introduction

Cardiovascular disease (CVD) has been the leading cause of death in the United States

since 1921. One of the greatest achievements in public health has been the decline of CVD by

60% since the 1950s, and yet one in three Americans still live with CVD (1). Among all of

Pennsylvania’s counties, Philadelphia ranks the second highest in terms of mortality rates due to

CVD (2).

Service Area

Philadelphia county alone accounts for 27% of all CVD related deaths in the state. With

Philadelphia having a premature CVD related death rate of 58.5 per 100,000, the burden is

particularly evident in people below the age of 65. When further broken down into districts

within the county, 3 out of the 18 planning districts bear most of the CVD death burden- West

Park, Lower North, and River Wards (3). The zip codes that are included are: 19151, 19131,

19121, 19122, 19125, 19134, and 19137.

Several risk factors predispose an individual to CVD. The modifiable factors are

hypertension, smoking, poor diet, and physical inactivity (World Health Foundation (WHF),

2015). Amongst those risk factors, smoking is Philadelphia’s greatest contributor of CVD risk.

Smoking has been shown to double the risk of CVD; this is more than the effect of alcohol, and

only second to diabetes (1). The prevalence rate of adult smoking in Philadelphia is 25%, which

is higher than the 17.3% national average. Also, the city ranks number one in smoking in large

cities in the US; these facts portray a need to focus on modifying this risk factor in the city (3).

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In an attempt to further narrow down which parts of the city are affected the most by

smoking related deaths, which include heart disease, a survey was conducted by the Philadelphia

Department of Public Health for their Community Health Assessment Report in May 2014. The

survey confirmed these 3 planning districts as being the most burdened- West, Lower North, and

River Wards (3). Of these 3 districts, Lower North and River Wards were also identified to have

the worst rates of CVD deaths in the city: 120.2 and 91.3 per 100,000, respectively. The zip

codes represented in these 2 regions are 19121, 19134, and 19137.

Priority Population: Low and Middle Income African-Americans

Income and educational level has a large impact on the rates of cardiovascular diseases.

Income below $15,000 a year increased the risk of CVD to 24% while income between $15,000

and $24,999 has a risk of 21%, versus the general rate of CVD regardless of income is only 12%

(1). To further compare, low-income adults in Pennsylvania are up to four times as likely as high

income adults to develop CVD, while the middle-income adults are almost twice as likely (1).

Education also has an important impact on CVD rates, with rates three times higher for people

with less than a high school degree than those with a college degree. However, it is important to

note that education level is directly correlated with income levels, and can be considered a

confounding factor in this case (1).

Another factor that is important to consider is the correlation between CVD and race.

CVD have been shown to disproportionately affect non-Hispanic Blacks; the premature CVD

mortality rate for Black non-Hispanics in 2012 was 88.5 per 100,000 which is much higher than

58.5 in the general population. In other words, Blacks have consistently higher rates of CVD

incidence and mortality than all other races (3). The same pattern is seen between smoking and

income level in Pennsylvania. Despite the tobacco tax, income levels are inversely proportional

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to smoking rates- both lower income and middle income have significantly higher rates of

smoking than higher income (14.9%) (1). When compared to other races, African-Americans

exhibit poor health outcomes when it comes to smoking and smoking deaths, where up to 26.7%

of African-American adults smoke and with the largest rate of smoking related deaths (322.2 per

100,00; Whites 245.1 per 100,000; Hispanics 115.5 per 100,000) (1). To further narrow down the

age group that is most burdened by cardiovascular deaths related to smoking in the US, trends

showed that the age group 25-44 ranked highest at 27.5% (4). However, in Pennsylvania, the rate

is highest in age group 18-24, 27.4% but the difference is by 0.1% and thus negligible (1).

Having carefully considered all the available data, it is clear that low to middle income

African-Americans particularly at age group 25-44 have the greatest burden for cardiovascular

deaths related to smoking when compared to other counterparts in the race and income categories

in Philadelphia. There is little effect of gender differences in CVD prevalence. This very narrow

target population is most condensed in the lower North District of Philadelphia, zip code 19121;

where 66% of the residents are African-American (3) and where poverty is listed as their worst

health indicator (Community Health Assessment, 2014). According to 2013 census data, 71%

make less than $30,000 a year, while the median income for Philadelphia County is $37,192.

Therefore, zip code 19121 in the Lower North district will be the target area.

Causal and Contributing Factors

The presence of smoking amongst individuals of low socioeconomic status (SES) results

in harmful health behaviors (5). The SES gradient in smoking – that is, the exponential growth of

cigarette smoking with people in low SES communities – has only continued regardless of a

decline in smoking prevalence in the general population (6). Furthermore, the impact of SES as a

casual and contributing factor on smoking is not limited to a single indicator; rather, multiple risk

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factors contribute to poor health outcomes over an individual’s life course. Such indicators

include the existence of social, behavioral, and environmental risk factors. The growing burden

of smoking-related diseases among racial/ethnic minority populations of low SES is of even

greater concern. Such disparities have been attributed to high smoking rates, low cessation rates,

and limited access to smoking cessation related programs in African-American (7). Data from

the CDC (8) reported a growing gap in smoking between college-educated adults and those

without a college education. This data is of critical relevance to the target population, because of

the overrepresentation of African-Americans of low SES and because of limited education, since

smoking results in unfavorable health outcomes (9).

It is evident that being of a lower SES results in an increased likelihood to engage in

smoking through complex pathways relating to social, behavioral, and environmental risk

factors. Furthermore, the presence of such risk factors among lower SES populations may be

increasing, and indicative of a lifelong impact of social and environmental stressors. Lifelong

stressors, such as financial insecurity and unemployment, are more common among those of

lower SES (5). Additionally, there is a strong association between smoking and poverty, as

roughly 29.2% of U.S. adults who are living in poverty smoke (10). Financial insecurity is

correlated with greater difficulty in smoking cessation and smoking relapse in the overall

population (11). Authors of a study on reducing social disparities in tobacco use suggest that

increased financial stress impacts how an individual chooses to cope with stress, which functions

as a causal and contributing behavioral factor (12). Thus, those of lower SES are more likely to

participate in cigarette smoking as a coping mechanism (12).

Being of low SES is only a contributing measure in relation to the aggregative effects of

behavioral factors and stressful environments that are the true predictors of smoking, which then

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increases the risk of CVD (9). In summary then, engaging in poor health behaviors has been

determined as being interrelated to being uneducated, of low SES, and being African-

American.

Also of note, Turner-Musa and Wilson (13) identified that among African-Americans,

recurrent stressful triggers, including educational and employment disparities, resulted in

increased likelihood of behavioral risks such as smoking. As specified by the United States

Surgeon General, African-Americans face challenges including access and availability of

smoking cessation programs and resources (14). These challenges are partly due to

environmental influences as opposed to simply being a result of individual “choice.” African-

Americans living in poor socioeconomic conditions have limited access to resources promoting

positive health behaviors.

Consequences of the Problem

According to the American Heart Association (15), smoking is not only linked to lung

cancer, but also smoking has been identified as a risk factor for heart disease (15). This risk

comes primarily from the inhalation of carbon monoxide and nicotine (15). The carbon

monoxide reduces the oxygen levels in red blood cells and increases the amount of cholesterol

that lines arteries, both of which lead to heart disease (15). Nicotine, the addictive chemical

found in cigarettes causes an increase in blood pressure and heart rate (15). In addition, the

nicotine constricts the arteries by narrowing them all while increasing the blood flow to the heart

(15). The combination of the narrowing and hardening of arteries, can lead to a heart attack (15).

These effects are not only found in smokers; those subjected to secondhand smoke are

also susceptible to the same risks (15). Studies have shown that the risk of developing heart

disease is 25-30% higher among people exposed to tobacco smoke at home or work, compared to

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those who are not exposed to second-hand smoke (15). Exposure to secondhand smoke now

causes more cardiovascular related deaths than lung cancer related deaths (16). A study included

in the Surgeon General’s report on The Health Consequences of Smoking showed that over the

last 50 years, there were 7,787,000 premature cardiovascular and metabolic disease related

deaths caused by smoking and exposure to secondhand smoke. (16). This total accounts for

almost 40% of all premature deaths caused by smoking and exposure to secondhand smoke

between 1965 and 2014 (16).

In addition to the health consequences of smoking, there is also a financial burden on the

country. Illnesses related to smoking cost the United States more than $300 billion a year and

this includes almost $170 million for medical care related costs for adults (17). According to the

American Cancer Society there is a $35 health-related cost to a smoker per pack of cigarettes

consumed (18). Cardiovascular disease costs more than smoking-related health costs.

Cardiovascular disease related costs were estimated to be $444 billion in 2010 (19). Both

cardiovascular disease and smoking-related health care costs are detrimental to the economy of

the United States and is only increasing the already stretched medical expenditure.

Existing Resources and Assets

The Lower North district of Philadelphia, with the zip code 19121, is located along the

Broad Street Line (BSL) of the Southeastern Pennsylvania Transportation Authority (SEPTA) on

one side and the Schuylkill River on the other. The nearest hospital to this area is St. Joseph’s

Hospital on 16th and Girard Avenue. Additionally, there are three health clinics in the vicinity: the

Philadelphia District Health Center #5, Meade Family Health Center and Vaux Family Health

Center.

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The Philadelphia District Health Center is operated by the City of Philadelphia and the

center located in 19121 does not offer any services related to tobacco education nor smoking

cessation (20). Meade and Vaux Family Health Centers are part of Quality Community Health

Care Inc., (QCHC) and provide health education services for students enrolled at Meade and

Vaux Elementary schools, respectively (21). Although families of the children enrolled in the

specific schools cannot access the health education services, they are allowed to access general

health services (21).

Located next to the targeted zip code is the Health Behavior Research Clinic (HBRC).

This clinic offers smoking cessation and relapse prevention services in the Temple University

Area (22). The HBRC offers clinical services that focus on prevention and treatment of

behavioral health problems, such as smoking (22). The HBRC provides services primarily to

underserved populations such as those who are homeless, jobless, or are from a low-income

population (22).

Additionally, there are smoking cessation programs in the Philadelphia area at large.

These programs include the JeffQuit Smoking Cessation Program, and the Smoking Cessation

Program at the Paul F. Jr. Lung Center (28, 29). The most comprehensive and accessible

smoking cessation program in the city is SmokeFree Philly. SmokeFree Philly is part of the Get

Healthy Philly project, which is a component of the Philadelphia Department of Public Health’s

efforts to reduce smoking rates in Philadelphia. SmokeFree Philly offers free resources to aid in

smoking cessation, such as telephone coaching, face to face coaching and support, online, text

messaging, and 12-step coaching resources, nicotine patches, gum and lozenges (23).

Although there are smoking cessation services offered near the 19121 zip code, there are

none located in the immediate area. Residents of the 19121 zip code can access services from

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nearby neighborhoods via the BSL or other routes of public transportation, however this is a

barrier for smoking cessation.

Barriers to Services

SmokeFree Philly was established to provide guidance and resources to help people quit

smoking. One of the main goals of this program is to reduce the risk of cardiovascular disease

and other smoking related illnesses. Since the launch of Get Healthy Philly, there has been a 15%

reduction in smoking rates among adults in Philadelphia (25). SmokeFree Philly provides online

smoking cessation resources, community-based classes in Center City, and a 24/7 hotline that

serves all adults 18 years or older all over Pennsylvania (24). In communities like Lower North

Philadelphia, residents may not have access to the Internet or to the community-based class for

face-to-face support. Therefore, lack of easy access to direct smoking cessation services is a

barrier (26).

SmokeFree Philly does offer avenues to other smoking cessation programs in the city

such as JeffQuit Smoking Cessation Program and several others are located in areas of

Philadelphia. These programs are offered through private agencies that offer tailored drug

therapy plans, medication, and counseling & relapse prevention sessions (27, 28, 29). However

since these are private businesses, the clientele will have to pay for the services. Some health

insurances may cover it or clients would have to pay an out-of-pocket fee. For the majority of the

residents in the 19121 zip code who are of low-income, it is unlikely they would consider

looking to these centers for help due to the fact that they will typically have little left over for

food, education, unexpected financial hardships, and health care (30).

This suggests that expenses are arduous for low-income residents, and thus it would be

difficult to prioritize smoking cessation as something needful to them if they have to pay for it.

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This fact reinforces the need for a program that will provide services at little or no cost to the

inhabitants of the 19121 zip code.

Community Engagement

An important part of planning any research program is community engagement and the

first step in community engagement is to identify key stakeholders. Key stakeholders are parties

that will be affected by the implementation of the project, so it is imperative for them to be used

as a resource during this process. Engaging the stakeholders can enhance the program’s efficacy,

provide various opinions from the community members and partnerships, and be a supporting

factor in the evaluation (31).

In the target population, stakeholders will include health educators, churches, community

centers, residents, and local businesses so there will be a collaborative vision on how the

program can evolve within the 19121 zip code. In order to maximize the success of any

partnership within the community, it will be important to communicate to the stakeholders that

they will be active participants on an on-going basis from the beginning of the project

implementation until the dissemination phase.

Stakeholders are able to act as a liaison between the project managers and various

community members, recommend methodologies, provide detailed information about the target

population, and evaluate the programs to be developed. In order to make sure that the

stakeholders are aware of the planning procedures, town hall meetings should be held regularly

where information about the program is disseminated to the rest of the community.

There are several advantages of having the community engaged in the

program. Community stakeholders can provide a multitude of well-tailored solutions,

opportunities for networking amongst organizations, accessibility to an abundance of resources

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and information, and means of communication with hard-to-reach populations (31). It is

important that the issue the program is addressing be thoroughly discussed before the program is

implemented.

Stakeholders need to know the criteria used to determine the need for the program,

objectives, the prospective methods that will be used, and the sources of the data that will be

collected (31). Once the stakeholders are informed of these components in the town hall

meetings, they will be able to understand the framework and suggest on areas of improvement.

Cultural competency is also necessary in order to effectively engage with various

stakeholders. Program planners need to be aware of the traditions, values and norms in order to

have background knowledge on the framework regarding views on smoking in this

community. The reason why stakeholders are included in the evaluation process is because they

can properly analyze the results of the program from different perspectives and they are able to

assist in tailoring program initiatives specifically to their community (31).

Linking Needs to Proposed Program

In order to properly link the established needs in our target community with a proposed

program, it is important to reiterate the burden of CVD in the US and particularly in our target

population. In the nation at large, one in every 4 deaths is due to CVD (32) and Philadelphia

alone accounts for 27% of all CVD-related deaths in Pennsylvania, which is concentrated largely

in three planning districts. Two of these three districts are also affected with the largest rates of

smoking related deaths in the city (3). Smoking was selected as the risk factor of interest because

of its burden in Philadelphia. Of all the 10 largest cities in the nation Philadelphia ranks as the #1

city with the most adult smokers (3).

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Additionally, the African-American population has been identified as most affected by

smoking and CVD. Compared to Whites and Hispanics, African-Americans have a

disproportionately high rate of smoking related death (1). The need to hone in on addressing this

population cannot be overstated as they are also shown to be from lower SES, and poverty is

linked with smoking (10). Finally, of the two districts highlighted earlier, the 19121 zip code

particularly has 66% of African-Americans in their population, which sets them apart as those in

the most need (3).

It is therefore apparent, that African-Americans living in the 19121 zip code of

Philadelphia have an undeniably higher burden of cardiovascular disease due to smoking. Thus,

to improve the health status of that community, a well-planned and robustly funded health

program must be designed to address this very multi-faceted problem.

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GOALS & OBJECTIVES

Program Goal:

SmokeBusters will improve cardiovascular health by enhancing access to quality smoking

cessation services and conducting peer-led health education sessions.

Process Objective #1

By the three-month mark of our program, the program coordinator will have recruited 12

community members to serve as Peer Educators for the program (33, 34)

Process Objective #2

By the three-month mark of our program, the program coordinator will have used standardized

and pretesting training materials to train 6 community members to be Peer Educators who will

provide smoking cessation education to their fellow community members within the 19121 zip

code area (33, 34)

Process Objective #3

By year one of the program, the program coordinators will have incorporated smoking cessation

tools by providing nicotine patches and nicotine gum to 14 of the 47 corner stores (30%

participation rate) in the 19121 neighborhood (35).

Process Objective #4

By year one of the program, 6 Peer Educators will educate 75% of the 47 corner store owners on

the health benefits of smoking cessation with the use of cessation materials such as nicotine

patches and nicotine gum (36).

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Outcome Objective #1

By year one of the program, the marketing director will have distributed smoking cessation

marketing materials such as pamphlets and posters to 75% of the 47 grocery businesses in the

19121 zip code area.

Outcome Objective #2

By year one of the program, 6 Peer Educators will offer two 12-week long workshop sessions to

90 self-identified smokers in the target population of 25-44 year old low-income African-

Americans in the 19121 zip code who attend weekly night classes that teach participants about

the negative health effects of smoking and smoking cessation tools available to them.

Impact Objective:

As a direct result of program initiatives, SmokeBusters anticipates that 50% of program

participants will have sustained smoking cessation following 3 years of program completion.

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PROGRAM PLAN

Program Description

SmokeBusters is a public health program focused on the secondary prevention of

cardiovascular disease (CVD) by targeting smoking as a risk factor. The program targets

predisposing, enabling, and reinforcing factors via program interventions to improve the

cardiovascular health of adult African-Americans ages 25-44 years in the 19121 area of North

Philadelphia. In order to properly accomplish this goal, SmokeBusters will be aligning with the

results of a comprehensive needs assessment that was conducted; the needs assessment showed

that our target population lacked access to quality smoking cessation services. The program is

therefore designed with a multi-strategic approach to address this problem.

Overall Strategy

SmokeBusters will train 6 Peer Educators to serve as health education ambassadors for

the program (33, 34). The program will hold community capacity building and empowerment

sessions, which will be incorporated into a thorough educational curriculum (33,31). The

curriculum will be extensive in its topic coverage and it will be the responsibility of the Program

Director to develop the training materials for Peer Educators and program participants by the end

of July 2015; Peer Educator training will begin in September 2015. Peer Educators will be

effectively trained in disseminating the curriculum mentioned in Table 1 with the use of visual

aids (pamphlets, informational DVDs, handouts etc.). The visual aids will be obtained from the

American Heart Association and SmokeFree Philly. SmokeFree Philly is a smoking cessation

program of the Philadelphia Department of Public Health that is funded by the Center for

Disease Control and Prevention (24).

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Table 1 provides a simple outline of the 12-week educational sessions that will be hosted

by the SmokeBusters program. The opening sessions will provide background information on

CVD and its risk factors. Subsequently, sessions will be targeted to dispel commonly held myths

and address the contributing factors to smoking (33). Once both topics are introduced and a

clear link has been established between them, a discussion on the burden of smoking will follow.

These workshops will address behavior modification and intends on being supportive of the

participant’s pace of attaining smoking cessation. Additionally, in an attempt to address some of

the contributing factors to smoking, Peer Educators will also conduct demonstrations on stress

management to deter participants from smoking as a stress reliever (38). These participatory and

informational educational sessions will be held for the program participants: self-identified

smokers. These 12-week sessions will begin January 2016. In addition, optional ECGs will be

conducted as a visual tool for the program participant to assess CVD status and risk (38). The

overall curriculum for health education will cover the following topics (Table 1) in weekly

sessions for program participants and will be developed by the end of September 2015. The

curriculum has been adapted from the PRAISEDD study to be more specifically applicable to

our program and program participants (33).

SmokeBusters will also provide smoking cessation aids and emotional support through a

strategic partnership with SmokeFree Philly to obtain free smoking cessation aids and access to

free coaching and support and a 24-hour hotline (24). In addition, the program will form a

partnership with grocery and corner stores in the target area (40). Corner storeowners will be

engaged with program details and will also be encouraged to have smoking cessation materials

and aids available to consumers. SmokeBusters will obtain the materials from SmokeFree Philly

and distribute them to storeowners. SmokeFree Philly volunteers will be utilized to keep local

18

businesses stocked with flyers and supplies. These strategies will address the enabling factor for

smoking of limited access to smoking cessation programs. The smoking cessation aids, such as

nicotine patches and nicotine gum will be available to community members in an effort to

alleviate the reinforcing factor, which is the addictive nature of nicotine.

Table 1: SmokeBusters Program Curriculum Breakdown

Weeks 1 & 2 Detailed Overview on CVD

Weeks 3 & 4 Busting the Myths of Smoking + General Overview on Ill-Effects of Smoking

Weeks 5 & 6 Link between Smoking and Risk of CVD

Weeks 7 & 8 Financial Implications of Smoking

Weeks 8 & 9 Stress as a Reinforcing Factor for Smoking Behavior with Physical Activity Demonstrations for

Stress Relief

Week 10 ECG Pictograms

Weeks 11 &

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Smoking Cessation Tools – Availability in Community and Proper Use

Recruitment

The initial recruitment goal of SmokeBusters is to recruit community members who will

be trained as Peer Educators. The use of fellow community members as Peer Educators is to

enhance the uptake of the program by participants in the 19121 zip code. The Program Manager

is responsible for the recruitment of 6 Peer Educators by email announcements (Phila.gov

Department of Human Services, Indeed.com) as well as by flyers mailed by the United States

Postal Service. The program anticipates that increased community involvement will be

instrumental in capacity building and community empowerment to attain desired goals and

objectives. The Peer Educators must live in the same zip code, be non-smokers or previous

smokers who have quit for at least a year. Applicants will be strongly encouraged to contact the

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Program Manager with their application materials and the selected Peer Educators will be

contacted promptly via telephone and/or email.

Upon the conclusion of a comprehensive 3-month training of the Peer Educators, they

will be tasked with the responsibility to recruit program participants. The SmokeBusters program

is designed to recruit and retain 45 African-American individuals from the 19121 zip code in a

behavioral program designed to provide several strategies to strengthen participant behaviors

associated with smoking cessation. Recruitment criteria are as follows:

1) African-American Adults

2) Age range of 25 – 44years old

3) Current smokers- with history of any length of time

4) Individual currently resides in the 19121 zip code

Additionally, the program intends to target self-identified African-American smokers

with diverse experiences, attitudes, and knowledge concerning smoking. Flyers, posters,

pamphlets, and newsletters that are distributed by the Peer Educators and SmokeFree Philly

volunteers will include information that provides program description and contact information

for potential participants. After each selection process is complete per cohort, a group session

will be held 2 weeks prior to the start of sessions for participants to meet each other in a more

social setting.

On the week of the initiation of the first cohort, reminder phone calls will be made the

Tuesday before each weekly session and reminder phone calls will be made the morning of each

session to confirm program participation. If a participant is unavailable during weekly session,

SmokeBusters will attempt to reschedule the session through a phone recording or email

summary. In order to incentivize participants to successfully complete the program, at the

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beginning of each cohort, they will be entered into a raffle that will reward 2 lucky participants

with $200 and $100 supermarket gift card respectively for 100% attendance and for having met

all the requirements for successful completion of the program.

Promotion

Marketing materials in the form of flyers, posters, pamphlets and radio ads will be

developed by the Marketing Coordinator. These materials will be created by the end of August

2015 and distribution will occur twice a month, to ensure that corner and local community

locations such as churches and schools are stocked with information regarding the program and

available smoking cessation resources. In addition, at local community events, volunteers will set

up tables and engage the community by giving verbal presentations and handing out pamphlets

and flyers to promote program and smoking cessation tools.

Program Availability & Accessibility

The program will operate out of a centralized location the Columbia North YMCA,

located near major SEPTA routes (40). This will ensure the program is physically accessible to

program participants. The Columbia North YMCA is also wheelchair accessible. In addition, the

program office will be open three days a week from 2pm-8pm, and weekly classes will be held

on Tuesdays from 6pm-7pm. The scheduling caters to the target population who are most likely

to be working adults.

As a result of this partnership with YMCA, the SmokeBusters Program will also have

access to child care services that come with the facility (42). The program is aware that the target

population in the community is of child rearing age.

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Community Engagement

For our program, we will partner with Columbia North YMCA (42). This partner will

serve as our liaison to the community members. Both the YMCA and the Life Center serve a

large portion of our target population and thus we anticipate that the program will easily gain the

trust of the community members.

The Peer Educators will host informal visits at local gathering spots such as grocery

stores and popular corner stores to inform them of the program details. SmokeBusters will also

engage the community by hosting health fairs at community centers and churches in order to

provide information about the program. During these events, Peer Educators will hand out flyers

and newsletters to potential program participants and talk to community members about the

program development and how this change in their community will be beneficial to their lives.

Peer Educators will also post the flyers and newsletters on church and community center bulletin

boards throughout the 19121 zip code.

Before the program is initialized, the Program Manager will facilitate town hall meetings

to engage community stakeholders in the program development. During these meetings, the

community and program planners will discuss the needs of the target population, strategies on

engaging that population, the monitoring of behavior change, and the sustainability of

implemented changes in the community.

Partnerships and Collaboration

Once the stakeholders are engaged in the process, the Project Manager and Peer

Educators will be cultured in the 19121 zip code’s socioeconomic status, political makeup,

cultural values and norms, and demographic trends (31).

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SmokeBusters intends on forming meaningful partnerships with local organizations and

stakeholders to enhance the program and its services. SmokeBusters will partner with

SmokeFree Philly to provide volunteers for the lifespan of the program to assist with the

distribution of marketing materials to community members and local businesses. Additionally,

SmokeFree Philly will provide the program with smoking cessation marketing materials and

quitting aids like nicotine patches and nicotine gum to ensure that all the corner stores have

supplies at all times for community members to easily access. SmokeBusters will also partner

with the American Heart Association Philadelphia office to obtain educational materials related

to smoking and cardiovascular health. These materials will be made available during the sessions

and afterwards at the corner stores.

Finally, SmokeBusters will partner with Donnelly Distribution. This is a business that

operates within Philadelphia at large. The company states that they can accomplish total

distribution of marketing materials in any designated area (37). To this end, we have access to a

well-established resource within Philadelphia that will enable us to attain a thorough coverage of

businesses within the 19121 zip code.

Cultural Competence

The implementation of a successful smoking cessation program requires SmokeBusters to

understand and respect the culture of its target population: the African-Americans living within

the 19121 zip code. In order to provide optimal program services, SmokeBusters must

understand the target population’s culture and community norms to know how individuals will

respond to certain program demands. Cultural competency is an essential characteristic for any

Peer Educator or volunteer engaging with a cultural or community group of which they have

23

limited experience working with. In a 2006 study by Frank Tesoriero, he asserts that cultural

differences attributed to contrasting worldviews can differ in meaning and as a result lead to

unique individual life experiences (33). It is imperative for SmokeBusters staff members and

volunteers to acknowledge and respect these differences and to integrate them into practice (33).

The program is incorporating this idea by ensuring that all the hired Peer Educators are

African-American community members that have a lived experience that is similar to the

program participants (33). During the course of the Peer Educator training, we will ask them to

educate the program participants on the social determinants of smoking related attitudes, norms,

and beliefs held by their fellow community members. Their input will then be incorporated into

the curriculum to ensure program efficacy and to achieve the program’s desired health outcome

in its target population.

Although the target population is solely African-American, it is essential for

SmokeBusters personnel to be cognizant of the astute variations within the target population

community in order to completely understand and respect the attitudes, values, and behaviors of

program participants. As discussed by Stanhope, Solomon, Pernell-Arnold, Sands, and Bourjolly

(2005), program contributors should expect that their ability to enact behavioral change is

dependent on their attainment of cultural competence (34).

In addition, it is critical to address the health literacy of program participants to ensure

that the development and delivery of SmokeBusters’ services are effective. In the research from

Berkman, Sheridan, Donahue, Halpern, and Crotty (2011), the authors explain how a deficiency

in health literacy has been linked to reduced use of preventive programs, specifically programs

designed at smoking cessation (24). To overcome potential deficits in communication,

SmokeBusters will incorporate a health literacy workshop into the Peer Educator training. This

24

will ensure that in all communication with their fellow community members, they are not only

sensitive to the varying literacy levels but are also trained to effectively communicate with all

program participants, regardless of literacy level.

MANAGEMENT & STAFFING PLAN

Key Personnel & Staffing Plan

1) Program Manager: One program manager at 0.5FTE*

Qualifications: MPH degree and Certified Health Education Specialist.

Responsibilities:

a) Oversee the entire grant and serve as the liaison to the funding agency.

b) Hire all staff members and ensure that all hired staff members are fulfilling the

requirements of their roles.

c) Develop the curriculum materials during the first 3 months, pre-implementation.

d) Conduct training for the Peer Educators.

e) Ensure that the necessary progress reports are completed at the defined timelines.

* The Program Manager works 20 hours a week. We believe that the supporting staff, coupled

with the fact that the SmokeBusters program is one hour a week, makes the responsibilities

manageable at 20 hours.

2) Peer Educator: Six Peer Educators will be hired.

Qualifications:

a) Must have a bachelor’s degree in public health, social work or health education.

b) Must live in the 19121 zip code.

c) Must either be non-smokers or previous smokers who have quit over a year ago.

25

Responsibilities:

a) Responsible for recruiting the program participants from the 19121 zip code.

b) Responsible for teaching the curriculum (after undergoing intensive training) by

conducting a once a week workshop in the local community center.

c) Responsible for administration of pre and post workshop surveys

d) Responsible for drafting the necessary summary reports per cohort.

Schedule & FTE: Each Peer Educator will be required to work 5 hours a week = 0.125FTE.

3) Marketing Coordinator: There will be 1 hired.

Qualifications:

a) Must live in the immediate community

b) Required to have at least a bachelor’s degree in marketing or a related field.

c) Possess strong communication skills as this position involves interfacing with people

at all times.

Responsibilities:

Responsible for handling all details of the partnerships with SmokeFree Philly as it relates to the

volunteers that will be given for the use of marketing the program.

a) Responsible for creating and managing the volunteer schedule and ensure they are

properly aligned with program goals.

b) Responsible for engaging the owners of the corner stores in the 19121 zip code to

convince them to keep stock of quitting aids.

c) Responsible for engaging Donnelly distribution - a sub-contracting company that will

be used for coverage of the community with marketing materials.

26

d) Responsible for collating all reports relating to the amount of marketing materials and

quitting aids that are being distributed over the course of the grant.

Schedule & FTE: 10 hours a week = 0.25FTE

4) Quality Improvement Specialist: There will be 1 hired.

Qualifications: MPH degree with at least two years experience in a similar position

Responsibilities:

a) Responsible for developing all the pre-post tests for Peer Educators and participants.

b) Responsible for training the Peer Educators and marketing coordinator to accurately

do the data collection and entry.

c) Responsible for all data analysis.

d) Responsible for defining and reporting data summaries of all set benchmarks for

each program cohort.

e) As a result of ongoing data surveillance, bi-annual recommendations will be

expected of the Quality Improvement specialist that will ensure that program is

running according to initial goals and objectives.

Schedule & FTE: 5-hour workweek; which is equivalent to 0.125FTE.

Management Plan

The overall leader of the SmokeBusters Program is the Project Manager. All other key

personnel, the Quality Improvement Specialist, the Marketing Director and the Peer Educators

will be reporting directly to the Project Manager.

The Marketing Director will be overseeing all of the program’s marketing efforts, which

include the program and smoking cessation awareness marketing. SmokeFree Philly volunteers

will be reporting directly to the Marketing Director; one of the volunteers will be designated as a

27

field coordinator during operations and coordinate with the Marketing Director. Additionally, all

correspondence with the program’s partner marketing firm -Donnelly Distribution will be led by

the Marketing Director.

Quality Assurance Protocols

In order to ensure proper Quality Assurance Protocols, it is the Program Manager’s

responsibility to ensure that the program’s goals and objectives are met. The Project Manager

will conduct monthly staff meetings with all key personnel to ensure continued alignment to the

program’s mission, goals and objectives.

Additionally, the Program Manager will work closely with the Quality Improvement

Specialist to develop evaluation guidelines and tools, to ensure the proper quality assurance

protocols are gathered and followed during the life course of the program. All key personnel will

be expected to submit quarterly progress reports detailing objective targets met, complications,

and future targets to the Quality Improvement Specialist.

The Program Manager will also work closely with SmokeFree Philly and Donnelly

Distribution to receive quarterly reports stating how many volunteers were assisting, and how

much marketing materials were donated and utilized, respectively, within the same quarterly

time frame. The Program Manager will compile these reports.

Finally, the Quality Improvement Specialist will analyze all quarterly data reports and

report trends and summaries to the Program Manager. At the conclusion of the quarterly

evaluations and results, a meeting will be scheduled by the Program Director and will require the

attendance of all Key Personnel and representatives from the Partner Organizations. The goal of

the quarterly gathering will be to keep all program parts aligned to the common goal of

promoting smoking cessation to reduce the CVD rates in the 19121 zip code.

28

LOGIC MODEL for SmokeBusters Program

Program Goal: To reduce cardiovascular disease as a result of smoking in adult African-Americans ages 25-44 years in the 19121 zip

code.

Long-term Outcome/Impact: To reduce the incidence of CVD deaths due to smoking in the 19121 zip code of Philadelphia.

INPUTS STRATEGIES ACTIVITIES SHORT-TERM OUTCOMES INTERMEDIATE OUTCOMES

Staff: Administrative

- Program Director

- Quality Improvement

Specialist

- Marketing Director

Teaching

- Peer Educators

Volunteers

- SmokeFree Philly

Money

Materials/Equipment Technology

- Laptop, electronics,

cords, etc.

Educational materials

- Pamphlets, brochures,

etc.

Time

Peer Educator

Training

1. Program Manager will develop

training materials for Peer

Educators and Participants.

2. Program Manager will recruit &

train 6 Peer Educators using visual

aids and demonstrations in addition

to the curriculum.

By month 6, all Peer Educators

demonstrate competency from

training of knowledge and

demonstrations using a survey

(>=80% score).

At year 1, all Peer Educators

demonstrate sustained competency

(>=80% score) to reflect knowledge

retention from previous training.

Captured therein will be additional

questions about satisfaction with

program implementation, which will

be utilized for year 2 improvements.

Participatory

and

Informational

Education

session

1. Peer Educators will teach 12-week

curriculum to 45 program

participants for Smoking cessation

as a risk factor for CVD

By month 9 for Cohort 1 and month

12 for Cohort 2, 90 total participants

demonstrate competencies based on

surveys designed to capture

knowledge and attitude change as a

result of training and demonstrations

(>=75% score)

By year 1, 75% of program

participants complete an exit

qualitative survey capturing

perceived effectiveness of program

and intent to change behavior.

Community

Engagement

with Corner

store owners &

19121

community

members at

large

1. Program Manager & Marketing

Director will establish and maintain

relationships with 75% of Corner

store owners in the 19121

community

2. Marketing Director will obtain

smoking cessation aids from

SmokeFree Philly to be distributed

to 75% of the 19121 corner stores

At month 6, 75% of the corner

storeowners would have distribution

logs to show that 40% of the received

quitting aids have been given out

within the community.

By year 1, 75% of corner-store

owners would have distribution logs

to show that 80% of the received

quitting aids have been given out

within the community. The doubling

effect is expected by year 1 because

more marketing and educations

would have transpired in community.

3. Marketing Director will create a

marketing distribution plan with

Donnelly Distribution to ensure

marketing materials received from

SmokeFree Philly are distributed to

75% of the 19121 community

(schools, corner stores, grocery

stores, churches, YMCA).

By month 6, conduct 15 informal

observations with checklists of all

sites where marketing materials are

distributed to ensure marketing

materials are distributed to 75% of

sites

By year 1, conduct a community-

wide short quantitative survey

assessing marketing efforts of the

program. The results will inform out

marketing activities in Year 2. (35%

community participation anticipated)

29

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(Ed.). Retrieved April 24, 2015 from http://phila.gov/health/pdfs/2013

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179). Bethesda, MD: National Institutes of Health. Retrieved from

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33. Resnick, B., Shaughnessy, M., Galik E., Scheve, A., Fitten R., Morrison, T.,

Michael, K., Agness, C. (2009) Pilot Testing of the PRAISEDD Intervention

Among African-American and Low-Income Older Adults. The Journal of

Cardiovascular Nursing, 352-361.

34. Bellg, A. J., Borrelli, B., Resnick, B., Hecht, J., Minicucci, D. S., Ory, M., ...

& Czajkowski, S. (2004). Enhancing treatment fidelity in health behavior

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hia%2C+PA+19121.

36. Philadelphia Department of Public Health. (n.d.). Walkable Access to Healthy

Food in Philadelphia, 2010‐ 2012 (March 2013). In A. Hiller, J. Sinker, G.

Mallya, L. Colby, S. Solomon, A. Wagner, J. Aquilante, & .(Eds.). Retrieved

from http://www.phila.gov/health/pdfs/Food_access_report.pdf

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http://www.donnellydistribution.com/common-

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38. Ussher, M. H., Taylor, A., & Faulkner, G. (2012). Exercise interventions for

smoking cessation. Cochrane Database Syst Rev, 1.

39. Dadlani, G. H., Wilkinson, J. D., Ludwig, D. A., Harmon, W. G., O’Brien, R.,

Sokoloski, M. C., . . . Lipshultz, S. E. (2013). A High School-Based Voluntary

Cardiovascular Risk Screening Program: Issues of Feasibility and Correlates

of Electrocardiographic Outcomes. Pediatric cardiology, 34(7), 1612-1619.

doi: 10.1007/s00246-013-0682-8

40. Philadelphia Department of Public Health. (n.d.). Walkable Access to Healthy

Food in Philadelphia, 2010‐ 2012 (March 2013). In A. Hiller, J. Sinker, G.

Mallya, L. Colby, S. Solomon, A. Wagner, J. Aquilante, & . (Eds.). Retrieved

from http://www.phila.gov/health/pdfs/Food_access_report.pdf

41. Southeastern Pennsylvania Transportation Authority (SEPTA). (2015). Broad

Street Line Map. Retrieved from http://www.septa.org/maps/transit/bsl.html

42. Clinical and Translational Science Awards Consortium Community

Engagement Key

33

BUDGET

LINE-ITEM BUDGET

SmokeBusters Budget

Salaries $84,400.00

Rewards $1,520.00

Program Manager 0.5 FTE $40,000.00

1st place

participation 2x$300 awards $600.00

Marketing Director 0.25 FTE $20,000.00

2nd place

participation 2x$200 awards $400.00

Quality Assurance Specialist 0.125 FTE $10,000.00

3rd place

participation 2x$100 awards $200.00

Peer Educators 0.125 FTE $14,400.00

1st place weight loss 2x$100 awards $200.00

2nd place weight

loss 2x$60 awards $120.00

Site $19,736.00

Stationary Supply $200/month*12 $2,400.00

Subcontractors $187.00

Equipment(computers,

furniture)

$7,500.00

Donnelly

Distribution

Single

Commission $187.00

Program Materials (flyers,

posters)

$1,000.00

Landline $25/month*12 $300.00

Other Expenses $2,820.00

Office Rent $20/sf/yr*400 $8,000.00

Food catering $210/session*12 $2,520.00

Utilities $1.34/sf/yr*400 $536.00

Snacks and

Beverages $75/month*12 $300.00

Other Indirect Costs $12,500.00

Security, payroll, insurance,

legal

10% of total

budget $12,500.00

Total Expenses $121,163.00

34

BUDGET JUSTIFICATION

Salaries:

Program Manager (MPH; 0.5 FTE; $40,000 salary with no benefits) will be a Certified

Health Education Specialist who will be responsible for supervising the grant and present project

updates to funding agency. In addition, the Program Manager will hire all program required staff

members as well as develop culturally competent curriculum materials. Salary is based on

workload and qualifications required for position.

Marketing Director (0.25 FTE; $20,000 salary with no benefits) will have a bachelor’s

degree in marketing and be responsible for facilitating program objectives with community and

program participants.

Quality Assurance Specialist (MPH; 0.125 FTE; $10,000 salary with no benefits) will

have at least two years of experience in a similar position. This individual will be responsible for

the development of pre-post tests for Peer Educators and participants. In addition, the Quality

Assurance Specialist will collect and analyze program data as well as define and report data

summaries of all set benchmarks for each program cohort.

Peer Educators (0.125 FTE; $14,400 salary with no benefits) will be required to have a

bachelor’s degree in any health related field. These individuals will be responsible for the

recruitment of program participants as well as teaching curriculum during weekly program

workshops.

Site Costs:

Stationery supplies are given a per-month budget to ensure flexibility and proper stock of

supplies for SmokeBusters staff and program participants. One-time purchases account for 3

workstation all-in-one desktops for program heads (Dell Inspiron All-In-One listed a $600), an

35

HP Officejet Pro X476dn printer/fax/scanner combo ($280), telephone sets ($55 each), and

appropriate furniture.

Finally, the office is expected to be 400 square feet to account for offices and meeting

zones, and average costs for rent and utilities per square foot in the 19121 area are derived

online.

Other Indirect Costs:

The fixed budget for other indirect costs is estimated to be 10.0% of the program budget,

which equates to $12,500. Indirect costs include security, payroll, insurance, and legal expenses.

Rewards:

Incentives and Rewards: an estimated cost of $1,520 has been designated to provide gift

cards and cash rewards as incentives to program participants. Rewards will play a major part in

maintaining program participation. SmokeBusters believes it is essential to recognize program

participants for their efforts and achievements in their commitment to the SmokeBusters’

initiative. Incentive cost based off leftover money after the cost of core programs were accounted

for.

Subcontractors:

Donnelly Distribution’s commission is $187 for the type and scale of service required,

according to a quote by a representative. Bulk printing services for the entire program have a

budget of $1,000, which can cover the cost of around 7,000 printable materials.

Other Expenses:

Food: The estimated costs of $2,820 will be designated for food and water during the

one-hour meetings. During weekly program sessions, participants will be provided healthy salads

and water supplied by Corner Bakery catering services.

36

ATTACHMENTS

ATTACHMENT 1: DETAILED WORK PLAN

Table 2: Program Work Plan

Year 1

STRATEGY 1: PROGRAM DEVELOPMENT Objective 1: By the three-month mark of our program, program coordinators will have recruited and used

standardized and pretesting training materials to train 6 community members as Peer Educators, to provide smoking

cessation education to their fellow community members within the 19121 zip code area.

KEY ACTION STEP RESPONSIBLE

PARTY

TIMELINE

Jul 15

Aug 15

Sep 15

Oct 15

Nov 15

Dec 15

Jan 16

Feb 16

Mar

16

Apr

16

May

16

Jun 16

1.1 In January 2016, the

Quality Improve Manger

will be responsible for

administering pre-surveys

based on smoking baseline

information and pre-

intervention knowledge

testing. During this time,

official SmokeBusters

program activities will

begin. Peer Educators will

begin educating

participants in Cohort 1.

Quality

Improvement

Manager

X

1.2 SmokeBusters

operation will begin July 1,

2015 in order to provide

sufficient time for the

Program Director to recruit

programs Marketing

Director and to begin

developing training

materials for ensuing Peer

Educators. The program

will operate for a year until

June 30, 2016.

Program Director X

1.3 In September 2015,

Program Director will be

responsible for developing

curriculum for later

program participants

Program Director

X

1.4 In August 2015,

recruited Marketing

Director will be responsible

for developing and

distributing marketing

materials.

Marketing Director

X

1.5 In June 2016, the

Quality Improvement

Manager will have the

Quality

Improvement

Manager

X

37

responsibility of posting

survey for evaluation of

program impact.

The community marketing

coordinator will have

distributed smoking

cessation marketing

materials such as

pamphlets and posters to

75% of the 56 grocery

businesses in the 19121 zip

code area by the end of the

first year of the program.

STRATEGY 2: RECRUITMENT Objective 2: Program coordinators will have incorporated smoking cessation tools by providing access to nicotine

patches and nicotine gum to 14 of the 47 corner stores (30% participation rate) in 19121 neighborhoods by the first

year. Before the availability of these products, storeowners will be educated on the health benefits of nicotine patches

and gum.

KEY ACTION STEP RESPONSIBLE

PARTY

TIMELINE

Jul 15

Aug 15

Sep 15

Oct 15

Nov 15

Dec 15

Jan 16

Feb 16

Mar

16

Apr

16

May

16

Jun 16

1. In August 2015, the

Program Director will

begin recruiting Peer

Educators who reside in the

19121 zip code.

Program Director

X

2. SmokeBusters operation

will begin July 1, 2015.

The Program Director will

be recruited during this

time to provide sufficient

time for the Program

Director to recruit

programs Marketing

Director and to begin

developing training

materials for ensuing Peer

Educators.

Program Director X

3. In September 2015, Peer

Educators will be

responsible for recruiting

paid interns/community

leaders from 19121 zip

code and to begin

educating the first cohort

participants with program

curriculum. By year end,

It is anticipated that by year

one of the program, Peer

Educators will have

educated 45 self-identified

smokers in the target

Peer Educators

X

38

population of 25-44 year

old low-income African-

Americans in the 19121 zip

code who attend weekly

night classes that teach

participants about the

negative health effects of

smoking and smoking

cessation tools available to

them.

4. In November, Peer

Educators will be

responsible for recruiting

program participants from

19121 zip code and to

begin educating second

cohort participants with

program curriculum.

Peer Educators

X

39

ATTACHMENT 2: ORGANIZATIONAL CHART

40

ATTACHMENT 3: PLANNING TEAM BIOS

Asha Dorsey, with a concentration in Epidemiology, brings to this group experience in

cardiovascular epidemiological research. These experiences have taught her how to collaborate

ideas with fellow researchers in the field. Her research experience aligns with the health problem

the program-planning group is focusing on: cardiovascular disease (CVD, and thus her

epidemiological insights will be valuable. Asha also possesses good listening skills and an ability

to properly identify problems. These strengths will serve the team by ensuring that team

dynamics work toward the SmokeBusters’ success.

Oluwatoyin (Toyin) Fadeyibi, with a concentration in Community Health and Prevention,

brings to this team her clinical background in pharmacy that will assist in framing the

cardiovascular health problem being addressed. She is also bringing to the project extensive

experience making presentations to small and large groups in a variety of settings. Additionally,

Toyin has been actively involved in non-profit organization leadership and thus has had ample

practice honing in her writing skills by drafting and editing a diverse array of professional

documents. Her focus, dedication and passion for purposeful, collaborative work is sure to

contribute positively to the success of this team project.

Philip Hall, with a concentration in Health Management and Policy, brings to this program

his background in the health sciences, which he treats not as a vocation, but rather a way of

thinking. Additionally, Phil has experience in clinical settings and in community service, which

have sharpened his interpersonal skills. His extensive research work makes him an asset in this

team, with sound writing and critical thinking skills. Phil’s diverse background also includes

finance, which will be utilized for SmokeBusters’ accounting and finance needs.

Yves Helou, with a concentration in Environmental Health, brings to SmokeBusters his

scientific background. His undergraduate degree in biology has left him with knowledge on what

is feasible and effective in addressing cardiovascular diseases. In addition, Yves has had

experience in research and data analysis, which will be very beneficial in ensuring that the needs

assessment and the program details are well grounded in evidence, and that the data sources are

reliable. His contribution to the team will ultimately be invaluable.

Bhavika Patel, with a concentration in Health Management and Policy, is a strong leader

with exceptional organizational qualities. A visionary, Bhavika has the ability to direct any team

in any situation towards goals and objectives set by the group. Bhavika is a team player with

successful experiences in-group settings, due to her strong interpersonal skills. Her strengths lie

in strategic thinking and program planning, which were an asset for the program-planning phase.

In addition, Bhavika’s professional portfolio boasts exemplary writing samples in public health

policy and advocacy, which will be utilized in writing up reports for SmokeBusters.