"Effective prevention strategies make use of natural support systems within the minority group, including the extended family, nontraditional resources, and community-based activities."

 

 

"Do more than change the color of the people in the brochure and advertisement. The “one-size-fits-all” approach to educating members of minority groups does not work. Many cultural, educational, and income levels exist within these groups."

Programs

Guidelines for producing appropriate and effective tobacco control programs should be developed and promulgated. Organizers need to know information about key audiences; strategies more likely to succeed and be effective; materials available for use; guidelines for producing and pretesting educational materials; and suggestions for tobacco control activities appropriate in conjunction with the materials (18,26,27).

Effective tobacco education and control efforts usually target youth. These efforts include offering school-based health education and prevention programs; restricting access to tobacco products; enforcing laws restricting minors’ access to tobacco products; supporting mass media campaigns; banning billboards advertising tobacco products within 1,000 feet of schools; limiting in-store advertising and billboards to black-and-white text; limiting advertising to black-and-white text in publications with a significant readership under age 18; prohibiting sponsorship of sporting or entertainment events using brand identification; and restricting the use of brand logos on promotional items (28,3).

The Centers for Disease Control identified two research-based curricula on tobacco prevention that appear to be successful. Life Skills Training is a compre-hensive drug use prevention curriculum. It uses demonstrations illustrating the physical effects of smoking, large and small group discussions, worksheets, brainstorming, and scripted and ad lib skill practice sessions. The target audience is students in grades six through nine. Project TNT targets students in seventh grade. It uses several teaching methods, including games, role plays, group discus-sions, and a video the students produce on the harmful effects of tobacco use.

According to the ERIC Clearinghouse on Urban Education, effective tobacco use prevention programs include these points:

  • Debunk the myths that smoking is attractive or relieves stress.
  • Speak directly to girls about smoking separately from boys. Be sure to discuss the effects of smoking on unborn children and the risks of secondhand smoke on others.
  • Emphasize that addiction removes freedom of choice.
  • Assure that it is OK to refuse to smoke and is a very adult thing to do.
  • In urban settings, support “take back the community” projects that promote tobacco use prevention messages, such as street plays or whitewashing tobacco ads.

Effective prevention strategies make use of natural support systems within the minority group, including the extended family, nontraditional resources, and community-based activities (29).

The following information summarizes general recommendations for developing effective tobacco education and prevention programs and materials:

  • Develop high-quality messages and materials for intended audiences. Tobacco prevention and control efforts compete directly with the tobacco industry, which spends millions of dollars each year on advertising. The public sector lacks that level of resources, but prevention and control messages and materials must be of sufficient quality to compete (18).
  • Pilot test and evaluate tobacco control education materials before they are disseminated. Pretesting and evaluation of materials is currently the exception, not the rule. To compete with an industry that spends many times the equivalent of tobacco control budgets on market research alone, at least minimum target audience testing should be the norm for the production of educational materials. Results from pretesting, market research, and evaluations should be shared across organizations (18).
  • Develop culturally specific materials and strategies for minority groups. The infor-mation also should be age and gender specific. The reading level of the materials also should be appropriate (18,26,27). (See “Making Prevention Work” below.)
  • Use a variety of educational strategies. Likewise, cooperative learning has been shown effective in promoting learning among African Americans (30). Coop-erative learning facilitates development of conceptual frameworks and incorporates factors that affect knowledge acquisition, attitude development, and behavior change. Producers of these materials should consider using innovative formats more appealing to certain audiences than the usual brochure. The materials also should provide practical information about the health consequences of tobacco use, resources to help people quit, and specific techniques for quitting (18).
  • Update educational materials to incorpo-rate new government reports and guidelines. In this way, the reports’ findings can be applied within the community setting. Culturally appropriate educational strategies and materials should reflect the contents of reports on young people and on people of color (18).
  • Develop programs and materials for children for use outside of formal school-based curricula, such as in religious organizations and after-school programs materials (18,26).
  • Do more than change the color of the people in the brochure and advertisement. The “one-size-fits-all” approach to educating members of minority groups does not work. Many cultural, educational, and income levels exist within these groups (18,26).
  • Involve the target group at all levels. Community members should be involved in activities such as serving on boards of directors, chairing or participating on ad hoc committees, serving as peer educators, and organizing health fairs (26).
  • Ask organizations to collaborate and share the cost to develop and evaluate materials (18).
  • Personalize the delivery of the program. Tobacco education should be provided in a warm, nurturing environment. Changes to existing programs can be as simple as encouraging staff and volunteers to be warm and friendly, offering programs in a house of worship rather than at a hospital or clinic, and providing transportation and child care (26,27).
  • Include family members whenever possible. Family confers a sense of identity and self-worth, provides social support, and helps with adherence to a particular dietary treatment (31). Programs targeted at children should have parental support. However, parents should model appropriate health habits and lifestyle choices.
  • Choose role models carefully. Identify positive role models from the community and train them to deliver messages to their neighborhoods. Using celebrities as role models may cause mixed reactions.
  • Train program staff and educators to be culturally competent and sensitive. If educators lack awareness, training, and information to deal with multicultural groups, they may mistakenly rely on stereotypical misinformation and distortion materials (26,27).
  • Emphasize individual and community empowerment. Programs often emphasize how individuals should change, but the environment in which they live also can contribute both to the problem and to the solution (26,27).

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