Research Needs in Support of Effective Tobacco Interventions with Priority Populations

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1 Research Needs in Support of Effective Tobacco Interventions with Priority Populations American Psychological Association Strengthening Psychology s Role in Reducing Tobacco Health Disparities December 10-11, 2012 Washington, D.C.

2 What progress have we made in supporting research that results in effective tobacco interventions with health priority populations? State and federal funding of population-specific research Gaps from a research support perspective In population-specific research In phase-specific research Research approaches and emerging research needs 4/10/2013 2

3 California s population in relation to the US population US Census Figures Foreign born persons Language other than English spoken Persons under 18 years, % Persons 65 years and over, % Persons below poverty level, % Multi-ethnic, % Native Hawaiian and Other Pacific American Indian and Alaska Native, % African American/ Black, % Asian Americans, % Latino/Hispanic, % Caucasian/ White, % US California 4/10/2013 3

4 30 Smoking Prevalence California Male Adults by race and ethnicity ( ) African American Non-Hispanic White Hispanic Asian/Pacific islander Source: Behavioral Risk Factor Surveillance System (BRFSS) , BRFSS and California Adult Tobacco Survey data is combined for California Tobacco Control Program, CDPH 4/10/2013 4

5 Smoking Prevalence California Female Adults by race and ethnicity ( ) African American Non-Hispanic White Hispanic Asian/Pacific islander Source: Behavioral Risk Factor Surveillance System (BRFSS) , BRFSS and California Adult Tobacco Survey data is combined for California Tobacco Control Program, CDPH 4/10/2013 5

6 California s Low 11.9% Smoking Rate Masks Disparities African Americans highest overall rate of four ethnic groups at18% for men and nearly 15% for women Low overall Asian and Pacific Islander rates obscure variations among specific ethnic and generational differences 41% of Korean men ages smoke LGBT rates double that of general population LGBT women smoke at 32.% rate versus 11.9% rate for all adult women Active military personnel smoke at 33.8% rate 4/10/2013 6

7 California Tobacco-Related Disease Research Program (TRDRP): Grant $ Supporting Interventions and Disparities Research ( ) All Other Grants Population-Specific Interventions Other Interventions 15% 13% 72% Legislative mandate: disseminate the most current research findings in the areas of smoking cessation and the prevention of tobacco use in order that these findings may be applied to the implementation of the state s tobacco control programs 4/10/2013 7

8 California Population-Specific Research Funding ( ): $ Per Smoker Mental Health & Substance Pacific Islander LGBT Latino/Hispanic Southeast Asian Asian Gaps in rate of support in LGBT and Latino populations American Indian African American All California Smokers /10/2013 8

9 California Population-Specific Research Funding by Phase: Number of Awards High concentration on more basic research Less on controlled studies Less on replicating, adapting, or translating All Other Participatory 4/10/2013 9

10 No. of Awards Research Phase Funding by Ethnic/Racial Groups No. of Awards American Indian African American Latino/Hispanic Asian 4/10/

11 No. of Awards No. of Awards Research Phase Funding by Multi-Ethnic, LGBT, Mental Health and Substance Abuse Groups LGBT Multi-ethnic Mental Health & Substance Abusers 4/10/

12 No. of Awards California Population-Specific Research Phase Funding by Settings Formative/Pilot 4 Observational 3 2 Quasi-Experimental 1 Experimental/Controlled 0 Replication Translation 4/10/

13 NIH Population-Specific Smoking Cessation Research Funding $ per smoker Vietnamese Puerto Rican Pacific Islander Mexican Mental Disorder LGBT Korean American Indian/Alaskan African American All US Smokers Gaps in rates of support in African American, Latino, Asian, LGBT and Mental Health groups /10/

14 $ per smoker $ per smoker NIH Population-Specific Smoking Cessation Research by Ethnic/Racial Groups All Cessation Cessation Trials Translation 0 All Cessation Cessation Trials Translation African American Vietnamese Latino/Hispanic American Indian 4/10/

15 $ per smoker NIH Population-Specific Smoking Cessation Research in Persons with Serious Mental Disorders All Cessation Cessation Trials Mental Disorder Translation 4/10/

16 Population-Specific Evidence-Based Tobacco Interventions NCI Research Tested Intervention Programs (RTIP) Smokers SAMHSA National Registry of Evidence- Based Programs and Practices (NREPP) Non Smokers Smokers Non- Smokers African American American Indian Asian Latino/Hispanic Native Hawaiian or Pacific Islander TOTAL Interventions with tobacco outcomes Studies including >50% specific ethnic/racial population Quality of evidence criteria Readiness for dissemination ratings (SAMSHA) 4/10/

17 Fourth Generation Research S.B.Thomas, et.al., Toward a Fourth Generation of Disparities Research to Achieve Health Equity. Annual Rev Public Health ; 32: doi: /annurev-publhealth

18 What are the research needs to reduce tobacco health disparities? Increase investment in research that will yield population-specific findings and action Incorporates discrimination based on race (sexuality and class) and structural inequalities (Thomas, et.al., 2011) Reviews of existing research for populationspecific evidence (Main, et.al., 2008) Some types of interventions appear to increase tobacco health disparities (Lorenc, et.al., 2012) 4/10/

19 What are the research needs to reduce tobacco health disparities? Increase in research and strategies that will accelerate real-world application of evidence-based populationspecific tobacco interventions Disruptive innovations and research agenda ( Rotheram- Borus, et.al., 2012) Use of practice-based research networks (McMillen, et.al, 2009; Westfall, 2007; Mold, et.al., 2005) Extend beyond clinicians to other community practitioners (Woolf, 2008) 4/10/

20 Health Priority Populations: Changing Context and Research Needs Cessation in context of new harm reduction products Prevention in the context of new products targeted at priority populations Disparities in access to prevention and cessation services Affordable Care Act New technology platforms and adoption by priority populations 4/10/

21 Final thoughts. All humans are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly Dr. Martin Luther King, Jr. Vision without resources is a hallucination Ross Perot If you don t change your direction, you re going to end up where you re headed Chinese proverb 4/10/

22 Thank you: TRDRP and University of California, Office of the President (UCOP) MF Bowen Phil Gardiner Norval Hickman Anwer Mujeeb Jewel Charles Mary Croughan State Agency Partners and Advisors TRDRP Scientific Advisory Committee (SAC) The Tobacco Education and Research Oversight Committee (TEROC) California Tobacco Control Program (CTCP) California Department of Education (CDE)

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