An evaluation of the California community intervention
Open Access
- 1 April 2010
- journal article
- research article
- Published by BMJ in Tobacco Control
- Vol. 19 (upplement ), i30-i36
- https://doi.org/10.1136/tc.2009.031252
Abstract
Aim We conducted this study to determine key community-level factors associated with higher tobacco control programme performance. Methods A combination of surveys, administrative and fiscal data were collected to measure local county-level health department performance over a 7-year period. Longitudinal analyses were performed using generalised estimating equations to examine whether counties that exerted higher effort were successful in creating more tobacco retail licensing (TRL) and secondhand smoke policies. Several social, political and contextual factors were examined as confounders. Results Local county health departments (CHDs) that demonstrated high effort on their work plans increased the proportion of residents covered by TRL policies (7.2%; 95% CI −1.7 to 16.1%) compared to CHDs with lower levels of effort. Having legislators who voted in favour of tobacco control bills was found to significantly increase the passage of local TRL policies. CHDs demonstrating higher efforts also increased the proportion of residents covered by secondhand smoke policies (9.2%; 95% CI −3.5 to 21.9%). Conclusion There was strong evidence that higher county-level efforts predicted an increasing number of local tobacco control policies. Evaluations using integrated designs are recommended as effective strategies to provide a more accurate assessment of how well community-level interventions catalyse community-wide change.Keywords
This publication has 20 references indexed in Scilit:
- Finding the Impact in a Messy Intervention: Using an Integrated Design to Evaluate a Comprehensive Citywide Health InitiativeAmerican Journal of Evaluation, 2009
- Assessing the Impact of Policy Interventions: The Influence of Evaluation MethodologyEnvironment and Planning C: Government and Policy, 2009
- Effect of the California Tobacco Control Program on Personal Health Care ExpendituresPLoS Medicine, 2008
- Tobacco Control Success Versus Demographic Destiny: Examining the Causes of the Low Smoking Prevalence in CaliforniaAmerican Journal of Public Health, 2008
- Examining trends in quantity smokedNicotine & Tobacco Research, 2007
- Evaluating comprehensive tobacco control interventions: challenges and recommendations for future action: Figure 1Tobacco Control, 2002
- Integrating a Comparison Group Design into a Theory of Change Evaluation: The Case of the Urban Health InitiativeAmerican Journal of Evaluation, 2002
- Strong theory, flexible methods: Evaluating complex community-based initiativesCritical Public Health, 2001
- The American Stop Smoking Intervention StudyEvaluation Review, 1999
- Review of Software to Fit Generalized Estimating Equation Regression ModelsThe American Statistician, 1999