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Abstract Background Community coalitions are rooted in complex and dynamic community systems. Despite recognition that environmental factors affect coalition behavior, few studies have examined how community context impacts coalition formation. Using the Community Coalition Action theory as an organizing framework, the current study employs multiple case study methodology to examine how five domains of community context affect coalitions in the formation stage of coalition development. Domains are history of collaboration, geography, community demographics and economic conditions, community politics and history, and community norms and values. Methods Data were from 8 sites that participated in an evaluation of a healthy cities and communities initiative in California. Twenty-three focus groups were conducted with coalition members, and 76 semi-structured interviews were conducted with local coordinators and coalition leaders. Cross-site analyses were conducted to identify the ways contextual domains influenced selection of the lead agency, coalition membership, staffing and leadership, and coalition processes and structures. Results History of collaboration influenced all four coalition factors examined, from lead agency selection to coalition structure. Geography influenced coalition formation largely through membership and staffing, whereas the demographic and economic makeup of the community had an impact on coalition membership, staffing, and infrastructure for coalition processes. The influence of community politics, history, norms and values was most noticeable on coalition membership. Conclusions Findings contribute to an ecologic and theory-based understanding of the range of ways community context influences coalitions in their formative stage.

AbstractCommunity coalitions are well established as an important strategy for addressing public health problems through the lens of health equity, social determinants of health, and/or a social ecologic perspective. After almost three decades of practice and research on community‐based collaborative approaches, a large number of evaluations have been conducted to examine the processes of coalition formation, approaches to creating community change, and whether intermediate and longer‐term outcomes have been achieved. This chapter reports the results of a scoping review of the methods commonly used to evaluate community coalitions. English‐language articles were identified through a search of keywords, including community coalitions and evaluation published in the PubMed database between 2000 and 2018. Only outcome evaluations were included for a total of fifty‐five eligible papers. Two coders abstracted the following domains: public health topic, number of coalitions, framework or theory, study design, data collection methods, temporality, and types of outcomes (i.e., behavioral or health, community change, community capacity). Strategies for attributing observed outcomes to coalitions also were assessed. Findings suggest that the same challenges which limited the field a decade ago remain. Community changes were documented most often, with no behavioral or health outcomes. Studies that evaluated behavioral or health outcomes most commonly evaluated a single program, with limited or no examination of how the coalition(s) influenced program effectiveness. Current methods are adequate for assessing community changes and community capacity outcomes and evaluating specific intervention strategies. The two real stumbling blocks are documenting whether complex and synergistic multi‐sectoral community change leads to population‐level behavioral and health outcomes and, then, parceling out the added value of a coalition approach over other approaches to creating community change.

Background: Nonsmokers living in multi-unit housing (MUH) without a smoke-free (SF) policy are vulnerable to secondhand and thirdhand smoke exposure. This study aimed to investigate the presence and type of SF policies in MUH in Georgia. Another aim was to explore knowledge, beliefs, and attitudes of property managers and owners (PM/Os) regarding SF MUH policies, including e-cigarettes. Methods: Throughout 2015 PM/Os of MUH in Savannah and Atlanta were surveyed regarding SF policies in MUH. A list with contact information of PM/Os was obtained from the ASDE Survey Sampler. The participants were mailed an invitation letter and were called one week later to schedule the interview. To be eligible, the participant must have been an English-speaking adult working as a PM/O in MUH. The survey administered was adapted from a survey designed by CDC's Office on Smoking and Health. All survey data were entered into SPSS and analyzed using SAS. Results: The greatest number of the 91 PM/Os surveyed were female (70.3%) and/or white (48.4%), with an average age of 41.7 years. Most properties were market-rate (71.3%) or were a mix of market-rate and subsidized units (17.2%). Forty-one PM/Os reported some smoking restriction, while 50 had no policy. Properties mainly prohibited smoking in common outdoor areas (n=18) or inside individual apartments (n=13). Policies included bans of non-cigarette combustible products (n=19), hookah (n=12), e-cigarettes (n=7), and smokeless tobacco (n=5). Most PM/Os reported high compliance and positive resident reactions to the policy. Comparing responses by policy status, no differences in knowledge nor support for tobacco control legislation were found, except for SF outdoor seating in restaurants, which was more frequently supported by PM/Os with smoking restrictions. Personal beliefs on restricting use of cigarettes and e-cigarettes in MUH did not differ significantly by policy status, but those with a SF policy were more supportive of prohibiting smokeless tobacco use in MUH. Conclusions: Implementing smoke-free policies in multi-unit housing is feasible and is generally supported by residents.

Research has shown that microenvironments such as homes and neighborhoods are associated with dietary and physical activity behaviors. This study examines self-reports of home and neighborhood environments of adult dyads living in the same household ( n = 83 dyads) and explores correlates of discrepant perceptions. Food and exercise equipment in the home and access to neighborhood recreational facilities were assessed. Agreement between pairs varied across measures, with dyads having less disagreement in reporting their physical activity environment compared with their food environment. Discrepancy indices were .20 for exercise equipment, .29 for neighborhood facilities, .25 for fruits, .26 for drinks, and .28 for vegetables and snacks/other foods. Differences in education, food shopping behavior, fat intake, BMI, and physical activity were associated with discordance in reporting among dyads. Results suggest that co-dwelling adults perceive their home and neighborhood environments differently. This has implications for how microenvironments are measured and how data are interpreted.

Abstract Background A certain level of public support for smoke-free environments is a prerequisite for adoption and enforcement of policies and can be used as an indicator of readiness for legislative action. This study assessed support for comprehensive smoke-free policies in a range of settings such as hotels and colleges among government workers in China and identified factors associated with support for smoke-free policies. Understanding the extent to which government workers, a large segment of the working population in China, report a smoke-free workplace and support for smoke-free policies may be important indicators of readiness for strengthened policies given their role in formulating, implementing and enforcing regulations. Methods Data were from an evaluation of the Tobacco Free Cities initiative of Emory University's Global Health Institute-China Tobacco Control Partnership. Self-administered surveys were completed by 6,646 workers in 160 government agencies in six Chinese cities. Multivariate logistic regression was used to identify factors associated with support for smoke-free worksites, bars, hotels, and colleges. Results Over half (54.6%) of participants were male. A large percentage of the male workers smoked (45.9%,) whereas very few women did (1.9%). Fewer than 50% of government workers reported smoke-free policies at work, with 19.0% reporting that smoking is allowed anywhere. Support for smoke-free policies was generally very high, with the lowest levels of support for smoke-free bars (79.0%) and hotels (82.3%), higher levels of support for restaurants (90.0%) and worksites (93.0%), and above 95% support for hospitals, schools, colleges, public transportation and religious settings. Knowledge of the harmfulness of secondhand smoke was positively associated with support for smoke-free policies. Stricter worksite smoking policies were associated with support for smoke-free workplaces and bars, but not hotels and colleges. Women and nonsmokers were more supportive of smoke-free policies in general. Conclusion Government workers play important roles in formulating, implementing and enforcing regulations; results suggest support for a more comprehensive approach to smoke-free environments in China among workers across a broad range of agencies.

Background: A certain level of public support for smoke-free environments is a prerequisite for adoption and enforcement of policies and can be used as an indicator of readiness for legislative action. This study assessed support for comprehensive smoke-free policies in a range of settings such as hotels and colleges among government workers in China and identified factors associated with support for smoke-free policies. Understanding the extent to which government workers, a large segment of the working population in China, report a smoke-free workplace and support for smoke-free policies may be important indicators of readiness for strengthened policies given their role in formulating, implementing and enforcing regulations. Methods: Data were from an evaluation of the Tobacco Free Cities initiative of Emory University's Global Health Institute-China Tobacco Control Partnership. Self-administered surveys were completed by 6,646 workers in 160 government agencies in six Chinese cities. Multivariate logistic regression was used to identify factors associated with support for smoke-free worksites, bars, hotels, and colleges. Results: Over half (54.6%) of participants were male. A large percentage of the male workers smoked (45.9%,) whereas very few women did (1.9%). Fewer than 50% of government workers reported smoke-free policies at work, with 19.0% reporting that smoking is allowed anywhere. Support for smoke-free policies was generally very high, with the lowest levels of support for smoke-free bars (79.0%) and hotels (82.3%), higher levels of support for restaurants (90.0%) and worksites (93.0%), and above 95% support for hospitals, schools, colleges, public transportation and religious settings. Knowledge of the harmfulness of secondhand smoke was positively associated with support for smoke-free policies. Stricter worksite smoking policies were associated with support for smoke-free workplaces and bars, but not hotels and colleges. Women and nonsmokers were more supportive of smoke-free policies in general. Conclusion: Government workers play important roles in formulating, implementing and enforcing regulations; results suggest support for a more comprehensive approach to smoke-free environments in China among workers across a broad range of agencies.

OBJECTIVES: Given high prevalence of smoking and secondhand smoke exposure in Armenia and Georgia and quicker implementation of tobacco legislation in Georgia versus Armenia, we examined correlates of having no/partial versus complete smoke-free home (SFH) restrictions across countries, particularly smoking characteristics, risk perceptions, social influences and public smoking restrictions. DESIGN: Cross-sectional survey study design. SETTING: 28 communities in Armenia and Georgia surveyed in 2018. PARTICIPANTS: 1456 adults ages 18–64 in Armenia (n=705) and Georgia (n=751). MEASUREMENTS: We used binary logistic regression to examine aforementioned correlates of no/partial versus complete SFH among non-smokers and smokers in Armenia and Georgia, respectively. RESULTS: Participants were an average age of 43.35, 60.5% women and 27.3% smokers. In Armenia, among non-smokers, having no/partial SFHs correlated with being men (OR=2.63, p=0.001) and having more friend smokers (OR=1.23, p=0.002); among smokers, having no/partial SFHs correlated with being unmarried (OR=10.00, p=0.001), lower quitting importance (OR=0.82, p=0.010) and less favourable smoking attitudes among friends/family/public (OR=0.48, p=0.034). In Georgia, among non-smokers, having no/partial SFHs correlated with older age (OR=1.04, p=0.002), being men (OR=5.56, p<0.001), lower SHS risk perception (OR=0.43, p<0.001), more friend smokers (OR=1.49, p=0.002) and fewer workplace (indoor) restrictions (OR=0.51, p=0.026); among smokers, having no/partial SFHs correlated with being men (OR=50.00, p<0.001), without children (OR=5.88, p<0.001), daily smoking (OR=4.30, p=0.050), lower quitting confidence (OR=0.81, p=0.004), more friend smokers (OR=1.62, p=0.038) and fewer community restrictions (OR=0.68, p=0.026). CONCLUSIONS: Private settings continue to lack smoking restrictions in Armenia and Georgia. Findings highlight the importance of social influences and comprehensive tobacco legislation, particularly smoke-free policies, in changing ...

Garnering support for smoke-free policies is critical for their successful adoption, particularly in countries with high smoking prevalence, such as Armenia and Georgia. In 2018, we surveyed 1456 residents (ages 18–64) of 28 cities in Armenia (n = 705) and Georgia (n = 751). We examined support for cigarette and electronic nicotine delivery systems (ENDS)/heated tobacco product (HTP) smoke-free policies in various locations and persuasiveness of pro- and anti-policy messaging. Participants were an average age of 43.35, 60.5% female, and 27.3% current smokers. Nonsmokers versus smokers indicated greater policy support for cigarette and ENDS/HTP and greater persuasiveness of pro-policy messaging. Armenians versus Georgians generally perceived pro- and anti-policy messaging more persuasive. In multilevel linear regression, sociodemographics (e.g., female) and tobacco use characteristics (e.g., smoking less frequently, higher quitting importance) correlated with more policy support. Greatest policy support was for healthcare, religious, government, and workplace settings; public transport; schools; and vehicles carrying children. Least policy support was for bar/restaurant outdoor areas. The most compelling pro-policy message focused on the right to clean air; the most compelling anti-policy message focused on using nonsmoking sections. Specific settings may present challenges for advancing smoke-free policies. Messaging focusing on individual rights to clean air and health may garner support.

Purpose. The Emory Prevention Research Center's Cancer Prevention and Control Research Network mini-grant program funded faith-based organizations to implement policy and environmental change to promote healthy eating and physical activity in rural South Georgia. This study describes the existing health promotion environment and its relationship to church member behavior. Design. Cross-sectional. Setting. Data were obtained from parishioners of six churches in predominantly rural South Georgia. Subjects. Participants were 319 church members with average age of 48 years, of whom 80% were female and 84% were black/African-American. Measures. Questionnaires assessed perceptions of the existing church health promotion environment relative to nutrition and physical activity, eating behavior and intention to use physical activity facilities at church, and eating and physical activity behaviors outside of church. Analysis. Multiple regression and ordinal logistic regression using generalized estimating equations were used to account for clustered data. Results. Results indicate that delivering messages via sermons and church bulletins, having healthy eating programs, and serving healthy foods are associated with participants' self-reported consumption of healthy foods at church (all p values ≤ .001). Serving more healthy food and less unhealthy food was associated with healthier eating in general but not to physical activity in general (p values ≤ .001). Conclusion. The church environment may play an important role in supporting healthy eating in this setting and more generally.

The Cancer Prevention and Control Research Network (CPCRN) surveyed 282 cancer control planners to inform its efforts to increase the use of evidence-based cancer control programs (EBPs; programs that have been scientifically tested and successfully changed behavior). Respondents included planners from organizations in state Comprehensive Cancer Control coalitions as well as other governmental and non-governmental organizations, and community-based coalitions. Respondents provided information about personal and organizational characteristics, their cancer control programs, their attitudes toward EBPs, and their awareness and use of Web-based resources for EBPs. Although findings showed strong preferences for cancer control programs that have been shown to work, less than half of respondents (48%) had ever used EBP resources. Regardless of whether they had used EBP resources, almost all respondents (97%) indicated that further training would help them and their organization adopt and adapt EBPs for use in their communities. The most frequently endorsed training needs were finding and securing additional resources (such as funding and technical assistance), followed by adapting EBPs for cultural appropriateness. The CPCRN consortium is using these findings to develop a Web-based interactive training and decision support tool that is responsive to the needs identified by the survey respondents.

The fourth edition of Community Organizing and Community Building for Health and Social Equity provides both classic and recent contributions to the field, with a special accent on how these approaches can contribute to health and social equity. The 23 chapters offer conceptual frameworks, skill- building and case studies in areas like coalition building, organizing by and with women of color, community assessment, and the power of the arts, the Internet, social media, and policy and media advocacy in such work. The use of participatory evaluation and strategies and tips on fundraising for community organizing also are presented, as are the ethical challenges that can arise in this work, and helpful tools for anticipating and addressing them. Also included are study questions for use in the classroom. Many of the book's contributors are leaders in their academic fields, from public health and social work, to community psychology and urban and regional planning, and to social and political science. One author was the 44th president of the United States, himself a former community organizer in Chicago, who reflects on his earlier vocation and its importance. Other contributors are inspiring community leaders whose work on-the-ground and in partnership with us "outsiders" highlights both the power of collaboration, and the cultural humility and other skills required to do it well. Throughout this book, and particularly in the case studies and examples shared, the role of context is critical, and never far from view. Included here most recently are the horrific and continuing toll of the COVID-19 pandemic, and a long overdue, yet still greatly circumscribed, "national reckoning with systemic racism," in the aftermath of the brutal police killing of yet another unarmed Black person, and then another and another, seemingly without end. In many chapters, the authors highlight different facets of the Black Lives Matter movement that took on new life across the country and the world in response to these atrocities. In other chapters, the existential threat of climate change and grave threats to democracy also are underscored. View the Table of Contents and introductory text for the supplementary instructor resources. (https://d3tto5i5w9ogdd.cloudfront.net/wp-content/uploads/2022/02/04143046/9781978832176_optimized_sampler.pdf) Supplementary instructor resources are available on request: https://www.rutgersuniversitypress.org/communityorganizing