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Committee Discussion

March 9, 2004: Tobacco-Related Disparities Among Racial/Ethnic Populations

Dr. Barry Portnoy, National Institutes for Health, asked presenters to elaborate more on several themes that he had heard throughout the presentations—the need for more data, research and better accountability.

On the issue of data, panelists responded that there is a need for better, more in-depth analysis of the data that we currently have to better understand racial and ethnic disparities. In addition, over-sampling may be called for within certain populations. Language barriers also exist in data collection efforts in some populations that may lead to underestimation of the extent of tobacco use. Even when data collection instruments have been tailored for specific populations, they may only be relevant for that specific population but none of its subgroups. While this issue is a high priority for CDC, and several surveys have been adapted for other languages/cultures, it will continue to pose challenges.

Regarding research, presenters discussed the importance of qualitative research that helps us better understand why populations differ in their use of tobacco products. It is also important that we increase the number of minority researchers and also involve community members in collecting and analyzing the data. Furthermore, even when good research exists, there is often a scarcity of resources to disseminate the information to those who would most benefit.

Finally, greater accountability is necessary to insure follow through from funding to program delivery. Protocols and measurable indicators must be developed (that include more than hiring staff to address the issue) and we must have better mechanisms for insuring that members of the targeted community are at the table for decision-making.

Dr. Scott Leischow, NCI, asked panelists to elaborate on how best to optimize the use of tobacco prevention and control networks.

Presenters emphasized the need for more local funding which supports collaboration and networking. The SWOT model (strengths, weaknesses, opportunities and threats) described by Ms. Carty is an effective way to optimize networks as well.

Dr. Michael Fiore, University of Wisconsin, asked panelists to describe marketing and communication strategies—those that are effective, and those that are not effective.

By and large, strategies that help build trust and engage community members are the most effective. Two examples are community-based participatory research and social marketing techniques. Often, minority communities do not have adequate resources to only address a single health issue—for example, tobacco use—so often many health issues must be addressed together.

William Corrigal, NIDA, requested comments from panelists regarding ways to insure that communities become engaged in getting effective treatments and interventions broadly disseminated into their respective communities.

Panelists discussed the power of case studies and stories as well as the importance of building alliances with "untraditional" partners such as the NAACP or National Council of La Raza. Unfortunately, publication in a journal, scientific or professional is not always the best way to disseminate information, particularly among underserved communities. It was also mentioned that many ethnic/racial populations need assistance with proposal writing and development—particularly for federal grant applications.

Following the discussion period, Rosemarie Henson asked panel members to give a brief overview of their organization or agencies current work in tobacco control and disparities issues. Each agency highlighted their organization's activities and many stressed the need for additional data.

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