Bonita Reinert

Distance learning and nursing education.

This descriptive study investigated the use of distance learning programs in schools of nursing. Postcards were mailed to all members of the American Association of College of Nursing, asking them about distance learning at their schools. Seven schools were selected for further interviews. Of the 353 schools (80%) that responded, 135 schools (38%) reported offering off-site courses. Forty-one schools reported plans for future offerings. The schools in this study offered a total of 33 masters and doctoral degrees by distance learning. A variety of media were used by the schools with the most common forms being one- and two-way video. Common themes identified from the interviews included faculty need for comfort, support, additional preparation time, and help developing courses. Student needs included structure, faculty contact, and a sense of belonging. The need for socialization was mentioned by all the informants.

Joys and Tribulations of Faith-Based Youth Tobacco Use Prevention: A Case Study in Mississippi

Faith-based health promotion initiatives are resurging in popularity among health promoters and providers, but few programs are systematic, large-scale, and funded at the state level. One exception is an initiative by the Partnership for a Healthy Mississippi (PHM), a nonprofit organization funded by tobacco settlement monies. PHM funded churches and other faith-based organizations to implement a grassroots youth tobacco use prevention program to coincide with other community- and school-based efforts. In the 2-year evolution of this faith-community health partnership, PHM experienced both successes and challenges. This article outlines the history of tobacco use prevention and control programs within Mississippis faith community, provides a brief case study of two churches, and makes 10 recommendations based on lessons learned.

Nonprofit organizations versus government agencies to reduce tobacco use.

Tobacco settlement money can be allocated to nonprofit organizations or government agencies. Both have advantages and disadvantages. Nonprofit organizations may have relatively (a) more efficiency/flexibility, but less accountability; (b) narrower focus, but less experience; (c) more ability to advocate, but more obligations; (d) more independence from tobacco industry influence, but less funding; and, (e) more public trust, but less visibility. The present case study of the Partnership for a Healthy Mississippi focuses on six interconnected areas: education (school and community), raising awareness, advocacy, service, enforcement, and research. In 1999 and 2000, tobacco use declined in Mississippi, even compared to neighboring states. This unique partnerships multifaceted approach to social change probably facilitated this decline.

Early Elementary Teachers' Receptivity to Tobacco Prevention in One Rural U.S. State

Although tobacco prevention programs in public schools may be effective, most focus on high school or middle school students. To assess teacher receptivity at an earlier level, 2,290 early elementary (K-3) teachers in one rural state attended a training workshop that included grade-specific tobacco prevention materials. Four weeks later, 986 completed a follow-up questionnaire. Even on the initial questionnaire, an overwhelming majority thought that tobacco prevention should start in early elementary school, and that they could make a difference in reducing youth tobacco use. Following training, there was a 25 percent increase in number of teachers who had taught tobacco prevention at least once. Early elementary teachers were receptive to grade-specific tobacco prevention efforts that were integrated into their existing curriculum.

Sustaining tobacco control coalitions amid declining resources.

Mississippi is unique among the 50 states in settling a lawsuit against tobacco companies earlier than the Master Settlement Agreement, devoting a relatively high amount of per capita funding on tobacco control, and avoiding tobacco-control budget cuts. Using a social-ecological approach combining insider and outsider strategies, tobacco-prevention coalitions in Mississippi succeeded in sustaining funding despite serious obstacles. Lessons learned included taking specific actions to embed themselves in the local community, wisely aligning with legislators, choosing courageous and effective champions, and ensuring that people are keenly aware of their existence and efforts. In using these strategies, tobacco-prevention coalitions in Mississippi have become an institution of the community and in so doing helped sustain their funding.

The Logic Model in Action against Tobacco Use: A Case Study

Mississippi, an early player in tobacco prevention efforts, used a logic model based in CDCs Best Practices that had seven levels: inputs (community leaders, statewide partners, state Health Department, Attorney Generals office), activities (cessation, chronic disease, media/marketing, youth programs, school programs, community/state programs, law enforcement), outputs (nicotine cessation and treatment programs, exposure to no-tobacco, pro-health media and other programs, smoking bans, ordinances, and policies), initial outcomes (awareness of programs, changes in youth knowledge and attitudes, increased enforcement efforts), intermediate outcomes (increased program utilization, reduced youth initiation of tobacco use, improved community culture regarding tobacco), long-term outcomes (reduced youth tobacco use, reduced exposure to secondhand smoke), and impact (reduced tobacco-related sickness and death). With enough simplicity to be clear, enough detail to offer guidance, and sufficient grounding in CDCs Best Practices to provide a persuasive rationale for each component, the present logic model had immediate applications and helped with program evaluation.

Collecting health data with youth at faith-based institutions: lessons learned.

Faith-based organizations (FBOs) are ideal for health promotion but can present unique challenges in data collection. The present initiative included 6 years of awards to mostly small, rural, predominantly African American FBOs to conduct tobacco prevention lessons for youth in Grades 4—6 while they were attending summer Vacation Bible School. In 2005, these awards included

Three years of evaluating community tobacco prevention coalitions: lessons learned.

1,500 disbursed to 64 geographically diverse FBOs who had never before received this funding. Lessons learned include the following: Plan for evaluation in every aspect of the project; pilot-test everything; use reminders judiciously; make backup plans at every step; personally collect data in a nonthreatening way; and safeguard data entry. Evaluation requires extensive time, money, and effort; so, in both the intermediate and the long run, this extra work is worth it.

Retailers’ views of tobacco policy and law enforcement

Though challenging, evaluation is essential for successful coalitions. In three years of annual evaluations of 30 tobacco prevention coalitions, lessons learned involve contracts, people (leaders, board members, oversight staff), and entire coalitions. Contracts should adjust within limits, include all work requirements, promote networking, and link directly to evaluation. Leaders need quarterly meetings and no numbers assigned to their performance. Board members, even youth, must be involved. Program monitors need practical or public health experience to provide encouragement with firmness. Fiscal monitors need financial acuity, fair-mindedness, communication skills, and a firm contract foundation. Program evaluators need people skills, program evaluation experience, and a coalition history. Coalitions improve nonlinearly, with awareness activities diminishing and programmatic activities increasing, so evaluation should evolve also. Oversight agencies are influential, so should restrain from introducing many new requirements and avoid blindsiding leaders. Best evaluations are cooperative, collegial dialogs between evaluator(s) and the entire coalition.

Early Adolescents and Anti-Tobacco Messages from School, Community, Media, Physicians, and Parents.

Aims: Tobacco retailers are in a unique position to implement policies that can influence sales and ultimately tobacco use, so the present survey explored retailers’ tobacco policies, involvement and problems with law enforcement, and pessimism about whether youth will obtain tobacco products. Methods: 144 randomly selected tobacco retailers (30.1% return rate) in Mississippi, USA, completed a 2-page questionnaire about their store tobacco policies. Findings: Present retailers, on average, endorsed fewer than half of eight commonly-adopted tobacco access policies. Significantly fewer anti-tobacco policies were complied with when those responding (a) were owners rather than managers, (b) worked at convenience stores rather than grocery stores, (c) had no law-enforcement involvement rather than some, and (d) had 18+ years of retail experience rather than less. Policy correlated significantly with law-enforcement involvement, but not significantly with tobacco-enforcement problems or pessimism about youth tobacco sales. Conclusions: By their own self-report, there is considerable room for improvement in retailers’ youth tobacco access policies. Individually-owned, convenience stores, where the owner has lots of retail experience, have few tobacco policies. They may be a particularly appropriate targets for educational efforts.