Community-based Settings

Community-based interventions usually involve a number of different strategies and activities aimed at creating changes in knowledge, attitudes, beliefs, and skills that influence health. One of the unique features of community approaches is that they typically include strategies to create change in individuals and families as well as efforts to change organizational and environmental factors and policies that influence behavior and health. These interventions are designed to prevent community members from starting to use tobacco, remove tobacco smoke exposure in the community, help community members stop using tobacco, and eliminate disparities in tobacco use among various community members.

Community-based interventions include strategies that are implemented in a variety of places including:

  • Large health care centers (e.g., cancer centers)
  • Neighborhood health care centers or clinics
  • Physician offices
  • Local public health agencies
  • Hospitals
  • HMOs
  • Health insurance companies
  • Pharmacies
  • Social service agencies
  • Community development agencies
  • Foundations
  • Schools
  • Churches
  • Worksites (e.g., offices, factories)
  • Public buildings and facilities
  • Restaurants
  • Local businesses (e.g., retail tobacco outlets)
  • Advertising companies
  • Community centers
  • Retirement centers
  • Clubs (e.g., Boys & Girls Club)
  • National associations (e.g., American Red Cross, American Lung Association, American Cancer Society)
  • Local associations (e.g., economic, cultural, nurses)
  • Community health fairs
  • Universities
  • Community colleges
  • Research institutions
  • Homes

Previous work in community-based settings has found:

  • Community-based tobacco related campaigns can reach populations that may not be reached in other settings.
  • Children spend many hours after school at community organizations (e.g., boys and girls clubs). Community-based settings provide an alternative to schools and allow for the tailoring of programs to each individual child. In these settings, children may work on goal setting and skills building to prevent smoking.
  • Community and leisure time settings for group education sessions can provide support, motivation, and reinforcement for anti-smoking skills (learned in other settings.
  • Group education done in a community setting can reach a wider audience as well as increase community awareness to support cessation efforts (e.g., youth restrictions on access to tobacco products, policies to minimize environmental tobacco smoke).
  • Maternal clinics can provide individual information exchange during patient/health care provider counseling sessions; therefore, this setting provides a great opportunity to reach an at-risk population.
  • Retirement villages can incorporate tobacco cessation activities into their social events to encourage healthy lifestyles among the older residents.
  • Day care centers have an abundance of children and can provide direct messages to parents regarding the health of their children (i.e., the effects of second hand smoke).
  • It is important to establish legitimacy for tobacco related interventions in the community as a community project and not an experiment.
  • Community-based campaigns directed toward youth allow time to be devoted to countering tobacco marketing without diminishing the time available for classroom-based instruction in school-based settings.
  • In community or organizational settings, intervention strategies often include informational support (information individuals have about tobacco use), tangible support (skills and abilities people have to live tobacco-free) and appraisal support (sense of acceptance and belonging as individuals make choices to live tobacco-free).

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