ABSTRACT
Lower levels of physical activity among children in the United States can be attributed in part to the lack of access to safe, low-cost recreational facilities. Shared use, or a partnership allowing the community to use school recreational facilities outside of normal hours, has received increased attention. The objective of this study was to determine the extent of knowledge among school district decision makers about a law passed clarifying liability for school shared use in Minnesota and to understand perceptions held by school decision makers regarding shared use of recreational facilities. A survey of Minnesota school superintendents and other decision makers (N = 182) was conducted to understand the issues relevant to sharing school recreational facilities with the public. The majority (90%) of respondents indicated concern about liability for injury on school property outside of normal hours, and that insurance and contracts provided the most protection from liability. Most respondents indicated they were not familiar with the Minnesota shared use legislation and its provisions (61.4%, n = 108). Findings suggest the importance of education and training to further school superintendents' knowledge of Minnesota shared use legislation, legal and policy issues relevant to shared use, and issues related to the implementation of shared use within their districts.
ABSTRACT
BACKGROUND: Taft-Hartley Health and Welfare Funds ("funds") administer health insurance plans that cover approximately nine million U.S. adults. Unionized workers covered by funds work primarily in blue- and pink-collar occupations and smoke at a rate almost twice that of workers in other occupations. Most funds do not provide comprehensive coverage for tobacco cessation treatment for fund participants (workers, family members, and retirees). PURPOSE: This study tested a pilot intervention to increase the provision and promotion of cessation benefits among Minnesota-based funds by educating the funds' advisors. METHODS: Tailored educational outreach was conducted to advisors (administrators, consultants, attorneys) of 10 Minnesota-based funds (2009-2011). Pre- and post-intervention advisor interviews measured perceptions/knowledge/attitudes about tobacco use, cessation, coverage, and promotion of benefits. Pre- and post-intervention data on benefit provision were collected from Summary Plan Descriptions (SPDs) and Summary Material Modifications (SMMs) of 10 Minnesota-based funds and 19 comparison funds in Massachusetts and Washington, and compared in 2011. SPDs/SMMs were scored on benefit adequacy, comparing services covered and the extent to which they met DHHS recommendations. RESULTS: Minnesota-based funds provided significantly higher coverage (except for copays and pre-conditions) pre-intervention. However, there were no significant differences between Minnesota and comparison funds in rate of improvement in benefits over time. At follow-up, advisors reported a significant increase in confidence in their knowledge to address smoking issues in funds. Advisors also reported sharing intervention information with fund trustees. CONCLUSIONS: Educational strategies to influence advisors who provide guidance to fund trustees may help to increase advisors' confidence to address cessation benefit improvement.
