Women's perspectives on smoking and pregnancy and graphic warning labels.

OBJECTIVES: To explore women's knowledge, attitudes, and beliefs about adverse outcomes associated with smoking during pregnancy and which outcomes might motivate cessation; to explore reactions to graphic warnings depicting 2 adverse outcomes. METHODS: Twelve focus groups were conducted with women of childbearing age who were current smokers. RESULTS: Participants had low to moderate awareness of many outcomes and believed it was acceptable to smoke in the first trimester before knowledge of pregnancy. Perceived susceptibility to outcomes was low. Motivators included risk-focused information, especially serious risks to the baby (eg, stillbirth, SIDS). Graphic warnings produced strong reactions, especially the warning with a real photo. CONCLUSIONS: Despite barriers to reducing rates of smoking during pregnancy, educational information and photos depicting babies' risks could motivate women to quit.

Assessment of the status of a National Action Plan for Cancer Survivorship in the USA.

PURPOSE: There are currently more than 12 million cancer survivors in the USA. Survivors face many issues related to cancer and treatment that are outside the purview of the clinical care system. Therefore, understanding and providing for the evolving needs of cancer survivors offers challenges and opportunities for the public health system. In 2004, the Centers for Disease Control and Prevention and the Lance Armstrong Foundation, now the Livestrong Foundation, partnered with national cancer survivorship organizations to develop the National Action Plan for Cancer Survivorship (NAPCS). This plan outlines public health strategies to address the needs of cancer survivors. To date, no assessment of NAPCS strategies and their alignment with domestic cancer survivorship activities has been conducted. METHODS: The activities of five national organizations with organized public health agendas about cancer survivorship were assessed qualitatively during 2003-2007. Using the NAPCS as an organizing framework, interviews were conducted with key informants from all participating organizations. Interview responses were supplemented with relevant materials from informants and reviews of the organizations' websites. RESULTS: Strategies associated with surveillance and applied research; communication, education, and training; and programs, policy, and infrastructure represent a large amount of the organizational efforts. However, there are gaps in research on preventive interventions, evaluation of implemented activities, and translation. CONCLUSIONS: Numerous NAPCS strategies have been implemented. Future efforts of national cancer survivorship organizations should include rigorous evaluation of implemented activities, increased translation of research to practice, and assessment of dissemination efforts. IMPLICATIONS FOR CANCER SURVIVORS: The results of this descriptive assessment provide cancer survivors, cancer survivorship organizations, researchers, providers, and policy makers with initial information about cancer survivorship public health efforts in the USA. Additionally, results suggest areas in need of further attention and next steps in advancing the national cancer survivorship public health agenda.

Examination of the relationship between community support and tobacco control activities as a part of youth empowerment programs.

Through the American Legacy Foundation's Statewide Youth Movement Against Tobacco Use (SYMATU), programs aimed at empowering youths to take action against tobacco use were funded. It is believed that the activities these groups undertake result in changes at the community level. This article examines the relationships between community support of tobacco control and the number and types of tobacco control-related activities these local youth groups conduct. Regression analyses examine the influence that different levels and sources of community support have on the quantity and focus of a group's activities. The influences of community support are briefly explored to understand if certain group characteristics have an impact on the quantity or sources of support for tobacco control. A deeper understanding of the importance and impact of community support will help groups understand the need for building community support networks and how these networks can assist them with implementation of program activities.

Effect of community coalition structure and preparation on the subsequent implementation of cancer control activities.

PURPOSE: The purpose of this paper is to identify factors within a three-phase community coalition development model that influence short-term success in cancer control coalitions based on the cumulative number of educational and screening activities conducted by the coalitions. DESIGN: This study was a nonrandomized community intervention trial involving four autonomous, independently funded multistate projects aimed at using coalitions to increase cancer screening and early detection. SETTING: The study was conducted in medically underserved, rural counties of Appalachia. SUBJECTS: Sixty-three coalitions involved 1725 members representing 71 counties within 10 states. Intervention. A network of local and regional community cancer control coalitions throughout rural Appalachia delivered culturally sensitive cancer control messages to women, with the long-term goal of increasing the early detection of breast cancer ANALYSIS: County-level coalitions were the unit of analysis for this study. Multiple linear regression was used to determine if three classes of variables corresponding to the developmental history of coalitions--formation, preparation for implementation, and implementation--were associated with the number of educational and screening activities conducted by the coalitions. RESULTS: The presence of a paid coordinator and formal organizational structure were both strongly associated with the number of activities conducted, accounting for 71% of the variability in coalition activities. Other variables positively associated with number of activities were the preparation of written community assessments and the modification of implementation plans. The same factors (structure, written plans) were associated with activities in coalitions without paid organizers (r2 = .57), as was the number of meetings. However, such coalitions produced an average of only 2.2 activities vs. 21.7 activities in coalitions with paid coordinators. CONCLUSION: The ALIC study would seem to indicate that community-based coalitions with paid coordinators and formal structures are capable of generating significantly higher levels of activity than those without either a paid coordinator or formal structure.