Citizen Science: A New Approach to Smoke-Free Policy Advocacy.

Kentucky has the second highest adult smoking rate, has the highest incidence of lung cancer in the nation, and does not have a state law prohibiting smoking inside workplaces. These tobacco disparities and policy gap leave Kentucky behind tobacco control progress made in other areas of the United States. Williamstown is a rural community with a population of 3,900 and a strong history of tobacco use. In 2017, the Northern Kentucky Health Department, in partnership with Interact for Health, worked with two coalitions to collect data, educate the community, and advocate for a local smoke-free policy. Coalition members collected 227 public opinion surveys. Community leaders-including the mayor-and advocates participated in Citizen Science, a research collaboration between scientists and volunteers. Advocates were trained on AirBeam monitors, wearable devices that gather air quality data in real time, and then were deployed in six establishments. The indoor air quality in smoking establishments was two times worse than the outdoor air quality standard. Community leaders and advocates then mobilized to educate City Council members on the benefits of a smoke-free policy, focusing on business, health, and tourism. In 2018, the Williamstown City Council voted in favor of the smoke-free policy, becoming the first jurisdiction in the Northern Kentucky region with a comprehensive smoke-free policy. The Citizen Science process helped develop coalition capacity, build community support, and engage policymakers in a successful smoke-free policy effort. Through participatory and inclusive efforts, local residents were able to affect policy change in the direction of health for all people.

Environmental changes to control obesity: a randomized controlled trial in manufacturing companies.

PURPOSE: To determine the effects of an environmental intervention on obesity, disease risk factors, and dietary intake in an employee population. DESIGN: Randomized controlled community trial. SETTING: Eight manufacturing companies in Kentucky with ∼150 to 350 employees each. SUBJECTS: Randomly selected employees. INTERVENTION: Multicomponent environmental intervention that included employee advisory committees, point-of-decision prompts, walking paths, cafeteria/vending changes, and educational materials. MEASURES: Height; weight; body fat; blood pressure; fasting lipids, glucose and insulin; and dietary intake were assessed prior to and 3, 6, and 12 months after initiation of the intervention. ANALYSIS: Mixed-model repeat-measure analyses of covariance were used to analyze data collected over the study period. Categorical data were analyzed in contingency tables. A p value of .05 was used to judge statistical significance. RESULTS: There were no intervention effects for outcome variables, with the exception of lower intake of saturated fat and dietary cholesterol in the intervention group compared to the control group. Over the course of the study, changes in anthropometry and biomeasures were similar in both groups. CONCLUSIONS: Findings indicate that subtle environmental changes alone may not impact employees' weight and health; however, such institutional-level approaches may be essential to support healthy lifestyle habits that are initiated by more intensive efforts. Academic researchers should continue to partner with employers and practitioners to develop, implement, and evaluate innovative health promotion strategies including environmental interventions.

Development of a pedestrian walkability database of Northern Kentucky using Geographic Information Systems (GIS).

BACKGROUND: Rising obesity rates in the United States has spurred efforts by health advocates to encourage more active lifestyles including walking. Ensuring the availability, quality and safety of pedestrian walkways has become an important issue for government at all levels. METHODS: Pedestrian paths in Campbell County Kentucky were evaluated using a ranking criteria developed by the Walking and Bicycling Suitability Assessment (WABSA) project at the University of North Carolina School of Public Health. A pedestrian path Geographic Information System (GIS) data-layer was created and mobile GIS units were used to assess the sidewalk segments using the ranking. Data from sidewalk surveys were compared with Census 2000 blockgroup information on age of housing, population density and household transportation characteristics to examine the correlation between these factors and sidewalk presence and quality. The analysis explored to use of census data to predict walkability factors and looked for trends in quality and availability of pedestrian paths over time. RESULTS: Results showed higher overall scores for older urban areas adjacent to the Ohio River and Cincinnati. Housing built in the 1970s and 1980s showed the lowest scores while more recent housing showed improvement over earlier decades. Age of housing was determined to be a useful predictor while economic and population density attributes showed no correlation with walkability factors. CONCLUSION: Census housing age data are the most useful predictor of walkability demonstrating clear trends over time. The study shows improvements in walkways availability over the past few decades. However infrastructure improvements are needed to provide more extensive pedestrian walkways and linkages between existing walkways in Campbell County.

Prevalence of obesity and cardiovascular risk factors among manufacturing company employees in Kentucky.

The purpose of this study was to examine the prevalence of obesity and cardiovascular risk factors among male and female employees of eight small manufacturing companies in Kentucky. Randomly selected employees were screened using anthropometric and metabolic measures and a food frequency questionnaire. More than 77% of participants were classified as overweight or obese, higher than national estimates. Obesity was associated with a higher prevalence of hypertension, dyslipidemia, and elevated fasting glucose. Consistent with national data, males had an increased prevalence of specific risk factors (i.e., elevated blood pressure, low high-density lipoprotein cholesterol, and hypertriglyceridemia), while females had an increased prevalence of at-risk waist circumference. One potential contributor to high prevalence rates was dietary practices that did not meet recommended guidelines for health. Results suggest an increased risk for cardiovascular disease among employees of Kentucky manufacturing companies and the need for interventions to reduce obesity and its comorbidities in this target population.

Changing the work environment to promote wellness: a focus group study.

It is estimated that employers spend more than 75 billion dollars annually on obesity-attributable health care. Interventions to reduce or prevent the risk of obesity are increasingly common at worksites and include health fairs, weight loss and nutrition classes, and fitness programs. However, many companies lack the resources to plan and implement these types of programs. Environmental approaches offer companies a low-cost option. A community-based participatory research model was used to bring academic researchers, human resources personnel, and health department educators together to plan and implement an environmental program aimed at increasing healthy eating and physical activity at four small manufacturing companies. The Diffusion of Innovations Theory guided the development of focus group questions. A focus group study was then conducted to gather information from employees and managers at these four companies. The questions identified workplace strategies that would aid in reducing barriers and developing appropriate communication channels to enhance employee participation in the program. The researchers identified themes from manager and employee focus groups regarding the following five environmental components: signs, walking paths, food changes, educational strategies, and advisory groups.