Healthy Carolinians Action Plan

County McDowell Partnership: McDowell County Partnership for Health Period Covered 6/2005 – 12/2010

LOCAL PRIORITY ISSUE

· Priority issue: Tobacco Use

· Was this issue described in your county’s most recent Community Health Assessment? x Yes __ No

· List other sources of information about this priority issue:

· 55% of survey respondents consider adult cigarette smoking a major problem in the county. N=569

· 83% of Community Health Assessment Survey respondents (n=569) favored tobacco free worksites.

· COPD is the 3^rd leading cause of death in McDowell County, 22% higher than state’s range, Source: NC State Center for Health Statistics 1999-2002

· Lung cancer was the 3^rd leading cause of death for ages 40-64 in 1999-2002, Source: 2004 McDowell Community Health Assessment

· 2000-2004 Age-Adjusted Death Rate from Lung and Bronchus Cancer in McDowell Co.- 76.1/100,000 and NC Rate -69.9/1000,000, Source: NC State Center of Health Statistics

LOCAL COMMUNITY OBJECTIVE - Please check one: New __ Ongoing from last re/certification

· By: 12/2010

· Objective: Reduce tobacco use (cigarette smoking) by adults through environmental and policy change by 10 %

· Original Baseline: 24.3% adult smokers in Mountain AHEC (Excludes Buncombe) area (NC 22.6%)

· Date and source of original baseline data: 2005 BRFSS Survey

Updated information (For continuing objective only):

· Date and source of updated information:

POPULATION(S)

· Local population(s) experiencing disparities in relation to this local objective:

· 32% smokers 18-44 years of age

· 29.9% with education high school or less

· 30.5% with income less than $50,000

· Describe the local population(s) that will benefit: Everyone benefits from the reduction of second-hand smoke

· Total number in population: 43,000 residents of McDowell county

· Number you plan to reach: Reduce the number of adult smokers in McDowell County (Estimated 10,320 adult smokers; according to the 2005 BRFSS Survey MAHEC mountain region 24% of adults are smokers) Goal is to reduce that number to 9288 by 2010.

NC 2010 FOCUS AREA AND NC 2010 HEALTH OBJECTIVE ADDRESSED

· Check one NC 2010 focus area:

__ Other - Please Describe: ______________________________________________________________________

· NC 2010 Health Objective: Reduce tobacco use (cigarette smoking) by adults.

Target: 12.5 percent

INTERVENTIONS, SETTING, & TIMEFRAME

COMMUNITY PARTNERS

Roles and Responsibilities

EVALUATION PLAN &

PROGRESS TO DATE

1. In order to secure the active involvement of the priority population(s), our Partnership will:

§ P2P youth are involved in program planning and meetings

§ Participants in smoking cessation groups provide input on needed services

§ Tobacco Free McDowell Coalition surveys restaurants and worksites and community groups

Progress to Date:

§ Health Department surveyed public on interest in smoke free worksites in Community Health Assessment

§ McDowell School Tobacco Prevention Program involves youth in assessment and program planning

§ McDowell Health Department and Hospital survey the needs of smoking cessation participants and clientele

§ Tobacco Free McDowell Coalition surveyed restaurants on interest in going tobacco free and offered assistance

§ McDowell Co. Partnership for Health held a county-wide health summit where the public gave input and was invited to participate on an action team for tobacco prevention

§ Health Department surveyed City employees at health fair and interviewed personnel director

2. Marketing/Communication activities related to this community objective:

Lead agency: McDowell School P2P Youth through Health and Wellness Trust Funding utilize media, events and political advocacy to achieve policy change

Other agencies:

§ Tobacco Free McDowell Coalition will

1. market going smoke-free to restaurants and worksites

2. design a brochure promoting tobacco free restaurants

§ Health department, Hospital and School Tobacco Prevention Program will

1. share costs and manpower in marketing to restaurants and worksites

2. inform community groups, county commissioners and chamber director about the benefits of tobacco free worksites

3. create a media campaign on spit tobacco

4. advertise smoking cessation workshops through media, radio, flyers, email lists and individual counseling by nurses

§ Health and Wellness Trust Fund will assist with funding the marketing

Progress to Date:

§ Results of community health assessment were publicized in newspaper and presented to RPM District Board of Health, Partnership for Children, School Health Advisory Council, Community Health Summit, Senior Center and Child Health Summit, and to county commissioners and county manager

§ 300 copies of Community Health Assessment Report distributed throughout the community

§ McDowell Mission Hospital publicized going 100% Tobacco-Free in newspaper and TV

§ HWTF provided tobacco free signs for the hospital

§ Activities of P2P Youth activities are regularly reported in newspaper

§ Annual Drag of Doom display for the public and school children on harmful effects of tobacco use

§ Billboard ad funded by HWTF

§ Movie slides in local theatre promote tobacco free restaurants

§ P2P Youth completed state restaurant survey in spring 2006

§ Health & Wellness Trust Funding (HWTF) via McDowell Schools Tobacco Prevention program has media campaign throughout the county and schools – radio, newspaper, flyers, channel 1, announcements at sporting events

§ HWTF met with restaurant owners and gave information packets on the dangers of second hand smoke

§ Letters were sent to restaurants and worksites surveying interest in going smoke-free and introducing the Tobacco Free McDowell Coalition

§ Tobacco Free McDowell Coalition recognized local smoke-free restaurants with certificate, picture and submission to newspaper

§ HWTF funding paid to place 1 ad monthly highlighting tobacco free restaurants

§ Health Department created a web site to promote Tobacco Free restaurants

§ Health Department and McDowell Schools Tobacco Prevention program faxed information to local family physicians about the Quit Now Fax referral program

§ Health Department made presentations to the Board of Health and County Manager to go 100% Tobacco Free in June 2007

§ Health Dept. had tobacco cessation display at City of Marion Health Fair 5/06

§ Asheville television station (13) produced two 3 minute feature stories on McDowell Health Department’s

Freedom From Smoking Cessation Clinic during Great American Smoke-out 2006

3. Intervention: By 2010, increase the number of tobacco free county recreation facilities

Setting: Community

Start Date - End Date: 07/07 - 07/10

Lead agency: McDowell Schools Tobacco Prevention P2P Youth will advocate for tobacco free county recreation facilities and conduct a survey of people attending county recreation events

Other agencies:

§ HWTF provides funding for advocacy efforts

§ Health Department will provide resources to hand out at games

§ All members of McDowell Tobacco Free Coalition will assist with efforts

This intervention is:
New Ongoing Completed

Process:

# facilities approached

Output/ Impact:

# facilities go smoke-free

Health/ Safety Outcomes:

· Elimination of second-hand smoke in public recreation areas

· Estimated # people who AREN’T subjected to smoke in those places

Progress to Date:

All recreation sites in the city of Marion are now tobacco free

4. Intervention: By 2010, increase the number of tobacco free restaurants

Setting: Restaurants/Community

Start Date - End Date: 05/2006 – 07/2010

Lead agency: HWTF (McDowell Schools Tobacco Prevention Program) will use the Go Light Campaign – a sticker on the door or window of a restaurant that designates tobacco free dining

Other agencies:

§ Tobacco Free Coalition members will

1. help with the Go Light Campaign

2. seek funding partners to publicize tobacco free restaurants in the local newspaper

§ Health Department will design a brochure of tobacco free restaurants with the help of the Tobacco Free McDowell Coalition by 12/2007

§ P2P Youth will help distribute brochures to locations in the county such as visitors bureau, hotels, businesses

This is New Ongoing Completed Process:

# facilities approached

Output/ Impact:

# facilities go smoke-free

Health/ Safety Outcomes:

Estimated # people who AREN’T subjected to smoke in those places

Progress to Date:

State Restaurant Survey finished in Spring 2006

P2P distributed dangers of second hand smoking information to 95% of restaurant owners in McDowell Co.

5. Intervention: Provide at least 3 tobacco cessation programs to the community annually

Setting: Community

Start Date – End Date: 05/2006– 07/2010

Lead Agency: McDowell Health Department will offer two smoking cessation workshops to the public annually and make a public presentation on spit tobacco

Other Agencies:

· McDowell Hospital will

1. counsel patients individually on how to stop smoking

2. explore providing nicotine replacement therapies (such as the nicotine patch, gum, inhaler, etc.) for under-insured

§ Health Department will provide training for facilitators in Fresh Start Cessation Program

§ McDowell Hospital, health department, American Cancer Society and school tobacco prevention program will host a luncheon for business owners promoting tobacco free work sites

§ McDowell Schools Tobacco Prevention program will conduct a workshop on Spit Tobacco targeting athletic staff

§ American Cancer Society will provide educational resources

This is New Ongoing Completed Process:

Output/ Impact: number of tobacco free worksites will increase

Health/ Safety Outcomes: Decrease the number of adults who smoke or use tobacco and suffer the effects of second hand smoke

Progress to Date:

§ Health Department held two cessation programs annually for past two years.

§ Hospital offers individual counseling for smoking cessation to staff

§ Health Department & HWTF McDowell Schools Tobacco Prevention program trained health department and hospital nursing staff in the 5 A’s

§ Health Department nurses counsel patients on 5 A’s and refer to the Fresh Start facilitators

§ HWTF (McDowell Schools Tobacco Prevention program) provided trainers/funding for 5 A’s, Spit Tobacco and Fresh Start training at the Health Department