Community Coalition for Tobacco-free Youth: Results of a Needs Assessment

One of the goals of Extension's national health agenda "Decisions for Health" is to expand the ability of communities to strengthen their health and health related infrastructure needs (United States Department of Agriculture-Extension Service & University of Wisconsin Extension, 1992). Under this goal, Extension educators will identify and develop strategic partnerships and coalitions at local, state, and national levels involving health providers, educators, and consumers. Towards this end, Penn State Cooperative Extension, The Pennsylvania Department of Health, and Fox Chase Cancer Center have joined hands to address the issue of tobacco use among teenagers.

In September 1993, needs assessments were conducted in six Pennsylvania counties (Bucks, Clarion, Columbia, Franklin, Wayne, and Westmoreland). These counties were selected based upon a socio-demographic review and factors associated with youth tobacco use. One of the purposes of this needs assessment was to ascertain a more detailed profile of six communities and their needs for developing a grass-roots community coalition to address tobacco use among youth. Specifically, this study sought to determine:

1. what key opinion leaders in the community feel are major issues related to youth and tobacco use;

2. which organizations should be approached formally to participate as a part of the coalition; and

3. who may be willing to participate as part of the coalition leadership.

Descriptive research methodology was used to collect data. Five hundred eleven individuals from the six counties were selected to participate in the needs assessments. These 511 individuals included local leaders, elected officials, representatives from health, service and religious organizations, teachers, business groups, and volunteer agencies.

A mail survey was developed to collect data for the study. The instrument had four sections: (a) assessing problems relative to tobacco and alcohol use in the community, (b) tobacco use prevention activities, (c) organizational information, and (d) respondent information. The instrument was validated for content and face validity by a panel of 16 individuals comprised of Extension agents, health education professionals, advocates for smoke-free Pennsylvania, and Pennsylvania State University faculty and graduate students. A total of 355 individuals responded to the survey for a return rate of 70%. Data were analyzed using frequencies, means, and percentages.

Demographic Profile

A majority of the respondents were male (55%). Regarding age, 49% were in the 25-44 year old age category and 46% were in the 45-64 year old age category. One hundred ninety-five (55%) of the respondents represented an agency or an organization. Of this 195, 46 (24%) were from educational institutions, 31 (16%) from human resource organizations, 25 (13%) from youth service organizations, 16 (8%) from religious institutions, and 14 (7%) from health service agencies. The remaining 160 respondents represented business persons, local leaders, individuals, and youth. Respondents were asked whether or not they currently use tobacco products. A little over one-half (56%) had never used tobacco products, while 30% did not use tobacco 30 days prior to responding to the survey. However, 11% and 3% of respondents did smoke and chew tobacco respectively 30 days prior to responding to the survey.

Assessment of Youth Issues

Respondents were asked to check the five most serious problems facing youth in their communities. A majority of the respondents (54%) indicated that cigarettes as a serious problem in their communities. In addition, 34% indicated that chewing or smokeless tobacco is also a serious problem. The other serious problems facing their communities included: alcohol, teenage pregnancy, vandalism, and sexually transmitted diseases. When asked at what age most youths normally try cigarettes/chewing tobacco, slightly over half (52%) checked the age category under 13, while 47% checked 14-17 years category. Sixty percent indicated that tobacco advertisements encourage youth to use tobacco. Respondents said that youth are most likely to get tobacco from friends (40%), followed by vending machines (30%), and stores (26%).

Important Resources and Groups to Prevent Tobacco Use by Youth

Respondents were asked to identify the five most important resources to prevent tobacco use by youth. Peer counseling and support to encourage youths not to use tobacco products was identified as the most important resource (64%), followed by enforcement of current restriction on tobacco sales to minors (57%), elimination of all use of tobacco products in schools (49%), and more emphasis on tobacco in the school curricula (39%).

Further, respondents identified parents and families (90%), youth themselves (89%), elementary and secondary schools (77%), mass media (73%), and youth service organizations (48%) as having the greatest potential to address youth tobacco use.

It appears that most respondents were aware of and knowledgeable about issues related to tobacco use in their communities. Awareness of these issues and perceptions about various issues relative to tobacco will be of immense use to Extension agents for organizing community coalitions. Extension agents should consider these aspects when recruiting members for their coalitions.

The results of this needs assessment has provided valuable information pertaining to the needs of the coalition, resources available in the community, perceptions of problems related to youth, and potential solutions. In addition, the results have helped Extension agents to: (a) identify membership for their coalitions, (b) establish goals and objectives, (c) develop action plans, and (d) develop agenda for their coalition meetings.

Extension agents should consider including parents and families, youth, representatives from elementary and secondary schools, mass media, and youth service organizations as potential members of their coalitions. Since 46% of the respondents in this study represented educational institutions, Extension agents should include schools, teachers, school administrators, and students in their coalitions. Schools are often the second agency (the first being family) to see a problem with the child. In many communities, schools have played an active role in addressing issues related to youth.

A summary of the needs assessment results was sent to all participants and a short summary of the results were also published in local newspapers. To follow-up on needs assessments results, two inservice workshops were conducted for Extension agents, which focused on coalition building strategies and developing action plans. Extension agents are using information presented in these workshops to organize their coalitions. As of November, 1994, all six counties had established coalitions. They have also recruited members for their coalitions. Membership in these coalitions include: girl and boy scouts, 4-H, dentists, teachers, a county commissioner, nurses, representatives from American Cancer Society, Drug and Alcohol, youth service organizations, and others. Activities of the established coalitions include: establishing a name for the their coalitions, developing a mission statement, identifying leadership for the coalitions, setting goals and objectives for their coalitions, and developing action plans for the next year.

United States Department of Agriculture-Extension Service & Wisconsin Extension. (1992). Decisions for health--an Extension system agenda (National Extension Health Agenda Task Force Special Project, No. 91-EXCA-2-0148). Madison, WI: Author.