Recruitment, training outcomes, retention, and performance of community health advisors in two tobacco control interventions for Latinos.

Community Health Advisors (CHAs) are indigenous lay health advisors who, with training, can create health awareness, disseminate health information and support behavior change in their communities. Little data are available that describe the characteristics, recruitment, training, retention, and performance of CHAs. The present study described the characteristics, recruitment process, training outcomes, retention activities, and performance of two sets of CHAs who delivered tobacco-related interventions in the local Latino community. The Tobacco Control in Latino Communities (TCLC) Center trained 35 CHAs to conduct either a smoking cessation program for Spanish-speaking adult smokers or a behavioral problem-solving intervention to reduce environmental tobacco smoke (ETS) exposure among low-income Latino children. Theoretical psychosocial constructs related to behavior change, general self-esteem, general self-efficacy, and demographics were collected from CHAs before and after training. Additional measures captured the level of professionalism exercised and effort undertaken by the CHAs, as well actual outcomes of their efforts. Of the 33 women and 2 men CHAs recruited, 86% were originally from Mexico, most had a high school education, most were married, and the average monthly household income was $1,100-$1,400. Mean participant age was 42 years, and level of acculturation was relatively low. There were changes in the desired direction pre-to-post training for both ETS and smoking cessation program CHAs for most of the psychosocial constructs. Expert ratings of CHA performance were good, and recipients of the CHAs' efforts showed positive changes in behavior. This information may aid in planning for recruitment and evaluation of CHAs for future tobacco control programs.

Parental prompts as risk factors for adolescent trial smoking: results of a prospective cohort study.

Our earlier cross-sectional research suggested that smoking parents, particularly Latino parents, engage in behaviors that may prompt their children to smoke (e.g., request their child to start the parent's cigarette in his/her own mouth). This prospective study of 478 adolescent never-smokers, mostly Latino, suggests that parental prompts to smoke were not significantly related to smoking initiation among adolescents over a 1-year period.

Concordance between parental and children's reports of parental smoking prompts.

STUDY OBJECTIVES: To describe the prevalence of parental prompting to smoke (eg, parent requests that their child light the parent's cigarette in his/her own mouth) in a sample of families, and to assess the agreement between child and parent reports of the prompting behaviors. DESIGN, SETTING, AND PARTICIPANTS: A total of 3,624 adolescents from 10 middle/junior high schools completed baseline surveys. Parents identified as smokers in these surveys were contacted to complete a telephone survey. These analyses included 270 parent/child pairs. Fifty-one percent of parents were Latino American, 51% had the equivalent of a high-school diploma, 83% were employed when surveyed, and the median household monthly income was between $2,200 and $2,599. MEASUREMENTS AND RESULTS: Students completed a paper-and-pencil survey assessing demographic characteristics, seven parental prompts to smoke, past month smoking, parental smoking, acculturation, and familism. A similar questionnaire was developed to collect information by telephone from smoking parents. Concordance between child- and parent-reported prompting was > 85% for five of seven prompts. However, the reported prevalence of six of the seven prompts was lower among parents than children. Thirty-two percent of mothers and 17% of fathers reported prompting their children to bring cigarettes to parents (the most common prompt). Students reported that 62% of their mothers and 54% of their fathers prompted them to bring their cigarettes, a substantial discrepancy in both cases. CONCLUSIONS: Child-reported prompting prevalence was consistently higher than parents' reports, with the biggest discrepancies between requests to clean ashtrays and bring cigarettes, the two most common prompts. In subsequent studies of parental prompting, it is advisable to collect data from both children and parents and to validate the accuracy of the sources.

Availability of cigarettes as a risk factor for trial smoking in adolescents.

OBJECTIVES: To examine associations between cigarette availability measures with trial (ie, first) use of cigarettes. METHODS: At Time 1 and one year later (Time 2), 478 adolescents completed smoking surveys. Trial smoking at Time 2 was predicted from Time 1 availability variables (prospective prediction), as well as Time 2 availability variables (cross-sectional prediction). RESULTS: Offers from friends/classmates were a significant cross-sectional predictor. In prospective analyses, greater perceptions of ease of obtaining cigarettes from parents and greater frequency of offers from an adult were related to trial smoking. CONCLUSIONS: Adult influences, including parental factors, may predispose a young adolescent to smoke.

Parental prompting and smoking among Latino youth.

OBJECTIVES: Our previous research indicated that Latino parents, more so than non-Latino parents, may prompt their children to engage in behaviors that encourage them to "practice" smoking-related behaviors. The present study examined Latino and non-Latino adolescents' reports of parental prompting, defined as parental requests to: 1) empty/clean ashtrays; 2) bring cigarettes to parent; 3) accept tobacco industry promotional gear as a gift; 4) buy cigarettes for parent; 5) light parent's cigarette with a match or lighter; 6) start the cigarette in his/her own mouth and then pass it to parent; and 7) smoke with the parent. DESIGN AND METHODS: In 10 schools in the Southbay area of San Diego, 3,599 7th and 8th grade middle school students, the majority of whom were Latino, completed cross-sectional surveys assessing 7 parental prompts, past-month smoking, parental smoking, acculturation, and familism. RESULTS: Findings indicated that parental prompts were less prevalent than in our previous work. We also found that there were not consistent or great differences in the prevalence of prompting between Latinos and non-Latinos and that parental prompting, particularly requests that the child light the parent's cigarettes with a match or lighter, was associated with children's smoking. Further, we found that Latino adolescents may be influenced by more parental prompts than non-Latinos, and finally that higher familism scores were significantly associated with lower risk of smoking, regardless of ethnicity. CONCLUSIONS: Parental prompting and familism appear to be important correlates of adolescent smoking.