The impact of responsible fatherhood programs on parenting, psychological well-being, and financial outcomes: A randomized controlled trial.

The objective of this study was to examine differences in parenting, psychological well-being, and economic outcomes between fathers receiving two different programs offered by Fathers & Families Support Center for economically disadvantaged fathers: (a) Family Formation (FF), a 6-week/240-h program focused on economic stability/mobility, responsible fatherhood, and healthy relationships, with case management and legal services; (b) Economic Stability (ES), a 4-week/80-h program focused only on economic stability with limited case management and legal services. A randomized controlled trial (RCT) was used to compare fathers in FF (n = 350) vs. ES (n = 342). Surveys were administered at enrollment and 3- and 12-months postintervention. Linear and generalized linear mixed models were used to assess changes in program outcomes over time and across study groups. Four hundred and eighty-two fathers responded to either follow-up survey (251 FF, 231 ES). Nearly all (98%) were non-white (93% Black, 5% other/mixed race) and were on average 34 years old. Approximately 46% attended ≥75% of program sessions (FF 48% vs. ES 44%). Both FF and ES groups experienced improvements in parenting, psychological well-being, and financial outcomes after the programs, but changes in outcomes over time did not differ significantly by program. The lack of difference in outcomes between fathers in FF and ES groups could be due to a similar core focus on employment-related curriculum for both groups. Gaining financial stability could have contributed to positive improvements in other fatherhood domains. Implications for future research and practice are discussed herein.

El objetivo de este estudio fue analizar las diferencias en la crianza, el bienestar psicológico y los resultados económicos entre padres que recibían dos programas diferentes ofrecidos por el Centro de Apoyo a los Padres y las Familias (Fathers & Familiares Support Center) para padres desfavorecidos económicamente: (a) Formación de una Familia (Family Formation, FF), un programa de 6 semanas/240 horas centrado en la estabilidad/movilidad económica, la paternidad responsable y las relaciones saludables, con gestión de casos y servicios legales; (b) Estabilidad Económica (Economic Stability, ES), un programa de 4 semanas/80 horas centrado solamente en la estabilidad económica con poca gestión de casos y servicios legales. Se usó un ensayo controlado aleatorizado para comparar a los padres de FF (n=350) con los de ES (n=342). Se realizaron encuestas en la inscripción y a los 3 y a los 12 meses posteriores a la intervención. Se usaron modelos lineales y modelos mixtos lineales generalizados para evaluar los cambios en los resultados de los programas con el tiempo y entre los grupos de estudio. 482 padres respondieron a cada encuesta de seguimiento (251 FF, 231 ES). Casi todos (el 98 %) eran de color (el 93 % negros, el 5 % de otra raza o de raza mestiza) y tenían, en promedio, 34 años. Aproximadamente el 46 % asistió a más del 75 % de las sesiones de los programas (el 48 % de FF frente al 44 % de ES). Tanto el grupo de FF como el de ES tuvieron mejoras en la crianza, en el bienestar psicológico y en los resultados económicos después de los programas, pero los cambios en los resultados con el tiempo no variaron significativamente por programa. La falta de diferencia en los resultados entre los padres del grupo de FF y los del grupo de ES podría deberse a un enfoque principal similar en un currículo relacionado con el empleo para ambos grupos. La adquisición de estabilidad económica podría haber contribuido a mejoras positivas en otras áreas de la paternidad. Se comentan las consecuencias para la futura investigación y la práctica.

Development of a computational modeling laboratory for examining tobacco control policies: Tobacco Town.

A key focus of recent policy efforts to curb tobacco product usage has been the role of place-specifically the density of retail and advertising and the resulting spatial pattern of access and exposure for consumers. Policies can alter the environment by reducing density or shifting distribution of tobacco retail and thus limiting access and exposure. Since little empirical evidence exists for the potential impact of these policies across potentially heterogeneous places, we develop and apply an original spatial computational model to simulate place-based retail tobacco control policies. The model is well-grounded in theory and available empirical evidence. We apply the model in four representative settings to demonstrate the utility of this approach as a policy laboratory, to develop general insights on the relationship between retailer density, retail interventions, and tobacco costs incurred by consumers, and to provide a framework to guide future modeling and empirical studies. Our results suggest that the potential impact on costs of reducing tobacco retailer density are highly dependent on context. Projected impacts are also influenced by assumptions made about agent (smoker) purchasing decision-making processes. In the absence of evidence in this area, we tested and compared three alternative decision rules; these interact with environmental properties to produce different results. Agent properties, namely income and cigarettes per day, also shape purchasing patterns before and after policy interventions. We conclude that agent-based modeling in general, and Tobacco Town specifically, hold much potential as a platform for testing and comparing the impact of various retail-based tobacco policies across different communities. Initial modeling efforts uncover important gaps in both data and theory and can provide guidance for new empirical studies in tobacco control.

Tobacco Town: Computational Modeling of Policy Options to Reduce Tobacco Retailer Density.

OBJECTIVES: To identify the behavioral mechanisms and effects of tobacco control policies designed to reduce tobacco retailer density. METHODS: We developed the Tobacco Town agent-based simulation model to examine 4 types of retailer reduction policies: (1) random retailer reduction, (2) restriction by type of retailer, (3) limiting proximity of retailers to schools, and (4) limiting proximity of retailers to each other. The model examined the effects of these policies alone and in combination across 4 different types of towns, defined by 2 levels of population density (urban vs suburban) and 2 levels of income (higher vs lower). RESULTS: Model results indicated that reduction of retailer density has the potential to decrease accessibility of tobacco products by driving up search and purchase costs. Policy effects varied by town type: proximity policies worked better in dense, urban towns whereas retailer type and random retailer reduction worked better in less-dense, suburban settings. CONCLUSIONS: Comprehensive retailer density reduction policies have excellent potential to reduce the public health burden of tobacco use in communities.

Reducing Disparities in Tobacco Retailer Density by Banning Tobacco Product Sales Near Schools.

INTRODUCTION: This study examined whether a policy of banning tobacco product retailers from operating within 1000 feet of schools could reduce existing socioeconomic and racial/ethnic disparities in tobacco retailer density. METHODS: We geocoded all tobacco retailers in Missouri (n = 4730) and New York (n = 17 672) and linked them with Census tract characteristics. We then tested the potential impact of a proximity policy that would ban retailers from selling tobacco products within 1000 feet of schools. RESULTS: Our results confirmed socioeconomic and racial/ethnic disparities in tobacco retailer density, with more retailers found in areas with lower income and greater proportions of African American residents. A high proportion of retailers located in these areas were in urban areas, which also have stores located in closer proximity to schools. If a ban on tobacco product sales within 1000 feet of schools were implemented in New York, the number of tobacco retailers per 1000 people would go from 1.28 to 0.36 in the lowest income quintile, and from 0.84 to 0.45 in the highest income quintile. In New York and Missouri, a ban on tobacco product sales near schools would either reduce or eliminate existing disparities in tobacco retailer density by income level and by proportion of African American. CONCLUSIONS: Proximity-based point of sale (POS) policies banning tobacco product sales near schools appear to be more effective in reducing retailer density in lower income and racially diverse neighborhoods than in higher income and white neighborhoods, and hold great promise for reducing tobacco-related disparities at the POS. IMPLICATIONS: Given the disparities-reducing potential of policies banning tobacco product sales near schools, jurisdictions with tobacco retailer licensing should consider adding this provision to their licensing requirements. Since relatively few jurisdictions currently ban tobacco sales near schools, future research should examine ways to increase and monitor the uptake of this policy, and assess whether it has an impact upon reducing exposure to tobacco marketing and on tobacco product availability and use.

Tobacco retail policy landscape: a longitudinal survey of US states.

BACKGROUND: There are ∼380 000 tobacco retailers in the USA, where the largest tobacco companies spend almost $9 billion a year to promote their products. No systematic survey has been conducted of state-level activities to regulate the retail environment, thus little is known about what policies are being planned, proposed or implemented. METHODS: This longitudinal study is the first US survey of state tobacco control programmes (TCPs) about retail policy activities. Surveyed in 2012 and 2014, programme managers (n=46) reported activities in multiple domains: e-cigarettes, retailer density and licensing, non-tax price increases, product placement, advertising and promotion, health warnings and other approaches. Policy activities were reported in one of five levels: no formal activity, planning or advocating, policy was proposed, policy was enacted or policy was implemented. Overall and domain-specific activity scores were calculated for each state. RESULTS: The average retail policy activity almost doubled between 2012 and 2014. States with the largest increase in scores included: Minnesota, which established a fee-based tobacco retail licensing system and banned self-service for e-cigarettes and all other tobacco products (OTP); Oregon, Kansas and Maine, all of which banned self-service for OTP; and West Virginia, which banned some types of flavoured OTP. CONCLUSIONS: Retail policy activities in US states increased dramatically in a short time. Given what is known about the impact of the retail environment on tobacco use by youth and adults, state and local TCPs may want diversify policy priorities by implementing retail policies alongside tax and smoke-free air laws.

State Level Point-of-Sale Policy Priority as a Result of the FSPTCA.

The Family Smoking Prevention and Tobacco Control Act (FSPTCA) give the U.S. Food and Drug Administration (FDA) unprecedented power to regulate tobacco products. One of the most significant provisions of the law allows state and local governments to adopt and enforce tobacco control legislation restricting the time, place, and manner (but not the content) of tobacco advertising. However, there is still reluctance among states and localities for mass adoption of laws due to challenges associated with legal feasibility and lack of U.S.-based evidence in effectiveness. The Center for Public Health Systems Science conducted interviews with key tobacco control contacts in 48 states at two time points (2012 and 2014) since the passage of the FSPTCA to assess the influence of the law on point-of-sale policy development in their state tobacco programs. Logistic regression results show that point-of-sale policy importance is growing post-FSPTCA, and that key influencers of this importance are states' tobacco control histories and environments, including that related to excise taxes and smoke free air policies. The adoption of smokefree and tax policies has become commonplace across the U.S., and the quality and extent of these laws and prevailing political will increasingly impact the ability of states to work in emerging tobacco control policy areas including those directed at the point of sale.

Family Smoking Prevention And Tobacco Control Act: banning outdoor tobacco advertising near schools and playgrounds.

BACKGROUND: The tobacco industry has challenged new FDA rules restricting outdoor tobacco advertising near schools and playgrounds on First Amendment grounds, arguing that they would lead to a near complete ban on tobacco advertising in dense urban areas. PURPOSE: To examine how the 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA) rules banning outdoor tobacco advertising near schools and playgrounds would affect tobacco retailers. METHODS: GIS spatial analyses of two different states (Missouri, New York), along with more detailed analyses of two urban areas within those states (St. Louis, New York City), were conducted in 2010. The percentage of tobacco retailers falling within 350-, 500-, and 1000-foot buffer zones was then calculated. RESULTS: 22% of retailers in Missouri and 51% in New York fall within 1000-foot buffers around schools. In urban settings, more retailers are affected, 29% in St. Louis and 79% in New York City. Sensitivity analyses demonstrate that smaller buffers decrease the proportion of affected retailers. That is, 350-foot buffers affect only 6.7% of retailers in St. Louis and 29% in New York City. CONCLUSIONS: The effects of new outdoor tobacco advertising restrictions vary by location and population density. In Missouri and New York, outdoor tobacco advertising would still be permitted in many locations if such advertising was prohibited in a 1000-foot buffer zone around schools and playgrounds. Much smaller buffer zones of 350 feet may result in almost no reduction of outdoor advertising in many parts of the country.