Examining local smoke-free coalitions in Armenia and Georgia: context and outcomes of a matched-pairs community-randomised controlled trial.

Autor:	Berg CJ; Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia, USA carlaberg@gwu.edu., Haardörfer R; Rollins School of Public Health, Emory University, Atlanta, Georgia, USA., Torosyan A; National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia., Dekanosidze A; National Center for Disease Control and Public Health, Tbilisi, Georgia.; Tbilisi State Medical University, Tbilisi, Georgia., Grigoryan L; National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia., Sargsyan Z; Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia., Hayrumyan V; Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia., Sturua L; National Center for Disease Control and Public Health, Tbilisi, Georgia.; Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia., Topuridze M; National Center for Disease Control and Public Health, Tbilisi, Georgia.; Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia., Petrosyan V; Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia., Bazarchyan A; National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia., Kegler MC; Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Jazyk:	angličtina
Zdroj:	BMJ global health [BMJ Glob Health] 2024 Feb 07; Vol. 9 (2). Date of Electronic Publication: 2024 Feb 07.
DOI:	10.1136/bmjgh-2023-013282
Abstrakt:	Introduction: Local coalitions can advance public health initiatives such as smoke-free air but have not been widely used or well-studied in low-income and middle-income countries. Methods: We conducted a matched-pairs community-randomised controlled trial in 28 communities in Armenia and Georgia (N=14/country) in which we helped establish local coalitions in 2019 and provided training and technical assistance for coalition activity promoting smoke-free policy development and enforcement (2019-2021). Surveys of ~1450 households (Fall 2018, May-June 2022) were conducted to evaluate coalition impact on smoke-free policy support, smoke-free home adoption, secondhand smoke exposure (SHSe), and coalition awareness and activity exposure, using multivariable mixed modelling. Results: Bivariate analyses indicated that, at follow-up versus baseline, both conditions reported greater smoke-free home rates (53.6% vs 38.5%) and fewer days of SHSe on average (~11 vs ~12 days), and that intervention versus control condition communities reported greater coalition awareness (24.3% vs 12.2%) and activity exposure (71.2% vs 64.5%). Multivariable modelling indicated that intervention (vs control) communities reported greater rates of complete smoke-free homes (adjusted Odds Ratio [aOR] 1.55, 95% confiedence interval [CI] 1.11 to 2.18, p=0.011) and coalition awareness (aOR 2.89, 95% CI 1.44 to 8.05, p=0.043) at follow-up. However, there were no intervention effects on policy support, SHSe or community-based activity exposure. Conclusions: Findings must be considered alongside several sociopolitical factors during the study, including national smoke-free policies implementation (Georgia, 2018; Armenia, 2022), these countries' participation in an international tobacco legislation initiative, the COVID-19 pandemic and regional/local war). The intervention effect on smoke-free homes is critical, as smoke-free policy implementation provides opportunities to accelerate smoke-free home adoption via local coalitions. Trial Registration Number: NCT03447912. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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