Using New Statewide Data to Implement Data-Driven Tobacco Cessation Programming
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Using New Statewide Data to Implement Data-Driven Tobacco Cessation Programming DARBY ANDRE PUBLIC HEALTH MANAGEMENT CORPORATION RESEARCH & EVALUATION GROUP I have no conflicts of interests to disclose. This program is supported by the Pennsylvania Department of Health. Its contents are solely the responsibility of the author and do not necessarily represent the official views of the Pennsylvania Department of Health. Pennsylvania Counties and Health Districts Southeastern Pennsylvania Tobacco Control Project (SEPA TCP) Overview Importance of local LGBTQ+ data Pennsylvania LGBT Health Needs Assessment ◦ Key Recommendations and Findings Health Promotion Council’s (HPC) use of the Needs Assessment in Southeastern Pennsylvania (SEPA) ◦ The work of community-based LGBTQ organizations in SEPA Data as social justice • What we don’t know can hurt us • Using data to support our communities • “Nothing about us without us” Philadelphia County Southcentral PA In 2018, Pennsylvania Department of Health and an LGBT community center partnered to re-administer the needs assessment, with some changes: o Statewide sample o New CDC-approved survey tool o 7-week data collection period o Many community partners for data collection This tool was developed in collaboration with LGBT HealthLink, a program of CenterLink. Usage of this survey tool may allow for cross-state data comparisons if LGBT HealthLink runs the survey in other states within a similar time- frame. For information visit lgbthealthlink.org Data collection partners Equality Pennsylvania Educational Fund Montgomery County LGBT Business Council Erie Gay News Pennsylvania Youth Congress Fighting AIDS Continuously Together Persad Center Philadelphia Gay News Greater Erie Alliance for Equality Rainbow NEPA Grindr for Equality The LGBT Center of Greater Reading Human Rights Campaign Triversity LGBT Center of Central PA Washington County GSA LGBT Equality Alliance of Chester County William Way LGBT Community Center LGBTQmunity Center of Montgomery County York Equality Fest Metropolitan Community Church of Lehigh Valley 4,679 Pennsylvanians who across their lifetimes consider themselves to be Lesbian, Gay, Bisexual, or Transgender Who completed the survey? 538 respondents wrote-in their About 17% of respondents did description, most commonly Pansexual, not identify as female or male Queer, and Asexual. Female 40.6% Gay 38.3% Male 42.3% Lesbian 24.0% Transgender 7.7% Bisexual 21.2% Another 6.4% Another 14.3% Gender Identity Do not identify as male, Sexual Orientation Sexual 3.0% female or transgender Straight 2.2% Who completed the survey? Just under half of all respondents Almost 3 out of 4 respondents are White, but are between ages 25 and 49. more than one race could be selected. Under 18 years 4.5% Native Hawaiian or Pacific Islander 18 to 24 years 20.9% Middle Eastern or North African American Indian or Alaskan Native 25 to 49 years 48.9% Age Asian Other 50 to 64 years 19.3% Black or African American Race & Ethnicity 65+ years 6.4% White Limitations Sexual orientation and gender identity options were limited 3 out of 4 respondents were white Most respondents were between 25 and 49 Online only Only available in English Cross sectional (single point in time) Convenience sample Findings – Statewide When asked: Have you advised your personal provider(s) that you are LGBT? More than 1 in 4 report they have not advised any provider. None of them 26.2% More than half of all respondents sometimes, often or always fear a negative reaction by a health care Some of them 28.8% provider. 3 in 4 transgender and gender non- with Providers Communication conforming respondents report this fear. All of them 45.0% Transgender and gender non-conforming 75.1% Sometimes, Often or Always fear a negative reaction Cisgender 52.3% Findings – Statewide Respondents find their health care providers, on average, vary in their competency about LGBT issues. Almost 1 in 3 report their provider is not at all or slightly competent. Not at all 7.6% Slightly 24.9% Moderately 42.1% Very 19.6% Provider Competency Provider Extremely 5.7% Findings – Tobacco Use Current Cigarette Use Transgender & Gender non- All LGBT conforming Northwest 42.9% n/a Southwest 35.4% n/a Allegheny County 24.1% 33.8% North Central 40.4% 42.9% South Central 28.1% 34.2% Northeast 37.4% 44.9% Southeast 27.3% 35.2% Current Tobacco Current Philadelphia County 22.0% 31.8% Any Region 30.2% 36.9% Findings – Tobacco Opinions Agree Neutral Disagree LGBT people smoke more than the general population. 44.9% 42.9% 12.3% Pride celebrations should be smoke-free events. 52.8% 31.6% 15.6% I would be likely to go to a smoke-free bar/club. 60.4% 28.4% 11.2% I would be likely to go to a smoke-free Pride event. 65.2% 28.8% 6.0% I would be likely to go to a smoke-free LGBT Community Center. 67.6% 27.8% 4.6% Findings – Southeastern Pennsylvania Recommendations 1. Support connection to LGBT-competent providers 2. Encourage health screening discussions 3. Prioritize chronic disease prevention 4. Promote tobacco cessation opportunities 5. Identify community-wide mental health supports 6. Continue and enhance data collection 7. Partner with LGBT community-based organizations Recommendation: Partner with LGBT community- based organizations Recommendation: Support connection to LGBTQ- competent Finding: One in four respondents providers sometimes, often, or always experience a health care provider react poorly when they come out as LGBT Recommendation: Cultural Humility Training for TDT Providers Support connection to Cultural humility over cultural competency LGBTQ- Individual trainings for all sites competent Training for all staff providers Technical assistance around organizational policies Recommendation: Promote tobacco cessation opportunities Finding: In SEPA, 37% of all LGBT smoke (compared to 18% statewide), and 53% of 18 to 24 year-old respondents smoke. Finding: 65% respondents said they would be likely to go to a smoke- free pride event and over half agreed that pride should be smoke-free events Tobacco companies have historically and still sponsor Prides HPC sponsors pride events in Southeastern Pennsylvania HPC’s LGBT community partners table at pride events with tobacco info and resources All Pride events in Southeastern Pennsylvania are smoke-free Finding: 30% of respondents were never screened for HIV even though 36% had at least one risk factor for HIV People living with HIV smoke at higher rates The risks of serious smoking-related health consequences are much higher for those living with HIV HPC pilot referral initiative between TDT providers and HIV clinics Finding: Transgender and gender non-conforming respondents report higher rates of current smoking than cisgender respondents HPC LGBT community partners do a lot of outreach work in high school and colleges on tobacco usage and work with a lot of transgender students o Emphasize the higher rates of smoking in trans communities and how smoking can affect the healing process for gender-affirming surgeries HPC is looking to use the data to reach this population in the future Recommendation: Continue and enhance data collection Thank you! Darby Andre [email protected] Research and Evaluation Group https://www.sepatobaccofree.org/ Sources https://www.livehealthypa.com/docs/default-source/toolkits/lgbt/pennsylvania-2018.pdf?sfvrsn=0 http://www.thetaskforce.org/why-data-collection-matters-to-lgbt-people/ https://www.hiv.gov/hiv-basics/staying-in-hiv-care/other-related-health-issues/smoking https://truthinitiative.org/news/one-trend-changing-pride-festivals-better https://CDC.gov/STATESystem .