Goal / Mission

The goal of the Southern Nevada Health District (SNHD) was “to have the voices of the NH/PI communities heard so then they cannot be diminished anymore.” This project was developed under the direction of Tobacco Control Program Coordinator Malcolm Ahlo to highlight the growing Native Hawaiian and Pacific Islander (NH/PI) and LGBTQ+ populations in Las Vegas and in Southern Nevada. Ahlo hoped to collect information, conduct a thorough analysis, and disaggregate data to show how smoking and/or vaping is affecting the community and what can be done to help them reduce these health disparities. The project was started in 2019. The final goal is to create a safe, culturally and linguistically tailored quitline and appropriate cessation protocol for the NH/PI community to call for services needed.

Description

The Southern Nevada Department of Health also known as the Southern Nevada Health District (SNHD) was awarded a 5 year grant through the Centers for Disease Control and Prevention (CDC) to identify and reduce health disparities within the Native Hawaiian and Pacific Islander (NH/PI) and LGBTQIA+ populations (two large segments of the population in Las Vegas often overlooked by health disparities studies) by conducting a more robust and improved survey than that of the General Statewide Adult Tobacco Survey data collection efforts of previously offered by the state of Nevada. SNHD would then follow up on data collected with focus groups. SNDH Tobacco Control Program Coordinator Malcolm Ahlo sought to collect data on these populations to help inform policymakers of the importance for anti-tobacco funding for underserved minorities and the need for policy change among these communities. SNHD hoped the survey would show the disproportionate effects of smoking commercial tobacco on the NH/PI community. SNHD knows that NH/PI communities have increased rates of smoking prevalence but there is a lack of disaggregated data for these communities.

SNHD worked with many community based organizations and nonprofits to identify partnerships to help with data collection. Through its partnership with the Asian Pacific Partners of Empowerment, Advocacy, and Leadership’s (APPEAL) ASPIRE Network, SNHD was able to make connections with its local partner Las Vegas Hawaiian Civic Club (LVHCC) in 2020 to help with data collection and focus group recruitment. LVHCC worked along with Nevada State Policy and Nevada Institute for Children Research and Policy to collect disaggregated data on Native Hawaiian and LGBTQIA + participants living in Southern Nevada and tobacco use. The first survey was conducted in 2020. The survey is conducted bi-yearly. The next survey will take place in 2022, and then, a final survey in 2024. SNHD plans to add additional questions about disparities that the population faces and collect further data on various other Asian American populations with each new survey. This data has been collected and disaggregated by Southern Nevada and its community partners. The data can be used to designate where the state needs to target resources, information to disseminate, and provide more guidance to those communities that need it.

The Southern Nevada Department of Health and the DOH disseminated report findings to other partner organizations and communities requiring TAT for further data sharing to inform programming and policy interventions. SNHD worked with APPEAL through the ASPIRE Network to provide TAT and helped to disseminate newly collected disaggregated data on NH/PIs to improve the General Statewide Adult Tobacco Survey data collection efforts. ASPIRE will be further working to help support SNHD improve tobacco cessation protocols by utilizing data to inform policy and programming initiatives for NH/PIs.

In March 2022, ASPIRE reached out to South Nevada Health District (SNHD) to discuss their data disaggregation efforts relating to expansion of statewide adult tobacco surveys for LGBTQ+ and NH/PIs, use of data to inform policy and culturally tailored quitline/cessation protocols, and future interventions through cessation programming as a success story and lessons learned for repository/ compendium write up. APPEAL is supporting SNHD with next steps for expanding data collection and increasing efforts in tobacco cessation through enhanced quitline protocols and will be standing by to assist with expanding policy initiatives through data.

Implementation Process

Southern Nevada Health District (SNHD) hoped to get the research and numbers to make a difference. From the general statewide adult tobacco survey done annually by the Nevada state tobacco control program, SNHD determined that there was an increased need for further data to improve tobacco policies for certain vulnerable priority populations to reduce tobacco related health disparities in the community. SNHD applied for and received grant funding to collect data on NH/PIs and the LGBTQIA+ communities.

Following the receipt of grant funding, SNHD worked with various policy stakeholders as well as community based organizations to identify partnerships for data collection. SNHD reached out to the CDC national networks working with special populations on tobacco and cancer control including Asian Pacific Partners for Empowerment, Advocacy, and Leadership (APPEAL) and the National LGBT Cancer Network for technical assistance. APPEAL helped facilitate connections with partner Las Vegas Hawaiian Civic Club (LVHCC) in 2020. SNHD also worked with Nevada State Policy and Nevada Institute for Children Research and Policy to develop a survey assessment and collect disaggregated data on NH and LGBTQIA + participants living in Southern Nevada and tobacco use.

SNHD worked with a variety of stakeholders and organizations to procure participants for data research, survey assessment, and focus groups. They were able to create technology and surveys to assess tobacco usage and behaviors in NH/PIs and LGBTQIA+. This information was gathered into a report to inform future policies for tobacco control and to push for more funding for research in these underserved populations. By showing the community disparities in tobacco through data, SNHD was able to advocate for community priorities, and more comprehensive funding and local policies in tobacco control for these populations. This project is still ongoing and SNHD hopes to create tailored quitline and cessation protocols for NH/PIs and LGBTQIA+ populations and to further expand its population scope to other communities.

 Impact / Results / Accomplishments / Outcomes

This project has allowed for grass roots and community based organizations to push community leaders to make many NH/PI events smoke-free and had a positive impact on educational outreach and awareness of commercial tobacco risks through increase in signage and other information to inform individuals, local businesses, and patrons within the community. Furthermore, it has allowed for SNHD to shine a light on the needs of the NH/PI community for local, state, and national organizations including the CDC to be aware of the tobacco health disparities within NH/PI communities through concrete data and statistics and to work towards offering better strategic solutions to decrease smoking within the NH/PI community. The data collected also indicates nuanced differences between Native Hawaiians and other Pacific Islanders and further stresses the need for appropriate data disaggregation to reflect these diverse community habits across other platforms and research for policy and program change to better suit these needs.

SNHD was able to make a lasting impact on the Las Vegas community through the collection and distribution of disaggregated data for populations of interest (NH/PI and LGBTQIA+) across organizations. The knowledge gained from the reported results can be leveraged as real statistics to inform and drive tobacco policy change. SNHD performed data collection and used this to inform and acknowledge current community readiness levels to develop policy. This study also highlights a need for programming and policy changes for culturally tailored tobacco cessation protocols and quit lines to better serve NH/PIs.

Lessons Learned

• Respect wisdom of the community and be humble and open in order to create a safe space for compassion, inclusivity, and intersectionality
• Communities are very different and diverse – recognize that similar cultures differ widely
• Use Cultural Advocates
• Be intentional
• Convene and facilitate multi-sectoral partnerships to foster and build strength based relationships
• It takes work to build trust and strengthen relationships with those who live and work in the community
• Local data can inspire policy action against tobacco and justify legislative action
• Investments in capacity building for surveillance and data infrastructure are essential to further strengthen the local evidence base and, as policies are enacted, to monitor the impact of policy change on tobacco use and its consequences

About this Promising Practice (Contact information)

1. Organization(s): Southern Nevada Health District
2. Primary Contact(s): APPEAL Staff and Tobacco Prevention and Control Program Southern Nevada Health District – Program Coordinator, Malcolm Ahlo – [email protected]
3. Authors: APPEAL Staff with informant interviews from SNHD staff Malcolm Ahlo
4. Topic(s): Commercial Tobacco Use, Tobacco Surveillance, NH/PI Tobacco Use, LGBTQ+ Tobacco Use, Data Disaggregation, LGBTQIA+, Native Hawaiians, Pacific Islanders
5. Source: Informant interviews from SNHD staff Malcolm Ahlo and 2021 Tobacco Use among LGBTQIA+ & Native Hawaiian/Pacific Islander Populations in Southern Nevada Report by Nevada Institute for Children’s Research and Policy
6. Date of Publication: 2021
7. Date of Implementation: 2019
8. Location: Nevada
9. More details (web address for study):
   1. https://www.cdc.gov/tobacco/stateandcommunity/guides/pdfs/best-practices-mapping-techniques.pdf
10. Target Audience: Tobacco Surveillance Policy makers, Epidemiologists, Tobacco Control Program Staff