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Purpose: The public health burden caused by tobacco is heavy among first-generation Chinese immigrant men whose home country has significantly higher smoking rates than the United States. The current study is part of a larger effort to pilot an mHealth tobacco cessation intervention using MMS (graphic) mobile phone technologies to target East Asian immigrant populations. Grounded in the Extended Parallel Process Model (EPPM), our specific aims were to determine what message themes, level of graphic intensity, and types of efficacy information are most appropriate and useful for mHealth interventions targeting this population.

Methodology/Approach: A qualitative study utilizing a series of focus groups (k = 5) was conducted with male adult smokers who were born in China and currently reside in the United States. The primary aim of the focus groups was to solicit reactions to a series of preliminary messages developed by the research team. A secondary aim was to gauge receptivity to the use of MMS as a vehicle for smoking cessation intervention. Participants (n = 32) were recruited from local Chinese communities in a large Mid-Atlantic metropolitan area.

Findings: Opinions about different message strategies were mixed. However, participants tended to rate messages more positively when they focused on the impact of smoking on family and loved ones, particularly children. Messages with fear-arousing images were also perceived to be effective at low frequency of exposure, but there were concerns that they may backfire at high exposure. Awareness of and interest in Quitline were low, and concrete quitting tips were perceived as more effective. Participants reported a preference for receiving messages a few times a week, and an MMS message platform was generally preferred to WeChat (a Chinese social media platform).

Implications: Our results suggest that graphic MMS messaging holds promise as an effective intervention method for this population and that EPPM is an appropriate framework to develop, test, and analyze mHealth intervention messages. While messages that focused primarily on impact on children, health, and specific quitting tips were generally found to be more effective, a mix of different types of messages that address a wide range of issues may be most appropriate for this population.

Originality/Value: This study is the first to explore the utility of graphic text messaging as an intervention method to promote smoking cessation among male Chinese immigrants. Findings from the study provide important insights for future intervention work targeting this underserved population.

Purpose: Lesbian, gay, and bisexual (LGB) young adults smoke at rates much higher than the general population. Young adults, in general, are less likely to seek medical help for smoking cessation and LGB individuals are less likely to seek health care generally. Alternative methods to encourage smoking cessation are necessary. This research seeks to establish whether LGB young adults in California would be willing to use social media for smoking cessation.

Approach: We conducted 41 qualitative interviews among LGB young adults in the San Francisco Bay Area and Los Angeles in Fall 2014.

Findings: The results suggest that our participants were interested in a LGB-focused social media intervention, as long as the intervention was private or anonymous and moderated. Further, across topical areas our participants spoke extensively about the import of social connections. We may be able to leverage these connections to encourage cessation.

Research Limitations: This is a qualitative, non-generalizable dataset from a fairly limited geographic area.

Public Health Implications: Online smoking cessation interventions aimed at young adults would benefit from further testing with LGB young adults to ensure efficacy among this population. In addition, states and localities concerned about young adult LGB smoking might benefit from investing in an online socially mediated cessation forum. Online interventions could be scalable and might be useful for other groups who regularly face discrimination, stigma, or other stressors that make successful smoking cessation difficult.

This chapter examines how people weigh and discuss opportunities for collective action to improve community health. Drawing from research on civic and social movement engagement, it focuses specifically on how cultural logics of pragmatism, activism, and cynicism are invoked in such debates.

Qualitative data come from four focus group discussions of strategies for reducing tobacco use in Atlanta’s lesbian, gay, bisexual, and transgender (LGBT) communities. Participants included 36 self-identified community members.

Pragmatic logics were used most often in evaluating the tobacco control strategies, with activist logics second and cynicism a distant third. This echoes prior research, but our participants used these logics in unexpected ways: they combined pragmatism and activism, downplaying the former’s emphasis on individual self-interest and the latter’s emphasis on contentious confrontation. In addition, use of the logics varied by focus group and strategy, but not with individual speaker’s identities.

Though limited by a narrow demographic focus and small convenience sample, our study suggests that public support for community health initiatives will likely depend on how they are framed and on the interactional dynamics and shared identities of the groups they are presented to.

Logics of pragmatism, activism, and cynicism inform debate over community health initiatives, as with other forms of civic action. However, use of these logics is not uniform but varies with the groups and issues at hand. Our study participants’ mutual LGBT identification gave them a sense of shared community and a familiarity with the politicization of personal life that led them to combine pragmatist and activist logics in novel ways.

Introduction. This study examined the association between self-rated physical and oral health, cigarette smoking, and history of criminal justice contact (i.e., never arrested; arrested, but never incarcerated; or incarcerated in reform school, detention, jail, or prison) among African American men and women. Methods. We conducted descriptive statistical, linear regression, and multinomial regression analyses of the African American subsample (n = 3,570) from the National Survey of American Life (2001–2003). Results. Overall, African American women reported lower arrest rates and histories of incarceration than African American men. Additionally, we found that criminal justice contact was associated with lower self-rated physical health and oral health and higher levels of smoking for both men and women. African American women who had been arrested and detained in facilities other than jail had more chronic health problems than their male counterparts. Furthermore, having been arrested or spent time in a reform school, detention center, jail, or prison significantly increased the odds of African American men being a current smoker. Lastly, among African American women, those who had any level of criminal justice contact were likely to be current smokers and former smokers compared to those without a history of criminal justice contact. Conclusion. Addressing the health of African Americans with criminal justice contact is a critical step in reducing health disparities and improving the overall health and well-being of African American men and women. Furthermore, attention to differences by gender and specific types of criminal justice contact are important for a more precise understanding of these relationships.

In Chapter 3, the author will problematise the youth smoking epidemic within SEA, in order to justify why the regional impacts of the tobacco trade on youths are worrisome. The author will present the major youth smoking trends in SEA, for the purpose of illustrating how the presence of tobacco products has adversely affected regional youths to a concerning degree. The author, next, will highlight the causes of the youth smoking epidemic, namely susceptibility and positive advertising. The author follows by emphasising the national and regional costs of youth smoking, by arguing how such a lifestyle results in negative consequences in relation to the delinquency itself. Lastly, the author will recommend policies for tobacco control that SEA governments should consider to contain the epidemic of youth smoking. It is noteworthy that all SEA governments have some degree of tobacco control policies in place. However, many lack the implementation of comprehensive national tobacco control strategic plans and tightened law enforcement endeavours to specifically target the problem of youth smoking. Therefore, the outputs of this chapter should contain scholarly values that are conducive to the betterment of policy-making.

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

Adults in the United States have low health literacy skills which puts them at high risk for serious health consequences. Libraries have traditionally provided programming on a variety of topics for patrons but barriers such as technology and transportation access may prevent potential patrons from attending. Librarians can help increase the health literacy skills of community members by providing health outreach programming to the communities they serve. This chapter examines strategies and specific examples that library managers can implement to facilitate technology and health literacy skills through programming in communities.

Purpose – To develop a framework for studying financial incentive program implementation mechanisms, the means by which physician practices and physicians translate incentive program goals into their specific office setting. Understanding how new financial incentives fit with the structure of physician practices and individual providers’ work may shed some insight on the variable effects of physician incentives documented in numerous reviews and meta-analyses.

Design/Methodology/Approach – Reviewing select articles on pay-for-performance evaluations to identify and characterize the presence of implementation mechanisms for designing, communicating, implementing, and maintaining financial incentive programs as well as recognizing participants’ success and effects on patient care.

Findings – Although uncommonly included in evaluations, evidence from 26 articles reveals financial incentive program sponsors and participants utilized a variety of strategies to facilitate communication about program goals and intentions, to provide feedback about participants’ progress, and to assist practices in providing recommended services. Despite diversity in programs’ geographic locations, clinical targets, scope, and market context, sponsors and participants deployed common strategies. While these methods largely pertained to communication between program sponsors and participants and the provision of information about performance through reports and registries, they also included other activities such as efforts to engage patients and ways to change staff roles.

Limitations – This review covers a limited body of research to develop a conceptual framework for future research; it did not exhaustively search for new articles and cannot definitively link particular implementation mechanisms to outcomes.

Practical Implications – Our results underscore the effects implementation mechanisms may have on how practices incorporate new programs into existing systems of care which implicates both the potential rewards from small changes as well as the resources which may be required to obtain buy-in and support.

Originality/Value – We identify gaps in previous research regarding actual changes occurring in physician practices in response to physician incentive programs. We offer suggestions for future evaluation by proposing a framework for understanding implementation. Our model will assist future scholars in translating site-specific experiences with incentive programs into more broadly relevant guidance for practices by facilitating comparisons across seemingly disparate programs.