MODELS FOR PRACTICE

focus area: TOBACCO USE

Program Name: Tobacco Intervention and Prevention Strategy

Location: Prosperity, South Carolina

Problem Addressed: Tobacco Use

Healthy People 2010 Objective: 27

Web Address: Under Construction

SNAPSHOT

Tobacco Intervention and Prevention Strategy (TIPS) is a tobacco education, prevention, cessation, policy development, and community empowerment program implemented in rural Newberry County, South Carolina. TIPS targets adults, teenagers, adolescents, and pregnant mothers.

THE MODEL

Blueprint: The Tobacco Intervention and Prevention Strategy program is multifaceted and delivered in a variety of settings including worksites, schools, the health department (during prenatal and Women, Infant, and Children [WIC] program visits), and the physician’s office. TIPS is a coalition between the Lovelace Family Medicine Practice and the South Carolina Department of Health and Environmental Control (SC DHEC). Community empowerment is achieved through the development of a TIPS task force, which is comprised of local community leaders. The program is designed around the Stages of Change Theory and Clinical Practice Guidelines. The components of TIPS include smoking cessation, education, and prevention; policy development and change; and community empowerment.

The program office is located in the Lovelace Family Medicine Practice. Staffing includes one full-time program manager, and Dr. Lovelace acts as the principle investigator. Volunteer and donated staff are also utilized. The program manager, office space, computer equipment, and telephone lines are provided as an in-kind donation by the Lovelace Family Medicine Practice. As a 501(c)(3) organization, the program is eligible to receive funding from a variety of sources, including its original funder¾the Lovelace Family Medicine Practice, as well as the South Carolina Department of Health and Environmental Control, the American Cancer Society, the March of Dimes, the Tobacco Free Midlands Coalition, and various pharmaceutical companies and community members.

The program is designed as a comprehensive approach to combating tobacco use. Smoking cessation interventions include the Stages of Change assessment, health education, stress management, and behavior modifications. Worksite and prenatal cessation is a primary focus of the cessation component. Free bassinets (paid for by a grant from the March of Dimes) are provided to pregnant women who complete the program. Smoking prevention is delivered through strategies targeting youth and adolescents, including programs such as the National Lung Association’s NOT (Not on Tobacco) program and Tar Wars (a program endorsed by the American Academy of Family Practice). The program also uses the American Cancer Society’s Fresh Start Program and Counseling Women Who Smoke Program. Policy development includes promotion of smoke-free environments. Community empowerment is achieved through establishment of a TIPS task force.

Making a Difference: Both process and outcome measures are utilized to determine the program’s effectiveness. During workshops, presentations, and training events, participants are given evaluation forms that include qualitative and quantitative questions. Data on participant demographics, opinions, program delivery, and logistics are collected at each activity.

Beginnings: Dr. Oscar Lovelace, MD, an established Newberry County family physician, saw the devastating effects of tobacco abuse among his patients in rural Newberry County. In 1998, Dr. Lovelace, with assistance from the School of Public Health Community Oriented Primary Care (COPC) residents, began a grassroots effort to not only raise community awareness of the problem but devise a smoking prevention, education, cessation, and policy development strategy for the county. The initial costs of underwriting the program were borne by the Lovelace Family Medicine Practice. As the program grew, it became necessary to involve additional partners. The TIPS program is currently a collaboration between the Lovelace Family Medicine Practice and the South Carolina Department of Health and Environmental control. The program also applied for and received status as a 501(c)(3) organization chartered by the Living Water Foundation, Inc. A TIPS task force, comprised of local community leaders, was also initiated, which serves as an advisory body to the program. The program was fully implemented in April 2001 and has received funding through 2003.

The program was developed to respond to the county’s alarming tobacco use statistics when compared to state data. The smoking rate for Newberry County High School was equal to the state average of 36 percent. Ten percent of the high school students use smokeless tobacco compared to the state average of 7.7 percent. Lung cancer in the county exceeded the state average. Adult tobacco use was only slightly less than the state average. Most disturbing was the rate of tobacco use among pregnant women. In South Carolina, 15.1 percent of pregnant women are smokers compared to Newberry County where nearly 16.3 percent are smokers. Newberry County also has a low birth weight rate of 9.9 percent, with a ranking of 36 out of 46 counties.

Challenges and Solutions: Transportation is a hurdle that is overcome by delivering the program to the people in worksite, school, and community settings. Enlisting the help of other physicians requires the program manager to build relationships with providers. The South Carolina Department of Health and Environmental Control’s Tobacco Control Program has expressed interest in replicating TIPS throughout South Carolina.

The program manager acts as the community liaison and is responsible for community awareness. In addition to local newspaper advertising, billboards, and public service announcements to the community, TIPS is promoted at the state and national levels through abstracts, policy papers, and a policy advocacy video. Dr. Lovelace also promotes the program through presentations at the state level.

The program received the National Tar Wars Star Award through the American Academy of Family Practice in 2001.

PROGRAM CONTACT INFORMATION

Renee Martin, TIPS Project Coordinator

Tobacco Intervention and Prevention Strategy

P.O. Box 1017

Prosperity, SC 29127

Phone: (803) 364-1011 ext. 197

Fax: (803) 364-2014