Stub It Out! Trying to Turn Unions Into No-Smoking Zones
From 1996 to 1997, researchers at the Dana-Farber Cancer Institute, Inc., Boston, carried out a project to determine the best mechanisms for disseminating information about the federal Agency for Health Care Policy and Research Guideline on Smoking Cessation to labor union leaders and membership.
The project was conducted in collaboration with two major labor organizations the AFL-CIO's Substance Abuse Institute and the Laborers' International Union of North America's Health and Safety Fund of North America (representing over 13.3 million workers).
- The research team conducted a needs assessment in each of the two target labor organizations and began to develop training modules for each organization.
The project thus took advantage of existing resources in the labor movement to disseminate the Guideline to key decision-makers involved in the purchase of health benefits for union members, a population shown to be at particularly high risk of suffering the consequences of smoking.
The Robert Wood Johnson Foundation (RWJF) supported the project with a grant of $39,542 between June 1996 and February 1997.
This project focused on determining the best mechanisms for disseminating information about the AHCPR Guideline on Smoking Cessation to the union members and labor leaders responsible for negotiating, purchasing, or providing health benefits. The specific goals of this project included conducting a needs assessment to:
- analyze the AHCPR Guideline and identify key factors that might influence receptivity of union leaders and determine which strategies would be most appropriate for dissemination purposes;
- explore the use of LaborNet as a means of disseminating information on-line about the AHCPR Smoking Guideline to labor leaders and individual union members;
- review the results of the Substance Abuse Institute's ongoing survey of union leadership to determine the factors influencing the dissemination of the Guideline; and
- conduct a survey of LIUNA through the Laborers Health and Safety Fund of North America (LHSFNA) to determine the factors to be considered in disseminating the Smoking Guideline to those labor and management trustees responsible for purchasing or providing health benefits.
A second goal of the project was to develop training modules for the Guideline to be used in ongoing training programs for labor leaders and trustees of LIUNA's health and welfare funds.
- The AHCPR Guideline was reviewed to determine which strategies would be most appropriate for dissemination purposes with labor groups. It was determined that five key labor channels would be appropriate for disseminating the Guideline, including the AFL-CIO Community Services Network, the Labor Assistance Professionals, the Employee Assistance Professionals, National/International Union Staff, and workplace representatives and stewards. A separate review was conducted of the dissemination channels available through LIUNA. The organization's labor-management training funds were identified as a key resource for dissemination of the Guideline as well as other LIUNA publications.
- The use of LaborNet, an on-line service available only to union members, was explored as a means of disseminating information about the AHCPR Smoking Guideline. Because of the relatively low number of users on the LaborNet, and low rate of access for its services, it was concluded that, at the present time, LaborNet does not serve as a primary information resource for labor. However, because LaborNet is anticipated to eventually become a common communication tool within the labor movement, it would be a useful strategy to continue to post smoking-related messages on the on-line service.
- Results of the Substance Abuse Institute's ongoing survey of union leadership was analyzed to determine the factors influencing the dissemination of the Guideline. The survey revealed the following: the AFL-CIO Community Services Network is a primary source for the dissemination of information to local labor leaders and central labor councils and state federations; local unions, state federations, and central labor councils can be utilized for the distribution of information related to smoking; and a receptivity exists among labor groups to external trainers, who may be able to provide training in smoking cessation.
- A survey of LIUNA's health and welfare funds was conducted to determine the factors to be considered in disseminating the Guideline to labor leaders. It found that over 85 percent of health and welfare funds are self-insured, and therefore have considerable autonomy in determining benefits covered and the extent of coverage provided; and only 29 percent of the funds covered smoking cessation programs of some kind. Approximately 50 percent of the health plan administrators thought that smoking was a serious problem among union members; 48 percent were very concerned about the financial impact of tobacco use on the health fund; and 23 percent were very interested in having smoking cessation counseling materials for health care providers who care for union members.
- An educational folder was created and tailored to specific labor audiences, including the LIUNA membership. Each folder contains a series of documents. Included among them: The guideline on smoking cessation: Where to begin; The role of fund administrators and trustees; What unions say about smoking; What everyone should know about smoking and quitting; Dollars and sense: The cost-benefits of smoking cessation; Union representatives' role in helping members quit smoking.
Additional funds are needed to produce and disseminate the educational folders. In addition, reports focusing on strategies for dissemination of health-related information through union channels and on the results of the LIUNA surveys are being prepared. These reports are expected to be completed and disseminated to the union leadership in 1998.
AFTER THE GRANT
Efforts to disseminate the AHCPR Guideline will continue through LIUNA. However, large-scale dissemination and evaluation of such efforts will require additional funding. This will be sought from RWJF as well as other sources. RWJF also funded dissemination to primary care physicians (see Grant Results on ID# 029466) and to pediatricians, obstetricians/gynecologists, femal physicians, nurses, and cardio-pulminary specialists (see Grant Results on all of these grants).
GRANT DETAILS & CONTACT INFORMATION
Dissemination of the Federal AHCPR Guideline on Smoking Cessation to Organized Labor
Dana-Farber Cancer Institute, Inc. (Boston, MA)
Dates: June 1996 to February 1997
Karen M. Emmons, Ph.D.
Report prepared by: David Kales
Reviewed by: Molly McKaughan
Program Officer: C. Tracy Orleans