Up one levelPathways to Freedom video: https://centerforblackhealth.org/pathways-to-freedom/ (60 min.)
Pathways to Freedom was first developed at the Fox Chase Cancer Center in Philadelphia in 1989-90 with funding from the National Cancer Institute. It was based on principles of Community Competence which makes explicit the importance of history, culture, context, geography, literacy, language, positive imagery, salient imagery, multigenerational, and diversity. Pathways to Freedom was adopted by CDC's Office on Smoking and Health (OSH) in 1993 as the state-of-the-art material for African Americans to aid them in successfully quitting. In 2003 Pathways to Freedom was revised by the Office on Smoking and Health, undergoing an extensive qualitative evaluation based on a national sample of smokers, practitioners and stakeholders. The primary results of this evaluation were inclusion of information regarding menthol and relapse, and improving messages regarding pharmaceutical aids, diversity and cultural components such as a more heterogeneous representation of religious beliefs. Indeed, Pathways to Freedom remains the only cessation material that suggests prayer will help in successful quitting. This recommendation is in direct response to the importance of faith and church in the African American Community. The National Quitlines, with funding from the Office on Smoking and Health, were evaluated by the National African American Educational Network in 2008; and one of their primary recommendations were for the Quitlines to utilize and disseminate Pathways to Freedom.
Pathways to Freedom served as the critical foundation for targeted cessation research and engagement of Churches and Community-based Organizations in tobacco prevention and control over the past several decades. Importantly, during the period when African Americans were reducing their use of tobacco at a rate two times greater than White smokers (1990-2001); resulting in the first major public health victory in disparity elimination, over 1 million copies of Pathways to Freedom were disseminated by OSH; and by the American Cancer Society who partnered with CDC in the 1990’s to aid in the dissemination. One result of this dissemination success was the first involvement of Black Churches and organizations serving the African American Community in tobacco prevention and control, in part, because for the first time they had a material benefit they could offer their clients and constituents. In sum, it was a major public health victory and a critical asset for the tobacco control movement. Indeed, if one reviews research initiatives one will note an increase in targeted research because the availability of Pathways to Freedom made it possible to provide both a service and an evaluation protocol; resulting in successful submissions to agencies such as the National Cancer Institute. And specific to the Quitlines, Pathways to Freedom helped smokers quit at a rate 1.5 times better compared to mainstream materials. This led to the National Cancer Institute formally recommending dissemination of Pathways to Freedom (see RTIPs link below). Equally important, Pathways to Freedom has served as the foundation for research endeavors that take us forward into the 21st Century; resonating with current technologies and emerging cultural norms facilitating the utilization of the internet. The National Cancer Institute funded the development of Pathways to Freedom into a DVD format. This research and development was successfully undertaken by Dr. Monica Hooper Webb at the University of Miami. Multiple evaluations over the past 20 years have demonstrated that Pathways to Freedom rates higher in acceptability by African American smokers; significantly aids in the advancement of smokers along the stages of change, and aids and facilitates the capacity of organizations in their outreach to the African American Community.
Integration of Pathways to Freedom into your Quitline apparatus or protocol will accomplish the following:
The following are important links related to Pathways to Freedom:
Distribution:
From the home page of the Office on Smoking and Health (CDC) at http://www.cdc.gov/tobacco/, scroll down to the sixth bullet under “Tools and Resources" to access the Publications Catalog. Once there, enter the title and click the "All of these words" button. Once the publication appears, click the box to the left of it and then the Continue button. You can order up to 500 PTFs at a time. If you'd like several lots of 500 delivered to the same address, I'd recommend spacing out your orders, because otherwise the system interprets the subsequent orders as duplicate (mistaken) orders and only fulfills the first one. Please also note the delivery time frame.
The Guide:
Research Tested Intervention Programs (RTIPs):
(http://rtips.cancer.gov/rtips/programDetails.do?programId=312567)
If you have any questions regarding Pathways to Freedom please do not hesitate to send me a query or reach me by phone.
Respectfully submitted,
Robert Robinson, MSW MPH, Dr.PH, Primary author of Pathways to Freedom
Public Health Consultant
Formerly, Associate Director for Health Equity, Office on Smoking and Health (CDC)
It is more important to understand than to be understood."(Bill Russell)
______________
William Robinson Blackmenshealth@aol.com
Date: Tuesday, April 29, 2014 at 4:40 AM
Subject: Re: Advisory Council Question
Anna,
Permit me to introduce myself, electronically, at this hour of the morning. While I'm not involved with tobacco control, directly, any longer, I'm never too far away from it after 30+ years of dealing with the issue from the national Black perspective, lastly, as a Founding "Elder" and Executive Director of the National African American Tobacco Prevention Network. I left NAATPN in July of 2011, which is still headquartered in downtown Durham (www.NAATPN.org).
Today, NAATPN is not nearly as active as when I headed the organization, as we were fearless in our advocacy, specifically dealing with the issue of mentholated tobacco products. Our efforts led to a provision being added to the law that gave FDA the authority to regulate tobacco for the FIRST time in the nation's history mandating that the study of menthol be the first order of business for the newly established Center for Tobacco Products at FDA. That law was signed in 2009 by President Obama, and the rest, as they say, is history. Sadly, the national and international momentum that we created has been lost, and this nation has still not banned menthol as a flavor additive, although all other candy and fruit flavors were banned at the signing of the bill. Only the City of Chicago and the State of Hawaii have and are looking to ban mentholated products, respectively, although many countries around the globe have alrea dy done so.
Why is this important, you might ask? Because nearly 90% of all Black smokers, smoke mentholated products...something NAATPN saw as discriminatory at least, and blatantly racist at worst, if the additive was not banned along with the other flavor additives. Additionally...and this is where Quitlines come in...there hasn't been a mandate to ensure that the quitlines use the ONLY smoking cessation product that has been developed to address the issue of menthol AND spirituality for African American smokers...CDC's Pathways to Freedom. While the guide is now dated, it still has proven to be the most effective tool in assisting Black smokers to quit.
All this background to say, that there was an effort in CA some years back, that employed a concerted effort to increase quitline use amongst African Americans. This effort included the engagement of Black media (print, radio, television), local leaders, churches, organizations, and businesses, including visits to the quitline operation centers. The result was a substantial increase in use of quitlines by Blacks during the time of the focused efforts. The lesson? That this type of focused community-based outreach and engagement is critical to the increased use of quitlines for all communities, but, especially communities of color. The National African American Education Foundation (NAATEN), one of NAATPN's partner organizations, was the group in CA that conducted the study.
In recent years, the paradigm in public health has shifted away from this level of engagement to "policy driven initiatives". Some thought, and still think, this approach would result in 'more bang for the public health buck', but without the community-based ground-level engagement I think quitlines will continue to suffer from poor utilization, and the current disparities will continue to exist and, eventually, worsen.
Just one insider's thoughts...with hopes that different understanding lead to different approaches which lead to different results.
Hope this helps!
Bill
"We must endeavor to eliminate, so far as possible, the problem elements which make a difference in health among people" ~ W.E.B. DuBois ~ 1899
William S. Robinson, MA
Founder/Director
Black Men's Health Initiative
Blackmenshealth@aol.com
www.BMHI.org
"innovative health education and promotion"
In a message dated 04/23/14 17:07:07 Eastern Daylight Time, cornell.wright@duke.edu writes:
Hello,
I am writing you all on behalf of fellow Advisory Council member, Anna Jones. She is seeking suggestions, advice, and input, on ways to increase utilization to the Quitline program in North Carolina. Anna has been selected to meet with a group consisting of; Public Health officials from the NC Tobacco Prevention and Control Branch, Medicaid, Medicare, major insurance companies, and other health professionals, who want to see an increase in the utilization of this program.
To learn more about the Quitline, please visit their website: http://quitlinenc.com/
To contact Anna directly, please use the following information:
Anna Jones | Account Representative, State Health Systems
South Atlantic Division | American Cancer Society, NC
8300 Health Park Suite 10
Raleigh, NC 27615
Thank you,
Cornell
Cornell P. Wright, MPA
Outreach & Screening Patient Navigation Coordinator
Office of Health Equity and Disparities
Duke Cancer Institute
Office of Health Equity and Disparities
2424 Erwin Road, Suite 601
Durham, NC 27705