The purpose of this study was to examine the Community Readiness Model as it relates to local smoke-free policy development in a major tobacco-producing state. While the model has been previously used to appraise communities' readiness for drug and alcohol prevention and intervention programs, HIV/AIDS, and intimate partner violence prevention programs, it has not been evaluated as a measure for examining public policy development. The model appears suitable for evaluating smoke-free policy development because the theoretical constructs, whether for prevention programs or public policy, remain similar. The model identifies a problem and its extent within a specific community, assists in development and implementation of strategies to address the problem, and evaluates both short and long-term outcomes.
Kentucky is the second largest tobacco producing state while also leading the nation in smoking prevalence, lung cancer incidence and mortality rates. Correctly identifying and then promoting communities to a stage of readiness to enact smoke-free policies play a vital role in protecting public health.
A descriptive, cross-sectional design was used to assess the six dimensions of readiness for local smoke-free policy and included a community's: (1) knowledge of the problem; (2) existing policy efforts; (3) tobacco control leadership; (4) resources for supporting tobacco control; (5) climate for tobacco control; and (6) political climate for tobacco control. Dimension scores were summed for each community to identify one of six overall readiness stages. One-way ANOVA evaluated regional trends of readiness, and multiple regression evaluated the influence of socio-demographic and political variables on policy development.
In relation to public policy advancement, the Community Readiness Model provides advocates with specific information concerning their community's knowledge, attitudes, leadership, voluntary efforts, and resources, in addition to what socio-demographic and political factors influence smoke-free policy advancement. These contexts can affect the trajectory of the local policy process and ultimately assist or derail smoke-free advocates' efforts.
Keywords . Community Readiness, Public Policy, Health Policy, Smoke-free Policy, Secondhand smoke
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