Introduction
One in five college students report tobacco use, thus universities are making strides to reduce tobacco use by adopting smoke- or tobacco-free policies.
Purpose
Describe an innovative ambassador program to increase adherence with a tobacco-free campus policy.
Methods
The Tobacco-Free Take Action! (TFTA!) Ambassador program was created to form an environment of compliance. Hot spots were targeted by Ambassadors, who were trained to use scripted messages. Ambassadors completed an online documentation form to assess the number of violators observed and approached. The Tobacco-Free Compliance Assessment Tool (TF-CAT) was used to collect pre- and post-cigarette butt data at each hot spot.
Results
During the 4-week intervention period, Ambassadors approached 332 violators (529 observed), of which 68% responded positively and complied with the policy. The number of cigarette butts declined by 25%.
Discussion
Adherence with campus tobacco-free policies remains a challenge. Lessons learned from this innovative approach will benefit those currently implementing and planning tobacco-free campus policies.
Background
Globally, communities are struggling to gain support for harm reduction strategies being implemented to address the impacts of substance use. A key part of this discussion is understanding and engaging with people who use drugs to help shape community harm reduction strategies. This study focused on how an overdose prevention site has influenced the lives of people who use drugs.
Methods
A critical narrative method was utilized, centred on photo-narratives. Twenty-seven individuals accessing an overdose prevention site were recruited to participate in preliminary interviews. Sixteen participants subsequently took photographs to describe the impact of the site and participated in a second round of interviews. Through independent coding and several rounds of team analysis, four themes were proposed to constitute a core narrative encompassing the diverse experiences of participants.
Results
A key message shared by participants was the sense that their lives have improved since accessing the site. The core narrative proposed is presented in a series of four themes or “chapters”: Enduring, Accessing Safety, Connecting and Belonging, and Transforming. The chapters follow a series of transitions, revealing a journey that participants presented through their own eyes: one of moving from utter despair to hope, opportunity, and inclusion. Where at the outset participants were simply trying to survive the challenges of chaotic substance use, through the relationships and services provided at the site they moved towards small or large life transformations.
Conclusions
This study contributes to an enhanced understanding of how caring relationships with staff at the overdose prevention site impacted site users’ sense of self. We propose that caring relationships are an intervention in and of themselves, and that these relationships contribute to transformation that extends far beyond the public health outcomes of disease reduction. The caring relationships at the site can be a starting point for significant social changes. However, the micro-environment that existed within the site needs to extend beyond its walls for true transformative change to take place. The marginalization and stigmatization that people who use drugs experience outside these sites remains a constant barrier to achieving stability in their lives.
Although only examined with a small sample, boundary spanning appears to be an essential function for public health managers (similar to their colleagues in the private sector). These findings present a rationale and an opportunity for public health leaders to set organizational conditions that foster the most positive type of boundary-spanning, ambassadorial behaviors, which, in turn, can improve group performance.
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