RTI International is a trade name of Research Triangle Institute Technical Assistance to North Carolinas Health & Wellness Trust Funds TUPC Grantees Presented by: Barri Burrus, Ph.D. RTI International Phase IV Orientation meeting Greensboro, NC August 13, 2009

August Brief Overview of RTI RTI International is a not-for-profit research institute dedicated to improving the human condition by turning knowledge into practice. Our work is conducted at the international, national, state and local levels. We provide research and technical expertise in various fields. Examples include health, education, training, evaluation, statistics, and economic and social policy. We deliver technical assistance designed to build capacity through the transfer of information, tools and methods. We often work in multidisciplinary teams that cut across traditional boundaries.

Examples of our Experience with Community-based Grantees in Tobacco Control Priority Populations Initiative - A grant program aimed at reducing disparities in access to tobacco prevention and cessation services in underserved populations Community Voices Initiative - A project established to support tobacco cessation or prevention efforts for underserved, underinsured communities that are chosen by the Community Voices program of the W.K. Kellogg Foundation American Legacy Foundation August 2009

Examples of our Experience with Community-based Grantees in Tobacco Control Floridas Students Working Against Tobacco (SWAT) initiative empowered youth to become advocates against tobacco at the state and local level The Community Partnerships component provided guidance and resources to local and county SWAT groups and in some cases initiate additional tobacco prevention and control efforts and activities. Floridas Tobacco Control Programs grassroots level initiatives August 2009

Examples of our Experience with Community- based Grantees in Substance Abuse Prevention Provides funding to States and Federally recognized Tribes in order to prevent the onset and reduce the progression of substance abuse, reduce substance abuse-related problems; and build prevention capacity and infrastructure at the State, tribal, territorial and community-levels. Center for Substance Abuse Prevention (CSAP) Strategic Prevention Framework- State Incentive Grant Programs August 2009

HWTF and RTI North Carolinas HWTF implements interventions through their TTUPC, CTUPC, and Priority Population grants to address the challenges of youth tobacco use by preventing and reducing youth tobacco use for youth populations across the state. RTI is tasked with identifying mechanisms to optimize the implementation and effectiveness of these funded grants. August

Priority areas RTIs work with HWTF Grantees 1) Identify and prioritize challenges related to intervening with diverse populations, and recommend strategies to improve recruitment, retention, and intervention relevance for diverse populations in tobacco prevention and control. August

Priority areas for RTIs work with HWTF Grantees 2) Provide with more intense technical assistance those grantees designated to serve key priority populations: Haliwa-Saponi Tribe NC CIA Lumbee Tribe of NC El Pueblo Old North State Medical Society August

Priority areas for the HWTF grantees 3) Identify how to optimize grant performance to improve the overall intervention implementation and effectiveness for all grantees. August

Proposed Approach Systematically identify all the grantees challenges when trying to accomplish their goals Prioritize the challenges faced by the granteesDevelop grantee-specific approaches to address challenges Provide more focused technical assistance to the priority population grantees Identify and make recommendations to improve implementation and effectiveness for all grantees August

Identify Solutions to the Priority Challenges We are committed to ensuring culturally competent approaches by developing culturally diverse teams that are reflective of the priority populations with whom we are working. Cultural competence of team members Members of the priority population group to be served should be included in the planning and implementation process to help guide what is to be done and how it is to be accomplished. Inclusivity The intervention is occurring within a community setting and in a unique cultural context. The intervention activities should be respectful of, and sensitive to that context. Cultural appropriateness of the intervention August 2009

August Examples of Common Challenges Engaging youth from diverse populations to take part in intervention activities Recruiting and retaining parents, particularly from vulnerable populations

Culturally tailored programs The extent to which ethnic/cultural characteristics, experiences, norms, values, behavioral patterns, and beliefs of a target population as well as relevant historical, environmental, and social forces are incorporated in the design, delivery, and evaluation of targeted health promotion materials and programs. Resnicow, K., Baranowski, T., Ahluwahlia, J. S. and Braithwaite, R. L. (1999) Cultural sensitivity in public health: defined and demystified. Ethnicity and Disease, 9, 10–21 August

Cultural tailoring Hire knowledgeable and culturally competent staff Conduct formative research Identify the communitys priorities Engage stakeholders in project planning Design services /materials specifically for targeted population Field test materials Document effective recruitment and retention strategies August

Approach to Working with RTI -Work will initially focus on five priority population grantees -Subsequent work will include work with a broader set of grantees -All technical assistance work with grantees will be coordinated through the HWTF grant managers August 2009