Different than Thou? Determinants of African American Attitudes toward Faith-based Environmental Tobacco Smoke Exposure Prevention Partnerships

BACKGROUND: Passive exposure to environmental tobacco smoke (ETS) is disproportionately associated with cancer and chronic diseases among African Americans(AAs). The determinants of ETS prevention and outreach among AA faith-communities are virtually unexplored. Faith-communities are seen as innovators of change regarding ETS prevention partnerships within higher risk communities. As early adoptors we know little about congregant's attitudes partnership toward higher risk communities OBJECTIVE: The objective was to conduct formative research among AA church innovators regarding ETS prevention partnerships. The aims are: 1)Are groups that researchers perceive as innovators (regularly attending church congregants) connected to higher risk communities? 2)What determinants make diffusion of innovation more likely? METHOD: A snowball sample of AA congregants was obtained. AA investigators moderated focus groups. Field notes were transcribed and analyzed. RESULTS: Church culture was seen as unsupportive of ETS education and prevention. Congregants viewed ETS and direct smoking reduction as a very low priority of the higher risk AA community. Respondents cited lack of education, apathy, and low perceived vulnerability to the effects of ETS exposure as barriers to successful partnerships in higher risk communities. CONCLUSIONS: This formative study dispels researcher myths about the homogenous diffusion of innovations across subgroups of the AA community. Our group of innovators(church congregants) perceived themselves as unlike AA communities with the highest risk of ETS exposure. Faith-based community interventions in community-based participatory research must reinforce linkages between innovators (church congregants), clergy, and higher risk communities as partners in ETS prevention.