An Online, Automated Readiness Survey and Stage-based Interventions for Rural Smoke-free Policy Development

Background: Rural communities are less likely to be protected by smoke-free policy than their urban counterparts. An online readiness assessment, based on The Community Readiness Model (CRM), linked to stage-based strategies, can be used to tailor advocacy interventions. Methods: An online, shortened readiness survey was found to be reliable and valid with a small sample of rural advocates (Fallin et al., 2012). We re-tested the survey with 84 advocates from 36 rural communities to determine community-level scoring. Content experts then matched advocacy interventions to specific readiness dimensions. Further testing is underway with 200 advocates from 40 rural communities to develop a system to automate the community readiness scores and direct participants to a listing of stage- and evidence-based interventions to promote smoke-free policy. Follow up telephone interviews will yield feedback on the usability and appropriateness of the interventions. Results: The online readiness assessment produced an overall county-level readiness score that was highly correlated with a longer, telephone administered readiness survey (.86, p<.001). Six readiness dimension scores were also highly correlated and significant (p < .001; resources: .46, knowledge: .90, leadership: .46, climate: .76, political climate: .76, existing policies: .54). On average, 4 advocates per community were needed to produce a valid community readiness score. Findings from testing the automated system linking dimension scores with interventions will be discussed. Conclusions: Further evidence suggests the online readiness survey is valid and reliable. An online, automated survey with stage-based interventions will help rural advocates develop effective smoke-free campaigns.