NURS FPX 4055 Assessment 1 Health Promotion Research

Health Promotion Research

Health promotion aims to enhance health outcomes by utilizing structured, evidence-informed educational and preventive approaches. Health promotion also considers disease social determinants and health-related behaviors and environments. Health promotion yields better health outcomes through improved health risk reduction and quality of life enhancement for broader populations. Education-based interventions for high-risk populations have the potential to reduce the burden of smoking by 30% (Kisling & Das, 2023). For this reason, this assessment will result in the development of a health promotion plan intended for the cessation of all tobacco use by African American male residents of Santa Rosa, California.

Population Analysis and Health Concerns

Having a varied demographic structure, comprising White, Hispanic, Asian, and African American populations, Santa Rosa, California, has urbanized. African Americans represent the minority of the community at approximately 1.9% (United States Census Bureau, 2024). Several parks and commercial facilities were mapped out, and smoking was observed at a number of locations, which were all found to be lacking adequate resources. In the areas that are better documented, approximately 69% of the community uses privately operated vehicles, with low-resource community members using them the least. The low-income African American males between 18 and 40, who are members of the Santa Rosa community, are the primary focus of this health promotion plan. The target population engages in social activities at the facilities located adjacent to tobacco usage activities. Street corners, commercial areas, and parks are laden with tobacco users.

The 2024 report from the Centers for Disease Control and Prevention (CDC) states that Black Americans experience the highest relative levels of tobacco-related illnesses, deaths, and health disparities of any racial or ethnic group in America. These communities are also disadvantaged in terms of awareness of and access to smoking cessation resources (Cigarette Smoking n.d.). The CDC (2024) states that 81% of Black smokers use menthol cigarettes compared to 34% of White smokers. Menthols can increase nicotine dependence and make cessation more difficult. African American adolescents and young adults (18 to 24) have higher smoking rates and use smoking more frequently than older adults. Colyer-Patel et al. (2023) state that those who begin smoking before 25 have a greater risk of becoming chronic tobacco users. Because of financial stress, social norms, and a lack of health care, the residents of the low-income neighborhoods of Santa Rosa have an increased risk of becoming tobacco dependent (Cano et al., 2025). This will decrease their quality of life and increase the risk of chronic illnesses.

There is a risk of developing respiratory illnesses, cancer, cardiovascular diseases, and even stroke and death from tobacco use. Smoking cessation is a public health challenge. Evidence-based tobacco cessation programs for low-income Black youth men in Santa Rosa should include customized cessation resources, stress management training, behavioral modification, and culturally based resources. The research on population-specific tobacco cessation strategies for high-risk groups has shown that the combination of nicotine replacement therapies, counseling, peer support, and structured health education has the greatest impact. For the high-risk groups, tobacco use reduction research recommends nicotine replacement therapies, counseling, peer support, and structured health education (Centers for Disease Control and Prevention, 2024b). The development of a community setting approach to health behavior change, in combination with the provision of resources and the use of cessation support, can help individuals make the behavioral change they seek while also being able to provide and assist in the creation of supportive environments. Long-term outcomes are most likely to be achieved by the combination of community setting approaches and behavioral change interventions that include the training of stress management skills and an awareness of the community support resources (Castillo, 2021). Santa Rosa must have a defined public health policy for African American men so that the inequalities in health promotion are reduced, and the health outcomes for this population improve in the long term.

• Assumptions and Uncertainties

There are a lot of assumptions and some unknowns with this project. One primary assumption is that tobacco use is accepted in the Santa Rosa community, meaning that African American men in Santa Rosa use tobacco to cope with financial and social stressors. Another assumption is that access to healthcare is determined by one’s insurance, job, and degree of health literacy. A major unknown is how the different levels of male adults’ (Matthews et al., 2021) interest in cessation will affect the outcome of this project. There are also significant differences in Santa Rosa’s literacy levels, and therefore, the different approaches to educating African American men must also be developed. There is also a lack of local epidemiological data for Santa Rosa, and thus, it is unknown what the prevalence rates and the community’s behavioral patterns may be. There may be different social and/or cultural pressures that could affect a community member’s interest or ability to quit smoking successfully.

Community Characteristics and Relevance Explained

Santa Rosa is a complex urban community. It is home to a multi ethnic population that includes all classes. Santa Rosa is approximately 52.9% White, 37.4% African American, and lesser percentages of Asian and Hispanic/Latino populations. About 69% of Africans travel by car, while only 8% use public transport, which may impact poorer sections of the African American male population’s access to healthcare. From the windshield survey, the dense retail concentration selling tobacco products to residents, and the observed public smoking in the parks and other commercial areas in Santa Rosa suggest easy access to tobacco and promotion of smoking. From the survey, although numerous parks and recreational facilities are present, the use of parks for health-promoting activities is minimal. Similarly, there are not many wellness programs for the African American male population. The Centers for Disease Control and Prevention (2024a) noted that approximately 11.5% of adults in the U.S. are active cigarette smokers. The prevalence of active smoking among adults from low socio-economic backgrounds is approximately 21%, which is a significant health disparity caused by tobacco smoking (Centers for Disease Control and Prevention, 2024b). There are few opportunities for Santa Rosa residents to engage in healthy activities.

The social and economic challenges experienced by the African man of working age add pressures of financial and social concerns and significantly compromise the built-in community health and preventive services. Transport costs and lack of knowledge or awareness about services already built into the community are challenges that health services face for low-income users. The socio-economic status and smoking are interrelated (Lorentzen et al., 2022). There are more chronic urban health inequalities for the lower-income community as compared to higher-income groups.

The increased smoking and other unhealthy behaviours of the community of lower-income African men from Santa Rosa are affected by the concentration of tobacco shops in urban convenient locations, as surveyed during the windshield survey (Capella University, 2024): all the above affect health behaviour and the availability of resources. Adult men from the African community who are low-income are most affected by tobacco availability in their daily communities. The urban community of the African population from Santa Rosa is most affected due to the concentration of services, socio-economic challenges, and the availability of tobacco, suggesting that health interventions should be simple and adaptable (Cipta et al., 2024). Many of the cited conditions exist in urban populations throughout the country and can be adapted to a larger community.

Considering their family obligations, these individuals are more likely to try to change their behavior. In contrast, greater social isolation and higher stress levels among this group are associated with increased tobacco use. These situations necessitate the implementation of health promotion strategies designed to target people where they are, that is, within culturally appropriate and accessible community spaces such as local sitting areas and green spaces, with relevant messaging focused on the community smoking and stress situation. Tailoring smoking cessation interventions to the individual needs and experiences of this group is more likely to result in successful tobacco control.

Health Need Importance and Data

The concern of smoking everywhere, including in Santa Rosa, is very valid, as smoking is related to many chronic diseases and even premature death. In Santa Rosa, smoking is more prevalent among African American young adult males, as smoking tends to be among low-income and minority groups, and is, in a lot of cases, even worse at the national level (CDC, 2024). Tobacco users who quit before the age of 30 have a much lower risk (90%) of dying from tobacco-related diseases (American Cancer Society, 2024). This shows that the programs that focus on the young adult population to quit smoking are very much needed. Young African Americans in the U.S. are known to have a lower age of first smoking, have a higher stress level that correlates with their economic situation, and are known to have a higher social exposure to smoking, placing Santa Rosa at an even greater need for these programs. The lack of Cessation programs also supports their need, as many people in these communities do not know cessation programs are available as a result of a lack of information and accessibility, and do not have a culturally specific program. This is also true because of the windshield survey that shows smoking cessation programs have a lack of visibility in a lot of community places, and tobacco promotions are more visible (Capella University, 2024). Thus, these communities are probably not aware that there are cessation programs, and because of that, have not used them.

Health inequities create another level of resource shortage. Lower socio-economic groups do not have the same access to smoking cessation programs, counseling, and medications as upper socio-economic groups do (Tsikrika et al., 2023). In Santa Rosa, inequities are compounded by gaps within quitting treatments, the accessibility of the health care system, and transportation within an inequity of employment opportunities despite the existence of community health centers. Programs designed to educate on smoking cessation and provide a framework for support have been instituted with the focus of increasing smoking cessation in these target communities. These programs are imperative to the African community in Santa Rosa, as they do not have the social support groups to embrace a smoking cessation decision, and they do have peer groups that support smoking practices.

Community venues like parks and recreation centers influence community behaviors about smoking. Through socio-grams, community members’ relationships will be mapped. This will include family relationships, peer relationships, and work relationships (Denney et al., 2022). These relationships can provide the needed support to community members in health behavior change and improvement of smoking cessation efforts.

S.M.A.R.T Goals

Most adult African Americans in Santa Rosa use tobacco and do not believe that using tobacco has any long-term impacts on their health. There are various environmental influences on this behavior in Santa Rosa. There is a lot of public smoking in the parks and other commercial areas (Capella University, 2024), along with easy access to tobacco products. During the windshield survey, it was reported that these people most likely do not receive encouragement from their social networks to quit smoking tobacco. Where there is encouragement, it is most likely not sufficient. To fulfill this objective, the young adult males will complete three goals. They will identify the health impacts of tobacco use. They will also develop behavioral coping skills to manage the urge to smoke, and they will gain knowledge of the smoking cessation services in their community.

Beyond engaging in conversations about individual historical benchmarks for quitting, participants will have the chance to discover additional participants’ quitting barriers and the motivating factors that drive participants to change (Centers for Disease Control and Prevention, 2024c). These objectives aim to address gaps at the individual level and will dismantle barriers or resistance at the community level that exist in Santa Rosa. To further encourage change after the session, participants will be provided smoking cessation resources that include quit lines, community smoking cessation programs, mobile health cessation apps, etc., through a prepared resource guide with a supplemental guide for additional content.

S.M.A.R.T. Goal 1: Raising Awareness of the Dangers of Tobacco Use to the African Community in Santa Rosa

• Specific: It is anticipated that 90% of participants in the tobacco education program will be able to cite at least three of the many health-related consequences of tobacco use by the end of the program.
• Measurable: A survey will be administered to assess the knowledge participants have gained at the conclusion of the tobacco education program.
• Attainable: Local examples, such as public parks and other community gathering locations where there is a high prevalence of smoking, will help participants understand the health risks of smoking tobacco.
• Relevant: Educating community members regarding tobacco use will help change the smoking habits of community members within the tobacco use and smoking behavioral norms established by the community, as evidenced by the windshield survey.
• Time Bound: Knowledge assessments will be administered at the conclusion of the tobacco education program.

S.M.A.R.T. Goal 2: Encouraging American Africans in Santa Rosa to Attempt to Quit

• Specific: By the end of the educational session, we expect that 5% of the participants will express a plan to stop using tobacco.
• Measurable: Change in behavior will be assessed by a follow-up survey 3-4 weeks after the session.
• Attainable: While there are challenges, including the lack of cessation support and financial barriers for low-income residents of Santa Rosa, participants will have access to counseling and peer support.
• Relevant: Given the population with a high prevalence (75%) of early tobacco use, increased effort to encourage individuals to quit is more likely to result in success (Colyer-Patel et al., 2023).
• Time Bound: Evaluations will take place approximately 4 weeks after the educational session.

S.M.A.R.T. Goal 3: Increase Access to Available Support Services for African Americans in Santa Rosa

• Specific: All participants will be able to name at least one resource to support stopping smoking by the end of the session.
• Measurable: Provide a checklist of stopping smoking resources.
• Achievable: Participants will have an accessible resource guide.
• Relevant: The resource guide will support smoking cessation in a community of approximately 8% users of public transportation, as there are barriers to centralized, public health services.
• Time Bound: The smoking cessation resource guide will be evaluated to determine if the goal has been successfully achieved at the end of the event.

Conclusion

There is a health issue within the African community of Santa Rosa linked to increased smoking. Environmental and social issues have resulted in a greater concentration of smoking and increased health risks within the community, and increased smoking among African American Men. Evidence-based educational initiatives on tobacco use can encourage the community to be actively involved in changing the tobacco use behaviors of the community and increasing community members’ health. Reaching this goal will help to reduce tobacco use in the entire community and will be achieved by a behavior change focused on the individual and social community tobacco use factors. This will have a long-term positive impact and decrease the health risks of tobacco use and tobacco-related death in the community.