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M.E.S.S.: An Evaluation and Validation Project

PI: Dolores B. Scott, MEd; Co-PI: John R. Ureda, MPH, DrPH; CameliaVitoc, MD, MPH; Michael Gibson, MPH, MD 
Introduction: Exposure to secondhand smoke has been identified as a serious health problem, especially among African American women and children. M.E.S.S., a collaborative effort between the faith community and state agencies, is designed to reduce exposure to secondhand smoke by creating voluntary smoke-free environments.
Purpose: Using a community-based participatory research approach, this pilot project seeks to evaluate and validate M.E.S.S. as a model for reducing exposure to secondhand smoke in faith-based community settings.
  • document the success of implementing M.E.S.S. in three African American churches in Greenville County, South Carolina;
  • describe the impact of M.E.S.S. on knowledge, beliefs, attitudes, practices, and policies relating to the purpose of M.E.S.S.;
  • utilize lessons learned on how M.E.S.S. may be implemented in other faith-based and community settings.
Methods: The research design, developed to accomplish the specific aims of this project, utilized a prospective cohort design with an external control comparison group. The State Baptist Young Woman’s Auxiliaries (YWA) from the New Jerusalem, Springfield, and Mountain View Baptist Churches volunteered to participate in the project. Three YWAs from each church were chosen  to serve as coordinators.  All were provided a comprehensive training by a team that included a physician who is a preventive medicine specialist.The training encompassed four key components:  Introduction to Tobacco, Secondhand Smoke and Passive Smoking, M.E.S.S. 101, and Developing an Action Plan.
Baseline surveys, pre- and post-evaluation tests, tobacco-free policy and pledge motivation were utilized as the primary components in the study. Interventions included:
  • hosting educational and information sessions about tobacco and secondhand smoke;
  • developing small print media and bulletin facts sheets; and
  • encouraging participants to commit voluntarily to adopting and enforcing smoke-free environments.
Preliminary Results: Only two of the three churches participating completed posttest surveys, and not all pretests have corresponding posttests, and vice versa.  About 30% of respondents (n=100) from these three African American churches reported ever smoking.  About 8% reported being current smokers.  Pledges to not smoke at home, in vehicles and at the church increased as a result of the M.E.S.S. program (to 53%).  However, the M.E.S.S. program appears to not have impacted attempts to quit smoking and current smoking at homes and in vehicles.  All three churches did implement no smoking policies for their churches, and about half as many incidents of smoking are reported in the churches following the program. 
Before the M.E.S.S. program about 10% of respondents had participated in tobacco prevention education within faith communities, 38% outside faith communities, and almost all respondents had told their children not to smoke.  After the M.E.S.S. program, respondents participating in tobacco prevention education within the faith community increase significantly from 10% to 42%; while respondents who had received tobacco prevention education outside the faith community rose slightly from 38% to 42%.
Conclusions: Based upon these findings, churches can be viable educational channels for tobacco prevention education.  Congregational members participating in programs were willing to make pledges related to tobacco use.  Faith communities are willing to adopt non-smoking policies.  It does appear that M.E.S.S. impacts smoking in churches, however it is uncertain at this time how M.E.S.S. impacts tobacco use outside the church environment.
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