OCTOBER 2016
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Yukon-Kuskokwim Health Corporation Raises the Bar on Tobacco Prevention
YKHC
partners with Alaska’s Tobacco Prevention
and Control Program and starts
several efforts to
prevent tobacco use and promote tobacco cessation
Throughout Alaska, community and tribal
policies are directly reducing the health risks of tobacco by helping people quit
tobacco use, preventing adults and children from starting tobacco use, and decreasing
exposure to the toxins in secondhand smoke.
The Yukon-Kuskokwim region in Southwest
Alaska is one of the largest geographic regions in the state that faces
challenges related to traveling from community to community due to difficult
weather, the lack of roads, and cost for airfare. The Yukon-Kuskokwim
Health Corporation (YKHC), headquartered
in Bethel, is striving to overcome those challenges and implement key efforts to
reduce or eliminate the leading cause of preventable death and disease in
Alaska – tobacco use.
YKHC’s
Role in Improving Health Care, Tobacco Prevention
Bethel is a regional hub that serves 56
communities, each with a federally recognized tribe. The tribes have authorized
YKHC to act on their behalf to provide health care services under the Indian
Self-Determination and Education Assistance Act of 1975. YKHC’s health care
system — including village clinics, sub-regional clinics, and a regional
hospital in Bethel — provides primary health services, dental and eye care,
mental health services, substance abuse counseling and treatment, health
promotion and disease prevention programs, environmental health services, and
more.
Since 2008, YKHC has received financial
and staff support from the State of Alaska Tobacco Prevention and Control (TPC) Program through the Community-Based Prevention Grant Program.
YKHC’s Tobacco Prevention program is committed to implementing proven methods
to prevent the initiation of tobacco use among youth and young adults, eliminating
exposure to secondhand smoke, and making it less socially acceptable to use
tobacco.
Reducing
Tobacco Use
YKHC and its partner — a local tobacco
prevention coalition called the Delta Tobacco Control Alliance — have made
significant progress passing policies that reduce tobacco use and increase
tobacco’s price:
-
In 1998, Bethel
was the first community in Alaska to pass a local workplace ordinance that
banned smoking inside workplaces and eliminated exposure to the toxins in secondhand
smoke.
-
Bethel was also
the first rural community to enact a local price increase on cigarettes and
other tobacco products, motivating several other
communities to follow suit.
-
YKHC is the
health corporation that has produced the highest number of tribal smokefree or
tobacco-free policies in the state, despite serving a large number of tribes
and its geographic challenges.
The YKHC Board of Directors recently approved
the addition of a sixth ‘Napartet’ (means
pillar in Yup’ik), the organization’s strategic plan known as Healthy People. This
strategic initiative prioritizes population health improvements, specifically
aiming to reduce tobacco use among youth and young adults and improve oral health
in the YK region.
YKHC enhanced its Brief Tobacco
Intervention model by improving RAVEN, YKHC’s electronic health record system,
to screen for tobacco use, advise quitting, and refer patients to their tobacco
cessation program. This model puts emphasis on two products that have high use
in the region: commercial smokeless tobacco and Iqmik (a homemade mix of
tobacco leaves and burned tree fungus ash that is highly addictive due to its
ability to increase available free nicotine to nearly 100 percent[1]).
Increasing
Tobacco Cessation Referrals and Creating a Tobacco-Free Campus
The Brief Tobacco Intervention is an
evidence-based approach that ensures each patient is screened for tobacco use
and history, advised to quit, and referred to a cessation counselor. All YKHC
cessation counselors are fluent in both Yup’ik and English so they can provide
effective services to anyone in need. Customizing the electronic health records
system allowed for faster, nearly automatic referrals to these counselors. This
significantly increased cessation referral rates.
Before customizing the electronic health
records system, reports showed only 20 cessation referrals each month.
Cessation referrals jumped to 119 within the first month of changes to the
records system, and 209 in the second month after changes. Total referrals have
since tapered off to an average of about 160 per month.
YKHC also has
strengthened its tobacco-free campus policy, both in Bethel and in the
surrounding 56 village clinics. YKHC has established a task force to update its
existing campus policy so that it will consider the local cultures, vast
geography, and the multiple locations throughout the YK Delta that house and
care for residents.
YKHC is committed to reducing the high rates of
tobacco use in the YK region. It is one of six public health regions in the
state that partner with Alaska’s TPC program to reduce tobacco use and promote
cessation. To learn more about these partnerships, visit the Tobacco-Free Alaska web site.
References:
-
Angstman, Patten et al., Am J of Health Behav.
2007;31(3):249-260
..........
Photograph courtesy of the Yukon-Kuskokwim Health Corporation. |
