Community readiness for local smoke-free policy change

Purpose. The purpose of this study was to use the Community Readiness Model to examine heal smoke-free policy development. Design, Setting, and Subjects. A descriptive, cross-sectional design was used to assess 64 Kentucky communities. Dimensions of readiness included a community's knowledge of the problem and existing voluntary smoke-free policies; leadership for policy development; resources for policy development; climate surrounding policy development; existing voluntary policy efforts; and political climate for policy development. Dimension scores were summed to identify one of six overall readiness stages: (1) unawareness; (2) vague awareness; (3) preplanning; (4) preparation; (5) initiation; and (6) endorsement. Analyses. Correlations between dimensions and overall readiness scores were evaluated. One-way analysis of variance was used to evaluate regional trends, and multiple regression was used to assess the influence of sociodemographic/political variables on policy readiness. Results. The knowledge dimension rated highest, and community climate rated lowest. Most communities were in the lower stages of readiness. No relationship was found between overall readiness and region (F[4,59] = 1.17; p > .05); nor were there regional differences among dimension scores. Smaller communities were less ready for local policy development than larger ones (adjusted R² = .25; p = .003). Conclusions. The Community Readiness Model is appropriate for understanding local policy development, and it provides advocates with information that may prove helpful in advancing smoke-free policy.