phased-in smoke-free policy.
- Introduction: What is GASA?The Girls after School Academy (GASA) is a comprehensive program that serves girls 8-18 years of age living in Sunnydale, San Francisco’s largest public housing development, and in the greater Visitacion Valley. The program provides a safe and nurturing environment for girls by offering positive role models, activities that inspire learning, and access to educational and recreational resources.GASA youth advocates develop skills that help them to communicate effectively, resolve conflicts non-violently, acquire gender and cultural pride, and become strong, competent leaders. GASA advocates previously worked on a successful campaign with Sunnydale Housing Development tenants to pass an initiative that would phase-in a smoke-free policy in one of the buildings.
- THE PROBLEM: Secondhand smoke exposure in San Francisco Housing Authority buildingsSecondhand smoke, a carcinogen responsible for about 3,000 lung cancer deaths among non-smoking Americans annually, is a serious health hazard for nonsmokers, particularly children. Exposure to secondhand smoke worsens conditions such as asthma and increases the risk of lower respiratory tract infections such as bronchitis and pneumonia. Nonsmokers with high blood pressure or high cholesterol have a much higher risk of developing heart diseases when exposed to secondhand smoke, which causes about ten times as many cardiovascular deaths as cancer deaths. Secondhand smoke seeps through doorways, ceiling crawl spaces, and light fixtures, and cannot be controlled by air filtration or other types of ventilation systems, air cleaning, or separating smokers’ apartments from those of nonsmokers.The San Francisco Housing Authority (SFHA), the oldest housing authority in California, administers 51 housing developments with over 6,200 units. The first of many of these aging, deteriorating buildings was built in the early 1940s. Today, an estimated $267 million is needed for immediate repair work.
In 2007, the Mayor and Board of Supervisors authorized $95 million in local bond funding to launch HOPE SF, a partnership consisting of 11 San Francisco city agencies, to coordinate planning and investment to redevelop 2,500 seriously deteriorated public housing units into sustainable and mixed-income communities. The SFHA has already selected development teams to help rebuild four public housing sites, totaling about 2,500 units.
The HOPE SF initiative represents a unique opportunity to advocate for the adoption of smoke-free policies in the rebuilt housing developments.
What the advocates were trying to accomplish
The goal of the project was to reduce exposure to secondhand smoke among tenants living in San Francisco Housing Authority Developments.
- THE INTERVENTION MODEL: GASA utilized the Community Action Model (CAM), a process that builds on the strengths or capacity of a community to create change from within and mobilizes community members and agencies to change environmental factors promoting economic and environmental inequalities.
The Community Action Model includes the following steps:
- Train Participants: Community Action Team (CAT) members are recruited and trained to develop skills, increase knowledge and build capacity. The participants will use this knowledge and skills to choose a specific issue or focus and then design and implement an action to address it.
- Do a Community Diagnosis: A community diagnosis is the process of finding the root causes of a community concern or issue and discovering the resources to overcome it.
- Choose an Action: to address the issue of concern. The Action should be: 1) achievable, 2) have the potential for sustainability, and 3) compel a group/agency/organization to change the place they live for the well being of all.
- Develop and Implement an Action Plan: The CAT develops and implements an action plan to achieve their Action which may include an outreach plan, a media advocacy plan, development of a model policy, advocating for a policy, making presentations as well as an evaluation component.
- Enforce and Maintain the Action: After successfully completing the action, the CAT ensures that their efforts will be maintained over the long term and enforced by the appropriate bodies.
- THE STRATEGIES: How GASA adapted the Community Action ModelWith a three-year grant from the San Francisco Tobacco Free Project, GASA implemented a project to reduce secondhand smoke exposure among tenants living in San Francisco housing developments that were in the process of being redeveloped, rebuilt, and upgraded.
GASA recruited nine high school age advocates. Advocates from GASA, along with advocates from other Tobacco Free Project funded projects participated in a 4 hour joint training on July 16 2008. The training covered a variety of topics including tobacco as a social justice issue, the global reach of tobacco, the impact of the tobacco industry on communities of color, and how to effectively implement the Community Action Model (CAM).
2. Do a Community Diagnosis
The advocates used a combination of research, interviews, surveys, and community mapping to conduct their community diagnosis.
Research. The advocates undertook a vigorous research phase. First, they conducted research on secondhand smoke, including:
- The impact of exposure to secondhand smoke on health.
- How secondhand smoke drifts between units in multi-unit housing complexes, the level of exposure to secondhand smoke, and populations most affected.
Second, they identified other groups in San Francisco, including the Chinese Progressive Association and Sunset Russian Tobacco Education Project that were also working on smoke-free housing issues and met with them to explore the following:
- The type of housing other projects were working on;
- The proposed policies;
- The policymakers or decisions makers;
- The potential barriers to policy change;
- Was outreach among tenants done and how would tenants be involved in the process;
- The steps involved in promoting smoke free policies in multi-unit housing;
- Materials, such as model policies and letters, that were available to share; and
- Specific ways or points at which the groups could collaborate on their projects.
Third, the advocates identified and interviewed groups that had successfully implemented 100 percent secondhand smoke policies in low-income housing developments. These housing developments included San Francisco’s Buena Vista Terrace low-income HUD housing, Alameda County Housing Authority’s senior complex and eight additional complexes, and housing authorities in Michigan. Information was collected, including a copy of the policy, whether the policy changed eligibility criteria, how the policy was implemented, and problems that surfaced.
Fourth, the advocates researched HUD regulations, including those that: 1) allow smoke-free policies in multi-unit buildings, and 2) restrict or limit smoke-free policies in multi-unit buildings. The advocates also investigated whether the HUD regulations are applicable to San Francisco housing developments, and legal information related to implementing a smoke-free policy.
Interviews/surveys. The advocates surveyed four multi-unit housing complexes for information about their existing policies and/or laws that provide protection from drifting secondhand smoke and how they are enforced. Requests were made to obtain copies of each of the property management companies’ smoking policies and what the eligibility criteria would be for residents applying to live in the rebuilt developments.
The advocates also surveyed tenants who would be directly affected by passage of a specific policy that addresses drifting secondhand smoke in their buildings. They designed a survey tool of residents and surveyed 200 tenants in four multi-housing complexes (about 50 tenants per development). The surveys were conducted using internet, phone, and person-to-person among tenants living in the Potrero Hill, Hunter’s View, Sunnydale, and Westside Court complexes.
Community mapping. The advocates used the Midwest Academy Strategy chart to identify individual and community strengths for the project. An asset map was developed that included skills, knowledge, experience, potential allies/supporters, potential opponents, and their relationships. The map included the four housing developments that to be rebuilt with possible types of smoke-free policies that could be adopted (e.g., smoke-free floors, buildings, sections, and/or units depending on the layout of the units/buildings). In addition, assets in the community surrounding the four complexes that could benefit from the smoke-free housing project, such as community groups or organizations, tenant groups, churches, community leaders, schools, and other groups were listed and mapped. Also mapped were institutions, businesses, agencies, organizations, associations, and policymaking bodies in the community that had a stake in the housing developments. Finally, potential opponents to the project were mapped, along with a plan to neutralize the opposition.
3. Choose an Action
GASA worked to reduce secondhand smoke exposure among tenants living in two housing developments of the San Francisco Housing Authority through a community engagement process by which tenants would agree to adopt a policy designating a minimum of 75% of units in each of the developments as smoke free. The project was specifically focused on public housing developments that were in the process of being redeveloped/rebuilt/upgraded.4. Develop and Implement an Action Plan
Based on the results of the community diagnosis, the advocates decided to focus their actions in two housing developments, Hunters View and Sunnydale. As a part of their funding, the developers are required to conduct a community engagement process to seek input from current tenants about the architectural design of units, house rules, and necessary community resources, such as transportation, general stores, markets, and child and senior care centers.
Since the model already required incorporating input from tenants, GASA’s campaign for the two developments to adopt smoke-free policies would naturally include tenants, along with the developers and project coordinators of Hunters View and Sunnydale as primary decision makers.
The advocates knew that their best chance of succeeding was to involve as many constituents/allies in the process as possible. Their initial strategy was to brainstorm ways to: 1) engage a large number of tenants to attend the developers’ monthly meetings, 2) help the developers identify key community leaders, and 3) work with the diverse tenant populations living in each of the complexes. These included tenants who might oppose the policy, particularly tenants that smoke, and ensure that they had an equal voice in the process. The advocates first identified key individuals from the developers and tenants, and then asked those individuals to help identify other key people that should be involved in the discussions.
GASA advocates scheduled a meeting to present the proposed policy and gauge the level of interest. The advocates prepared an educational packet for developers and tenants that included information about the harmful effects of secondhand smoke and sent all participants advance flyers announcing meetings.
Using sample policies they had acquired during the research phase, the advocates developed model policies that included: 1) clear language specifying which units or buildings are nonsmoking, 2) where smoking is permitted and not permitted throughout the development, including individual units and/or buildings, enclosed and unenclosed common areas, and balconies, 3) an explanation of the consequences of violating nonsmoking rules, and 4) an explanation about where to report violations of nonsmoking rules.
The advocates made three presentations to request support and collaboration from the San Francisco Tobacco Free Coalition, allies, and residents and developers of Sunnydale and Hunters View housing developments. The advocates also conducted a media/awareness campaign at Hunters View and Sunnydale.
Then midway through the project, the advocates encountered multiple bureaucratic barriers, including problems with uncooperative developers working on the Sunnydale project. After some discussion, the advocates decided that Sunnydale was not a viable site in which to achieve policy change and focused instead on Hunters View.
At Hunters View, GASA advocates conducted a considerable amount of research and education, along with prepared written and oral presentations. GASA surveyed tenants about which ones would prefer to be moved into smoke free units. The survey results were to be given to the redevelopers, however, by the time the surveys were compiled, the advocates learned that the tenants had already been relocated into new units. Nonetheless, the advocates continued working with the tenants, urging them to decide if they wanted their new units to be smoke free and what percentage that should be. Then, in early January 2010, the tenants told GASA that they would no longer participate due to “internal problems” within the tenant association.
GASA met with the Housing Commission to discuss the next steps that should be taken. This resulted in GASA moving to work with Westside Court’s existing units to work on getting a smoke-free policy based on whatever percentage the tenants want. As before, the process was required to be tenant-initiated for GASA to have credibility with the Housing Commission. Once a group of tenants agreed to adopt a policy, GASA could then go to the Housing Commission and have them put the modification into the housing plan.
GASA was successful in getting a policy passed at Westside Court.
5. Enforce and Maintain the Action
Once GASA had gotten a smoke free policy passed, the next step was for the Housing Authority to make a formal agreement with Westside’s management to implement the tenant-initiated policy.
GASA’s next steps are to schedule a meeting with the Housing Commission (so far to no avail) to talk about the language that will be used for the policy and implementation. GASA has expressed commitment to ensuring enforcement of the policy, no matter how long it takes.
- THE RESULTS: High level of support for smoke-free policyTenants living in Westside were overwhelmingly supportive of adopting a smokefree policy. Sixty percent of existing tenants supported the adoption of aphased-in smokefree policy. Tenants were also in favor of prohibiting smoking within 20 feet of doorways, playground areas, and other common areas where people gather.
- CHALLENGES: GASA experienced multiple and nearly insurmountable bureaucratic barriers throughout the course of the project.
The greatest challenge was learning that the developers were not willing to meet or talk about issues with GASA.Probably most discouraging was that when the developments were initially proposed, the end date was to be 10 to 20 years. Now, the more realistic timeframe is closer to 30 or 40 years to accomplish the redevelopment. Working with a 10-20 year finish date was challenge enough; doubling the timeframe has made trying to pass policies that will not come into effect for that long an unrealistic venture.
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