Tobacco Programming Needs Assessment Survey

Introduction

The Sacramento Native American Health Clinic’s Prevent, Restore, and Organize To End Commercial Tobacco ("PROTECT") project Needs Assessment is designed to better understand tobacco-related priorities, existing services, organizational capacity, training needs, and gaps among our community partner organizations. The questions in this assessment are informed by established tobacco control and public health frameworks including the Community of Excellence (CXE)1, American Indian Adult Tobacco Survey (AIATS)2 and the Policy Systems and Environmental change (PSE)3, each of which emphasizes understanding local tobacco use patterns, service availability, workforce readiness, cultural relevance, and sustainability when planning effective tobacco prevention/cessation programs.

Moreover, the questions in this assessment focus on community partner knowledge of current and future educational opportunities, services, and needs, recognizing that effective tobacco programming builds on organizational strengths while also addressing structural, workforce, and engagement barriers.

Information collected through this assessment will be analyzed in aggregate and used solely to guide program planning and development, training, and technical assistance, and sustainability efforts. Individual responses will not be identified.

Who should complete this assessment: Staff or leadership familiar with your organization’s services and communities you serve.

Estimated completion time: 10-15 minutes

Section 1: Organization Information.

Question Title

* 1. Organization type:

Tribal Government

Community-based organization

Healthcare/clinic/tribal health program

Public health department/agency

Social service organization

School or education program

Other (please specify)

Question Title

* 2. Primary population(s) served (select all that apply):

American Indian / Alaska Native

Pregnant or postpartum individuals

Early childhood

Youth/adolescents

Adults

Elders

Other (please specify)

Question Title

* 3. Approximately how many community members does your organization serve annually?

0-50

51-499

500-1,000

1,001-5,000

5,001 or more

Prefer not to state

Question Title

* 4. What is your organization’s approximate annual operating budget?

Less than $1 million

Greater than $1 million-$5 million

$5 million-$9.9 million

$10 million-24.9 million

Above $25 million

Prefer not to state

Question Title

* 5. Does your organization have a tobacco/smoke free facility policy?

Yes

I don’t know

Section 2: Tobacco Use and Community Impact

Question Title

* 6. On a scale of 1 to 10, how significant is commercial tobacco use a health concern among your clients/population served (1 lowest to 10 greatest concern)?

Question Title

* 7. Which commercial tobacco or nicotine product(s) use is of most concern among your clients/population served? (select all that apply)

Cigarettes

Cigars or cigarillos

E-cigarettes / vaping products

Hookah

Smokeless tobacco

Other (please specify)

Section 3: Current Organization Tobacco-Related Activities.

Question Title

* 8. Does your organization currently offer or promote any of the following commercial tobacco prevention or cessation services?

Yes (please select all that apply below)

Brief tobacco cessation counseling (e.g. Ask, Advise, Refer)

Referrals to Kick-It CA/Quitline services or group cessation programs

Nicotine replacement therapy (NRT)

Group or peer-based cessation classes

Community-based or culturally specific cessation programs

Digital, phone, or text-based cessation tools

Youth tobacco prevention education

Adult tobacco prevention education

Prenatal or postpartum tobacco support

Guest speakers or trained educator presentations/workshops

Unsure

Other (please specify)

Question Title

* 9. Does your organization currently offer any of the following commercial tobacco prevention or cessation health education material resources? (select all that apply)

Yes (please select all that apply below)

Printed educational materials (Brochures, Rack cards, Infographics, Posters)

Cessation resources (Quitline materials (cards, 800#, quit guides, Quit kits)

Waiting room: Digital resources (videos, social media content)

Waiting room: Displays of Commercial products or traditional tobacco

Tobacco Education materials (worksheets, coloring books, stickers, etc)

Cultural tobacco information/handouts or Native specific materials

Unsure

Other (please specify)

Question Title

* 10. How confident is your organization with the cultural accuracy and relevance to AIAN of the commercial tobacco education materials you currently use or access?

Not applicable / we do not use or have access to materials

Not confident

Neutral

Barely confident

Somewhat confident

Very confident

Section 4: Organizational Priorities and Partnership Interest.

Question Title

* 11. Which statement best describes your organization’s awareness of data on commercial tobacco use in your community?

We are not aware of any existing data

We are aware data exists, but not sure where it comes from

We are aware of local or community-specific data and its source

Unsure

Question Title

* 12. Which resources would be most helpful to your organization to support tobacco-related efforts? (select all that apply)

Educational support (presentations, workshops, activities)

Flexible schedule/platform (after hours, weekends, lunch hour, webinar, in-person)

Resources (print material, posters, infographics, electronic media, social media products)

Technical Assistance

Trained staff

All the above

Other (please specify)

Section 5: Organizational Team Training Needs Related to Tobacco.

Question Title

* 13. How familiar is your team with the commercial tobacco health impacts related to:

	Very	Somewhat	Aware but limited	Not familiar
Secondhand smoke	Secondhand smoke Very	Secondhand smoke Somewhat	Secondhand smoke Aware but limited	Secondhand smoke Not familiar
Thirdhand smoke	Thirdhand smoke Very	Thirdhand smoke Somewhat	Thirdhand smoke Aware but limited	Thirdhand smoke Not familiar
Vapes/E-cigarettes	Vapes/E-cigarettes Very	Vapes/E-cigarettes Somewhat	Vapes/E-cigarettes Aware but limited	Vapes/E-cigarettes Not familiar
Cigarettes/cigars	Cigarettes/cigars Very	Cigarettes/cigars Somewhat	Cigarettes/cigars Aware but limited	Cigarettes/cigars Not familiar
Chew tobacco	Chew tobacco Very	Chew tobacco Somewhat	Chew tobacco Aware but limited	Chew tobacco Not familiar
Nicotine salts/pouches	Nicotine salts/pouches Very	Nicotine salts/pouches Somewhat	Nicotine salts/pouches Aware but limited	Nicotine salts/pouches Not familiar
Flavored products	Flavored products Very	Flavored products Somewhat	Flavored products Aware but limited	Flavored products Not familiar

Question Title

* 14. In which areas would your team benefit from additional tobacco training or skill-building? (select all that apply)

Cessation resources promotion

Community level tobacco and health education

Community level tobacco and culture education

Culturally responsive approaches to protect against tobacco industry targeting

Distinguishing traditional/sacred tobacco vs. commercial tobacco

Prenatal or postpartum tobacco cessation/prevention

Referral systems (e.g. Quitline, clinical services, insurance benefits)

Youth tobacco prevention strategies

Other (please specify)

Question Title

* 15. What challenges make it difficult for your organization to engage the community in tobacco-related education programming? (select all that apply)

Community fatigue or low participation

Competing organizational or community priorities

Lack of tobacco expertise/partners

Limited funding, materials, incentives

Limited staff time

No significant barriers

Not aligned with organizational priorities

Scheduling constraints

Staff turnover

Training/resources not tailored to our population

Other (please specify)

Section 6: Community Engagement Needs for Tobacco Programming.

Question Title

* 16. Does your organization currently offer any health education or wellness programs?

Yes – Occasionally

Yes – Regularly

Unsure

Question Title

* 17. Which of the following engagement strategies would your organization like to use or strengthen in the future to engage the community in tobacco programming? (Select all that apply)

Community events or gatherings

Cultural or arts-based activities

Elder or intergenerational programming

Partnerships with tribal or community organizations

Policy or systems-level approaches

Social marketing or digital campaigns

Training for staff or volunteers

Youth-led or youth designed activities

Unsure

Other (please specify)

Section 7: Cultural Relevance and Community Values.

Question Title

* 18. How confident is your organization in explaining the difference between commercial tobacco and sacred/traditional tobacco to the community at-large?

Not applicable (we do not provide this type of education)

Not confident

Neutral

Barely confident

Somewhat confident

Very confident

Question Title

* 19. In your opinion, are there community beliefs, sensitivities or concerns that make it challenging to discuss commercial tobacco use or prevention? (select all that apply)

Competing priorities (e.g., housing, mental health, food access)

Cultural bias/stigma

Limited community awareness of commercial tobacco harm(s)

Misinformation or conflicting messages

Potential of stigmatizing people who use tobacco

Tobacco’s sacred role in culture

Unsure

Other (please specify)

Question Title

* 20. How does your organization typically tailor engagement strategies to be culturally relevant for the community you serve?

Question Title

* 21. Based on your experience, what recommendations do you have for improving future commercial tobacco cessation, education, and prevention efforts with American Indian and Alaska Native (AIAN) communities?