The enactment of California's Proposition 215 stipulates that patients may use marijuana for medical reasons, provided that it is recommended by a physician. Yet, medical marijuana patients risk being stigmatized for this practice. This paper examines the way in which medical marijuana patients perceive and process stigma, and how it affects their interactions and experiences with others. Eighteen semi-structured interviews of medical marijuana patients were carried out using a semi-structured interview guide. Most patients circumvented their own physicians in obtaining a recommendation to use medicinal marijuana, and also used a host of strategies in order to justify their medical marijuana use to family, friends and colleagues in order to stave off potential stigma. The stigmatization of medical marijuana thus has a profound effect on how patients seek treatment, and whether they seek medical marijuana treatment at all.

Objective-This article reports the results of the Sacramento Neighborhood Alcohol Prevention Project (SNAPP). SNAPP set as its goal the reduction of alcohol access, drinking, and related problems in two low-income, predominantly ethnic minority neighborhoods, focusing on individuals between the ages 15 and 29, an age group identified with high rates of alcoholinvolved problems.Method-Two neighborhoods in Sacramento were selected to be the intervention sites because they were economically and ethnically diverse and had high rates of crime and other drinkingrelated problems. The quasi-experimental design of the study took a "phased" approach to program implementation and statistical examination of outcome data. Outcome-related data were collected in the intervention sites as well as in the Sacramento community at large. Five project interventions included a mobilization component to support the overall project, a community awareness component, a responsible beverage-service component, an underage-access law enforcement component, and an intoxicated-patron law enforcement component. Archival data were collected to measure and evaluate study outcomes and to provide background and demographic information for the study.Results-Overall, we found significant (p < .05) reductions in assaults as reported by police, aggregate emergency medical services (EMS) outcomes, EMS assaults, and EMS motor vehicle accidents. Conclusions-Results from the Sacramento Neighborhood Alcohol PreventionProject demonstrate the effectiveness of neighborhood-based interventions in the reduction of alcoholrelated problems such as assaults, motor vehicle crashes, and sale of alcohol to minors.Much enthusiasm has been generated by recent efforts to reduce alcohol-related problems with the use of environmentally based strategies. Included among these strategies are efforts to alter serving policies at on-premise alcohol outlets; increased enforcement of laws regulating drinking and driving; enforcement of alcohol-service and sales-to-minors laws; regulation of the proliferation of alcohol outlets; and, increasingly, efforts to reduce social access of alcohol to underage persons (Casswell and Gilmore, 1989;Hauritz et al., 1998 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript Hingson et al., 1996;Holder et al., 1997;Holmila, 1995Holmila, , 1997Homel et al., 1997;Midford et al., 1999;Putnam et al., 1993;Stewart and Casswell, 1993;Treno et al., 2005;Wagenaar et al., 2000).The enthusiasm is merited, as these strategies have been generally demonstrated across a series of studies to be effective in the reduction of youth access to alcohol, subsequent drinking by young people, problematic consumption patterns among drinkers, rates of drinking and driving, and increases in community mobilization and media advocacy surrounding alcohol use and drinking-related problems.However, such programs have generally been implemented across entire communities, leaving the question of whether they may be effectively applied at the neigh...

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Background Cambodian Americans experience great disparities in health compared to other Americans, yet may be underserved by conventional healthcare systems. CBPR is a means to engage underserved communities in health research and programming. We describe results of our efforts to engage the Cambodian grassroots members as well as formal leaders in Oakland, CA. Objectives In addition to a community advisory group, we convened a Community Work Group (CWG), composed of ten grassroots community women of varying ages and backgrounds. The project aimed to leverage the lived experiences of these women and their understandings of health and wellness in identifying specific health issues and developing culturally resonant strategies. Methods The CWG met weekly with staff facilitators using methods for collective analysis including theater, body mapping, and other expressive arts. Results The approach proved logistically challenging, but resulted in novel analyses and strategies. The group identified trauma, along with poor access to education, un- and under-employment, social isolation, and generation gap, together with community violence, as root causes of key behavioral health issues, i.e. alcohol abuse, gambling, prescription drug misuse, and domestic violence. Strategies proposed and implemented by the group and project staff were a community garden, Cambodian New Year’s celebrations, and a museum exhibit on the Cambodian refugee experiences. Conclusions Grassroots community engagement can support projects in identifying social determinants of health and developing the capacities of community members to conduct research and actions to improve health.