ObjectiveThe Standardized Tobacco Assessment for Retail Settings (STARS) was designed to characterise the availability, placement, promotion and price of tobacco products, with items chosen for relevance to regulating the retail tobacco environment. This study describes the process to develop the STARS instrument and protocol employed by a collaboration of US government agencies, US state tobacco control programmes (TCPs), advocacy organisations, public health attorneys and researchers from the National Cancer Institute's State and Community Tobacco Control (SCTC) Research Initiative.MethodsTo evaluate dissemination and early implementation experiences, we conducted telephone surveys with state TCP leaders (n=50, response rate=100%), and with individuals recruited via a STARS download registry on the SCTC website. Website registrants were surveyed within 6 months of the STARS release (n=105, response rate=66%) and again after ∼5 months (retention rate=62%).ResultsAmong the state TCPs, 42 reported conducting any retail marketing surveillance, with actual or planned STARS use in 34 of these states and in 12 of the 17 states where marketing surveillance was not previously reported. Within 6 months of the STARS release, 21% of surveyed registrants reported using STARS and 35% were likely/very likely to use it in the next 6 months. To investigate implementation fidelity, we compared data collected by self-trained volunteers and by trained professionals, the latter method being more typically in retail marketing surveillance studies. Results suggest high or moderate reliability for most STARS measures.ConclusionThe study concludes with examples of states that used STARS to inform policy change.

IntroductionHistorically, federal funding streams to address cancer and tobacco use have been provided separately to state health departments. This study aims to document the impact of a recent focus on coordinating chronic disease efforts through collaboration between the 2 programs.MethodsThrough a case-study approach using semistructured interviews, we collected information on the organizational context, infrastructure, and interaction between cancer and tobacco control programs in 6 states from March through July 2012. Data were analyzed with NVivo software, using a grounded-theory approach.ResultsWe found between-program activities in the state health department and coordinated implementation of interventions in the community. Factors identified as facilitating integrated interventions in the community included collaboration between programs in the strategic planning process, incorporation of one another’s priorities into state strategic plans, co-location, and leadership support for collaboration. Coalitions were used to deliver integrated interventions to the community. Five states perceived high staff turnover as a barrier to collaboration, and all 5 states felt that federal funding requirements were a barrier.ConclusionsCancer and tobacco programs are beginning to implement integrated interventions to address chronic disease. Findings can inform the development of future efforts to integrate program activities across chronic disease prevention efforts.

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The Centers for Disease Control and Prevention (CDC)’s National Diabetes Prevention Program (National DPP) lifestyle change program (LCP) is effective in preventing or delaying type 2 diabetes among people with prediabetes. Increasing enrollment in the National DPP LCP remains a priority. Some LCPs attempt to increase enrollment by offering introductory sessions, pre-enrollment sessions that aim to recruit, engage, and enroll participants based on emerging evidence linking introductory sessions with increased enrollment. As part of a national survey of CDC-recognized organizations offering the National DPP LCP, we examined the content and characteristics of introductory sessions currently offered. Of the 544 organizations who reported offering introductory sessions, the majority provide essential information by overviewing the organization’s LCP (98%) and providing information about type 2 diabetes prevention (79%) during the session. Most provide social support by offering an opportunity to meet the coach (86%) and for program staff and participants to mingle (69%), but only 36% offer light refreshments. Most assess eligibility and readiness to change by offering participants an opportunity to take a risk test to determine eligibility (74%), assess their readiness to join (63%), and to enroll in the program, if interested (71%). Only 34% provide resources for participants not eligible for the program. Session characteristics intended to overcome behavioral barriers to enrollment as identified in prior studies are less common: 39% conduct activities to help participants feel that they can be successful, 38% include testimonials from successful program participants, and 26% assess how soon a participant plans to enroll. There is room for improvement in incorporating behavioral science principles in introductory sessions. Future work will examine associations between specific introductory session characteristics and enrollment. Disclosure P. Williams: None. W. Elkins: None. K. Proia: None. Z. Tayebali: None. K. Axelrod: None. N. S. Esquivel: None. A. Smith: None. D. Porterfield: None.

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