[Unidentified]: 本次会议正在录制中。
[MaryAnn O'Connor]: 好的。 大家好，欢迎参加梅德福市卫生委员会一月份的会议。 今天，成员 Platterwoods 博士和 Kathy Chabonier 也加入了我们的行列。 我希望每个人都能收到议程记录。 是的，准备好了。 一切都好。 Platterwoods 博士，您愿意宣布会议开始吗？
[Adam Hurtubise]: 当然，我将正式宣布会议开幕。 首先是2022年12月20日会议记录的批准。 有人反对吗？ 凯蒂？
[Unidentified]: 不。 他们看起来不错。
[Adam Hurtubise]: 好的。 会议记录被接受。
[MaryAnn O'Connor]: 一切都好。
[Adam Hurtubise]: 梅费尔特烟草法规更新。
[MaryAnn O'Connor]: 我可以获得正式投票吗？ 我一会儿就回来记录。 普拉托维茨博士，正式投票批准会议记录吗？
[Adam Hurtubise]: 是的。
[MaryAnn O'Connor]: 是的，谢谢。 一切都好。 抱歉，继续。
[Adam Hurtubise]: 接下来是烟草监管。
[MaryAnn O'Connor]: 所以我发送了更新版本，效果很好。 莫琳将其发送给我，以便您可以查看。 我不知道你面前是否有它们。 是的。 通常，就像我们的大多数章程一样，我们有目的声明，并且包含我们的所有定义。 实际的规定列在定义之后。 嗯，直到第七页才开始。 其中许多是我们目前医用烟草法规中的内容。 但现在我们正在尝试纳入州级违规和暂停以及该州于 2019 年 7 月和 2021 年实施的其他一些附加更新。 正确。 2020 年，玛丽安娜。 一切都结束了。 出色地。 所以，一切都很好。 我认为第七页的一部分，标牌有一点更新。 正确吗？我们想问。 因此，正确的标志。 我的意思是，我们不能对那艘船投票，因为这就是该州目前的情况，所以我们只是进去运营。 所以更新后的标牌，现在每个烟草制品购买者的身份证明，无论年龄大小，都必须出示身份证明文件，对吗？ 这在该州是新鲜事。 我们实际上没有什么可以投票支持的。 烟草销售许可证位于第八页。 这就是我们目前的规则的编写方式。 如果您愿意，我们可以在销售第九页上进行更新。 我们有一个有限的最低价格。 现在我们的雪茄单支售价为 2.5 美元，一包两支而不是五支。 我不知道改变它有什么重要，只是保持原样。
[Maureen Busby]: 然后谢丽尔就能更好地了解全州范围内有多少个城市更新了此信息。 我想我的三个社区的单包价格从 250 美元到 290 美元，多包价格从 5 美元到 580 美元。 但前几天晚上我合作的一个社区决定不提高最低价格。 所以这实际上取决于董事会，提高最低价格的想法是为了跟上通货膨胀。 这是几年前制定的，当时我们试图限制年轻人购买粉色和紫色香烟，用铝箔包裹，售价为 69 美分、79 美分。 我们认为，如果孩子们走进学校，你知道，高中生放学后走进学校，走进商店，他们可以获得一美元或两美元。 我们只是想通过提高价格来限制他们的访问。 然后，单件装的最低价格为 2.50 美元，多件装的最低价格为 5 美元。 那么问题来了：你想提高这个最低价格吗？
[MCM00001745_SPEAKER_04]: 如果我错了，请纠正我，但我认为他们已经做出了不想提高价格的决定。 也许我错了。
[Maureen Busby]: 是的。
[Maureen Busby]: 我认为米里亚姆是对的。 我们的想法是起草理事会当时的想法草案，然后在会议上对所有事项进行投票。
[MaryAnn O'Connor]: 好的。 正确的。 正确的。 我的意思是，如果您不希望我们这样做，我们就不必扩大规模。
[Unidentified]: 你保持沉默。
[Adam Hurtubise]: 我就离开它。 下一个是255。
[Unidentified]: 其他增加最多的城市在做什么？
[MCM00001745_SPEAKER_04]: 之所以提出上调，是因为波士顿是根据消费者价格指数上调的。 现在的不同之处在于，许多产品 法规中发现带有此部分香烟包装的产品现在是非法的，因为它们主要是调味烟草产品，现在已被州法律禁止。 所以我想说，各市政府保持价格不变的比例是 50-50，其中一半会根据波士顿的做法提高价格。
[Unidentified]: 我的意思是，我同意 Plotowicz 博士的观点，比方说 50-50。
[MaryAnn O'Connor]: 好吧，看起来不错。 第 10-H 页的下一部分同样是调味烟草产品的销售，现已成为州法律，因此包含在我们的法规中。 尼古丁含量也是如此，不超过35毫克。 文件现在已成为州法律。 所以我们将其添加到我们的章程中。 我们始终禁止血图、优惠券和散装销售。 然后，下一刻，其他一切都阻碍了我们。 没有变化。 医疗机构没有变化。 教育机构。 因此，下一个更改将是第 12 页的第 s 节。 这就是州和州法律的合并。 再说一遍，我们无能为力。 但在有关违规行为的 T 节中，我们在上次会议中讨论了这一点。 首次向未成年人出售后，州罚款现为 1,000 美元。 但我们今天必须投票的是允许我们设立一个暂停期。 至少有一个 30 岁以下的人做对了。 正确的。 这就是为什么在这项规定中，我们建议在向未成年人出售后连续三个工作日处以 1,000 美元的罚款。 这是董事会必须决定的事情，也是他们想要做的事情。 再次强调，不少于1天，也不少于30天。 我们在这个条例中连续提出了三个规定。 仅供参考，我们有两家商店接受了马丁最近的合规检查。 我们有两家卖给未成年人的商店。 因此，他们将被处以 1,000 美元的罚款，但我们目前尚未透露暂停的具体内容，因为我们正在等待董事会的决定。 克拉特曼博士，你想干预吗？
[Adam Hurtubise]: 哦，他们是最小的。 我只是好奇。
[Maureen Busby]: 717女，17岁女性。
[Adam Hurtubise]: 好的。
[MaryAnn O'Connor]: 一切都好。 他还索要了一份母亲的包裹。 正确的。
[Maureen Busby]: 好的。 就是这样。 我在两家商店都卖过。 是的。
[Unidentified]: 这对我来说似乎是一个问题，我们应该增加更多的暂停。
[Adam Hurtubise]: 是的，我很关心这个，虽然第一罪一、罪二是很多夫妻店和卷烟处方，但烟草制品收入是其实质内容的很大一部分。 所以，作为第一次违规，我倾向于宽容一点。 考虑到小企业主，我相信很多这样的商店都在梅德福市。 我也第二次重重地摔倒了，这已经是根深蒂固的了。 但我倾向于对第一次进攻更加宽容，因为这是第一次进攻，也因为我们正在谈论的是谁。 你知道，夫妻店、五型和十型街角商店。
[Unidentified]: 是不是都不需要出示身份证啊？
[Adam Hurtubise]: 是的，它们应该是卡片。 但如果你有一个兼职工人，你知道，另一个可能在雷达下飞行的孩子，这种情况以前发生过。 你知道，他是一名新助理，而且这个人很人造。 主人被发明了，这种事再也没有发生过。 他训练了每个人，你知道，这些事情都有可能发生。 所以我只是不想。 受到家庭商店 30 天的暂停。 这取决于那些销售。 这不是一家大型连锁店，你知道吗？
[MaryAnn O'Connor]: 对于停赛三天，你怎么看？
[Adam Hurtubise]: 是的，好的。 一切都好。
[MaryAnn O'Connor]: 今天摆在我们面前的不止一个。 一切都好吗？
[Adam Hurtubise]: 虽然声音有点大，但还是传达了信息。 我认为这是一个很好的妥协。 不止1个，但肯定不是30个。 第一次。 是的，你再做一次，结果就不一样了。
[Unidentified]: 好的，我可以提出动议，处以 1,000 美元的第一笔罚款并暂停三天吗？
[MaryAnn O'Connor]: 因我的第一次犯罪而出售。
[Adam Hurtubise]: 我希望你能认同你刚才所说的话。
[Unidentified]: 好的。
[MaryAnn O'Connor]: 我对此投赞成票。 好的。 第二位是凯西. 一切都好。 普拉托维茨博士，我可以获得正式投票吗？
[Adam Hurtubise]: 是的。
[MaryAnn O'Connor]: 凯西·沙巴尼亚？ 是的。 同意。 设定三天的动议获得批准。 谢谢。 我想如果你看到的话。 噢，第 13 页干得好。 很明显，列出了州和地方罚款的清单。 至此，违反第一状态进攻千第二违反。 2,000 美元，第三次违规为 5,000 美元出售给未成年人。 但是，该政策受梅德福当地法规的约束。 我们将第一道防御限制为 100 美元，第二道防御为 200 美元，第三道防御为 300 美元。 所以我想我真的很欣赏这种发生的方式。 我认为，找到该州与地点或将其列出可以让人们更清楚地理解。 我认为这就是我们真正需要改变或整合的全部内容。 其他一切似乎都非常接近。 我想我们很好。 我想我们已经结束了。 我还得再去这两家店。 你是什么意思？ 是的，只有最后一件事。 那么，这些变化的生效日期是什么呢？ 我认为生效日期可能是今天。 对吧，谢丽尔？
[MCM00001745_SPEAKER_04]: 是的，因为如果零售商知道他们已经受到这些法律的约束，那不会改变任何事情。
[MaryAnn O'Connor]: 好的，让我们进行正式投票，批准在各州纳入的书面规定以及为期三天的暂停，生效日期为今天，即 7 月 17 日。 哦，我会说七月？ 我希望日期是 2023 年 7 月 17 日。 好的，普拉托维茨博士，我可以提出批准该法规的动议吗？
[Adam Hurtubise]: 是的，批准动议。 你刚才说的话。
[MaryAnn O'Connor]: 好的。获取正式报价，德。普拉托维茨。是的？
[Adam Hurtubise]: 是的。
[MaryAnn O'Connor]: 沙巴纳，西姆？
[Unidentified]: 是的。 是的。 你能听到我吗？ 是的。
[MaryAnn O'Connor]: 是的，谢谢。 好的，完美。 我们准备出发了。 非常感谢。 非常感谢。 感谢您的帮助。
[Unidentified]: 谢谢。
[MaryAnn O'Connor]: 好的，议程上的下一个项目，我将离开 Sophie Greenbaum 请更好地总结一下，因为现在我正在溺水。 但索菲将展示她的研究小组一直在研究的一些数据。 这是一个区域性交流，但它也有优秀的元数据、对青年的关注和预防主题。 我会一边咳嗽一边让你解释。
[MCM00001230_SPEAKER_01]: Sure. Thanks, Marianne. So my name is Sophie Greenbaum. I am the Mystic Valley prevention coordinator on this specific grant that's called Mass Call 3B. So I'll tell you a little bit about the grant and then I'll walk us through the assessment. I'll try to keep it as entertaining as possible. I know data presentations are not always the most fun, but I think it's really helpful. There's some great quotes in here and we can learn a lot about what's happening in the region. So I'm going to share my screen and okay. All right, so we have the mystic Valley Public Health Coalition, as our overarching organization, and then mass call three be which is within a grant that is funding mystic Valley. So this is our central coalition, but then we're working across Malden, Medford, Melrose, Reading, Stoneham, Wakefield, and Winchester. So they have their individual organizations that are doing the work within their own towns that are collaborations across A couple of different sectors trying to think about youth prevention efforts. For the most part, some of them have a little bit of flexibility in what they do. And then representatives from each of those coalitions come together and join us as a part of the Mystic Valley Public Health Coalition. Right now we are working on a grant that is looking at primary prevention for substance misuse among our youth and young adults. Some of the main goals for this are making sure that what we actually implement is evidence-based or at least evidenced informed. We have this period of data collection that happened over this past summer, so summer 2021, And then we're making sure that we apply a racial equity framework to every stage of our grant, as well as a couple of guiding principles that are from BSAS, from actual funder. So they're just highlighted out here. We're using this as our framework as we think about our capacity building, as we think about our strategic planning. This is also a big part of what was infused into our actual data collection period. So, if we're going to just take a look at the Mystic Valley Public Health assessment, there are a couple of key areas that I'm going to go over. There's the assessment information itself, the demographics of who we talked to, what did that look like, some of the key findings, and then where we're going with this grant. Where is this supposed to be taking us? So our assessment information, we had qualitative and quantitative data. Our qualitative data were key stakeholder interviews, focus groups, and then we had our quantitative scores, which came from primarily our school surveys. So it was the YRBS, the communities that care data that happens here in Medford, and then just a smattering of other data about suicide and overdose. our court data, and a variety of other things that were available that everyone was able to then collectively pull together and give us a better picture of what's actually happening across this region. I am going to spend some time focusing on the qualitative data today because I think that that gives this really nice picture of what's going on, and then I'll complement it with a little bit of the quantitative findings. A lot of this probably will already be familiar to many of the folks here. I'm sure that many of these findings you've heard in other presentations that might be specifically towards Medford or, you know, just in general kind of makes sense. But it's important to see what's happening as a region so that when we do start to make actual implementation strategies, we have something that we can cohesively say works across the entire network. Some of our limitations with qualitative data is just, it's subjective. It's one of the things that makes qualitative data really wonderful but it also makes it challenging in that we can't take a single quote or a single theme and say that this applies to every single person in the region. These are just experiences that are sort of coloring in what we see in our quantitative data. There is also a decent amount of representation that came from Melrose and lesser from some of our other towns and communities. So it is a little bit skewed in that way. And then we recruited on social media, I believe actually primarily through Facebook. That also skews a little bit of who actually responded to the call for stakeholder interviews and things like that. We're going to go over the demographics for qualitative data. I won't take too much time here, but just give you the highlights. We have primarily cis women and girls, primarily people who identify as heterosexual or straight, Primarily black or African American respondents, followed closely by white. We have a lot of youth who were interviewed, which is awesome because that's giving us a really good idea of what's actually happening, what are they seeing, what are they talking about, and then a solid representation between 25 to 44. about half and half almost for people who have parents who are immigrants to the United States. And then representation of languages spoken at home. This asterisk over here is just saying that people were allowed to respond to more than one language. So if these percentages are not making sense to you over here, it's because people could endorse multiple. And I'll also say that all of the interviews were done in English. take that as we're going through this. Some of our key findings. So we had a consultant conduct the actual analysis. She took our qualitative and quantitative, put it together and gave this really pretty thorough report. I can actually distribute that to you all if that's something of interest that you'd like to see. There's a lot of detail. Anything that you might be interested in here is certainly covered from that report. This presentation is built based on her report and based on the highlights. Those are a lot of data that she combed through. She had a couple of key areas that she uses these big buckets to separate out the qualitative data. I'll go over the risk factors, protective factors, and the needs because those are some of the key areas. The substance use, I'll also cover lightly, but you'll see it all works together. So as far as our protective factors, there are four main themes that popped out pretty quickly. So people are endorsing supportive communities. There were a lot of conversations about our schools, having trusted adults in the schools, feeling like there are environments where people can be supported based on their identity and their authentic self, whether that's within the community or within their home or within the schools. There were also some great comments about prevention education and feeling like there were opportunities for professional development or opportunities to have students learn in their health classes. Positive youth development, which is really awesome that that is something that even came up in these conversations. but just the idea that students feel like they have these opportunities to be autonomous and take control over their own health and choices. And then adult relationships. So people endorsed having trusted adults across a couple of different spaces, including their coaches, guidance Councilors, parents, siblings, family members, and neighbors. So, I won't read you every single quote that is on the next couple of slides but I do think that they're really helpful way to think about the way that some of our students and community members are thinking about what a supportive community means. So in these quotes here, there are a couple of comments about being able to feel like as you're walking home. There are people who are waving at you who recognize you you have the sense of belonging, and a sense of, you know, other people are here to support you even from a distance. There are some comments about having supportive teachers for LGBTQ students and teachers who are openly supportive of that and may even identify as a part of the LGBTQ community. And then talking about the connections with faculty members that feel really supportive and engaging. The prevention and education piece, I think, is a little bit more straightforward. It's kind of what I just said about having these overarching programs that are available for students and community members that are really focused on prevention and a little bit more proactive. The comments about positive youth development is saying that there are a couple of locations where it feels like you can just go and you can enjoy being a student or enjoy being a young community member and that there are people, adults specifically, who are going to uplift your voice and have you as a part of the decision-making process. I like this like bottom piece down here with the high school Councilors. Let's help them be responsible as community citizens and take charge of who your community is and you're a part of that community, which I think is one of those big takeaway messages that's so important to have our students feeling like they're empowered and they have the ability to shift change and shift culture within the school or within the community. Adult relationships, again, very straightforward. People feel like they have them. They're available across a couple of different areas in the community. We also have our risk factors. So mental health was a big one. And that really spanned across a couple of different ideas. So we had the issue of treatment options, the issue of being a young adult who may have to get their parents involved if they want mental health services and maybe not feeling comfortable doing that. So some of the stigma components, community norms. So again, this survey really is in the context of substance use. So there were some people who endorsed just confusion around what is normal substance use. Some of this was about alcohol use in the way that adults consume in social function. Some of it was about marijuana, conflicting messages, the impacts of COVID. I don't think anyone here is surprised to see that that came up in the survey. and then using substances to cope or self-medicate with issues like bullying or trauma or family stress, things like that. Mental health, this is exactly what you would think about where there are people who are really struggling and end up using substances in the context of mental health struggles like anxiety. There's also a piece where there's the disconnection from normalcy with school and kind of that structure that happened during COVID and also concerns about when people are isolated and those mental health issues just increasing, especially for young adults and students. Community norms. So I think that the second quote here is really important to think about. This is taking the context of adults and what they're doing and thinking about the way that people are using substances in the community. And it's just very normalized. And so then it becomes pretty quickly confusing for our students. impacts of COVID. People got to hide behind their screen for a year and they lost some of their confidence and motivation. I think being kept inside for a year or two years and then being like let loose, spike substance use in a lot of teenagers. So again, these are perceptions and things that students feel like they are seeing in their school community and among their friends. And then the coping and self-medicating piece. I think that also is a little bit more straightforward. So, when we're thinking overall about substance use across our qualitative and quantitative data, you'll see here that this maps very, very closely to what we're seeing here. So, in this past 30-day use with our quantitative data, people are talking about alcohol, marijuana, and vapes. This is how our qualitative data ended up laying out. So the first discussion point was vapes, then marijuana, then alcohol. But again, these are the top three pretty consistently. In most places, you know, most of the coalition meetings that I've been a part of, vaping comes up. almost every single time. Marijuana is also a major point of discussion and it seems like as far as vaping goes, it doesn't seem like there are a lot of solutions that are readily available and that's going to be something that I'm pretty certain we'll end up focusing on through this grant. And then the major areas for improvement in needs, this goes back to our mental health issue. So there need to be more treatment options. There are issues of expense, issues of people wanting in-person services rather than something that's online. Schools, people were talking about needing more prevention education and having some of these things be proactive rather than a reactive response to something that's happening in the community or already happened. And then more youth activities. So there's this gap between our elementary schools and high schools where it doesn't feel like there's a lot, or in our high schools, a lot of things being focused around sports and competitive activities, after school activities, rather than things like the arts or other spaces. Here, I know I'm kind of coming close on some of the time I don't want to take up too much time here but I'm happy to share these slides if you want to take a look through some of the quotes. I think it's especially helpful to see with our students. I think this was also an interesting quote having the Winchester parent who's talking about just trying to look for someone to see their daughter to help with some pretty basic issues as far as stress and anxiety, and then just not being able to find anyone. We've heard that very consistently I know that there is the change. to the community health behavioral clinics, but we'll kind of see how that rolls out and if maybe that alleviates some of the burden that people are feeling right now. Our schools, so this is the first quote talking about vaping in bathrooms that comes up all the time. And then just a way to get information into the schools and have that communication back and forth between what we're doing, what other community organizations are doing and what our schools are doing. And then youth activities, which I pretty much already outlined. And then this contributes a piece about youth action teams. So in Wakefield, they have a youth action team. A couple of our other communities have these teams where they bring together the students and they are running some of their initiatives. We also have a regional group that is run through this grant as well. So the next steps for this grant really look like a couple of things. So we'll have data share back events, so we're going to take all the information, not all of it, actually let me rephrase that, the highlights of the information that we got in this assessment and share them back with the community to get feedback. We really want to know some of these qualitative pieces of information here. Does that ring true for a lot of our community members? Does it vary by population? What are we missing? What did we not get here? That's really important to think about when we're starting to consider strategic planning. Capacity building is another piece and another component of this grant. So We had a meeting in actually about a month ago as part of the prevention professionals, which is a part of the Mystic Valley Public Health Coalition, to think about what tools do we need to make sure that what we actually come up with is sustainable. And then our strategic planning. So we have all this information, we have feedback, hopefully in a couple, you know, like in a month. What are we going to do with this, how are we going to best make use of these funds and make sure that we're coming up with things that feel. like they resonate with the community and they're actually changeable. So that's gonna be probably our biggest upcoming challenge as we try to make something work across seven communities that all are pretty different, but also a really exciting part of the grant where we can get to the action and get to the pieces where we're actually doing something with our individual communities. And that is all. Thank you so much.
[Adam Hurtubise]: 一个简单的问题。 是否有任何数据可以将学生的反应与他们的家庭联系起来，即，与成年人相比，您自己的家庭吸食大麻的流行程度是多少？ 因为如果他们自己的家人正在这样做，我认为他们现在没有选择不这样做。
[MCM00001230_SPEAKER_01]: 是的，这是一个很好的问题。 我不一定觉得我有数字可以支持。我可以看看我们拥有什么，但这是我们可能需要考虑的最重要的事情之一，所以我分享了一些谈论成人使用的引言，然后是孩子们所说的，但肯定有 就像另一段定性引言，人们谈论，好吧，我的父母说我不应该喝酒，我不应该这样做，但他们说，好吧，你可以在家里喝一杯啤酒或一杯葡萄酒，然后他们举办一个聚会，每个人都喝醉了，你知道这真的很混乱，学生们不一定知道什么是合适的，所以这是我们要考虑的另一件事，我们如何才能 我们将其发送给社区中的父母，以便他们可以向自己的孩子传达更一致的信息。
[Unidentified]: 还有其他问题或意见吗？
[MaryAnn O'Connor]: 普拉托维奇博士说得好。 我想我已经看过这个演示几次了，但我认为它听起来很真实。 这些都是我们已经知道和听说了一段时间的事情，你知道，有保护因素和风险因素，以及缺乏青年活动和归属感等等。 所以，你知道，没什么，我不应该说 没有什么能让我如此惊讶。 我的意思是，我真的考虑过这些引言，虽然真的，当你一直看数据时，但听到年轻人嘴里的话真的让我明白这不仅仅是日常，而是真实的，它确实影响了这些孩子。 继续努力，祝你获得这项奖学金好运。请随时通知我们，我们会就此回复您。 我希望您考虑社区中的一些评论，并且这种情况也发生在社区内。
[MCM00001230_SPEAKER_01]: 是的，绝对是。 我还要对这些引述和年轻人的声音说最后一点。 当我们共享数据时，我们希望我们的公共卫生青年领导小组能够在我们的共享活动中派出一些代表，以便他们能够阅读一些社区引言，并为我们所看到的内容注入更多活力。 我只是把它写在幻灯片上。 然后，如果没有的话，也有一些我们学生预先录制的引言，这样人们就可以玩，让人们明白我们正在谈论真正的孩子，你知道，他们就像你的邻居，只是，你知道，在小学或高中或其他什么地方尽力做到最好。 所以，是的，我希望在我们前进的过程中回来分享更多。 非常感谢。 谢谢。
[MaryAnn O'Connor]: 那太好了。 嗯，我想这就是我们现在议程上的全部内容。 还有其他问题或意见吗？ 我现在没有什么其他事情可以做。 那么我们有休会动议吗？
[Adam Hurtubise]: 关闭会议的动议。
[MaryAnn O'Connor]: 第二。嗯，德。克利莫维奇，好吗？是的。凯西肥皂，好吗？
[Unidentified]: 是的。
[MaryAnn O'Connor]: 嗯，休会动议获得批准。 谢谢大家。
[Unidentified]: 小心。 谢谢你，索菲亚。 那很棒。
[MaryAnn O'Connor]: 下个月见。