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Thibaut A, Olga FB, Fanyu H, Jeremy G, Jean G, Sophia B, Isabelle R, Céline PE, Michel D, Philippe B. Binding communication to improve peripheral venous catheter monitoring. J Eval Clin Pract 2022; 28:186-193. [PMID: 34346126 DOI: 10.1111/jep.13602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/08/2021] [Accepted: 07/11/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Optimizing the monitoring of peripheral venous catheters is essential. We developed a nursing record system at bedside (Patient Smart Reader) to track peripheral venous catheter acts. AIMS The aim of the present study was to improve peripheral venous catheter monitoring. To improve the quality of monitoring, we aimed to increase the usage of the nursing record system at the bedside. METHODS We developed a 'commitment intervention' course based on a binding communication paradigm. The corresponding effect on monitoring was analysed using a p-chart and time series analysis. FINDINGS Nurses observed a significant improvement in compliance with catheter monitoring over time (shifts after shifts), ranging from 27.6% (CI = [25.3; 30.0]) compliance before the commitment intervention to 47.4% (CI = [45.0; 49.9]) compliance after training. The commitment intervention increased the chances of carrying out monitoring through the tool for acts related to peripheral venous catheters by a factor of 2.42 (odds ratio) (CI = [1.88; 3.11]). CONCLUSION Binding communication provides an effective method for changing nurses' behaviours in terms of safe care. The determinants of engagement (individual vs collective) can be indicators for defining future communication and training strategies in care centers for all health care workers.
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Affiliation(s)
- Albertini Thibaut
- AP-HM, IRD, IHU-Méditerranée Infection, MEPHI, Aix Marseille Univ, Marseille, France.,Mediterranean Institute for Information and Communication Science, Aix Marseille Univ, Marseille, France
| | - Florea Bodean Olga
- AP-HM, IRD, IHU-Méditerranée Infection, MEPHI, Aix Marseille Univ, Marseille, France
| | - Huang Fanyu
- AP-HM, IRD, IHU-Méditerranée Infection, MEPHI, Aix Marseille Univ, Marseille, France
| | - Gonin Jeremy
- AP-HM, IRD, IHU-Méditerranée Infection, MEPHI, Aix Marseille Univ, Marseille, France.,AP-HM, INSERM, IRD, SESSTIM, Hop Timone, BioSTIC, Biostatistics & ICT, Aix Marseille Univ, Marseille, France
| | - Gaudart Jean
- AP-HM, INSERM, IRD, SESSTIM, Hop Timone, BioSTIC, Biostatistics & ICT, Aix Marseille Univ, Marseille, France
| | - Boudjema Sophia
- AP-HM, IRD, IHU-Méditerranée Infection, MEPHI, Aix Marseille Univ, Marseille, France
| | - Richer Isabelle
- AP-HM, IRD, IHU-Méditerranée Infection, MEPHI, Aix Marseille Univ, Marseille, France
| | - Pascual-Espuny Céline
- Mediterranean Institute for Information and Communication Science, Aix Marseille Univ, Marseille, France
| | - Durampart Michel
- Mediterranean Institute for Information and Communication Science, Aix Marseille Univ, Marseille, France
| | - Brouqui Philippe
- AP-HM, IRD, IHU-Méditerranée Infection, MEPHI, Aix Marseille Univ, Marseille, France
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LOGO DIVINED, OPPONG FELIXB, SINGH ARTI, AMENYAGLO SEIDU, WIRU KENNETH, ANKRAH SAMPSONT, MUSAH LABRAMM, KYEI-FARIED SARDICK, ANSONG JOANA, OWUSU-DABO ELLIS. Profile and predictors of adolescent tobacco use in Ghana: evidence from the 2017 Global Youth Tobacco Survey (GYTS). JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E664-E672. [PMID: 34909494 PMCID: PMC8639124 DOI: 10.15167/2421-4248/jpmh2021.62.3.2035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/09/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Understanding the predictive factors for tobacco use, and initiation among the youth is critical for effective intervention and prevention. We, therefore, aimed to determine the profile, associated factors, the regional disparities in the use of tobacco products among the youth in Ghana. METHOD The study used the 2017 Ghana Global Youth Tobacco Survey (GYTS) to obtain tobacco-related information among the youth in Junior High Schools across the country. The survey used a two-stage cluster randomized sampling technique to obtain nationally representative data. Weighted univariate and multivariate logistic regression analyses were used to assess the association of participant's characteristics and use of tobacco. RESULTS Out of the 6039 targeted respondents, 5,664 (93.8%) participated, 2,707 males, 2,929 females, and 28 of the participants had missing gender data. The use of any tobacco product (cigarette, smokeless tobacco, electronic cigarette, or waterpipe tobacco) was 28.3, 7.0, and 4.8% in the Savanna/northern zone, middle/forest zone, and Coastal zone respectively. From the univariate analysis, age (p = 0.005), pocket money (p < 0.001), and exposure to secondhand smoke (SHS) at home (p < 0.001) were significantly associated with tobacco use. In the multivariate analysis, age (p = 0.002), pocket money (p < 0.001), exposure to SHS at home (p < 0.001), and being taught about the dangers of tobacco use (p = 0.043) were significantly associated with tobacco use. CONCLUSION Multiple factors including age, pocket money, exposure to SHS were identified to be associated with tobacco use among the youth in Ghana. Promoting anti-smoking campaigns in early adolescence, as well as programmes targeting early tobacco use can guard the youth against initiating tobacco use.
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Affiliation(s)
- DIVINE D. LOGO
- Research and Development Division, Ghana Health Service, Accra, Ghana
- Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - ARTI SINGH
- Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - SEIDU AMENYAGLO
- Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - KENNETH WIRU
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - SAMPSON T. ANKRAH
- Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - JOANA ANSONG
- World Health Organization Ghana Country Office, Accra, Ghana
| | - ELLIS OWUSU-DABO
- Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Kim N, Loh WY, McCarthy DE. Machine learning models of tobacco susceptibility and current use among adolescents from 97 countries in the Global Youth Tobacco Survey, 2013-2017. PLOS GLOBAL PUBLIC HEALTH 2021; 1:e0000060. [PMID: 36962106 PMCID: PMC10021689 DOI: 10.1371/journal.pgph.0000060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 11/09/2021] [Indexed: 01/30/2023]
Abstract
Adolescents are particularly vulnerable to tobacco initiation and escalation. Identifying factors associated with adolescent tobacco susceptibility and use can guide tobacco prevention efforts. Novel machine learning (ML) approaches efficiently identify interactive relations among factors of tobacco risks and identify high-risk subpopulations that may benefit from targeted prevention interventions. Nationally representative cross-sectional 2013-2017 Global Youth Tobacco Survey (GYTS) data from 97 countries (28 high-income and 69 low-and middle-income countries) from 342,481 adolescents aged 13-15 years (weighted N = 52,817,455) were analyzed using ML regression tree models, accounting for sampling weights. Predictors included demographics (sex, age), geography (region, country-income), and self-reported exposure to tobacco marketing, secondhand smoke, and tobacco control policies. 11.9% (95% CI 11.1%-12.6%) of tobacco-naïve adolescents were susceptible to tobacco use and 11.7% (11.0%-12.5%) of adolescents reported using any tobacco product (cigarettes, other smoked tobacco, smokeless tobacco) in the past 30 days. Regression tree models found that exposure or receptivity to tobacco industry promotions and secondhand smoke exposure predicted increased risks of susceptibility and use, while support for smoke-free air policies predicted decreased risks of tobacco susceptibility and use. Anti-tobacco school education and health warning messages on product packs predicted susceptibility or use, but their protective effects were not evident across all adolescent subgroups. Sex, region, and country-income moderated the effects of tobacco promotion and control factors on susceptibility or use, showing higher rates of susceptibility and use in males and high-income countries, Africa and the Americas (susceptibility), and Europe and Southeast Asia (use). Tobacco policy-related factors robustly predicted both tobacco susceptibility and use in global adolescents, and interacted with adolescent characteristics and other environments in complex ways that stratified adolescents based on their tobacco risk. These findings emphasize the importance of efficient ML modeling of interactions in tobacco risk prediction and suggest a role for targeted prevention strategies for high-risk adolescents.
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Affiliation(s)
- Nayoung Kim
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Wei-Yin Loh
- Department of Statistics, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Danielle E McCarthy
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
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Mutaz M, de Vries N, Cheung KL, de Vries H. Towards a better understanding of factors affecting smoking uptake among Saudi male adolescents: A qualitative study. Tob Prev Cessat 2020; 6:29. [PMID: 32760864 PMCID: PMC7398134 DOI: 10.18332/tpc/120000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION An increased smoking uptake by Saudi male adolescents and a lack of data about its determinants emphasize the need for a better understanding of factors leading to the onset of smoking and identifying ways to prevent it. The aim of this qualitative study is to explore adolescents' views on smoking and their opinions about a smoking prevention program. METHODS A total of 103 school-going adolescents, aged 12-16 years, were purposely selected from grades seven, eight and nine from nine schools in Taif in Saudi Arabia. They were interviewed in 11 focus group discussions; five groups were held for smokers and six for non-smokers. An interview scheme was developed based on the I-Change Model, a model used for understanding smoking onset and prevention. We used QDA Lite version 2:0 software for data analysis. RESULTS Most of the participants agreed on the importance of social influences as determining factors to start smoking. The presence of smoking friend(s) and family member(s), especially the father, were mentioned. Factors such as having extra pocket money, absence of alternatives, showing off, to be seen as western, to be seen as an adult and the good taste of cigarettes were also mentioned as beliefs associated with smoking. Adolescents indicated to have low confidence not to smoke under peer pressure, suggesting self-efficacy problems. Intentions to smoke were also often mentioned. Almost all participants agreed that an interactive approach is optimal for an effective smoking prevention program. CONCLUSIONS Determinants of smoking seem to be very similar to those outlined by previous studies. A smoking prevention program for Saudi adolescents should address how to cope with social pressure to smoke, the advantages connected with smoking, and how to increase self-efficacy. Information should be presented in an interactive rather than static way.
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Affiliation(s)
- Mohammed Mutaz
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
| | - Nanne de Vries
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
| | - Kei L Cheung
- College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Hein de Vries
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
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Nativel A, Clerico JB, Guilbert L, Priolo D. Utilisation de l’engagement pour limiter la valorisation des fumeurs chez les adolescents. PRAT PSYCHOL 2020. [DOI: 10.1016/j.prps.2019.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Brinker TJ, Buslaff F, Suhre JL, Silchmüller MP, Divizieva E, Wilhelm J, Hillebrand G, Penka D, Gaim B, Swoboda S, Baumermann S, Walther JW, Brieske CM, Jakob L, Baumert HM, Anhuef O, Schmidt SM, Alfitian J, Batra A, Taha L, Mons U, Hofmann FJ, Haney AC, Haney CM, Schaible S, Tran TA, Beißwenger H, Stark T, Groneberg DA, Seeger W, Srivastava A, Gall H, Holzapfel J, Rigotti NA, Baudson TG, Enk AH, Fröhling S, von Kalle C, Bernardes-Souza B, Pereira RMDOS, Thomas R. Process Evaluation of a Medical Student-Delivered Smoking Prevention Program for Secondary Schools: Protocol for the Education Against Tobacco Cluster Randomized Trial. JMIR Res Protoc 2019; 8:e13508. [PMID: 30973348 PMCID: PMC6482400 DOI: 10.2196/13508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/22/2019] [Accepted: 03/23/2019] [Indexed: 01/10/2023] Open
Abstract
Background Most smokers start smoking during their early adolescence under the impression that smoking entails positive attributes. Given the addictive nature of cigarettes, however, many of them might end up as long-term smokers and suffering from tobacco-related diseases. To prevent tobacco use among adolescents, the large international medical students’ network Education Against Tobacco (EAT) educates more than 40,000 secondary school students per year in the classroom setting, using evidence-based self-developed apps and strategies. Objective This study aimed to evaluate the long-term effectiveness of the school-based EAT intervention in reducing smoking prevalence among seventh-grade students in Germany. Additionally, we aimed to improve the intervention by drawing conclusions from our process evaluation. Methods We conduct a cluster-randomized controlled trial with measurements at baseline and 9, 16, and 24 months postintervention via paper-and-pencil questionnaires administered by teachers. The study groups consist of randomized schools receiving the 2016 EAT curriculum and control schools with comparable baseline data (no intervention). The primary outcome is the difference of change in smoking prevalence between the intervention and control groups at the 24-month follow-up. Secondary outcomes are between-group differences of changes in smoking-related attitudes and the number of new smokers, quitters, and never-smokers. Results A total of 11,268 students of both sexes, with an average age of 12.32 years, in seventh grade of 144 secondary schools in Germany were included at baseline. The prevalence of cigarette smoking in our sample was 2.6%. The process evaluation surveys were filled out by 324 medical student volunteers, 63 medical student supervisors, 4896 students, and 141 teachers. Conclusions The EAT cluster randomized trial is the largest school-based tobacco-prevention study in Germany conducted to date. Its results will provide important insights with regards to the effectiveness of medical student–delivered smoking prevention programs at school. International Registered Report Identifier (IRRID) DERR1-10.2196/13508
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Affiliation(s)
- Titus Josef Brinker
- Department of Translational Oncology, National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany.,Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Fabian Buslaff
- Department of Translational Oncology, National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | | | | | | | - Jilada Wilhelm
- Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Gabriel Hillebrand
- National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Dominik Penka
- Faculty of Medicine, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Benedikt Gaim
- Faculty of Medicine, University of Regensburg, Regensburg, Germany
| | - Susanne Swoboda
- Faculty of Medicine, University of Regensburg, Regensburg, Germany
| | | | - Jörg Werner Walther
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bochum, Germany
| | | | - Lena Jakob
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | | | - Ole Anhuef
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen, Germany
| | - Selina Marisa Schmidt
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen, Germany
| | - Jonas Alfitian
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Anil Batra
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen, Germany
| | - Lava Taha
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - Ute Mons
- Cancer Prevention Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Ailís Ceara Haney
- National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Caelán Max Haney
- National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Samuel Schaible
- National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Thien-An Tran
- National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Hanna Beißwenger
- Faculty of Medicine, University of Göttingen, Göttingen, Germany
| | - Tobias Stark
- Faculty of Medicine, University of Regensburg, Regensburg, Germany
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University of Frankfurt am Main, Frankfurt am Main, Germany
| | - Werner Seeger
- Faculty of Medicine, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Aayushi Srivastava
- National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Henning Gall
- Faculty of Medicine, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Julia Holzapfel
- Faculty of Medicine, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Nancy A Rigotti
- Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Tanja Gabriele Baudson
- Cognitive Science and Assessment Institute, University of Luxembourg, Luxembourg, Luxembourg
| | - Alexander H Enk
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefan Fröhling
- National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Christof von Kalle
- Department of Translational Oncology, National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | | | | | - Roger Thomas
- Health Sciences Centre, University of Calgary, Calgary, AB, Canada
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Conner M, Grogan S, West R, Simms-Ellis R, Scholtens K, Sykes-Muskett B, Cowap L, Lawton R, Armitage CJ, Meads D, Schmitt L, Torgerson C, Siddiqi K. Effectiveness and cost-effectiveness of repeated implementation intention formation on adolescent smoking initiation: A cluster randomized controlled trial. J Consult Clin Psychol 2019; 87:422-432. [PMID: 30843703 PMCID: PMC6474716 DOI: 10.1037/ccp0000387] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Forming implementation intentions (if-then plans) about how to refuse cigarette offers plus antismoking messages was tested for reducing adolescent smoking. METHOD Cluster randomized controlled trial with schools randomized (1:1) to receive implementation intention intervention and messages targeting not smoking (intervention) or completing homework (control). Adolescents (11-12 years at baseline) formed implementation intentions and read messages on 8 occasions over 4 years meaning masking treatment allocation was not possible. Outcomes were: follow-up (48 months) ever smoking, any smoking in last 30 days, regular smoking, and breath carbon monoxide levels. Analyses excluded baseline ever smokers, controlled for clustering by schools and examined effects of controlling for demographic variables. Economic evaluation (incremental cost effectiveness ratio; ICER) was conducted. Trial is registered (ISRCTN27596806). RESULTS Schools were randomly allocated (September-October 2012) to intervention (n = 25) or control (n = 23). At follow-up, among 6,155 baseline never smokers from 45 retained schools, ever smoking was significantly lower (RR = 0.83, 95% CI [0.71, 0.97], p = .016) in intervention (29.3%) compared with control (35.8%) and remained so controlling for demographics. Similar patterns observed for any smoking in last 30 days. Less consistent effects were observed for regular smoking and breath carbon monoxide levels. Economic analysis yielded an ICER of $134 per ever smoker avoided at age 15-16 years. CONCLUSIONS This pragmatic trial supports the use of repeated implementation intentions about how to refuse the offer of a cigarette plus antismoking messages as an effective and cost-effective intervention to reduce smoking initiation in adolescents. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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McMenamin SB, Cummins SE, Zhuang YL, Gamst AC, Ruiz CG, Mayoral A, Zhu SH. Evaluation of the Tobacco-Use Prevention Education (TUPE) program in California. PLoS One 2018; 13:e0206921. [PMID: 30388176 PMCID: PMC6214574 DOI: 10.1371/journal.pone.0206921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 10/21/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND AIMS The California Tobacco-Use Prevention Education (TUPE) program promotes the use of evidence-based tobacco-specific prevention and cessation programs for adolescents within the school setting. Through a competitive grant process, schools are funded to provide programs for grades 6-12. This research evaluates the association between TUPE funding and tobacco prevention activities and tobacco use prevalence. METHODS This study utilized two data sources: (1) 2016 California Educator Tobacco Survey (CETS), and (2) 2015-2016 California Student Tobacco Survey (CSTS). The CETS collected data from educators about school prevention efforts, priority of tobacco prevention, and confidence in addressing tobacco issues with students. A total of 3,564 educators from 590 schools participated in CETS. The CSTS collected data from 8th, 10th, and 12th graders in California on their exposure to, attitudes about, and utilization of tobacco products. A total of 47,981 students from 117 schools participated in CSTS. RESULTS This study found that TUPE-funded schools were more likely to provide tobacco-specific health education programs, to place a priority on tobacco-prevention efforts, and to prepare educators to address tobacco use than non-TUPE schools. Educators at both types of schools felt better prepared to talk with students about traditional tobacco products than about emerging products such as e-cigarettes. Overall, students at TUPE-funded schools were more likely to report receiving anti-tobacco messages from school-based programs than those at non-TUPE schools. The former were also less likely to use tobacco products, even when the analysis controlled for demographics and school-level characteristics (OR = 0.82 [95% CI = 0.70-0.96]). CONCLUSIONS TUPE funding was associated with an increase in schools' tobacco-specific prevention activities and these enhanced activities were associated with lower tobacco use among students. This study also found that education and prevention efforts regarding emerging tobacco products need to be strengthened across all schools.
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Affiliation(s)
- Sara B. McMenamin
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Sharon E. Cummins
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
- Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America
| | - Yue-Lin Zhuang
- Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America
| | - Anthony C. Gamst
- Department of Mathematics, University of California San Diego, La Jolla, California, United States of America
| | - Carlos G. Ruiz
- Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America
| | - Antonio Mayoral
- Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America
| | - Shu-Hong Zhu
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
- Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America
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9
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Leiva A, Estela A, Bennasar-Veny M, Aguiló A, Llobera J, Yáñez AM. Effectiveness of a complex intervention on smoking in adolescents: A cluster-randomized controlled trial. Prev Med 2018; 114:88-94. [PMID: 29940292 DOI: 10.1016/j.ypmed.2018.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 06/19/2018] [Accepted: 06/21/2018] [Indexed: 11/25/2022]
Abstract
UNLABELLED Tobacco smoking is a major preventable cause of death, and a significant public health problem worldwide. Most smokers begin in adolescence, age at which they are more susceptible to nicotine addiction. The prevalence of smoking in adolescence is considerable. Therefore, it would be convenient to incorporate smoking prevention programs in the school environment. It is necessary to provide evidence of its effectiveness. The primary objective of the study was to evaluate the effectiveness of a teacher-delivered school-based intervention on the initiation of smoking in adolescents (ITACA smoking prevention education program). A multi-center cluster randomized trial was designed. Twenty-two secondary schools from Spain were enrolled in 2 successive cohorts, from 2010 to 2011. The intervention consisted in the application of the ITACA smoking prevention education program. A 4-year cognitive-behavioral intervention that is based on the social-influences model and is integrated into schools' regular curricular activities. A total of 1055 students were surveyed before the intervention (age: 12-13 years-old), and at the third year of the intervention (age: 14-15 years-old) of a 4-year education program. The outcome measures were daily and weekly use of cigarettes, and initiation of smoking. There was no evidence that the intervention impacted the incidence of regular smoking (OR = 1.08; 95% CI: 0.50-2.33) or the initiation of smoking (OR = 1.09; 95% CI: 0.56-1.72). This trial provides evidence supporting the non-effectiveness of a complex educational smoking prevention program at 3 years after the intervention. TRIAL REGISTRATION NUMBER Current Controlled Trials: NCT01602796.
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Affiliation(s)
- Alfonso Leiva
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Mallorca, Spain; Balearic Islands Health Research Institute (IdISPA), Palma, Spain; Primary Care Preventive and Health Promotion Research Network (redIAPP), Spain
| | - Andreu Estela
- Dalt Sant Joan Primary Health Care Centre, Balearic Islands Health Service, Menorca, Spain
| | - Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy, Balearic Islands University, Palma, Spain; Evidence, Lifestyles and Health Research Group, Research Institute of Health Sciences, Balearic Islands University, Palma, Spain.
| | - Antoni Aguiló
- Department of Nursing and Physiotherapy, Balearic Islands University, Palma, Spain; Evidence, Lifestyles and Health Research Group, Research Institute of Health Sciences, Balearic Islands University, Palma, Spain
| | - Joan Llobera
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Mallorca, Spain; Balearic Islands Health Research Institute (IdISPA), Palma, Spain; Primary Care Preventive and Health Promotion Research Network (redIAPP), Spain
| | - Aina M Yáñez
- Department of Nursing and Physiotherapy, Balearic Islands University, Palma, Spain; Evidence, Lifestyles and Health Research Group, Research Institute of Health Sciences, Balearic Islands University, Palma, Spain
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Verghese C, Redko C, Fink B. Screening for Lung Cancer Has Limited Effectiveness Globally and Distracts From Much Needed Efforts to Reduce the Critical Worldwide Prevalence of Smoking and Related Morbidity and Mortality. J Glob Oncol 2018; 4:1-7. [PMID: 30241213 PMCID: PMC6181518 DOI: 10.1200/jgo.2017.1700016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Cherian Verghese
- Cherian Verghese and Brian Fink, University
of Toledo Medical Center, Toledo; and Cristina Redko, Wright State
University, Dayton, OH
| | - Cristina Redko
- Cherian Verghese and Brian Fink, University
of Toledo Medical Center, Toledo; and Cristina Redko, Wright State
University, Dayton, OH
| | - Brian Fink
- Cherian Verghese and Brian Fink, University
of Toledo Medical Center, Toledo; and Cristina Redko, Wright State
University, Dayton, OH
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Riedijk L, Harakeh Z. Imitating the Risky Decision-Making of Peers: An Experimental Study Among Emerging Adults. EMERGING ADULTHOOD (PRINT) 2018; 6:255-265. [PMID: 30443439 PMCID: PMC6195170 DOI: 10.1177/2167696817722918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This experiment examined whether emerging adults imitate the risky decision-making of peers and whether peer susceptibility functions as a moderator. Overall, 63 emerging adults participated with a confederate of the same gender. The participants were randomly assigned to the experimental (confederate engaged in risky decision-making) or control (confederate did not engage in risky decision-making) condition. Risky decision-making was measured with the Stop-Light Game task, and peer susceptibility was measured with a questionnaire. Linear regression analyses showed that the participants engaged in more risky decision-making when the peer displayed risky decision-making. Peer susceptibility was not found to be a significant moderator of this relationship. The findings showed that health education programs need to consider imitation to reduce the risky decision-making of emerging adults more effectively.
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Affiliation(s)
- Larisa Riedijk
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Zeena Harakeh
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
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Cousson-Gélie F, Lareyre O, Margueritte M, Paillart J, Huteau ME, Djoufelkit K, Pereira B, Stoebner A. Preventing tobacco in vocational high schools: study protocol for a randomized controlled trial of P2P, a peer to peer and theory planned behavior-based program. BMC Public Health 2018; 18:494. [PMID: 29653527 PMCID: PMC5899383 DOI: 10.1186/s12889-018-5226-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 02/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In France, the issue of youth smoking remains a major challenge for public health. School failure, socio-economic and socio-cultural backgrounds influence the initiation and maintenance of smoking behavior in adolescents. Vocational students are at particularly high risk of using psychoactive substances, including tobacco. One of the most important factors is the environment, whether family, friends or peers. Therefore, peer education has a positive potential to change smoking behavior of adolescents. It has also been demonstrated that the Theory of Planned Behavior (TPB) has yielded the best prediction of intentions and behavior, in several health domains, including on tobacco. However, it is usually confined to the measurement of processes by which interventions change behavior, rather than to the development of these interventions. The objective of this paper is to describe the protocol for a randomized controlled trial of a peer intervention based on the TPB on a highly exposed young population. METHODS/DESIGNS This is a cluster randomized controlled trial comparing an intervention group to a control group, randomized into clusters (professional schools and classes) and stratified in three departments (Hérault, Aude and Gard) in the Languedoc-Roussillon region. The primary issue is the prevalence of daily smoking at 24 months, defined by a daily tobacco use of at least 1 cigarette, validated by CO levels in exhaled air. The primary hypothesis is that intervention will lead to decrease the daily smoking prevalence of 10% between the intervention group and the control group during a 2-year follow-up. DISCUSSION The results from this trial will provide evidence on the effectiveness of an innovative peer-to-peer intervention based on the TPB. TRIAL REGISTRATION ISRCTN: 37336035 , Retrospectively registered 11/12/2015.
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Affiliation(s)
- Florence Cousson-Gélie
- Univ Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON, EA 4556, F34000, Montpellier, France
- Epidaure Prevention Department of the Regional Institute of Cancer of Montpellier-Val d’Aurelle, Montpellier, France
| | - Olivier Lareyre
- Univ Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON, EA 4556, F34000, Montpellier, France
- Epidaure Prevention Department of the Regional Institute of Cancer of Montpellier-Val d’Aurelle, Montpellier, France
| | - Maryline Margueritte
- Epidaure Prevention Department of the Regional Institute of Cancer of Montpellier-Val d’Aurelle, Montpellier, France
| | - Julie Paillart
- Epidaure Prevention Department of the Regional Institute of Cancer of Montpellier-Val d’Aurelle, Montpellier, France
| | - Marie-Eve Huteau
- Epidaure Prevention Department of the Regional Institute of Cancer of Montpellier-Val d’Aurelle, Montpellier, France
| | - Kela Djoufelkit
- Epidaure Prevention Department of the Regional Institute of Cancer of Montpellier-Val d’Aurelle, Montpellier, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Biostatistics Unit, Délégation de la Recherche Clinique et des Innovations, Clermont-Ferrand, France
| | - Anne Stoebner
- Epidaure Prevention Department of the Regional Institute of Cancer of Montpellier-Val d’Aurelle, Montpellier, France
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Gordon JS, Andrews JA, Hampson SH, Gunn B, Christiansen SM, Jacobs T. Postintervention Effects of Click City ® : Alcohol on Changing Etiological Mechanisms Related to the Onset of Heavy Drinking. HEALTH EDUCATION & BEHAVIOR 2017; 44:626-637. [PMID: 28058851 PMCID: PMC5529045 DOI: 10.1177/1090198116683678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Alcohol consumption, including heavy drinking, is the fourth leading preventable cause of death in the United States. Youth who engage in heavy drinking are likely to experience a number of problems associated with their use. In 2015, U.S. prevalence of heavy drinking was 17% among 12th graders. These data suggest a clear need for conducting alcohol prevention activities among youth. METHOD We designed the Click City®: Alcohol program for 7th graders, with a booster in 8th grade. We conducted an efficacy trial in 25 schools in three counties in Oregon. Schools were randomized to either the Click City: Alcohol ( n = 12) or Usual Curriculum condition ( n = 13). We present the results of a short-term evaluation, assessing change in outcomes from baseline to 1 week following the intervention among students in Click City: Alcohol schools versus those in Usual Curriculum schools. RESULTS Students who used the Click City: Alcohol program significantly decreased their intentions to drink heavily in the future, as compared with students in the Usual Curriculum control condition, although the effect size was small. Changes in the targeted mechanisms were in the expected direction and were significant for all but one mechanism, with moderate effect sizes. CONCLUSION Our short-term findings provide preliminary support for the efficacy of the Click City: Alcohol program to change adolescents' intentions to engage in heavy drinking. If the results are maintained over time, the program has the potential to prevent the onset of heavy drinking among teens and reduce the negative consequences associated with heavy drinking, including neurological and other health consequences.
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Systematic review of universal school-based 'resilience' interventions targeting adolescent tobacco, alcohol or illicit substance use: A meta-analysis. Prev Med 2017; 100:248-268. [PMID: 28390835 DOI: 10.1016/j.ypmed.2017.04.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 03/02/2017] [Accepted: 04/02/2017] [Indexed: 01/03/2023]
Abstract
Universal school-based interventions that address adolescent 'resilience' may represent a means of reducing adolescent substance use, however previous systematic reviews have not examined the effectiveness of such an intervention approach. A systematic review was undertaken to 1) assess whether universal school-based 'resilience' interventions are effective in reducing the prevalence of tobacco, alcohol or illicit substance use by adolescents, and 2) describe such effectiveness per intervention characteristic subgroups. Eligible studies were peer-reviewed reports (1994-2015) of randomised controlled trials including participants aged 5-18years that reported adolescent tobacco, alcohol or illicit substance use, and implemented a universal school-based 'resilience' intervention (i.e. those addressing both individual (e.g. self-esteem) and environmental (e.g. school connectedness) protective factors of resilience). Trial effects for binary outcomes were synthesised via meta-analyses and effect sizes reported as odds ratios. Subgroup (by intervention type, prevention approach, setting, intervention duration, follow-up length) and sensitivity analyses (excluding studies at high risk of bias) were conducted. Nineteen eligible studies were identified from 16,619 records (tobacco: n=15, alcohol: n=17, illicit: n=11). An overall intervention effect was found for binary measures of illicit substance use (n=10; OR: 0.78, 95%CI: 0.6-0.93, p=0.007,Tau2=0.0, I2=0%), but not tobacco or alcohol use. A similar result was found when studies assessed as high risk of bias were excluded. Overall intervention effects were evident for illicit substance use within multiple intervention characteristic subgroups, but not tobacco and alcohol. Such results support the implementation of universal school-based interventions that address 'resilience' protective factors to reduce adolescent illicit substance use, however suggest alternate approaches are required for tobacco and alcohol use. PROSPERO registration: CRD42014004906.
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Brinker TJ, Owczarek AD, Seeger W, Groneberg DA, Brieske CM, Jansen P, Klode J, Stoffels I, Schadendorf D, Izar B, Fries FN, Hofmann FJ. A Medical Student-Delivered Smoking Prevention Program, Education Against Tobacco, for Secondary Schools in Germany: Randomized Controlled Trial. J Med Internet Res 2017; 19:e199. [PMID: 28588007 PMCID: PMC5478798 DOI: 10.2196/jmir.7906] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 05/15/2017] [Accepted: 05/23/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND More than 8.5 million Germans suffer from chronic diseases attributable to smoking. Education Against Tobacco (EAT) is a multinational network of medical students who volunteer for school-based prevention in the classroom setting, amongst other activities. EAT has been implemented in 28 medical schools in Germany and is present in 13 additional countries around the globe. A recent quasi-experimental study showed significant short-term smoking cessation effects on 11-to-15-year-old adolescents. OBJECTIVE The aim of this study was to provide the first randomized long-term evaluation of the optimized 2014 EAT curriculum involving a photoaging software for its effectiveness in reducing the smoking prevalence among 11-to-15-year-old pupils in German secondary schools. METHODS A randomized controlled trial was undertaken with 1504 adolescents from 9 German secondary schools, aged 11-15 years in grades 6-8, of which 718 (47.74%) were identifiable for the prospective sample at the 12-month follow-up. The experimental study design included measurements at baseline (t1), 6 months (t2), and 12 months postintervention (t3), via questionnaire. The study groups consisted of 40 randomized classes that received the standardized EAT intervention (two medical student-led interactive modules taking 120 minutes total) and 34 control classes within the same schools (no intervention). The primary endpoint was the difference in smoking prevalence from t1 to t3 in the control group versus the difference from t1 to t3 in the intervention group. The differences in smoking behavior (smoking onset, quitting) between the two groups, as well as gender-specific effects, were studied as secondary outcomes. RESULTS None of the effects were significant due to a high loss-to-follow-up effect (52.26%, 786/1504). From baseline to the two follow-up time points, the prevalence of smoking increased from 3.1% to 5.2% to 7.2% in the control group and from 3.0% to 5.4% to 5.8% in the intervention group (number needed to treat [NNT]=68). Notable differences were observed between the groups for the female gender (4.2% to 9.5% for control vs 4.0% to 5.2% for intervention; NNT=24 for females vs NNT=207 for males), low educational background (7.3% to 12% for control vs 6.1% to 8.7% for intervention; NNT=30), and migrational background (students who claimed that at least one parent was not born in Germany) at the 12-month follow-up. The intervention appears to prevent smoking onset (NNT=63) but does not appear to initiate quitting. CONCLUSIONS The intervention appears to prevent smoking, especially in females and students with a low educational background.
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Affiliation(s)
- Titus Josef Brinker
- Universities of Giessen and Marburg Lung Center; Member of the German Center for Lung Research (DZL), Department of Internal Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt am Main, Germany
- Essen University Hospital, Department of Dermatology, Venerology and Allergology, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), University of Heidelberg, Heidelberg, Germany
| | - Andreas Dawid Owczarek
- Universities of Giessen and Marburg Lung Center; Member of the German Center for Lung Research (DZL), Department of Internal Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
| | - Werner Seeger
- Universities of Giessen and Marburg Lung Center; Member of the German Center for Lung Research (DZL), Department of Internal Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
| | - David Alexander Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt am Main, Germany
| | - Christian Martin Brieske
- Essen University Hospital, Department of Dermatology, Venerology and Allergology, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), University of Heidelberg, Heidelberg, Germany
| | - Philipp Jansen
- Essen University Hospital, Department of Dermatology, Venerology and Allergology, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), University of Heidelberg, Heidelberg, Germany
| | - Joachim Klode
- Essen University Hospital, Department of Dermatology, Venerology and Allergology, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), University of Heidelberg, Heidelberg, Germany
| | - Ingo Stoffels
- Essen University Hospital, Department of Dermatology, Venerology and Allergology, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), University of Heidelberg, Heidelberg, Germany
| | - Dirk Schadendorf
- Essen University Hospital, Department of Dermatology, Venerology and Allergology, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), University of Heidelberg, Heidelberg, Germany
| | - Benjamin Izar
- Dana-Farber Cancer Institute, Department of Medical Oncology, Boston, MA, United States
| | - Fabian Norbert Fries
- Saarland University Medical Center and Saarland University Faculty of Medicine, Department of Ophthalmology, University of Homburg, Homburg, Germany
| | - Felix Johannes Hofmann
- Universities of Giessen and Marburg Lung Center; Member of the German Center for Lung Research (DZL), Department of Internal Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
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Broc G, Edjolo A. Communiquer plus efficacement en prévention. Modèle intégratif et recommandations à l’usage des professionnels de la santé publique. Rev Epidemiol Sante Publique 2017; 65:149-158. [DOI: 10.1016/j.respe.2016.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 07/21/2016] [Accepted: 08/29/2016] [Indexed: 11/28/2022] Open
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Xavier LEDF, Bernardes-Souza B, Lisboa OC, Seeger W, Groneberg DA, Tran TA, Fries FN, Corrêa PCRP, Brinker TJ. A Medical Student-Delivered Smoking Prevention Program, Education Against Tobacco, for Secondary Schools in Brazil: Study Protocol for a Randomized Trial. JMIR Res Protoc 2017; 6:e16. [PMID: 28137703 PMCID: PMC5306613 DOI: 10.2196/resprot.7134] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 01/15/2017] [Accepted: 01/21/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Smoking is the largest preventable cause of morbidity and mortality in Brazil. Education Against Tobacco (EAT) is a large network of medical students in 13 countries who volunteer for school-based prevention in the classroom setting. A recent quasi-experimental EAT study conducted in Germany showed significant short-term smoking cessation effects on 11- to 15-year-old adolescents. OBJECTIVE The aim of this study is both to describe and to provide the first randomized long-term evaluation of the EAT intervention involving a photoaging app for its effectiveness to reduce the smoking prevalence among 12- to 17-year-old pupils in Brazilian public schools. METHODS A randomized controlled trial will be conducted among approximately 1500 adolescents aged 12 to 17 years in grades 7-11 of public secondary schools in Brazil. The prospective experimental study design includes measurements at baseline and at 6 and 12 months postintervention. The study groups will consist of randomized classes receiving the standardized EAT intervention (90 minutes of mentoring in a classroom setting) and control classes within the same schools (no intervention). The questionnaire measures smoking status, gender, social, and cultural aspects as well as predictors of smoking. Biochemical validation of smoking status is conducted via random carbon monoxide measurements. The primary end point is the difference of the change in smoking prevalence in the intervention group versus the difference in the control group at 12 months of follow-up. The differences in smoking behavior (smoking onset, quitting) between the 2 groups as well as effects on the different genders will be studied as secondary outcomes. RESULTS The recruitment of schools, participating adolescents, and medical students was conducted from August 2016 until January 2017. The planned period of data collection is February 2017 until June 2018. Data analysis will follow in July 2018 and data presentation/publication will follow shortly thereafter. CONCLUSIONS This is the first evaluative study of a medical student-delivered tobacco prevention program in Brazil and the first randomized trial on the long-term effectiveness of a school-based medical student-delivered tobacco prevention program in general. CLINICALTRIAL ClinicalTrials.gov NCT02725021; https://clinicaltrials.gov/ct2/show/NCT02725021 (archived by WebCite at http://www.webcitation.org/6njy3nNml).
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Affiliation(s)
| | | | | | - Werner Seeger
- Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research, Department of Internal Medicine, University of Giessen, Giessen, Germany
| | - David Alexander Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | - Thien-An Tran
- Pulmonary and Respiratory Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research, University of Heidelberg, Heidelberg, Germany
| | - Fabian Norbert Fries
- Saarland University Medical Center and Saarland University Faculty of Medicine, Saarland University, Homburg, Germany
| | | | - Titus Josef Brinker
- Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research, Department of Internal Medicine, University of Giessen, Giessen, Germany
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Tobacco use patterns, knowledge, attitudes towards tobacco and availability of tobacco control training among school personnel from a rural area in Poland. Tob Induc Dis 2017; 15:3. [PMID: 28096794 PMCID: PMC5225631 DOI: 10.1186/s12971-016-0110-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 12/30/2016] [Indexed: 11/30/2022] Open
Abstract
Background Tobacco-free school environment as well as non-smoking teachers and school personnel provide positive role models for children and young people. In Poland, smoking should be banned in colleges, schools, educational establishments and educational care facilities. However, for the existing law to be effective, awareness of all people in school curriculum and enforcement of the law are crucial. The aim of the study was to evaluate tobacco use patterns, knowledge and attitudes towards tobacco as well as availability of tobacco control training among school personnel in a rural area in Poland. Moreover, compliance with tobacco control policies and their enforcement were assessed. Methods The study was carried out in Piotrkowski district between November 2014 and May 2015 in accordance with the Global School Personnel Survey (GSPS) methodology. Sixty schools participated in the survey (92% of the schools from the region) with involvement of 1044 teachers and 500 non-teaching staff (the response rate – 83.1%). The multivariate linear regression analyses were applied to study factors linked to the need for anti-tobacco training dedicated to the youth and teachers’ knowledge as well as activities to educate the students about tobacco use and its prevention. Results About 24% of the school personnel were current and 9% were ex-smokers. Significantly more teachers than the non-teaching staff indicated that the schools had a policy prohibiting tobacco use among students. In addition, 6% of the study participants indicated everyday violations of the tobacco control policy by the school personnel. More than 80% of the teaching personnel indicated the need for training dedicated to the youth to prevent their tobacco use. In the multivariate linear regression model, longer duration of working experience predicted higher levels of knowledge and more activities performed to teach the youth about tobacco use and its prevention. The smokers comparing to the non–smokers perceived the need for anti- tobacco training among the youth less strongly. Conclusions In order to make it possible for the inhabitants of Piotrkowski district to work and learn in tobacco smoke free environment there is an urgent need for taking actions aiming at increasing effectiveness of enforcing applicable tobacco control regulations in educational units. The necessity for systematic training dedicated to the youth to prevent their tobacco use, including accurate preparation of teachers, also needs to be highlighted. Electronic supplementary material The online version of this article (doi:10.1186/s12971-016-0110-y) contains supplementary material, which is available to authorized users.
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Fonte D, Blondé J, Girandola F. How to encourage non-donors to be more willing to donate blood? Testing of binding communication based interventions. Transfus Med 2016; 27:207-212. [PMID: 27859798 DOI: 10.1111/tme.12376] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 10/10/2016] [Accepted: 10/14/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Our study aims to test the effectiveness of binding communication based interventions (vs classical persuasive communication based ones) inciting non-donors to act in favour of blood donation. BACKGROUND The implementation of effective communication interventions represents a major public health issue. Nevertheless, persuasive media campaigns appear to have little effect on behaviours. Even though non-donors hold a positive attitude towards blood donation, they are not inclined to donate. As an alternative to producing behavioural changes, many recent studies have shown the superiority of binding communication over persuasive communication. METHODS All participants, non-donors, were randomly assigned to one of four experimental conditions of a 2 (type of communication: persuasive vs binding) × 2 (source credibility: low vs high) factorial design. Then, they were asked to report their intention to donate blood, and their intention to distribute leaflets regarding blood donation. RESULTS Binding communication is a more effective strategy for increasing intention towards blood donation compared with persuasive communication, especially when combined with high credibility source. DISCUSSION Accordingly this study calls for more consideration of knowledge of social psychology to design effective communication interventions and increase the number of donations.
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Affiliation(s)
- D Fonte
- Aix Marseille Université, LPS EA 849, 13621, Aix en Provence, France
| | - J Blondé
- Aix Marseille Université, LPS EA 849, 13621, Aix en Provence, France
| | - F Girandola
- Aix Marseille Université, LPS EA 849, 13621, Aix en Provence, France
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20
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Brinker TJ, Holzapfel J, Baudson TG, Sies K, Jakob L, Baumert HM, Heckl M, Cirac A, Suhre JL, Mathes V, Fries FN, Spielmann H, Rigotti N, Seeger W, Herth F, Groneberg DA, Raupach T, Gall H, Bauer C, Marek P, Batra A, Harrison CH, Taha L, Owczarek A, Hofmann FJ, Thomas R, Mons U, Kreuter M. Photoaging smartphone app promoting poster campaign to reduce smoking prevalence in secondary schools: the Smokerface Randomized Trial: design and baseline characteristics. BMJ Open 2016; 6:e014288. [PMID: 27821601 PMCID: PMC5128772 DOI: 10.1136/bmjopen-2016-014288] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Smoking is the largest cause of preventable death globally. Most smokers smoke their first cigarette in early adolescence. We took advantage of the widespread availability of mobile phones and adolescents' interest in appearance to develop a free photoaging app which is promoted via a poster campaign in secondary schools. This study aims to evaluate its effectiveness regarding smoking prevalence and students' attitudes towards smoking. METHODS AND ANALYSIS A randomised controlled trial is conducted with 9851 students of both genders with an average age of 12 years in grades 6 and 7 of 126 secondary schools in Germany. At present, cigarette smoking prevalence in our sample is 4.7%, with 4.6% of the students currently using e-cigarettes (1.6% use both). The prospective experimental study design includes measurements at baseline and at 6, 12 and 24 months postintervention via a questionnaire plus a random cotinine saliva sample at 24 months postintervention. The study groups consist of randomised schools receiving the Smokerface poster campaign and control schools with comparable baseline data (no intervention). The primary end point is the difference of change in smoking prevalence in the intervention group versus the difference in the control group at 24 months follow-up. Longitudinal changes in smoking-related attitudes, the number of new smokers and quitters and the change in the number of never-smokers will be compared between the two groups as secondary outcomes. ETHICS AND DISSEMINATION Ethical approval was obtained from the ethics committee of the University of Gießen and the ministries of cultural affairs, both in Germany. Results will be disseminated at conferences, in peer-reviewed journals, on our websites and throughout the multinational Education Against Tobacco network. TRIAL REGISTRATION NUMBER NCT02544360, Pre-results.
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Affiliation(s)
- Titus J Brinker
- Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
| | - Julia Holzapfel
- Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
| | | | | | - Lena Jakob
- University of Freiburg, Freiburg im Breisgau, Germany
| | | | | | - Ana Cirac
- Technical University of Munich, Munich, Germany
| | | | - Verena Mathes
- Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
| | - Fabian N Fries
- Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg, Germany
| | - Hannah Spielmann
- Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg, Germany
| | - Nancy Rigotti
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Werner Seeger
- Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
| | - Felix Herth
- Pulmonary and Respiratory Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg (TLRCH), Member of the German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt, Germany
| | - Tobias Raupach
- Department of Cardiology and Pneumology, University Medical Centre, Göttingen, Germany
| | - Henning Gall
- Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
| | - Claudia Bauer
- Pulmonary and Respiratory Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg (TLRCH), Member of the German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
| | - Pat Marek
- Division of Public Health Sciences, Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Anil Batra
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany
| | - Chase H Harrison
- Department of Government, Faculty of Arts and Sciences, Harvard University, Cambridge, Massachusetts, USA
| | - Lava Taha
- University of Erlangen-Nuremberg, Erlangen, Germany
| | - Andreas Owczarek
- Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
| | - Felix J Hofmann
- Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
| | - Roger Thomas
- University of Calgary, Health Sciences Centre, Calgary, Alberta, Canada
| | - Ute Mons
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Kreuter
- Pulmonary and Respiratory Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg (TLRCH), Member of the German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
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Racic M, Tanovic S, Joksimovic VR, Joksimovic BN, Ristic S. Prevalence and determinants of smoking initiation among school students in Bosnia and Herzegovina. Int J Adolesc Med Health 2016; 27:397-403. [PMID: 25427060 DOI: 10.1515/ijamh-2014-0041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 08/09/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Tobacco smoking amongst the young is a matter of public health concern because of the immediate and long-term health consequences associated with tobacco use, such as asthma, cancers, and cardiovascular diseases. The purpose of this study was to identify the determinants of smoking initiation among a sample of high school students in Bosnia and Herzegovina. METHODS The study was conducted among 198 high school students in Zvornik, Bosnia and Herzegovina, during April 2013. A self-administered, pre-tested, structured, close-ended questionnaire was used for data collection. RESULTS Fourth grade students mainly initiated smoking in high school (45%), while the majority of third and second grade students initiated smoking in primary school. Among students who smoke, an average duration of the smoking habit was <2 years. A multivariate analysis showed that males were 5.27 times more likely to have initiated smoking. For every unit increase in pro-smoking attitude towards smoking, students were 5.3 times more likely to have initiated smoking. Those with parents and friends who are smokers were 6.106 and 5.175 times, respectively, more likely to have initiated smoking. CONCLUSION This study indicates that a high proportion of 15-18 year olds in the town of Zvornik are current smokers. Gender, age, and parent and peer influence were identified as important associations with smoking. Interventions should not only be confined to the secondary school environment but they should also extend to their places of residence so that influences in the home environment and social surroundings that contribute to tobacco use are also tackled.
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Mohammed M, Eggers SM, Alotaiby FF, de Vries N, de Vries H. Effects of a randomized controlled trial to assess the six-months effects of a school based smoking prevention program in Saudi Arabia. Prev Med 2016; 90:100-6. [PMID: 27386742 DOI: 10.1016/j.ypmed.2016.06.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 05/19/2016] [Accepted: 06/27/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the efficacy of a smoking prevention program which aimed to address smoking related cognitions and smoking behavior among Saudi adolescents age 13 to 15. METHOD A randomized controlled trial was used. Respondents in the experimental group (N=698) received five in-school sessions, while those in the control group (N=683) received no smoking prevention information (usual curriculum). Post-intervention data was collected six months after baseline. Logistic regression analysis was applied to assess effects on smoking initiation, and linear regression analysis was applied to assess changes in beliefs and analysis of covariance (ANCOVA) was used to assess intervention effects. All analyses were adjusted for the nested structure of students within schools. RESULTS At post-intervention respondents from the experimental group reported in comparison with those from the control group a significantly more negative attitude towards smoking, stronger social norms against smoking, higher self-efficacy towards non-smoking, more action planning to remain a non-smoker, and lower intentions to smoke in the future. Smoking initiation was 3.2% in the experimental group and 8.8% in the control group (p<0.01). CONCLUSION The prevention program reinforced non-smoking cognitions and non-smoking behavior. Therefore it is recommended to implement the program at a national level in Saudi-Arabia. Future studies are recommended to assess long term program effects and the conditions favoring national implementation of the program.
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Affiliation(s)
- Mutaz Mohammed
- Maastricht University, School for Public Health and Primary Care (Caphri), P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Sander Matthijs Eggers
- Maastricht University, School for Public Health and Primary Care (Caphri), P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Fahad F Alotaiby
- School Health Program, Dawadmy School Health Unit Saudi Arabia, Saudi Arabia, Dawadmi, -11911, -P.O Box 760.
| | - Nanne de Vries
- Maastricht University, School for Public Health and Primary Care (Caphri), P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Hein de Vries
- Maastricht University, School for Public Health and Primary Care (Caphri), P.O. Box 616, 6200 MD Maastricht, The Netherlands.
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Szatkowski L, Taylor J, Taylor A, Lewis S, Britton J, McNeill A, Bauld L, Wu Q, Parrott S, Jones L, Bains M. Development and evaluation of an intervention providing insight into the tobacco industry to prevent smoking uptake: a mixed-methods study. PUBLIC HEALTH RESEARCH 2016. [DOI: 10.3310/phr04090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundSmokers who start smoking at an early age are less likely to quit and more likely to die from their habit. Evidence from the USTruth®campaign suggests that interventions focusing on tobacco industry practices and ethics may be effective in preventing smoking uptake.ObjectivesIn an exploratory study, to develop, pilot and provide preliminary evidence of the acceptability and effectiveness of Operation Smoke Storm, a school-based intervention based on the premise of theTruth®campaign, to prevent smoking uptake.DesignMixed-methods, non-randomised controlled study. Component 1 was delivered to Year 7 students, and student focus groups and teacher interviews were conducted to refine the lessons and to develop components 2 and 3. The revised Year 7 lessons and accompanying family booklet were delivered to new Year 7 students 1 year later in one school only; Year 8 students in both schools received the booster session.Setting and participantsStudents in Years 7–8 (aged 11–13 years) in two UK schools.InterventionA three-component intervention comprising (1) three 50-minute classroom-based sessions in Year 7 in which students acted as secret agents to uncover industry practices through videos, quizzes, discussions and presentations; (2) an accompanying family booklet containing activities designed to stimulate discussions about smoking between parents and students; and (3) a 1-hour interactive classroom-based booster session for Year 8 students, in which students learnt about tobacco marketing strategies from the perspectives of an industry executive, a marketing company and a health campaigner.Main outcome measuresOdds ratios to compare the self-reported prevalence of ever smoking and susceptibility to smoking in Year 8 students after the delivery of the booster session in study schools compared with students in local control schools. Qualitative data on acceptability of the intervention.ResultsThe combined prevalence of ever smoking and susceptibility increased from 18.2% in Year 7 to 33.8% in Year 8. After adjusting for confounders there was no significant difference in the odds of a Year 8 student in an intervention school being an ever smoker or susceptible never smoker compared with controls [adjusted odds ratio (aOR) 1.28, 95% confidence interval (CI) 0.83 to 1.97;p = 0.263] and no significant difference in the odds of ever smoking (aOR 0.82, 95% CI 0.42 to 1.58;p = 0.549). Students mostly enjoyed the intervention and acquired new knowledge that appeared to strengthen their aversion to smoking. Teachers liked the ‘off-the-shelf’ nature of the resource, although they highlighted differences by academic ability in the extent to which students understood the messages being presented. Use of the family component was low but it was received positively by those parents who did engage with it.LimitationsLogistical difficulties meant that students’ responses in Year 7 and Year 8 could not be linked; however, baseline smoking behaviours differed little between intervention and control schools, and analyses were adjusted for confounders measured at follow-up.ConclusionsOperation Smoke Storm is an acceptable resource for delivering smoking-prevention education but it does not appear to have reduced smoking and susceptibility.Future workThe lack of a strong signal for potential effectiveness, considered alongside logistical difficulties in recruiting and working with schools, suggests that a fully powered cluster randomised trial of the intervention is not warranted.FundingThe National Institute for Health Research (NIHR) Public Health Research programme.
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Affiliation(s)
- Lisa Szatkowski
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - John Taylor
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Amy Taylor
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Sarah Lewis
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - John Britton
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Ann McNeill
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Linda Bauld
- Institute for Social Marketing, University of Stirling, Stirling, UK
| | - Qi Wu
- Department of Health Sciences, University of York, York, UK
| | - Steve Parrott
- Department of Health Sciences, University of York, York, UK
| | - Laura Jones
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Manpreet Bains
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
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Abstract
This study examined the impact of tobacco possession laws on public smoking among youth. There were two intervention sites: a fast food restaurant and a shopping mall. Two control sites were also monitored for public smoking among youth. Preliminary findings suggest that when police issued tickets to minors for violating tobacco possession laws, the number of youth smoking in public declined in both towns, with a more dramatic decrease occurring at the fast food site. In contrast, public smoking among youth in the control sites was not affected. The significance of reducing number of youth smoking in public through tobacco possession laws is discussed.
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Affiliation(s)
- Leonard A Jason
- Center for Community Research, DePaul University, Chicago, IL 60614, USA.
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Faire « appel à la peur » pour persuader ? Revue de la littérature et perspectives de recherche. ANNEE PSYCHOLOGIQUE 2016. [DOI: 10.4074/s0003503316000282] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Blondé J, Girandola F. Faire « appel à la peur » pour persuader ? Revue de la littérature et perspectives de recherche. ANNEE PSYCHOLOGIQUE 2016. [DOI: 10.3917/anpsy.161.0067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Adams J, Schaefer DR. How Initial Prevalence Moderates Network-based Smoking Change: Estimating Contextual Effects with Stochastic Actor-based Models. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2016; 57:22-38. [PMID: 26957133 PMCID: PMC6679597 DOI: 10.1177/0022146515627848] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
We use an empirically grounded simulation model to examine how initial smoking prevalence moderates the effectiveness of potential interventions designed to change adolescent smoking behavior. Our model investigates the differences that result when manipulating peer influence and smoker popularity as intervention levers. We demonstrate how a simulation-based approach allows us to estimate outcomes that arise (1) when intervention effects could plausibly alter peer influence and/or smoker popularity effects and (2) across a sample of schools that match the range of initial conditions of smoking prevalence in U.S. schools. We show how these different initial conditions combined with the exact same intervention effects can produce substantially different outcomes-for example, effects that produce smoking declines in some settings can actually increase smoking in others. We explore the form and magnitude of these differences. Our model also provides a template to evaluate the potential effects of alternative intervention scenarios.
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Affiliation(s)
- Jimi Adams
- University of Colorado Denver, Denver CO, USA
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Midford R, Cahill H, Lester L, Foxcroft DR, Ramsden R, Venning L. Smoking Prevention for Students: Findings From a Three-Year Program of Integrated Harm Minimization School Drug Education. Subst Use Misuse 2016; 51:395-407. [PMID: 26886503 DOI: 10.3109/10826084.2015.1110173] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND This study investigated the impact of the Drug Education in Victorian Schools (DEVS) program on tobacco smoking. The program taught about licit and illicit drugs in an integrated manner over 2 years, with follow up in the third year. It focused on minimizing harm, rather than achieving abstinence, and employed participatory, critical-thinking and skill-based teaching methods. METHODS A cluster-randomized, controlled trial of the program was conducted with a student cohort during years 8 (13 years), 9 (14 years), and 10 (15 years). Twenty-one schools were randomly allocated to the DEVS program (14 schools, n = 1163), or their usual drug education program (7 schools, n = 589). One intervention school withdrew in year two. RESULTS There was a greater increase in the intervention students' knowledge about drugs, including tobacco, in all 3 years. Intervention students talked more with their parents about smoking at the end of the 3-year program. They recalled receiving more education on smoking in all 3 years. Their consumption of cigarettes had not increased to the same extent as controls at the end of the program. Their change in smoking harms, relative to controls, was positive in all 3 years. There was no difference between groups in the proportionate increase of smokers, or in attitudes towards smoking, at any time. CONCLUSIONS These findings indicate that a school program that teaches about all drugs in an integrated fashion, and focuses on minimizing harm, does not increase initiation into smoking, while providing strategies for reducing consumption and harm to those who choose to smoke.
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Affiliation(s)
- Richard Midford
- a School of Education, Charles Darwin University , Darwin , Australia
| | - Helen Cahill
- b Youth Research Centre, University of Melbourne , Carlton , Australia
| | - Leanne Lester
- c Health Promotion Evaluation Unit (School of Sport Science, Exercise and Health), University of Western Australia , Crawley , Australia
| | - David R Foxcroft
- d Department of Social Work and Public Health, Oxford Brookes University , Oxford , United Kingdom
| | - Robyn Ramsden
- e Department of Research and Evaluation, Royal Far West , Manly , Australia
| | - Lynne Venning
- f Victorian Department of Education and Early Childhood Development , Dandenong , Australia
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Younge JO, Kouwenhoven-Pasmooij TA, Freak-Poli R, Roos-Hesselink JW, Hunink MGM. Randomized study designs for lifestyle interventions: a tutorial. Int J Epidemiol 2015; 44:2006-19. [DOI: 10.1093/ije/dyv183] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2015] [Indexed: 11/14/2022] Open
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30
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Terrier L, Marfaing B. Using Binding Communication to Promote Conservation Among Hotel Guests. SWISS JOURNAL OF PSYCHOLOGY 2015. [DOI: 10.1024/1421-0185/a000160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This research applies the binding communication model to the sustainable communication strategies implemented in most hotels. The binding communication model links a persuasive message with the implementation of a low-cost commitment to strengthen the link between the attitudes and behavior of those receiving the message. We compared the effectiveness of a classical communication strategy (n = 86) with that of a binding communication strategy (n = 101) to encourage guests to choose sustainable behavior. Our results show that using the binding communication strategy generates significantly more sustainable behavior in guests than using the classical communication strategy. We discuss our results and suggest future avenues of research.
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Hawe P, Riley T, Gartrell A, Turner K, Canales C, Omstead D. Comparison communities in a cluster randomised trial innovate in response to 'being controlled'. Soc Sci Med 2015; 133:102-10. [PMID: 25863725 DOI: 10.1016/j.socscimed.2015.03.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We conducted qualitative interviews among primary health care teams and community agencies in eight communities in Victoria, Australia which had (1) agreed to be part of a universal primary care and community development intervention to reduce post natal depression and promote maternal health; and (2) were randomised to the comparison arm. The purpose was to document their experience with and interpretation of the trial. Although 'control' in a controlled trial refers to the control of confounding of the trial result by factors other than allocation to the intervention, participants interpreted 'control' to mean restrictions on what they were allowed to do during the trial period. They had agreed not to use the Edinburgh Post Natal Depression Scale or the SF 36 in clinical practice and not to implement any of the elements of the intervention. We found that no elements of the intervention were implemented. However, the extension of the trial from three to five years made the trial agreement a strain. The imposition of trial conditions also encouraged a degree of lateral thinking and innovation in service delivery (quality improvement). This may have potentially contributed to the null trial results. The observations invite interrogation of intervention theory and consequent rethinking of the way contamination in a cluster trial is defined.
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Affiliation(s)
- Penelope Hawe
- Menzies Centre for Health Policy, University of Sydney, Australia; The Australian Prevention Partnership Centre, Australia.
| | - Therese Riley
- Judith Lumley Centre, LaTrobe University (Now based at Centre of Excellence in Intervention and Prevention Science, Melbourne), Australia
| | - Alexandra Gartrell
- Judith Lumley Centre, Now based at School of Geography and Environmental Sciences, Monash University, Australia
| | - Karen Turner
- Centre for Health and Society, Melbourne School of Population and Global Health, University of Melbourne (Now based at Department of Anthropology, School of Social and Political Sciences, University of Melbourne, Australia
| | - Claudia Canales
- O'Brien Institute of Public Health, University of Calgary, Canada
| | - Darlene Omstead
- O'Brien Institute of Public Health, University of Calgary, Canada
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Abstract
OBJECTIVE To assess effectiveness of school-based smoking prevention curricula keeping children never-smokers. DESIGN Systematic review, meta-analysis. DATA MEDLINE (1966+), EMBASE (1974+), Cinahl, PsycINFO (1967+), ERIC (1982+), Cochrane CENTRAL, Health Star, Dissertation Abstracts, conference proceedings. DATA SYNTHESIS pooled analyses, fixed-effects models, adjusted ORs. Risk of bias assessed with Cochrane Risk of Bias tool. SETTING 50 randomised controlled trials (RCTs) of school-based smoking curricula. PARTICIPANTS Never-smokers age 5-18 (n=143,495); follow-up ≥6 months; all countries; no date/language limitations. INTERVENTIONS Information, social influences, social competence, combined social influences/competence and multimodal curricula. OUTCOME MEASURE Remaining a never-smoker at follow-up. RESULTS Pooling all curricula, trials with follow-up ≤1 year showed no statistically significant differences compared with controls (OR 0.91 (0.82 to 1.01)), though trials of combined social competence/social influences curricula had a significant effect on smoking prevention (7 trials, OR 0.59 (95% CI 0.41 to 0.85)). Pooling all trials with longest follow-up showed an overall significant effect in favour of the interventions (OR 0.88 (0.82 to 0.95)), as did the social competence (OR 0.65 (0.43 to 0.96)) and combined social competence/social influences curricula (OR 0.60 (0.43 to 0.83)). No effect for information, social influences or multimodal curricula. Principal findings were not sensitive to inclusion of booster sessions in curricula or to whether they were peer-led or adult-led. Differentiation into tobacco-only or multifocal curricula had a similar effect on the primary findings. Few trials assessed outcomes by gender: there were significant effects for females at both follow-up periods, but not for males. CONCLUSIONS RCTs of baseline never-smokers at longest follow-up found an overall significant effect with average 12% reduction in starting smoking compared with controls, but no effect for all trials pooled at ≤1 year. However, combined social competence/social influences curricula showed a significant effect at both follow-up periods. SYSTEMATIC REVIEW REGISTRATION Cochrane Tobacco Review Group CD001293.
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Affiliation(s)
- Roger E Thomas
- Department of Family Medicine, Faculty of Medicine, University of Calgary, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, Canada
| | - Julie McLellan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Rafael Perera
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Abstract
Complexity-resulting from interactions among many component parts-is a property of both the intervention and the context (or system) into which it is placed. Complexity increases the unpredictability of effects. Complexity invites new approaches to logic modeling, definitions of integrity and means of standardization, and evaluation. New metaphors and terminology are needed to capture the recognition that knowledge generation comes from the hands of practitioners/implementers as much as it comes from those usually playing the role of intervention researcher. Failure to acknowledge this may blind us to the very mechanisms we seek to understand. Researchers in clinical settings are documenting health improvement gains made as a consequence of complex systems thinking. Improvement science in clinical settings has much to offer researchers in population health.
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Affiliation(s)
- Penelope Hawe
- Menzies Center for Health Policy, University of Sydney, New South Wales, 2006, Australia; and The Australian Prevention Partnership Center;
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Agaku IT, Obadan EM, Odukoya OO, Olufajo O. Tobacco-free schools as a core component of youth tobacco prevention programs: a secondary analysis of data from 43 countries. Eur J Public Health 2014; 25:210-5. [DOI: 10.1093/eurpub/cku203] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Scott JM, deCamp A, Juraska M, Fay MP, Gilbert PB. Finite-sample corrected generalized estimating equation of population average treatment effects in stepped wedge cluster randomized trials. Stat Methods Med Res 2014; 26:583-597. [PMID: 25267551 DOI: 10.1177/0962280214552092] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Stepped wedge designs are increasingly commonplace and advantageous for cluster randomized trials when it is both unethical to assign placebo, and it is logistically difficult to allocate an intervention simultaneously to many clusters. We study marginal mean models fit with generalized estimating equations for assessing treatment effectiveness in stepped wedge cluster randomized trials. This approach has advantages over the more commonly used mixed models that (1) the population-average parameters have an important interpretation for public health applications and (2) they avoid untestable assumptions on latent variable distributions and avoid parametric assumptions about error distributions, therefore, providing more robust evidence on treatment effects. However, cluster randomized trials typically have a small number of clusters, rendering the standard generalized estimating equation sandwich variance estimator biased and highly variable and hence yielding incorrect inferences. We study the usual asymptotic generalized estimating equation inferences (i.e., using sandwich variance estimators and asymptotic normality) and four small-sample corrections to generalized estimating equation for stepped wedge cluster randomized trials and for parallel cluster randomized trials as a comparison. We show by simulation that the small-sample corrections provide improvement, with one correction appearing to provide at least nominal coverage even with only 10 clusters per group. These results demonstrate the viability of the marginal mean approach for both stepped wedge and parallel cluster randomized trials. We also study the comparative performance of the corrected methods for stepped wedge and parallel designs, and describe how the methods can accommodate interval censoring of individual failure times and incorporate semiparametric efficient estimators.
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Affiliation(s)
- JoAnna M Scott
- 1 Department of Pediatric Dentistry, University of Washington, Seattle, Washington, USA
| | - Allan deCamp
- 2 Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,3 Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Michal Juraska
- 2 Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Michael P Fay
- 4 Division of Biostatistics, National Institute of Allergies and Infectious Diseases, Bethesda, USA
| | - Peter B Gilbert
- 2 Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,3 Department of Biostatistics, University of Washington, Seattle, Washington, USA
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Schaefer DR, Adams J, Haas SA. Social networks and smoking: exploring the effects of peer influence and smoker popularity through simulations. HEALTH EDUCATION & BEHAVIOR 2014; 40:24S-32S. [PMID: 24084397 DOI: 10.1177/1090198113493091] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Adolescent smoking and friendship networks are related in many ways that can amplify smoking prevalence. Understanding and developing interventions within such a complex system requires new analytic approaches. We draw on recent advances in dynamic network modeling to develop a technique that explores the implications of various intervention strategies targeted toward micro-level processes. Our approach begins by estimating a stochastic actor-based model using data from one school in the National Longitudinal Study of Adolescent Health. The model provides estimates of several factors predicting friendship ties and smoking behavior. We then use estimated model parameters to simulate the coevolution of friendship and smoking behavior under potential intervention scenarios. Namely, we manipulate the strength of peer influence on smoking and the popularity of smokers relative to nonsmokers. We measure how these manipulations affect smoking prevalence, smoking initiation, and smoking cessation. Results indicate that both peer influence and smoking-based popularity affect smoking behavior and that their joint effects are nonlinear. This study demonstrates how a simulation-based approach can be used to explore alternative scenarios that may be achievable through intervention efforts and offers new hypotheses about the association between friendship and smoking.
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Leiva A, Estela A, Torrent M, Calafat A, Bennasar M, Yáñez A. Effectiveness of a complex intervention in reducing the prevalence of smoking among adolescents: study design of a cluster-randomized controlled trial. BMC Public Health 2014; 14:373. [PMID: 24739452 PMCID: PMC4008389 DOI: 10.1186/1471-2458-14-373] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 03/27/2014] [Indexed: 11/24/2022] Open
Abstract
Background The likelihood of an adolescent taking up smoking may be influenced by his or her society, school and family. Thus, changes in the immediate environment may alter a young person’s perception of smoking. Methods/Design The proposed multi-center, cluster-randomized controlled trial will be stratified by the baseline prevalence of smoking in schools. Municipalities with fewer than 100,000 inhabitants will be randomly assigned to a control or intervention group. One secondary school will be randomly selected from each municipality. These schools will be randomized to two groups: the students of one will receive any existing educational course regarding smoking, while those of the other school will receive a four-year, class-based curriculum intervention (22 classroom lessons) aimed at reinforcing a smoke-free school policy and encouraging smoking cessation in parents, pupils, and teachers. The intervention will also include annual meetings with parents and efforts to empower adolescents to change the smoking-related attitudes and behaviors in their homes, classrooms and communities. We will enroll children aged 12-13 years as they enter secondary school during two consecutive school years (to obtain sufficient enrolled subjects). We will follow them for five years, until two years after they leave secondary school. All external evaluators and analysts will be blinded to school allocation. The aim of this study is to analyze the effectiveness of a complex intervention in reducing the prevalence of smoking in the third year of compulsory secondary education (ESO) and two years after secondary school, when the participants are 14-15 and 17-18 years old, respectively. Discussion Most interventions aimed at preventing smoking among adolescents yield little to no positive long-term effects. This clinical trial will analyze the effectiveness of a complex intervention aimed at reducing the incidence and prevalence of smoking in this vulnerable age group. Trial registration Current Controlled Trials: NCT01602796.
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Affiliation(s)
- Alfonso Leiva
- Primary Care Research Unit of Mallorca, Baleares Health services-IbSalut, Mallorca, Spain.
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38
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Primack BA, Douglas EL, Land SR, Miller E, Fine MJ. Comparison of media literacy and usual education to prevent tobacco use: a cluster-randomized trial. THE JOURNAL OF SCHOOL HEALTH 2014; 84:106-15. [PMID: 25099425 PMCID: PMC4126196 DOI: 10.1111/josh.12130] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 10/26/2012] [Accepted: 12/02/2012] [Indexed: 05/27/2023]
Abstract
BACKGROUND Media literacy programs have shown potential for reduction of adolescent tobacco use. We aimed to determine if an anti-smoking media literacy curriculum improves students' media literacy and affects factors related to adolescent smoking. METHODS We recruited 1170 9th-grade students from 64 classrooms in 3 public urban high schools. Students were randomized by classroom to a media literacy curriculum versus a standard educational program. In an intent-to-treat analysis, we used multilevel modeling to determine if changes in study outcomes were associated with the curricular intervention, controlling for baseline student covariates and the clustering of students within classrooms. RESULTS Among participants, mean age was 14.5 years and 51% were male, with no significant differences in baseline characteristics between groups. Smoking media literacy changed more among intervention participants compared with control participants (0.24 vs. 0.08, p < .001). Compared with controls, intervention students exhibited a greater reduction in the perceived prevalence of smoking (-14.0% vs. -4.6%, p < .001). Among those initially susceptible to smoking, intervention participants more commonly reverted to being nonsusceptible post-intervention (24% vs. 16%, p = .08). CONCLUSIONS A school-based media literacy curriculum is more effective than a standard educational program in teaching media literacy and improving perceptions of the true prevalence of smoking among adolescents.
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Affiliation(s)
- Brian A. Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 230 McKee Place Suite 600, Pittsburgh, PA 15213, Phone: (412) 586-9789
| | - Erika L. Douglas
- University of Pittsburgh Medical Center, USS Tower, 57-W90, 600 Grant Street; Pittsburgh, PA 15219, Phone: (412) 647-7617
| | - Stephanie R. Land
- National Cancer Institute, National Institutes of Health, 6130 Executive Blvd., MSC 7337, Bethesda, MD 20892-7337, Phone: (301) 496-0277
| | - Elizabeth Miller
- Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, 3420 Fifth Avenue, Pittsburgh, PA 15213, Phone: (412) 692-8504
| | - Michael J. Fine
- VA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System (646), 7180 Highland Drive (151C-H), Pittsburgh, PA 15206, Phone: (412) 954-5206
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Sandler I, Wolchik SA, Cruden G, Mahrer NE, Ahn S, Brincks A, Brown CH. Overview of meta-analyses of the prevention of mental health, substance use, and conduct problems. Annu Rev Clin Psychol 2014; 10:243-73. [PMID: 24471372 PMCID: PMC3984908 DOI: 10.1146/annurev-clinpsy-050212-185524] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This review presents findings from an overview of meta-analyses of the effects of prevention and promotion programs to prevent mental health, substance use, and conduct problems. The review of 48 meta-analyses found small but significant changes that reduce depression, anxiety, antisocial behavior, and substance use. Furthermore, the results were sustained over time. Meta-analyses often found that the effects were heterogeneous. A conceptual model is proposed to guide the study of moderators of program effects in future meta-analyses, and methodological issues in synthesizing findings across preventive interventions are discussed.
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Affiliation(s)
- Irwin Sandler
- Department of Psychology and Prevention Research Center, Arizona State University, Tempe, Arizona 85287-6005;
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Pansu P, Lima L, Fointiat V. When saying no leads to compliance: The door-in-the-face technique for changing attitudes and behaviors towards smoking at work. EUROPEAN REVIEW OF APPLIED PSYCHOLOGY 2014. [DOI: 10.1016/j.erap.2013.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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A Statistical Perspective on Prevention Trials: A View from the Women’s Health Initiative. STATISTICS IN BIOSCIENCES 2013. [DOI: 10.1007/s12561-013-9079-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Thomas RE, McLellan J, Perera R. School-based programmes for preventing smoking. ACTA ACUST UNITED AC 2013. [DOI: 10.1002/ebch.1937] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Matias MA, Steindl SR, Plonka KA, Pukkallus M, Palmer J, Holcombe T, Seymour GJ, Marshall RI. Do school based anti-smoking campaigns delivered by oral health therapists work? Aust Dent J 2013; 58:301-5. [DOI: 10.1111/adj.12078] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Revised: 10/25/2012] [Accepted: 11/26/2012] [Indexed: 11/26/2022]
Affiliation(s)
- MA Matias
- School of Dentistry; The University of Queensland; Australia
| | - SR Steindl
- School of Psychiatry; The University of Queensland; Australia
| | | | - M Pukkallus
- Oral Health Program (Logan-Beaudesert Division); Metro South Health Service District; Queensland; Australia
| | - J Palmer
- School of Dentistry; The University of Queensland; Australia
| | - T Holcombe
- Oral Health Program (Logan-Beaudesert Division); Metro South Health Service District; Queensland; Australia
| | | | - RI Marshall
- School of Dentistry; The University of Queensland; Australia
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Holman LR, Bricker JB, Comstock BA. Psychological predictors of male smokeless tobacco use initiation and cessation: a 16-year longitudinal study. Addiction 2013; 108:1327-35. [PMID: 23607490 PMCID: PMC3679343 DOI: 10.1111/add.12164] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Revised: 07/12/2012] [Accepted: 02/15/2013] [Indexed: 11/29/2022]
Abstract
AIMS To test whether psychological factors predict male smokeless tobacco (SLT) initiation and cessation longitudinally. DESIGN Sixteen-year longitudinal design with 95% retention at year 6 and 82% at year 16. SETTING Forty Washington State school districts. PARTICIPANTS SLT use data were gathered on a cohort of adolescents (91% Caucasian). For SLT initiation, the sample size was 2468. For SLT cessation, sample sizes were 219 (age 20 outcome) and 192 (age 28 outcome). MEASUREMENTS Self-reported psychological measures of parental disobedience ('parent non-compliance'), peer influence ('friend compliance'), rebelliousness and thrill-seeking were taken at ages 12 and 18. SLT use was measured at ages 12, 18, 20 and 28 years. FINDINGS For SLT initiation, scoring highly on the following psychological factors at age 12 at least doubled the odds of daily SLT use at age 18 (P < 0.001): friend compliance [odds ratio (OR): 2.56, 95% confidence interval (CI): 1.78-3.68), rebelliousness (OR: 2.16, 95% CI: 1.46-3.19) and thrill-seeking (OR: 2.33, 95% CI: 1.45-3.75). For SLT cessation, none of the psychological factors at age 18 predicted SLT cessation at age 20 or 28 (P value range: 0.06-0.84). CONCLUSION Peer influence, rebelliousness, and thrill-seeking appear to predict smokeless tobacco initiation strongly among male youth in the United States.
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Affiliation(s)
- Leela R. Holman
- Cancer Prevention Research Program, Division of Public Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States,Department of Psychology, University of Washington, Seattle, Washington, United States
| | - Jonathan B. Bricker
- Cancer Prevention Research Program, Division of Public Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States,Department of Psychology, University of Washington, Seattle, Washington, United States
| | - Bryan A. Comstock
- Cancer Prevention Research Program, Division of Public Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States,Department of Biostatistics, University of Washington, Seattle, Washington, United States
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Abstract
BACKGROUND Helping young people to avoid starting smoking is a widely endorsed public health goal, and schools provide a route to communicate with nearly all young people. School-based interventions have been delivered for close to 40 years. OBJECTIVES The primary aim of this review was to determine whether school smoking interventions prevent youth from starting smoking. Our secondary objective was to determine which interventions were most effective. This included evaluating the effects of theoretical approaches; additional booster sessions; programme deliverers; gender effects; and multifocal interventions versus those focused solely on smoking. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Tobacco Addiction Group's Specialised Register, MEDLINE, EMBASE, PsycINFO, ERIC, CINAHL, Health Star, and Dissertation Abstracts for terms relating to school-based smoking cessation programmes. In addition, we screened the bibliographies of articles and ran individual MEDLINE searches for 133 authors who had undertaken randomised controlled trials in this area. The most recent searches were conducted in October 2012. SELECTION CRITERIA We selected randomised controlled trials (RCTs) where students, classes, schools, or school districts were randomised to intervention arm(s) versus a control group, and followed for at least six months. Participants had to be youth (aged 5 to 18). Interventions could be any curricula used in a school setting to deter tobacco use, and outcome measures could be never smoking, frequency of smoking, number of cigarettes smoked, or smoking indices. DATA COLLECTION AND ANALYSIS Two reviewers independently assessed studies for inclusion, extracted data and assessed risk of bias. Based on the type of outcome, we placed studies into three groups for analysis: Pure Prevention cohorts (Group 1), Change in Smoking Behaviour over time (Group 2) and Point Prevalence of Smoking (Group 3). MAIN RESULTS One hundred and thirty-four studies involving 428,293 participants met the inclusion criteria. Some studies provided data for more than one group.Pure Prevention cohorts (Group 1) included 49 studies (N = 142,447). Pooled results at follow-up at one year or less found no overall effect of intervention curricula versus control (odds ratio (OR) 0.94, 95% confidence interval (CI) 0.85 to 1.05). In a subgroup analysis, the combined social competence and social influences curricula (six RCTs) showed a statistically significant effect in preventing the onset of smoking (OR 0.49, 95% CI 0.28 to 0.87; seven arms); whereas significant effects were not detected in programmes involving information only (OR 0.12, 95% CI 0.00 to 14.87; one study), social influences only (OR 1.00, 95% CI 0.88 to 1.13; 25 studies), or multimodal interventions (OR 0.89, 95% CI 0.73 to 1.08; five studies). In contrast, pooled results at longest follow-up showed an overall significant effect favouring the intervention (OR 0.88, 95% CI 0.82 to 0.96). Subgroup analyses detected significant effects in programmes with social competence curricula (OR 0.52, 95% CI 0.30 to 0.88), and the combined social competence and social influences curricula (OR 0.50, 95% CI 0.28 to 0.87), but not in those programmes with information only, social influence only, and multimodal programmes.Change in Smoking Behaviour over time (Group 2) included 15 studies (N = 45,555). At one year or less there was a small but statistically significant effect favouring controls (standardised mean difference (SMD) 0.04, 95% CI 0.02 to 0.06). For follow-up longer than one year there was a statistically nonsignificant effect (SMD 0.02, 95% CI -0.00 to 0.02).Twenty-five studies reported data on the Point Prevalence of Smoking (Group 3), though heterogeneity in this group was too high for data to be pooled.We were unable to analyse data for 49 studies (N = 152,544).Subgroup analyses (Pure Prevention cohorts only) demonstrated that at longest follow-up for all curricula combined, there was a significant effect favouring adult presenters (OR 0.88, 95% CI 0.81 to 0.96). There were no differences between tobacco-only and multifocal interventions. For curricula with booster sessions there was a significant effect only for combined social competence and social influences interventions with follow-up of one year or less (OR 0.50, 95% CI 0.26 to 0.96) and at longest follow-up (OR 0.51, 95% CI 0.27 to 0.96). Limited data on gender differences suggested no overall effect, although one study found an effect of multimodal intervention at one year for male students. Sensitivity analyses for Pure Prevention cohorts and Change in Smoking Behaviour over time outcomes suggested that neither selection nor attrition bias affected the results. AUTHORS' CONCLUSIONS Pure Prevention cohorts showed a significant effect at longest follow-up, with an average 12% reduction in starting smoking compared to the control groups. However, no overall effect was detected at one year or less. The combined social competence and social influences interventions showed a significant effect at one year and at longest follow-up. Studies that deployed a social influences programme showed no overall effect at any time point; multimodal interventions and those with an information-only approach were similarly ineffective.Studies reporting Change in Smoking Behaviour over time did not show an overall effect, but at an intervention level there were positive findings for social competence and combined social competence and social influences interventions.
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Affiliation(s)
- Roger E Thomas
- Department of Family Medicine, Faculty of Medicine, University of Calgary, Calgary, Canada.
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Cole AG, Leatherdale ST, Burkhalter R. An examination of different smoking patterns among Canadian youth: new insight for tobacco control programming. Addict Behav 2013; 38:1610-5. [PMID: 23254206 DOI: 10.1016/j.addbeh.2012.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 09/19/2012] [Accepted: 10/04/2012] [Indexed: 10/27/2022]
Abstract
Patterns of smoking can vary among youth smokers. The purpose of this study was to examine three different patterns of smoking among youth (daily smoking, smoking sporadically on weekdays and weekends, and smoking during weekdays only), and to examine the sociodemographic characteristics that are associated with each smoking pattern in a representative sample of Canadian youth smokers. Data were collected as part of the 2010/2011 Youth Smoking Survey (YSS) from 31,396 students in grades 9 to 12 from secondary schools in 9 Canadian provinces. Data from the YSS were used to assess smoking behaviors and sociodemographic factors that are associated with smoking patterns among youth. We used logistic regression models to examine factors associated with week day only and some day smoking patterns relative to daily smoking patterns. Results indicate that among current youth smokers, the majority are daily smokers (62.0%), followed by some day (23.5%) and week day only (13.5%) smokers. Students who smoke some days were more likely than daily smokers to share cigarettes with others; however, they were less likely than daily smokers to have a parent, step-parent or guardian who smokes cigarettes and less likely to have close friends who smoke cigarettes. Conversely, students who smoke week days only were less likely than daily smokers to have a sibling who smokes cigarettes. These data suggest that the school environment continues to play an important role in reducing youth smoking rates in Canada, especially among youth who only smoke week days. The high percentage of week day only smokers suggests that current school-level tobacco control initiatives may be insufficient for preventing youth smoking onset.
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Velicer WF, Redding CA, Paiva AL, Mauriello LM, Blissmer B, Oatley K, Meier KS, Babbin SF, McGee H, Prochaska JO, Burditt C, Fernandez AC. Multiple behavior interventions to prevent substance abuse and increase energy balance behaviors in middle school students. Transl Behav Med 2013; 3:82-93. [PMID: 23585821 DOI: 10.1007/s13142-013-0197-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
This study examined the effectiveness of two transtheoretical model-tailored, computer-delivered interventions designed to impact multiple substance use or energy balance behaviors in a middle school population recruited in schools. Twenty middle schools in Rhode Island including sixth grade students (N=4,158) were stratified and randomly assigned by school to either a substance use prevention (decreasing smoking and alcohol) or an energy balance (increasing physical activity, fruit and vegetable consumption, and limiting TV time) intervention group in 2007. Each intervention involved five in-class contacts over a 3-year period with assessments at 12, 24, and 36 months. Main outcomes were analyzed using random effects modeling. In the full energy balance group and in subsamples at risk and not at risk at baseline, strong effects were found for physical activity, healthy diet, and reducing TV time, for both categorical and continuous outcomes. Despite no direct treatment, the energy balance group also showed significantly lower smoking and alcohol use over time than the substance use prevention group. The energy balance intervention demonstrated strong effects across all behaviors over 3 years among middle school students. The substance use prevention intervention was less effective than the energy balance intervention in preventing both smoking and alcohol use over 3 years in middle school students. The lack of a true control group and unrepresented secular trends suggest the need for further study.
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Affiliation(s)
- Wayne F Velicer
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Rd, Kingston, RI 02881, USA
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Sussman S, Levy D, Lich KH, Cené CW, Kim MM, Rohrbach LA, Chaloupka FJ. Comparing effects of tobacco use prevention modalities: need for complex system models. Tob Induc Dis 2013; 11:2. [PMID: 23339410 PMCID: PMC3567972 DOI: 10.1186/1617-9625-11-2] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 01/17/2013] [Indexed: 11/29/2022] Open
Abstract
Many modalities of tobacco use prevention programming have been implemented including various policy regulations (tax increases, warning labels, limits on access, smoke-free policies, and restrictions on marketing), mass media programming, school-based classroom education, family involvement, and involvement of community agents (i.e., medical, social, political). The present manuscript provides a glance at these modalities to compare relative and combined impact of them on youth tobacco use. In a majority of trials, community-wide programming, which includes multiple modalities, has not been found to achieve impacts greater than single modality programming. Possibly, the most effective means of prevention involves a careful selection of program type combinations. Also, it is likely that a mechanism for coordinating maximally across program types (e.g., staging of programming) is needed to encourage a synergistic impact. Studying tobacco use prevention as a complex system is considered as a means to maximize effects from combinations of prevention types. Future studies will need to more systematically consider the role of combined programming.
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Affiliation(s)
- Steve Sussman
- Departments of Preventive Medicine and Psychology, University of Southern California, Soto Street Building 302A, 2001 N. Soto Street, Los Angeles, CA, 90033-9045, USA
| | - David Levy
- Department of Oncology, Georgetown University, Washington, DC, WA, USA
| | - Kristen Hassmiller Lich
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Crystal W Cené
- University of North Carolina, School of Medicine, Chapel Hill, NC, USA
| | - Mimi M Kim
- University of North Carolina, Cecil G. Sheps Center for Health Services Research and the NCTRaCS Institute, Chapel Hill, NC, USA
| | - Louise A Rohrbach
- Departments of Preventive Medicine and Psychology, University of Southern California, Soto Street Building 302A, 2001 N. Soto Street, Los Angeles, CA, 90033-9045, USA
| | - Frank J Chaloupka
- Institute for Health Research and Policy, Health Policy Center, University of Illinois, Chicago, IL, USA
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Conner M, Grogan S, Lawton R, Armitage C, West R, Siddiqi K, Gannon B, Torgerson C, Flett K, Simms-Ellis R. Study protocol: A cluster randomised controlled trial of implementation intentions to reduce smoking initiation in adolescents. BMC Public Health 2013; 13:54. [PMID: 23332020 PMCID: PMC3623649 DOI: 10.1186/1471-2458-13-54] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 01/11/2013] [Indexed: 11/24/2022] Open
Abstract
Background The current literature suggests that forming implementation intentions (simple ‘if-then’ plans) about how to refuse the offer of a cigarette may be an effective intervention to reduce smoking initiation in adolescents. This study is a pragmatic trial to test the effectiveness and cost-effectiveness of such an intervention in reducing smoking initiation in a sample of UK adolescents. Methods/Design A cluster randomised controlled trial with at least 36 schools randomised to receive an implementation intention intervention targeting reducing smoking initiation (intervention group) or increasing homework (control group). Interventions will be conducted at the classroom level and be repeated every six months for four years (eight interventions). Objectively assessed (carbon monoxide monitor) and self-reported smoking plus smoking related cognitions (e.g., smoking intentions, attitudes, norms and self-efficacy) will be assessed at baseline and 12, 24, 36 and 48 months post baseline. Objectively assessed smoking at 48 months post baseline will be the primary outcome variable. Health economic analyses will assess life years gained. Discussion The results of the trial will provide information on the impact of a repeated implementation intention for refusing offers of cigarettes on rates of smoking initiation in adolescents. Trial registration ISRCTN27596806
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Affiliation(s)
- Mark Conner
- Institute of Psychological Sciences, University of Leeds, Leeds, UK.
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Rogers ER, King SR. Intervention based on social cognitive theory: Evaluating adolescents' knowledge of OTC pain medications. J Am Pharm Assoc (2003) 2013; 53:30-8. [DOI: 10.1331/japha.2013.11231] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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