Winkleby Marilyn A, Feighery Ellen, Dunn Meredith, Kole Sara, Ahn David, Killen Joel D
Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, USA.
Arch Pediatr Adolesc Med. 2004 Mar;158(3):269-75. doi: 10.1001/archpedi.158.3.269.
To test whether high school students' participation in advocacy activities related to the advertising, availability, and use of tobacco in their communities would prevent or reduce their own tobacco use.
Ten continuation high schools in northern California, randomly assigned to a semester-long program in which students either carried out advocacy activities to counter environmental-level smoking influences in their communities (treatment) or learned about drug and alcohol abuse prevention (control).
Eleventh and 12th grade high school students; 5 (advocacy) treatment and 5 control schools over 4 semesters from 2000 through 2002.
Self-reported smoking defined as nonsmokers (those who had never smoked tobacco or those who were former smokers), light smokers (those who smoked <1 pack per week), or regular smokers (those who smoked >or=1 pack per week), and confirmed by carbon monoxide level readings. The following 3 constructs related to social cognitive theory- perceived incentive value, perceived self-efficacy, and outcome expectancies-were assessed.
There was a significant net change from baseline to the end of the semester (after the intervention) between treatment and control schools for students who were regular smokers, but not for students who were nonsmokers or light smokers. Regular smoking decreased 3.8% in treatment schools and increased 1.5% in control schools (P<.001). Regular smoking continued to decrease at 6 months after the intervention in treatment schools, with a total change in prevalence from 25.1% to 20.3%. Involvement in community-advocacy activities and the 3 social constructs-perceived incentive value, perceived self-efficacy, and outcome expectancies-also showed significant net changes between treatment and control schools (all P values <.01).
Student engagement in community-advocacy activities that addressed environmental influences of cigarette smoking resulted in significant decreases in regular smoking.
测试高中生参与所在社区与烟草广告、可得性及使用相关的宣传活动是否会预防或减少他们自身的烟草使用。
加利福尼亚北部的10所延续高中，被随机分配到一个为期一学期的项目中，学生们要么开展宣传活动以对抗所在社区环境层面的吸烟影响（干预组），要么学习预防药物和酒精滥用知识（对照组）。
11年级和12年级的高中生；2000年至2002年期间，4个学期里有5所（宣传）干预学校和5所对照学校。
自我报告的吸烟情况定义为非吸烟者（那些从未吸过烟草或曾经吸烟的人）、轻度吸烟者（那些每周吸烟少于1包的人）或经常吸烟者（那些每周吸烟≥1包的人），并通过一氧化碳水平读数进行确认。评估了与社会认知理论相关的以下3个结构——感知激励价值、感知自我效能和结果预期。
对于经常吸烟者，干预组和对照组学校的学生从基线到学期末（干预后）有显著的净变化，但对于非吸烟者或轻度吸烟者则没有。干预组学校的经常吸烟率下降了3.8%，对照组学校上升了1.5%（P<0.001）。干预学校在干预后6个月时经常吸烟率继续下降，患病率从25.1%降至20.3%。参与社区宣传活动以及3个社会结构——感知激励价值、感知自我效能和结果预期——在干预组和对照组学校之间也显示出显著的净变化（所有P值<0.01）。
学生参与应对吸烟环境影响的社区宣传活动导致经常吸烟率显著下降。
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