Gingiss Phyllis M, Boerm Melynda
University of Houston, Department of Health and Human Performance, Health Network for Evaluation and Training Systems, Houston, Texas 77204-6015, USA.
J Sch Health. 2009 Aug;79(8):361-8; quiz 388-90. doi: 10.1111/j.1746-1561.2009.00422.x.
Following the Master Settlement Agreement, state tobacco prevention spending peaked in 2002, but has subsequently been diminishing annually. This study compared the influence of 2004 Texas tobacco program budget cuts on school practices a year after funding loss.
Three school groups were compared: continuously funded for a 2-year minimum (n = 109), funded but discontinued (n = 123), and never funded (n = 70). Among the 123 schools with discontinued funding, differences were examined based on funding cut decision level (state or local). Written responses to surveys based on the Centers for Disease Control and Prevention (CDC) School Health Education Profile Tobacco Module were received from 49% of health coordinators and 58% of principals.
Principals and health coordinators from continuously funded schools reported more 1) tobacco instrunctional activities; 2) teacher training; 3) student cessation support; 4) program leadership; 5) a district advocate; 6) interest in tobacco use prevention education; 7) use of evidence-based programs and CDC-recommended teaching methods; 8) involvement of school staff; 9) student tobacco cessation programs at school and community; 10) family involvement; and 11) staff development funding. Previously funded schools approached profiles of those never funded. Few differences were noted among schools with funding loss due to state or local decisions.
The continuously funded schools consistently were better positioned to positively reach their students with effective tobacco programs. Funding reductions were associated with rapid reductions in programming. Results emphasize the need for early programmatic initiation of capacity building skill development to ensure implementation and retention of health programs during fiscally challenging circumstances.
根据《主和解协议》,各州的烟草预防支出在2002年达到峰值,但随后逐年减少。本研究比较了2004年德克萨斯州烟草项目预算削减对资金损失一年后学校实践的影响。
比较了三个学校组:连续至少获得两年资金资助的学校(n = 109)、获得过资助但已停止的学校(n = 123)和从未获得过资助的学校(n = 70)。在123所停止资助的学校中,根据资金削减决策层面(州或地方)进行了差异分析。收到了49%的健康协调员和58%的校长对基于疾病控制和预防中心(CDC)学校健康教育概况烟草模块的调查问卷的书面回复。
连续获得资助的学校的校长和健康协调员报告了更多的方面,包括:1)烟草教学活动;2)教师培训;3)学生戒烟支持;4)项目领导;5)地区倡导者;6)对烟草使用预防教育的兴趣;7)使用基于证据的项目和CDC推荐的教学方法;8)学校工作人员的参与;9)学校和社区的学生戒烟项目;10)家庭参与;以及11)工作人员发展资金。以前获得资助的学校接近从未获得资助的学校的概况。因州或地方决策而失去资金的学校之间几乎没有差异。
持续获得资助的学校始终更有能力通过有效的烟草项目积极影响学生。资金削减与项目的迅速减少相关。结果强调了在财政困难情况下,需要尽早启动能力建设技能发展项目,以确保健康项目得以实施和持续开展。