印度学校烟草预防计划的效果评价——方法、结果与经验教训。
Process evaluation of a tobacco prevention program in Indian schools--methods, results and lessons learnt.
机构信息
Centre for Chronic Disease Control, Delhi, India.
出版信息
Health Educ Res. 2010 Dec;25(6):917-35. doi: 10.1093/her/cyq042. Epub 2010 Sep 30.
In India, 57% of men between 15 and 54 years and 10.8% of women between 15 and 49 years use tobacco. A wide variety of tobacco gets used and the poor and the underprivileged are the dominant victims of tobacco and its adverse consequences. Project MYTRI (Mobilizing Youth for Tobacco-Related Initiatives in India) was a tobacco prevention intervention program, a cluster-randomized trial in 32 Indian schools which aimed to decrease susceptibility to tobacco use among sixth- to ninth-grade students in urban settings in India. This culture-specific intervention, which addressed both smokeless and smoked forms of tobacco, was Indian in content and communication. We qualitatively developed indicators which would help accurately measure the dose of the intervention given, received and reached. A multi-staged process evaluation was done through both subjective and objective measures. Training the teachers critically contributed toward a rigorous implementation and also correlated with the outcomes, as did a higher proportion of students participating in the classroom discussions and better peer-leader-student communication. A sizeable proportion of subjective responses were 'socially desirable', making objective assessment a preferred methodology even for 'dose received'. The peer-led health activism was successful. Teachers' manuals need to be concise.
在印度,15 至 54 岁的男性中有 57%、15 至 49 岁的女性中有 10.8%使用烟草。印度使用的烟草种类繁多,贫困人口和弱势群体是烟草及其不良后果的主要受害者。项目 MYTRI(在印度促进与烟草有关的倡议的青年动员)是一个烟草预防干预项目,在印度 32 所学校进行了一项集群随机试验,旨在减少印度城市环境中六至九年级学生对烟草使用的易感性。这种针对特定文化的干预措施同时针对无烟和吸烟形式的烟草,内容和信息均具有印度特色。我们制定了定性指标,以帮助准确衡量干预措施的给予、接受和覆盖剂量。通过主观和客观措施进行了多阶段的过程评估。对教师的严格培训对严格执行计划起到了关键作用,与结果相关的还有更多学生参与课堂讨论以及更好的同伴-领导-学生沟通。相当一部分主观反应是“社会期望”,因此即使对于“接受剂量”,客观评估也是一种更可取的方法。同伴主导的健康行动是成功的。教师手册需要简洁。