一项针对中学生的医学生提供的吸烟预防计划的过程评估：烟草防治整群随机试验方案

Process Evaluation of a Medical Student-Delivered Smoking Prevention Program for Secondary Schools: Protocol for the Education Against Tobacco Cluster Randomized Trial.

作者信息

Brinker Titus Josef, Buslaff Fabian, Suhre Janina Leonie, Silchmüller Marc Philipp, Divizieva Evgenia, Wilhelm Jilada, Hillebrand Gabriel, Penka Dominik, Gaim Benedikt, Swoboda Susanne, Baumermann Sonja, Walther Jörg Werner, Brieske Christian Martin, Jakob Lena, Baumert Hannah Maria, Anhuef Ole, Schmidt Selina Marisa, Alfitian Jonas, Batra Anil, Taha Lava, Mons Ute, Hofmann Felix Johannes, Haney Ailís Ceara, Haney Caelán Max, Schaible Samuel, Tran Thien-An, Beißwenger Hanna, Stark Tobias, Groneberg David A, Seeger Werner, Srivastava Aayushi, Gall Henning, Holzapfel Julia, Rigotti Nancy A, Baudson Tanja Gabriele, Enk Alexander H, Fröhling Stefan, von Kalle Christof, Bernardes-Souza Breno, Pereira Rayanna Mara de Oliveira Santos, Thomas Roger

机构信息

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.

出版信息

JMIR Res Protoc. 2019 Apr 11;8(4):e13508. doi: 10.2196/13508.

DOI:10.2196/13508

PMID:30973348

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6482400/

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.

摘要

背景

大多数吸烟者在青春期早期开始吸烟，认为吸烟有积极的一面。然而，鉴于香烟的成瘾性，他们中的许多人最终可能成为长期吸烟者，并患上与烟草相关的疾病。为了防止青少年吸烟，大型国际医学生网络“抵制烟草教育”（EAT）每年在课堂上使用自行开发的循证应用程序和策略，对4万多名中学生进行教育。

目的

本研究旨在评估基于学校的EAT干预措施在降低德国七年级学生吸烟率方面的长期效果。此外，我们旨在通过对过程评估得出结论来改进干预措施。

方法

我们进行了一项整群随机对照试验，在基线以及干预后9个月、16个月和24个月通过教师发放的纸笔问卷进行测量。研究组包括随机分配接受2016年EAT课程的学校和基线数据可比的对照学校（无干预）。主要结局是干预组和对照组在24个月随访时吸烟率变化的差异。次要结局是吸烟相关态度变化、新吸烟者、戒烟者和从不吸烟者数量的组间差异。