Best J A, Thomson S J, Santi S M, Smith E A, Brown K S
Department of Health Studies, University of Waterloo, Ontario, Canada.
Annu Rev Public Health. 1988;9:161-201. doi: 10.1146/annurev.pu.09.050188.001113.
Research to develop and ensure diffusion of smoking prevention programs must (a) be based on an appreciation of the social, psychological, and biological determinants at each stage in the onset process, (b) disentangle major interactions between program content, participant, provider, and setting factors as they determine impact, and (c) ensure both that diffusion is based on empirically grounded principles and that the process is monitored and its effectiveness evaluated. Sufficient evidence supports the tentative conclusion that social influence curricula can be efficacious--at least with some youth. However, we lack key information for diffusion, in particular concerning provider and setting factors. Thus, a cautious advance to diffusion research is recommended, noting that there is much we do not know, and that the public health need for applications must be balanced with continuing research to clarify for whom and under what circumstances current curricula work. At the same time, there should be strong continuing research to improve current interventions, especially for high risk populations.
(a) 基于对吸烟起始过程各阶段社会、心理和生物学决定因素的认识；(b) 梳理项目内容、参与者、提供者和环境因素之间的主要相互作用，因为这些因素决定了项目的影响；(c) 确保推广基于实证原则，同时对推广过程进行监测并评估其效果。有充分证据支持这一初步结论：社会影响课程可能有效——至少对一些青少年有效。然而，我们缺乏推广方面的关键信息，尤其是关于提供者和环境因素的信息。因此，建议谨慎推进推广研究，注意到我们还有很多未知之处，而且应用的公共卫生需求必须与持续研究相平衡，以明确当前课程对哪些人有效以及在何种情况下有效。与此同时，应该持续大力开展研究以改进当前的干预措施，特别是针对高危人群的措施。
