沙特阿拉伯一项针对中学生的校内烟草预防项目的效果：一项准实验对照试验。
Effectiveness of a School-Based Tobacco Prevention Program for Middle School Students in Saudi Arabia: A Quasi-Experimental Controlled Trial.
作者信息
Al Agili Dania E, Salihu Hamisu M
机构信息
Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA.
出版信息
Tob Use Insights. 2020 Oct 11;13:1179173X20953403. doi: 10.1177/1179173X20953403. eCollection 2020.
OBJECTIVE
To evaluate the effect of a school-based tobacco program in preventing initiation of tobacco use among adolescents in Saudi Arabia.
METHODS
We used a quasi-experimental controlled design. Four intervention and four control schools were selected from the regional education registry. A baseline questionnaire was administered to all grade 7 students before implementing the tobacco prevention program, Dentists Fighting Nicotine Dependence (DFND). The intervention group (n =379) received the DFND program whereas the control group (n = 255) received the regular tobacco program administered by the Department of Education. The program was delivered by trained health educators over 5 weeks. Pre- and post-test surveys (immediate and 2-year post-intervention) were collected. Study outcomes were current tobacco use, tobacco knowledge, attitude towards not using tobacco, and perceived behavioral control (PBC) of tobacco use. Covariates included sex, parent education, academic performance, absenteeism, student allowance, and religiosity. Data were analyzed using a two-level hierarchical mixed models.
RESULTS
In the immediate post-test, 597 participants (intervention, n = 366; control, n = 231) were surveyed. There was no difference in tobacco use between intervention and control schools, however, the intervention group had significantly higher mean scores for knowledge (β = 1.27, SE = 0.27, < .01) and attitude toward not using tobacco (β = 5.17, SE = 2.48, < .05) after adjusting for covariates. At 2-year post-intervention, 463 participants (intervention, n = 289; control, n = 173) were surveyed. There were no differences in tobacco use, knowledge, attitude or PBC between intervention and control groups.
CONCLUSIONS
Our program did not impact tobacco use. In the short-term, the program significantly improved knowledge and attitude towards not using tobacco. These effects decayed 2 years post-intervention without additional programming. Increasing the effectiveness of DFND may be achieved by expanding curriculum content and practice time throughout the school years and by targeting high-risk adolescents within the program.
目的
评估一项以学校为基础的烟草项目对沙特阿拉伯青少年预防开始使用烟草的效果。
方法
我们采用了准实验对照设计。从地区教育登记处选取了4所干预学校和4所对照学校。在实施烟草预防项目“牙医对抗尼古丁依赖（DFND）”之前，对所有七年级学生进行了基线问卷调查。干预组（n = 379）接受DFND项目，而对照组（n = 255）接受教育部实施的常规烟草项目。该项目由经过培训的健康教育工作者在5周内完成。收集了干预前和干预后的调查（干预后立即和干预后2年）。研究结果包括当前烟草使用情况、烟草知识、不使用烟草的态度以及对烟草使用的感知行为控制（PBC）。协变量包括性别、父母教育程度、学业成绩、旷课情况、学生津贴和宗教信仰。数据使用两级分层混合模型进行分析。
结果
在干预后立即进行的测试中，对597名参与者（干预组，n = 366；对照组，n = 231）进行了调查。干预学校和对照学校在烟草使用方面没有差异，然而，在调整协变量后，干预组在知识（β = 1.27，标准误 = 0.27，P <.01）和不使用烟草的态度（β = 5.17，标准误 = 2.48，P <.05）方面的平均得分显著更高。在干预后2年，对463名参与者（干预组，n = 289；对照组，n = 173）进行了调查。干预组和对照组在烟草使用、知识、态度或PBC方面没有差异。
结论
我们的项目没有对烟草使用产生影响。在短期内，该项目显著提高了对不使用烟草的知识和态度。这些效果在干预后2年衰减，且没有额外的项目支持。通过在整个学年扩展课程内容和实践时间以及针对项目中的高风险青少年，可以提高DFND的有效性。
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