Univ. Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, F34000, Montpellier, France; Epidaure-Prevention Department of the Montpellier Cancer Institute, 208 Avenue des Apothicaires, 34298 Montpellier cedex 5, France.
Onco-Addiction and Patient Education Unit - Supportive Care Department, Montpellier Cancer Institute (ICM), 208 Avenue des Apothicaires, 34298 Montpellier cedex 5, France.
Prev Med. 2021 Feb;143:106327. doi: 10.1016/j.ypmed.2020.106327. Epub 2020 Nov 21.
Theoretical frameworks such as the theory of planned behavior (TPB) can be applied to design and evaluate smoking behavior interventions. The present systematic review aimed to: (i) determine the characteristics of TPB-based interventions and their reported impact on smoking behavior and TPB variables, (ii) evaluate the level of methodological quality in the included studies, and (iii) assess the quality of the theoretical implementation. Studies were eligible for inclusion if the intervention targeted smoking behavior, was explicitly based on the TPB, and if smoking behavior or intention was measured at least at post-intervention. Relevant articles were identified through searches on databases and internet search engines, responses to messages sent on thematic forums, consultation of prominent authors, and manual searches on key websites and key TPB-publications. Seventeen studies met the inclusion criteria. A majority of studies (65%) targeted the student population (i.e., elementary school, high school, university). Interventions minimally included the provision of health messages. The proportion of studies that reported a significant impact on smoking behavior, intention, attitude, subjective norm, or PBC ranged between 42% and 50%. Regarding methodological quality, unclear or high risks of bias were notably found regarding the selection of participants, data collection methods, withdrawal and drop-outs, and blinding. Regarding theoretical implementation, the reciprocal link between intervention techniques and TPB variables targeted remain unclear for a majority of studies. To better inform tobacco prevention and TPB research, future studies should more systematically use rigorous methods when designing, implementing, and reporting TPB-based interventions.
理论框架，如计划行为理论（TPB），可用于设计和评估吸烟行为干预措施。本系统综述旨在：（i）确定基于 TPB 的干预措施的特征及其对吸烟行为和 TPB 变量的报告影响，（ii）评估纳入研究的方法学质量水平，以及（iii）评估理论实施的质量。如果干预措施针对吸烟行为，明确基于 TPB，并且至少在干预后测量吸烟行为或意图，则研究符合纳入标准。通过在数据库和互联网搜索引擎上搜索、回复主题论坛上发送的消息、咨询知名作者以及在关键网站和 TPB 出版物上手动搜索，确定了相关文章。有 17 项研究符合纳入标准。大多数研究（65%）针对学生群体（即小学、中学、大学）。干预措施至少包括提供健康信息。报告对吸烟行为、意图、态度、主观规范或 PBC 有显著影响的研究比例在 42%至 50%之间。关于方法学质量，在参与者选择、数据收集方法、退出和辍学以及盲法方面，明显存在不明确或高偏倚风险。关于理论实施，对于大多数研究来说，干预技术与 TPB 变量之间的相互联系仍然不清楚。为了更好地为烟草预防和 TPB 研究提供信息，未来的研究在设计、实施和报告基于 TPB 的干预措施时应更系统地使用严格的方法。
