Hjort Anneke Vang, Schreuders Michael, Rasmussen Kathrine Højlund, Klinker Charlotte Demant
Health Promotion Research, Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820, Gentofte, Denmark.
National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark.
Implement Sci Commun. 2021 Apr 9;2(1):40. doi: 10.1186/s43058-021-00140-x.
The smoking prevalence is high among students enrolled in vocational education and training, which is considered a lower level of education. The school tobacco policy regarding smoke-free school hours stipulates that students and staff are not allowed to smoke during school hours-inside or outside school premises-and it might be an effective intervention for reducing smoking in vocational schools. For school tobacco policies to be effective, they must be appropriately implemented. A primary predictor for successful implementation is organizational readiness for change. This study seeks to identify and understand the barriers to and facilitators for developing organizational readiness to implement smoke-free school hours in Danish vocational schools.
Semi-structured interviews and focus groups were carried out with managers and teachers (n = 22 participants) from six vocational schools. The interview guides were informed by "A theory of organizational readiness for change" developed by Weiner, which was also used as a framework to analyze the data.
We identified 13 facilitators and barriers. Nine factors acted as facilitators, including the following: believing that health promotion is a school role and duty; believing that society and workplaces are becoming more smoke-free, and believing that smoke-free school hours is a beneficial strategy to achieve fewer educational interruptions. Additional facilitators include establishing clear rules for sanctioning and enforcement, developing a joint understanding about smoke-free school hours, developing skills to deal with student responses to smoke-free school hours, establishing social alternatives to smoking, offering smoking cessation help, and mandating smoke-free school hours by law. Four organizational norms, practices, or discourses acted as barriers: believing that smoke-free school hours violate personal freedom, believing that students have more important problems than smoking, believing that it is difficult to administer the level of enforcement, and believing that the enforcement of smoke-free school hours negatively influences student-teacher relations.
Our results suggest that developing organizational readiness before adopting a comprehensive tobacco policy such as smoke-free school hours is important for successful implementation. Further research should investigate how to strengthen the facilitators for and counter the barriers to developing readiness for implementing smoke-free school hours.
在接受职业教育培训的学生中，吸烟率很高，职业教育被认为是较低层次的教育。学校关于无烟上课时间的烟草政策规定，学生和教职员工在上课时间内（无论校内还是校外）不得吸烟，这可能是减少职业学校吸烟行为的有效干预措施。要使学校烟草政策有效，必须得到妥善实施。成功实施的一个主要预测因素是组织对变革的准备程度。本研究旨在识别和理解丹麦职业学校在发展实施无烟上课时间的组织准备方面的障碍和促进因素。
对来自六所职业学校的管理人员和教师（共22名参与者）进行了半结构化访谈和焦点小组讨论。访谈指南以韦纳提出的“变革的组织准备理论”为依据，并将其作为分析数据的框架。
我们识别出13个促进因素和障碍。九个因素起到了促进作用，包括：认为健康促进是学校的职责；认为社会和工作场所越来越无烟，且认为无烟上课时间是减少教育中断的有益策略。其他促进因素包括制定明确的制裁和执行规则、就无烟上课时间形成共同理解、培养应对学生对无烟上课时间反应的技能、建立吸烟的社交替代方式、提供戒烟帮助以及依法规定无烟上课时间。四个组织规范、做法或话语起到了障碍作用：认为无烟上课时间侵犯个人自由、认为学生有比吸烟更重要的问题、认为难以管理执行力度以及认为无烟上课时间的执行会对师生关系产生负面影响。
我们的结果表明，在采用诸如无烟上课时间这样的全面烟草政策之前发展组织准备程度对于成功实施至关重要。进一步的研究应调查如何加强实施无烟上课时间准备程度方面的促进因素并克服障碍。
