School of Medicine, Universidad de los Andes, Carrera 1 # 18A-10 Block Q, 111711018, Bogotá, Colombia.
College of Human Sciences, Florida State University, Florida, USA.
Int J Behav Med. 2024 Oct;31(5):691-704. doi: 10.1007/s12529-023-10211-z. Epub 2023 Sep 11.
Adolescent smoking is associated with significant health and social risks. Previous research has demonstrated the effectiveness of interventions based on behavior change theories in preventing adolescent smoking uptake. However, evidence from the theory-based perspective of evaluation is limited, especially for how such complex interventions work, and how they work when implemented in different contextual settings.
A comparative qualitative analysis was conducted to explore various influences on behavior change among participants taking part in two smoking prevention interventions in Northern Ireland and Bogotá. Twenty-seven focus groups were conducted in 12 schools (6 in Northern Ireland and 6 in Bogota, n = 195 pupils participated; aged 11-15 years). The Theoretical Domains Framework guided a content analysis of the data.
We found similarities across settings in terms of knowledge, skills, and beliefs related to smoking or vaping behavior change, as well as differences in contextual resources and social influence. Different environmental resources included availability to purchase tobacco products in the neighborhoods and previous information about tobacco risk. Participants in both interventions perceived behavioral change outcomes related to personal skills and intention to not smoke or vape.
These findings have highlighted how both individual factors and contextual resources influence behavior change for smoking prevention in practice. Local contextual factors and social influences affecting pupils should be taken into account in the implementation and evaluation of health behavior change interventions. In particular, this study supports using social and contextual influence strategies in interventions to reduce the onset of adolescent smoking and vaping.
青少年吸烟与重大的健康和社会风险相关。先前的研究已经证实，基于行为改变理论的干预措施在预防青少年吸烟方面是有效的。然而，从基于理论的评估角度来看，相关证据有限，尤其是对于此类复杂干预措施的作用机制，以及在不同背景环境下的实施效果。
采用比较定性分析方法，探究参与北爱尔兰和波哥大两项吸烟预防干预措施的参与者的行为改变的各种影响因素。在 12 所学校（北爱尔兰 6 所，波哥大 6 所）开展了 27 次焦点小组，共 195 名学生参与（年龄 11-15 岁）。研究采用理论领域框架对数据进行内容分析。
我们发现，在与吸烟或吸电子烟行为改变相关的知识、技能和信念方面，两个研究地点有相似之处，但在环境资源和社会影响方面存在差异。不同的环境资源包括社区中购买烟草产品的便利性，以及之前关于烟草风险的信息。两个干预组的参与者都认为行为改变的结果与个人技能和不吸烟或吸电子烟的意愿有关。
这些发现强调了个体因素和环境资源如何在实践中影响吸烟预防的行为改变。在实施和评估健康行为改变干预措施时，应考虑影响学生的当地背景因素和社会影响。特别是，本研究支持在干预措施中使用社会和环境影响策略，以减少青少年吸烟和吸电子烟的发生。
