Effectiveness of E-Learning Program in Preventing WP Smoking in Adolescent Females in West of Iran by Applying Prototype-Willingness Model: A Randomized Controlled Trial

Abstract

Background: Given the increasing trend of Water pipe (WP) smoking in adolescent females, it is necessary to use effective educational strategies in preventing WP smoking in developing countries. We aimed to determine effectiveness of e-learning program in preventing WP smoking in adolescent females west of Iran using prototype-willingness model. Study Design: A randomized controlled trial. Methods: This study was performed on 221 adolescent females in Kermanshah City, Iran during 2019-2020. Multistage random sampling was used. Data collection tool included a researcher-made questionnaire based on prototype-willingness model. E-learning-based intervention program included 5 training sessions. Participants were followed up for 3 months after the intervention. The data were analyzed using SPSS software. Results: The mean scores of attitude, subjective norms, prototype, intention, and behavioral willingness structures were similar in both experimental and control groups before the educational intervention. However, after educational interventions, mean scores of structures of positive attitude towards WP, subjective norms about WP smoking, positive prototype about WP smokers, intention, and behavioral willingness towards WP smoking were decreased in the experimental group. Moreover, frequency of WP smoking was decreased in the experimental group compared to the control group after the educational intervention (P=0.003). Conclusion: The use of e-learning-based interventions is an educational strategy for reducing WP smoking in adolescent females.

The Effect of Educational Intervention Based on Health Belief Model on Smoking Preventive Behaviors Among Female Students

“…Hence, one of the reasons for adjusting the perceived barrier score of the experimental group in this study can be the increase in self-efficacy, which matches the results of Solhi and Abolfathi (36), Giti and Shojaizadeh (37), and Rakhshani et al (28), while not being in line with the results of Panahi et al (13) and Lee et al (15). In the present study, the mean score of cues to action in the experimental group significantly increased after education, and a significant difference was found between the two groups in this respect, which is consistent with the results of Bashirian et al (39) Based on the results of this study the mean selfefficacy score of the intervention group demonstrated a considerable increase after training, and there was a significant difference between the two groups in terms of this variable. Self-efficacy is defined as a person's belief and confidence in their abilities to successfully perform a behavior and is a vital and influential construct emphasized in educational theories (39).…”

“…In the present study, the mean score of cues to action in the experimental group significantly increased after education, and a significant difference was found between the two groups in this respect, which is consistent with the results of Bashirian et al (39) Based on the results of this study the mean selfefficacy score of the intervention group demonstrated a considerable increase after training, and there was a significant difference between the two groups in terms of this variable. Self-efficacy is defined as a person's belief and confidence in their abilities to successfully perform a behavior and is a vital and influential construct emphasized in educational theories (39). Accordingly, in designing educational programs, the special and practical role of this construct should be considered regarding habitual behaviors such as smoking behavior or smoking prevention.…”

“…Based on the findings of the study, after training, the mean score of adopting preventive behaviors of smoking increased significantly in the students of the experimental group, and a significant difference was observed between the experimental and control groups in this regard. This finding is consistent with the results of similar studies (28,39,40). However, no predictive factor was obtained in the research by Budden (41).…”

Prevalence of water pipe smoking and associated risk factors among female adolescents

“…In this study, the results indicate that having a friend who smokes WPs increases the probability of WP smoking, similar to the results of a study. [ 13 25 26 ]…”

“…This theory holds that adolescents derive their beliefs about high-risk behaviors from role models, especially close friends and parents. [ 26 36 ]…”