The long-term prevention of tobacco use among junior high school students: classroom and telephone interventions.

Abstract

OBJECTIVES. The purpose of this study was to implement and evaluate the effectiveness of a long-term tobacco use prevention program for junior high school students that used college undergraduate change agents and telephone boosters. METHODS. A psychosocial intervention combining refusal skills training, contingency management, and other tobacco use prevention methodologies such as telephone and mail boosters was implemented in 11 junior high schools in San Diego County, California. Eleven other junior high schools served as controls. Of the 2668 participants, 57% were White/non-Hispanic, 24% were Hispanic, and 19% were of other racial/ethnic groups. College undergraduates served as change agents for both the classroom and booster interventions, the latter of which was delivered in the third (ninth-grade) year of the program. RESULTS. At the end of the third year, the prevalence of tobacco use within the past month was 14.2% among the intervention students and 22.5% among the controls, yielding an odds ratio of 0.71 for analysis at the school level. CONCLUSIONS. Both college undergraduate change agents and direct one-to-one telephone interventions appear to provide cost-effective tobacco-related behavior modification.

Peer‐led interventions to prevent tobacco, alcohol and/or drug use among young people aged 11–21 years: a systematic review and meta‐analysis

“…The number of sessions in the peer‐led programmes ranged from two to 36, but for most studies ( n  = 11) the number ranged between five and 12 sessions (see Supporting information, Table S3). There was also variation between studies in the follow‐up period, which ranged from the end of intervention 30, 31, 52 to 7 years 50, although the maximum period of follow‐up for studies included in the quantitative synthesis was 1 year.…”

“…In eight studies 19, 20, 33, 34, 35, 37, 39, 52, peers of a similar age were nominated by their classmates, while in four studies, older‐age peers were selected by staff or researchers 32, 36, 51, 53. In other programmes, PLs either volunteered 31, 36, 38 or the age or method of selection was unclear. Few of the interventions were solely peer‐led; in many cases, peers provided part of the curriculum or led discussions or group work, while teachers acted as facilitators or supervisors.…”

“…Among those interventions that were the most effective 19, 20, 31, 54, however, there was no clear pattern of factors associated with impact, such as shared intervention domains, duration of intervention or underlying theory. In addition, no clear message emerged regarding whether peers, teachers or professionals were more effective at instigating behaviour change.…”

“…Where this was not reported, odds ratios (ORs) were calculated in Stata (version 13.1) using the raw data 30, 31, 32, 33, 34, 35, 36. For continuous outcomes, the standardized mean difference (SMD) was calculated and converted to a log OR 20, 37, 38, 39 using standard methods 40 (InlogOR = d(π/sqrt)3).…”

“…A second programme 31 implemented an intervention over a number of school years, culminating in one‐to‐one communication with participants. Taken together with the finding that interventions that included a booster session were more effective than those without 30, 31, 32, 51, the data suggest that the repeated communication of health messages over an extended time‐period may have a more pronounced impact on the behaviour of young people.…”