Based on this knowledge, STIVORO, the Dutch expert center on tobacco control, developed an education program called “But I don’t smoke”, which was especially targeted at children in
elementary school. Here we describe the effects of this program by investigating the following questions: 1. What are the immediate effects of the smoking prevention program in elementary school on children’s self-reported social influences, attitudes, self-efficacy, intentions towards non-smoking, and smoking behavior? The study design is a cluster randomized controlled trial. Recruitment and participants: in 2002, 121 Dutch elementary schools at the level of 5th grade participated in the study. They were recruited in five community health center regions. Selleck BMS-354825 Sample size: a power calculation indicated that 1400 students were needed in both the intervention and the control group to find a difference Selleckchem NVP-AUY922 of 5% in smoking increase:
a power of 80%, alpha of 0.05, and an intra-class correlation of 0.075. Cluster randomization: we ranked the schools by community health center region. Within each region, the schools were randomly assigned to either the intervention or the control group. This was done by asking an independent person to toss a coin. In total 121 schools participated in the study representing 151 classes. During the study, the control schools provided any smoking prevention program that they would normally give to their students
(usual treatment). The researchers trained experimental and control schools in the same way regarding their tasks in the evaluation. The intervention consisted of six lessons of 1 hour each, and it was based on the evidence on the effectiveness of education programs on smoking prevention (Flay, 2009, Hwang et al., 2004 and Thomas and Perera, 2006Cuijpers, 2002). Lessons 1 to 3 were provided in 5th grade of elementary school and were directed at increasing knowledge on the consequences of smoking, forming an attitude towards (non-)smoking, and expressing mafosfamide the intention not to smoke. Intervention methods used were developing a school smoking project, interviewing parents, discussing attitudes towards smoking, and advising/encouraging making a non-smoking deal with their parents. Lessons 4 to 6 were provided in 6th grade and were aimed at providing insight into the factors that influence attitudes towards smoking, teaching skills to express one’s opinion, planning how to react to social pressure, and strengthening the intention not to smoke. Showing a video followed by classroom discussion, developing campaign materials, role-playing, and handing the non-smoking certificate were important activities in 6th grade. The teachers delivered the intervention. They were trained on the ins and outs of the program by someone from the community health center.