Process evaluation and challenges of implementation of a school-based waterpipe tobacco smoking prevention program for teens in Lebanon

Abstract Background The UNODC with the collaboration of the Government implemented in Nigeria a large-scale project to promote healthy lifestyles in schools, families and communities. Within the project, the prevention program Unplugged was tested through a randomized controlled trial. This study aims to evaluate the implementation of the program in the intervention schools and the satisfaction of teachers and students. Methods 32 schools were randomly extracted from a list of 60 schools provided by the Federal Ministry of Education. 16 schools were randomly allocated to intervention and implemented Unplugged. To monitor program implementation, the teachers filled a form reporting data on fidelity of implementation. To monitor satisfaction, teachers and students filled an anonymous form at the end of the program. Results 69% of intervention schools participated in the process evaluation. The duration of the units was on average 55 min. The implementation rate was very high. All classes implemented six units whilst less than 10% did not implement the other six units. The highest rate of not implementing classes was observed for unit 11 and 12. The highest student interest as declared by the teachers was observed for Unit 1 and 8, the highest interactivity for Unit 9 and 8. Most teachers found the units easy to lead and referred an improvement of teaching skills, knowledge about substances, relationship with the students and class climate, and found very useful the Teacher Handbook. Ninety percent of students considered Unplugged useful for their choices, for 82% it improved the vision of themselves, for 95% their knowledge, for 80% the relationship with mates and for 77% the relationship with teachers. 97.5% of students would like to have a similar program next year. Conclusions Unplugged reached in Nigeria very good results in terms of implementation and satisfaction of teachers and students. Process evaluation is useful to improve the quality of prevention interventions. Key messages School based prevention interventions like Unplugged can be successfully implemented in low income countries, especially when supported by printed Handbook for teachers. Teachers and students participating in Unplugged perceived an improvement of class climate and relationship between teachers and students due to the program.

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Effects of a randomized controlled trial to assess the six-months effects of a school based smoking prevention program in Saudi Arabia

Preventive Medicine ◽

10.1016/j.ypmed.2016.06.032 ◽

2016 ◽

Vol 90 ◽

pp. 100-106 ◽

Cited By ~ 3

Author(s):

Mutaz Mohammed ◽

Sander Matthijs Eggers ◽

Fahad F. Alotaiby ◽

Nanne de Vries ◽

Hein de Vries

Keyword(s):

Randomized Controlled Trial ◽

Saudi Arabia ◽

Prevention Program ◽

Controlled Trial ◽

Smoking Prevention ◽

Randomized Controlled ◽

School Based

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Implemented or not implemented? Process evaluation of the school-based obesity prevention program DOiT and associations with program effectiveness

Health Education Research ◽

10.1093/her/cyw007 ◽

2016 ◽

Vol 31 (2) ◽

pp. 220-233 ◽

Cited By ~ 15

Author(s):

Femke van Nassau ◽

Amika S. Singh ◽

Trynke Hoekstra ◽

Willem van Mechelen ◽

Johannes Brug ◽

...

Keyword(s):

Process Evaluation ◽

Obesity Prevention ◽

Prevention Program ◽

Program Effectiveness ◽

School Based ◽

Obesity Prevention Program

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Process Evaluation of a Medical Student–Delivered Smoking Prevention Program for Secondary Schools: Protocol for the Education Against Tobacco Cluster Randomized Trial (Preprint)

10.2196/preprints.13508 ◽

2019 ◽

Author(s):

Titus Josef Brinker ◽

Fabian Buslaff ◽

Janina Leonie Suhre ◽

Marc Philipp Silchmüller ◽

Evgenia Divizieva ◽

...

Keyword(s):

Medical Student ◽

Randomized Trial ◽

Process Evaluation ◽

Smoking Prevalence ◽

Cluster Randomized Trial ◽

Smoking Prevention ◽

School Based ◽

Cluster Randomized ◽

And Control

BACKGROUND Most smokers start smoking during their early adolescence under the impression that smoking entails positive attributes. Given the addictive nature of cigarettes, however, many of them might end up as long-term smokers and suffering from tobacco-related diseases. To prevent tobacco use among adolescents, the large international medical students’ network Education Against Tobacco (EAT) educates more than 40,000 secondary school students per year in the classroom setting, using evidence-based self-developed apps and strategies. OBJECTIVE This study aimed to evaluate the long-term effectiveness of the school-based EAT intervention in reducing smoking prevalence among seventh-grade students in Germany. Additionally, we aimed to improve the intervention by drawing conclusions from our process evaluation. METHODS We conduct a cluster-randomized controlled trial with measurements at baseline and 9, 16, and 24 months postintervention via paper-and-pencil questionnaires administered by teachers. The study groups consist of randomized schools receiving the 2016 EAT curriculum and control schools with comparable baseline data (no intervention). The primary outcome is the difference of change in smoking prevalence between the intervention and control groups at the 24-month follow-up. Secondary outcomes are between-group differences of changes in smoking-related attitudes and the number of new smokers, quitters, and never-smokers. RESULTS A total of 11,268 students of both sexes, with an average age of 12.32 years, in seventh grade of 144 secondary schools in Germany were included at baseline. The prevalence of cigarette smoking in our sample was 2.6%. The process evaluation surveys were filled out by 324 medical student volunteers, 63 medical student supervisors, 4896 students, and 141 teachers. CONCLUSIONS The EAT cluster randomized trial is the largest school-based tobacco-prevention study in Germany conducted to date. Its results will provide important insights with regards to the effectiveness of medical student–delivered smoking prevention programs at school. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13508

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