University of Guam/University of Hawaii Cancer Center Partnership for Cancer Health Equity, Full Project I: Developing and Testing a School-Based Curriculum for E-cigarette, Tobacco, and Betel (Areca) Nut Use Prevention for Guam Youths
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 534
- 试验地点
- 1
- 主要终点
- Changes in Youth Risk Behavior Surveillance (YRBS) Survey-based self-reported past-30-day tobacco, e-cigarette, and areca nut use
研究概览
简要总结
The people of the U.S. Affiliated Pacific Islands (USAPI) face higher cancer incidence, especially lung/bronchia and head-and-neck cancer, and poorer cancer outcomes, compared with the U.S. nationally. This may partly be driven by the high rates of cigarette smoking and betel (areca) nut use in the USAPI. Previous data suggest that that adolescents on Guam, as young as middle school students report markedly higher e-cigarette and tobacco product use prevalence in the USAPI compared with the USAPI nationally. Guam youths are also at risk for the use of betel nuts. Yet, currently there are no tobacco product/areca nut use prevention programs that have been developed for and tested specifically USAPI adolescents. The proposed study will develop a school-based substance use prevention curriculum for e-cigarette, tobacco product, and areca nut use prevention among Guam youths. The curriculum will use lessons incorporating innovative videos and culturally grounded activities.
The study's specific aims are:
- To develop a school-based curriculum for e-cigarette, tobacco product (i.e., cigarette, smokeless tobacco), and betel nut use prevention among middle school students in Guam.
- Test the efficacy of the school-based curriculum in a randomized controlled trial.
详细描述
BACKGROUND AND SIGNIFICANCE
The study focuses on e-cigarette, tobacco and areca nut prevention among adolescents in Guam. By developing and testing a school-based e-cigarette, tobacco and areca nut prevention program, the project will target psychosocial, lifestyle, and environmental/physical factors contributing to cancer disparities in the US Affiliated Pacific Islands (USAPI). Thus far, nationally, there has been limited effort in terms of developing a theoretical framework that would attempt to explain tobacco and areca nut use etiology among USAPI youth. Previous research indicates that social and environmental influences play key roles in shaping tobacco and areca nut use among USAPI youths. In addition, skills needed to resist social influence appear to be protective against tobacco and areca nut use. Particularly, past research has found peer influence and environmental risk factors such as parental permissiveness, ease of access to tobacco/areca nut at home and school and through adults and friends, to be strongly associated with current tobacco/areca nut use. On the other hand, competence in navigating through social situations conducive to tobacco/areca nut use and refusal self-efficacy (i.e., confidence in being able to say "no" at the face of peer pressure) have been found to be strongly associated with lower likelihood of current tobacco/areca nut use.
The curriculum to be developed and tested will focus on informing adolescents on the risks of tobacco product/areca nut use as well as training adolescents on social influence resistance skills in a culturally appropriate way, using innovative use of video vignettes. The intervention will seek to influence behavior (i.e., prevention and reduction of tobacco product/areca nut use) by countering the cognitive predispositions to tobacco product/areca nut use (e.g., by increasing risk perceptions, reducing positive expectancies) and by providing youths with skills to resist specific social influence to use tobacco products/areca nut on specific occasions.
RESEARCH DESIGN
This is an experimental study. Of the eight public middle schools in Guam, four schools will be randomly assigned to the "Treatment" and four to the "Control" condition. Students in the Treatment schools will receive the classroom-based curriculum whereas students in the Control schools will receive the standard health education curriculum (treatment-as-usual). Participants will be assessed at pre-test, immediate post-test, and six months after the post-test. Note that the decision to provide an intervention, albeit weaker, to the control group was guided by the ethics of good community practice. In preliminary discussions with schools, principals unanimously expected an intervention.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 11 Years 至 15 Years（Child）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •All students enrolled in public middle schools in Guam (age: 11-15 years old)
- •Provide signed parental informed consent and student assent
排除标准
- •Participants whose parents decline participation or students who decline participation.
研究组 & 干预措施
Control
Students in the control group will receive the standard health education curriculum.
Experimental
Students in the treatment group will receive the school-based classroom curriculum.
干预措施: School-based curriculum (Behavioral)
结局指标
主要结局
Changes in Youth Risk Behavior Surveillance (YRBS) Survey-based self-reported past-30-day tobacco, e-cigarette, and areca nut use
时间窗: Outcomes will be assessed at baseline (pre-test), 5 weeks after baseline, immediately following curriculum/standard of care delivery (i.e., post-test), and 6 months after baseline (follow-up)
Tobacco, e-cigarette, and areca nut use behavior will be assessed using a standardized self-report measure of recent use that is use in the national YRBS survey. The questionnaire item will ask: "In the past 30 days, on how many days did you smoke a cigarette?" This question will be adapted for e-cigarette and areca nut. Response options include: "0 days," "1-2 days," "3-5 days," "6-9 days," "10-19 days," "20-29 days," "all 30 days."
Changes in Pierce's Smoking Susceptibility Scale (also adapted for e-cigarette and areca nut use)
时间窗: Outcomes will be assessed at baseline (pre-test), 5 weeks after baseline, immediately following curriculum/standard of care delivery (i.e., post-test), and 6 months after baseline (follow-up)
This is a standardized self-report measure containing 4 items originally designed to assess smoking susceptibility among adolescents. In addition to the original measure, the current study will also adapt the measure to assess e-cigarette and areca nut use susceptibility. The 4 items are: "Do you think you will smoke a cigarette soon?", "Do you think you will smoke a cigarette in the next year?", "Do you think in the future you might experiment with cigarettes?", "If one of you friends were to offer you a cigarette, would you smoke it?"
次要结局
- Jackson et al.'s Social Competence Scale(Outcomes will be assessed at baseline (pre-test), 5 weeks after baseline, immediately following curriculum/standard of care delivery (i.e., post-test), and 6 months after baseline (follow-up))
- Sherer et al.'s General Self-Efficacy Scale(Outcomes will be assessed at baseline (pre-test), 5 weeks after baseline, immediately following curriculum/standard of care delivery (i.e., post-test), and 6 months after baseline (follow-up))
- Kendall Wilcox Self-control Scale(Outcomes will be assessed at baseline (pre-test), 5 weeks after baseline, immediately following curriculum/standard of care delivery (i.e., post-test), and 6 months after baseline (follow-up))
- Flay et al.'s Refusal Self-Efficacy(Outcomes will be assessed at baseline (pre-test), 5 weeks after baseline, immediately following curriculum/standard of care delivery (i.e., post-test), and 6 months after baseline (follow-up))