The Effect of Peer Education and Traditional Education on University Students' Awareness Levels Regarding Exposure to Tobacco Smoke: A Randomized Controlled Tria
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 107
- 试验地点
- 1
- 主要终点
- Change in passive exposure knowledge level measured 21 days after the start
研究概览
简要总结
This is a randomized controlled trial comparing the effects of peer education and traditional education on increasing knowledge and awareness of secondhand and thirdhand tobacco smoke exposure among geriatric care program students. Tobacco use and passive smoking are serious public health problems that cause millions of deaths each year and are highly prevalent among university students. Not only smoke dispersed in the air (secondhand smoke), but also toxic residues that accumulate on surfaces and can be absorbed through the skin and ingestion (thirdhand smoke) carry carcinogenic risks. It is a professional obligation for these students, who are the health professionals of the future, to protect the vulnerable elderly population they will serve from this exposure (especially residues carried on clothing/hair). It is also aimed to protect their own health against the risk of smoking triggered by occupational stress. Traditional education that only imparts information may be insufficient in changing behavior. Peer education based on Social Learning Theory offers a sincere and effective alternative that encounters less resistance among young people. While existing experimental studies in the literature generally focus on "active smoking and motivation to quit," this study fills an important gap by focusing on passive and third-hand exposure. If successful, this peer education model could be implemented as a standardized educational module at the national level in university campuses.
Research hypotheses:
H1: Students who receive peer education have higher levels of knowledge about secondhand smoke than students who receive traditional education.
H2: Students who receive peer education have higher levels of awareness about thirdhand smoke than students who receive traditional education.
H3: There is a difference between the pre- and post-intervention and between the experimental and control groups in terms of students' average scores for their awareness level of secondhand smoke.
H4: There is a difference between the pre- and post-intervention and between the experimental and control groups in terms of students' average scores for their knowledge level of thirdhand smoke.
详细描述
The research will be conducted at the Karabük University Health Services Vocational School Elderly Care Program between March 1, 2026, and March 1, 2027.
The research population consists of first- and second-year students enrolled in the Karabük University Health Services Vocational School Elderly Care Program. Although there are a total of 144 students registered in the department records, the number of students actively attending classes has been determined to be 124. Of these students, 68 are first-year students and 56 are second-year students. No sample selection was made in the research; the aim was to reach the entire population actively receiving education.
Prior to the intervention, students who would serve as "Peer Educators" were selected based on volunteerism and academic achievement criteria. A total of 8 students, 4 from the 1st grade and 4 from the 2nd grade, were included in the "Educator" group and were not included in the sample group of the study.
After the peer educators were separated, the number of active students remaining in the universe where the study was conducted was 116.
The sample size for the study was calculated using the G*Power (v3.1.9.7) statistical software package. In the study, since the tobacco exposure awareness levels of the experimental and control groups were to be compared at three different time points (pre-test, post-test, and 21st day T3 follow-up measurement), the power analysis was performed based on the Repeated Measures ANOVA (Within-Between Interaction) design. The "medium effect size" (f = 0.25), which is the standard accepted in studies measuring the effect of educational interventions, was used as a reference. When the Type I error rate (α = 0.05), test power (1-β = 0.80), number of groups (2), and number of repeated measures (3) were included in the model, the minimum total sample size required to statistically detect an interaction between groups was calculated to be 28. Considering the 10% potential data loss (absenteeism, discontinuation of the test, etc.) that may occur due to the time-series structure of the study, the minimum safe sample size to be achieved was updated to 32. It was observed that the current active population size (N=116) more than meets this minimum value; therefore, it was decided not to proceed with sample selection and to include the entire active population in the study.
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
- Single (Participant)
盲法说明
To prevent "selection bias" in assigning participants to groups in the study, the "Sequential Numbering, Closed Envelope Method" will be used.
Random Assignment List: Participants will first be divided into two separate groups: "1st Grade" and "2nd Grade." Using a Computer-Assisted Simple Random Number Table, two different "Group Assignment Lists" (Experimental and Control) will be created separately for each group.
Preparation of Envelopes: Opaque envelopes of different colors will be prepared for each class level. Group assignment cards will be placed inside the envelopes according to the randomly generated lists.
Implementation: Participants will be invited to an informational meeting before the training begins. At the briefing meeting, participants will be asked about their grade levels in order of arrival. Then, they will be asked to draw the next numbered sealed envelope from the box corresponding to their grade level, completing the group assignment process.
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Be enrolled in the first or second year of the Elderly Care Program at Karabük University School of Health Services,
- •Agree to participate in the study voluntarily,
- •Be able to participate in the training process and follow-up measurements (T0, T1, and T2),
- •Be able to respond to Google Forms applications via a device with internet access (phone, tablet, computer)
排除标准
- •Receiving any training on tobacco use, secondhand and thirdhand smoke exposure within 6 months,
- •Participants who incomplete survey forms or leave at least one scale blank,
- •Students who do not participate in training programs and for whom follow-up measurements cannot be taken,
- •Those who cannot complete all stages of the study due to health reasons or absenteeism.
研究组 & 干预措施
Experimental Group
The intervention group will undergo peer education training
- Selection: Based on academic achievement (≥2.50), leadership qualities, and volunteer experience, a total of 8 peer educators will be selected, 4 from each of the 1st and 2nd grades.
- Training: Candidates will receive a 2-week (4 sessions) training on tobacco awareness and group dynamics, guided by the expert-approved "Peer Educator Guide"; those scoring ≥80 on the final exam will be assigned to the field.
- Implementation: Seven to eight students will be assigned to eight different groups led by peer educators through simple random sampling. Face-to-face theoretical sessions will be held during the first seven days of the 15-day program; environmental risk mapping on campus and clinical field observation at hospitals where internships are conducted will take place between the 8th and 15th days.
- Monitoring: Weekly follow-up meetings will be held under the researcher's leadership to maintain the training standard.
干预措施: Peer Education (Behavioral)
Control Group
The basic structure of the traditional training program to be applied to the intervention group is summarized as follows:
Implementer and Method: The training will be conducted by the researcher himself. In a classic classroom environment; PowerPoint presentations, straightforward narration, and question-and-answer techniques will be used.
Content and Duration: The training, whose content validity is ensured by the Davis Technique, is planned to take place face-to-face outside of class hours so as not to interfere with students' classes. It will be conducted in two separate 40-minute sessions once a week over a total period of 15 days.
Timing and Monitoring: To prevent time-related deviations, peer education will be conducted simultaneously with one-on-one sessions. In both groups, the process will begin immediately after the briefing and pre-test (T0) data collection and will end simultaneously on the day the training ends.
干预措施: traditional education (Behavioral)
结局指标
主要结局
Change in passive exposure knowledge level measured 21 days after the start
时间窗: start time (T0), immediately after the intervention (T1), and 21 days after the intervention (T2).
Passive Exposure Information Test Developed by Hançer Tok and colleagues (2023) to determine individuals' knowledge levels regarding secondhand tobacco smoke. The scale consists of 13 items and has four subscales: Awareness (1-5), Cancer (6-7), Passive Effects (8-11), and Drinkable-Undrinkable Areas (12-13). Items are answered as "True / False / Don't know"; correct answers are scored as 1 point, while incorrect and "don't know" answers are scored as 0 points. The total score obtainable from the scale ranges from 0 to 13, with higher scores indicating a higher level of knowledge. The Cronbach's alpha value of the scale is reported as 0.749.
Change in Third-Hand Smoke Awareness Measured 21 Days After Baseline
时间窗: start time (T0), immediately after the intervention (T1), and 21 days after the intervention (T2).
Third-Hand Smoke Awareness Scale It was developed to measure individual beliefs and awareness regarding third-hand tobacco smoke. The original form of the scale was developed by Haardörfer and colleagues (2017), and the Turkish adaptation and validity-reliability study was conducted by Önal and colleagues (2021). The scale consists of 9 items and has two subscales: Health Effects (5 items) and Environmental Persistence (4 items). Items are scored on a 5-point Likert scale (1=Strongly disagree, 5=Strongly agree) and there are no reverse items. The total score that can be obtained from the scale ranges from 9 to 45, with high scores indicating a high level of awareness regarding thirdhand tobacco smoke. The Cronbach's alpha coefficient of the scale was reported as 0.712.
次要结局
未报告次要终点
研究者
Simge Erdal
Lecturer
Karabuk University