An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST): a cluster randomised trial
An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST): a cluster randomised trial
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DOI：
10.1016/s0140-6736(08)60692-3
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发表时间：
2008-05-10
期刊：
影响因子：
168.9
通讯作者：
Moore, L.
中科院分区：
文献类型：
--
作者：
Campbell, R.;Starkey, F.;Moore, L.
背景：许多国家的学校都开展了预防吸烟的规划，但系统审查显示其有效性的证据好坏参半。大多数同伴主导的方法都是以课堂为基础的，严格的评估很少。我们评估了旨在防止中学吸烟的同伴主导干预的有效性。方法对英格兰和威尔士59所学校的10730名12-13岁学生进行整群随机对照试验，采用分层块随机法将29所学校（5372名学生）随机分配到对照组继续常规吸烟教育，30所学校（5358名学生）随机分配到干预组。干预（ASSIST[学校戒烟试验]项目）包括训练有影响力的学生在课堂外的非正式互动中充当同伴的支持者，鼓励他们的同伴不要吸烟。干预后立即随访，1年和2年随访。主要结果是在过去一周内，在学年组和经常吸烟的高风险组中吸烟，这些高风险组在基线时被确定为偶尔吸烟者，实验性吸烟者或戒烟者。分析的目的是治疗。本次研究已注册，注册号为ISRCTN55572965。结果干预学校吸烟者与对照学校吸烟者的比值比为0。75 (95% Cl 0。在干预后立即（n=9349名学生），0.77（0.59-0.99）在1年随访（n=9147），和0。85(0.72 - 1。01)，随访2年（n=8756）。高危组相应的比值比为0。[译文]55-1。13 [n=3561])、0.75 （0.56-0.99 [n=3483]）和0。85 （0.70-1.02 [n=3294]）。在一个包含所有三个随访数据的三层多层模型中，与对照学校相比，在干预学校吸烟的几率为0。78(0.64 - -0.96)。结果表明，如果在人群基础上实施，ASSIST干预可能导致青少年吸烟率降低，这对公共卫生具有重要意义。
Background Schools in many countries undertake programmes for smoking prevention, but systematic reviews have shown mixed evidence of their effectiveness. Most peer-led approaches have been classroom-based, and rigorous assessments are scarce. We assessed the effectiveness of a peer-led intervention that aimed to prevent smoking uptake in secondary schools.Methods We undertook a cluster randomised controlled trial of 10730 students aged 12-13 years in 59 schools in England and Wales. 29 schools (5372 students) were randomly assigned by stratified block randomisation to the control group to continue their usual smoking education and 30 (5358 students) to the intervention group. The intervention (ASSIST [A Stop Smoking In Schools Trial] programme) consisted of training influential students to act as peer supporters during informal interactions outside the classroom to encourage their peers not to smoke. Follow-up was immediately after the intervention and at 1 and 2 years. Primary outcomes were smoking in the past week in both the school year group and in a group at high risk of regular smoking uptake, which was identified at baseline as occasional, experimental, or ex-smokers. Analysis was by intention to treat. This study is registered, number ISRCTN55572965.Findings The odds ratio of being a smoker in intervention compared with control schools was 0 . 75 (95% Cl 0 . 55-1.01) immediately after the intervention (n=9349 students), 0.77 (0.59-0.99) at 1-year follow-up (n=9147), and 0 . 85 (0.72-1. 01) at 2-year follow-up (n=8756). The corresponding odds ratios for the high-risk group were 0 . 79 (0 . 55-1 . 13 [n=3561]), 0.75 (0.56-0.99 [n=3483]), and 0 . 85 (0.70-1.02 [n=3294]), respectively. In a three-tier multilevel model with data from all three follow-ups, the odds of being a smoker in intervention compared with control schools was 0 . 78 (0.64-0.96).Interpretation The results suggest that, if implemented on a population basis, the ASSIST intervention could lead to a reduction in adolescent smoking prevalence of public-health importance.