Hutchinson smoking prevention project: Long-term randomized trial in school-based tobacco use prevention - Results on smoking
Hutchinson smoking prevention project: Long-term randomized trial in school-based tobacco use prevention - Results on smoking
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DOI：
10.1093/jnci/92.24.1979
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发表时间：
2000-12-20
影响因子：
10.3
通讯作者：
Sarason, IG
中科院分区：
文献类型：
--
作者：
Peterson, AV;Kealey, KA;Sarason, IG
背景：尚未观察到使用社会影响方法对青少年以学校为基础的吸烟预防的长期影响。然而，这种影响的缺乏是由于研究的方法问题还是干预措施的失败尚不清楚。哈钦森吸烟预防项目(HSPP)于1984年9月至1999年8月期间进行，旨在获得尽可能严格的随机试验，以确定基于理论的、社会影响的、3-12级干预措施对青少年吸烟流行率的长期影响。方法：将40个华盛顿学区随机分为干预组和对照组。研究参与者是在40个区(n=8388)连续两个3年级注册的儿童；他们在高中后被跟踪到2年。试验取得了较高的实施保真度和94%的随访率。数据采用分组排序法进行分析，所有统计检验均为双侧。结果：控制区和实验区学生的日常吸烟率在12年级(差值[Delta]=0.2%，95%可信区间[CI]=-4.6%~4.4%，P=0.91；Delta=0.3%，95%CI=-5.0%~5.5%，P=0.89)或高中毕业后2年(差值=-1.4%，95%CI=-5.0%~1.6%，P=0.38)；Delta=2.6%，95%CI=-2.5%~7.7%，男孩P=0.30)。此外，没有观察到对其他吸烟结果的干预影响，如当前吸烟程度或累计吸烟量，或在n先验特定变量不同的亚组中，如家庭吸烟风险。结论：HSPP试验的严谨性表明干预影响结果具有很高的可信度。与之前的试验一致，这次试验没有证据表明以学校为基础的社会影响方法在长期阻止青少年吸烟方面是有效的。
Background: No long-term impact has yet been observed with the use of the social-influences approach to school-based smoking prevention for youth. However, whether this lack of impact is due to methodologic problems with the studies or to the failure of the interventions is unclear. The Hutchinson Smoking Prevention Project (HSPP), conducted from September 1984 through August 1999, aimed to attain the most rigorous randomized trial possible to determine the long-term impact of a theory-based, social-influences, grade 3-12 intervention on smoking prevalence among youth. Methods: Forty Washington school districts were randomly assigned to the intervention or to the control condition. Study participants were children enrolled in two consecutive 3(rd) grades in the 40 districts (n = 8388); they were followed to 2 years after high school. The trial achieved high implementation fidelity and 94% follow-up. Data were analyzed with the use of group-permutation methods, and all statistical tests were two-sided. Results: No significant difference in prevalence of daily smoking was found between students in the control and experimental districts, either at grade 12 (difference [Delta] = 0.2%, 95% confidence interval [CI] = -4.6% to 4.4%, and P = .91 for girls; Delta = 0.3%, 95% CI = -5.0% to 5.5%, and P = .89 for boys) or at 2 years after high school (Delta = -1.4%, 95% CI = -5.0% to 1.6%, and P = .38 for girls; Delta = 2.6%, 95% CI = -2.5% to 7.7%, and P = .30 for boys). Moreover, no intervention impact was observed for other smoking outcomes, such as extent of current smoking or cumulative amount smoked, or in subgroups that differ in n priori specified variables, such as family risk for smoking. Conclusion: The rigor of the HSPP trial suggests high credence for the intervention impact results. Consistent with previous trials, there is no evidence from this trial that a school-based social-influences approach is effective in the long-term deterrence of smoking among youth.