Hutchinson Smoking Prevention Project: a new gold standard in prevention science requires new transdisciplinary thinking.
Hutchinson Smoking Prevention Project: a new gold standard in prevention science requires new transdisciplinary thinking.
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哈钦森预防吸烟项目：预防科学的新黄金标准需要新的跨学科思维。
DOI：
10.1093/jnci/92.24.1964
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
Wyatt,SW
中科院分区：
文献类型：
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作者：
Clayton,RR;Scutchfield,FD;Wyatt,SW
本期杂志刊登了健康行为改变干预的经典研究。哈钦森吸烟预防项目 (HSPP)(1) 注定会成为预防科学的黄金标准，这是对社会影响预防方法的权威研究。每当如此令人印象深刻的干预研究发现对结果没有影响时，就会寻找可能出现问题的地方 (2, 3)。在对研究结果发表更合理的解释之前，我们将回顾一下通常的嫌疑人名单。首先，研究设计很优雅。四十个学区被匹配、随机排序并随机分配到实验（即干预）或控制条件。研究设计的完整性持续了 15 年。在最终结果公布之前，没有公布任何调查结果。此外，随机分配的区域对的初始等效性令人印象深刻。因此，就随机试验而言，本研究的设计非常出色。干预措施是强化社会影响（即基于理论）的课程，其中包含美国国家癌症研究所 (4) 制定的基于学校和课程驱动的吸烟预防计划的所有 15 个“基本要素”，并得到美国疾病控制和预防中心 (5) 认可为最佳实践指南。这些元素被融入到针对从三年级到十年级每一年的发展的课程中，旨在解决吸烟习得的多个假定阶段。因此，干预措施开始得足够早（三年级），可以被视为一级预防。学生接受的干预时间为 46.75 小时，远远超过生活技能培训 (6) 的 30 小时，该课程被誉为最有效的社会影响计划。此外，HSPP 开始得更早，涵盖 3-12 年级，而不是生活技能培训中的 6-8 年级。因此，该干预措施达到并超过了接触单元的数量，并包含了基于学校、课程驱动的计划的所有推荐组成部分。
In this issue of the Journal is a classic study of health behavioral change intervention. The Hutchinson Smoking Prevention Project (HSPP)(1) is destined to become the gold standard in prevention science, the definitive study on the social-influences approach to prevention. Whenever such an impressive intervention study finds no effect on the outcomes, there is a search for what could possibly have gone wrong (2, 3). Before commenting on more plausible explanations for the findings, we will review the usual list of suspects.First, the research design was elegant. Forty school districts were matched, randomly ordered, and randomly assigned to either the experimental (ie, intervention) or the control condition. The integrity of the research design was sustained for 15 years. No findings were released before the final results were compiled. Moreover, there was impressive initial equivalence in the pairs of randomly assigned districts. Thus, in terms of randomized trials, the design of this study is outstanding. The intervention was an enhanced social-influences (ie, theory-based) curriculum containing all 15 “essential elements” of school-based and curriculum-driven smoking prevention programs developed by the National Cancer Institute (4) and endorsed as best practices guidelines by the Centers for Disease Control and Prevention (5). These elements were infused into a curriculum that was developmentally specific for each year from grade 3 through grade 10 and that was intended to address multiple putative stages of smoking acquisition. Consequently, the intervention started early enough (3rd grade) to be considered primary prevention. The number of hours of intervention to which students were exposed was 46.75, much more than the 30 hours for Life Skills Training (6), the curriculum touted as the most effective social-influences program. Furthermore, HSPP started earlier and covered grades 3–12 instead of grades 6–8, as in Life Skills Training. Thus, this intervention met and exceeded the number of exposure units and contained all of the recommended components of a school-based, curriculum-driven program.