Smokeless tobacco cessation cluster randomized trial with rural high school males: intervention interaction with baseline smoking.
Smokeless tobacco cessation cluster randomized trial with rural high school males: intervention interaction with baseline smoking.
复制标题
对农村高中男性进行无烟戒烟集群随机试验：与基线吸烟的干预相互作用。
DOI：
10.1093/ntr/ntq022
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Gansky,StuartA
中科院分区：
文献类型：
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作者：
Walsh,MargaretM;Langer,TimothyJ;Kavanagh,Niall;Mansell,Chuck;MacDougal,William;Kavanagh,Catherine;Gansky,StuartA
农村地区青少年男性使用无烟烟草（ST）。我们评估了以学校为基础的护士指导的性行为干预在农村高中男生中的效果。方法从加州农村县的公立高中名单中随机选择研究高中。同意的高中按学校规模分层，并在分层中随机分配到干预组或不干预组。在征得家长同意后，男学生完成基线和1年随访问卷。干预包括同伴主导的教育会议和由学校护士进行的口头考试，护士还提供简短的戒烟咨询。我们使用二元广义估计方程（GEE）模型来解释学校内的聚类，在调整高中学年后，使用仅完成者和对那些失去随访的人进行多重代入，以检验各组之间没有差异。亚组分析评估了GEE模型中基线因子与组间的相互作用。结果21个农村县（72%）、41所随机抽取的高中（56%）、4731名男生（50%）参与调查，保留率为65%。干预组中不吸烟的ST使用者在随访时停止使用ST的可能性显著高于无干预组；同时吸烟的基线ST使用者没有干预效果。在随访中，基线不吸烟的ST使用者报告吸烟的百分比高于基线不使用ST的吸烟者报告使用ST的百分比。讨论一项以学校为基础的护士指导的ST戒烟计划在农村不吸烟使用ST的高中男性中有效。潜在的项目覆盖范围具有重要的公共卫生价值。基线ST使用促进了随访时的吸烟。
IntroductionAdolescent males in rural areas use smokeless tobacco (ST). We assessed the efficacy of a school-based nurse-directed ST intervention among rural high school males.MethodsStudy high schools were randomly selected from a public high school list of California rural counties. Consenting high schools were stratified by school size and randomly assigned within strata to intervention or no-intervention groups. After gaining parental consent, male students completed baseline and 1-year follow-up questionnaires. The intervention included peer-led educational sessions and an oral exam by the school nurse who also provided brief tobacco cessation counseling. We used binary generalized estimating equation (GEE) models accounting for clustering within schools to test no difference between groups after adjusting for year in high school using both completers only and multiple imputation for those lost to follow-up. Subgroup analyses assessed Baseline Factor × Group interaction in GEE models.ResultsTwenty-one rural counties (72%), 41 randomly selected high schools (56%), and 4,731 male students (50%) participated with 65% retention. Nonsmoking ST users in the intervention group were significantly more likely to stop using ST at follow-up than those in the no-intervention group; there was no intervention effect among baseline ST users who also smoked. A higher percentage of baseline nonsmoking ST users reported smoking at follow-up than baseline non-ST-using smokers who reported using ST.DiscussionA school-based nurse-directed ST cessation program was efficacious among rural nonsmoking ST-using high school males. The potential program reach holds significant public health value. Baseline ST use facilitated smoking at follow-up.