An Innovative and Interactive Supplemental Tobacco Curriculum for Native Youth

描述（由申请人提供）：烟草使用是美国过早发病和死亡的主要可预防原因，也是癌症风险的主要原因。预防和戒烟工作无疑是减少烟草使用在过早死亡、疾病以及卫生保健资源和资金方面造成的巨大损失的关键。在美国，绝大多数吸烟者是在青少年时期开始吸烟的，而最终成为常规吸烟者的大多数人在18岁之前就开始吸烟了。虽然在减少青少年吸烟率方面取得了相当大的进展，但吸烟率仍然高得令人无法接受。由于美国印第安人的土地不受禁止向未成年人销售和促销烟草产品的州法律的约束，美国印第安青年在很小的时候就可以接触到烟草产品，与其他种族/族裔群体的同龄人相比，他们的吸烟率特别高。此外，美国印第安人的吸烟率并没有像过去十年在美国总人口中那样呈下降趋势。华盛顿州公立学校的调查显示，2002年，-18%的8年级美国印第安青年、31%的10年级美国印第安青年和44%的12年级美国印第安青年报告在过去30天内至少抽过一支烟。尽管华盛顿州规定要求所有初中和高中向学生提供某种形式的烟草教育，但仍出现了如此高的吸烟率。社会发展模式和以技能为基础的方法特别有希望帮助美洲印第安青年认识和避免不健康的行为，并通过技能建设、解决问题、应对和沟通技能促进他们的健康。在这个项目中，我们将把这样一个理论驱动的战略纳入一个补充的、创新的、互动式的学校课程，以减少烟草使用。我们的具体目标是：1)开发和试点适合文化和年龄的八年级补充课程，重点关注美国印第安青年的烟草使用；2)估计烟草使用和开始吸烟的基线率；3)比较课程设计前后学生对烟草使用的知识和态度。该项目将提供以烟草信息为重点的视频、媒体技能培养和积极行动主义榜样的写照，并附有相应的课程计划。这个项目将在位于亚基马印第安人保留地的Toppenish学区的八年级班级进行。补充课程将整合到现有的科学、社会研究和其他强制性课程中。该项目符合2010年健康人口目标，即将青少年吸烟率降低到16%，并符合印第安人保健服务机构、部落政府、印第安人保健委员会、疾病预防控制中心、美国国立卫生研究院、美国心脏协会和美国糖尿病协会的任务，即为印第安青年制定一项以学校为基础的教育和提高认识倡议，重点是减少烟草使用等危险因素。

DESCRIPTION (provided by applicant): Tobacco use is the leading preventable cause of premature morbidity and mortality in the U.S. and is the leading cause of cancer risk. Prevention and cessation efforts are undoubtedly the key to reducing the enormous toll tobacco use takes in terms of premature death, disease, and health care resources and dollars. The vast majority of smokers in the U.S. begin their tobacco use during the adolescent years, and the majority of those who will eventually become regular smokers do so by age 18. Although considerable strides have been made in reducing the prevalence of smoking among adolescents, rates of cigarette smoking remain unacceptably high. Because American Indian lands are not subject to state laws prohibiting the sale and promotion of tobacco products to minors, American Indian youth have access to tobacco products at a very early age, and show particularly high smoking rates compared to their peers in other racial/ethnic groups. Further, smoking prevalence among American Indians has not followed the downward trend seen over the past decade in the general U.S. population. Public school-based surveys in Washington State showed that, in 2002, -18% of American Indian youth in 8th grade, 31% in 10th grade, and 44% in 12th grade reported smoking at least 1 cigarette during the past 30 days. These high rates are occurring in spite of regulations in Washington State requiring all middle and high schools to provide some form of tobacco education to students. Social development models and skill-based approaches hold special promise to help American Indian youth recognize and avoid unhealthy behaviors and promote their health through skill building, problem solving, coping, and communication skills. In this project, we will incorporate such a theory-driven strategy into a supplemental, innovative, interactive school-based curriculum to reduce tobacco use. Our specific aims are to 1) develop and pilot-test a cultural and age appropriate 8th grade supplemental curriculum using focusing on tobacco use for American Indian youth; 2) estimate baseline rates of tobacco use and initiation; and 3) compare knowledge and attitudes about tobacco use in a pre- and post curriculum design. The project will feature videos focusing on tobacco information, media skill building, and portrayal of positive role models engaged in activism, accompanied by corresponding lesson plans. This project will be conducted in the Toppenish School district on the Yakima Indian reservation in the 8th grade classes. The supplemental curriculum will be integrated into existing science, social studies, and other mandated classes. This project is consistent with the Healthy People 2010 objective of reducing smoking among adolescents to 16% and with the mandate of the Indian Health Service, Tribal governments, Indian health boards, CDC, NIH, American Heart Association, and the American Diabetes Association to develop a school-based education and awareness initiative for Indian youth that focuses on reducing risk factors such as tobacco use.