Randomized Trial of a State Tobacco Prevention Program

描述（申请人提供）：拟开展一项俄勒冈州综合预防干预的随机对照试验。该项目将扩展州政府机构和俄勒冈州研究所之间的成功合作，该研究所在俄勒冈州三分之一的初中和高中的集群样本中测量了烟草控制实践、个人风险/保护因素、烟草使用的流行率以及青少年的其他健康/有害行为。俄勒冈州的烟草预防和教育计划（TPEP）是一项由烟草税资助的干预措施，支持学区及其社区实施预防计划。该方案的组成部分包括反对烟草使用的政策、学校课程、青少年反烟草活动、关于烟草的家庭沟通以及减少获得烟草的努力。采用分组随机设计，具有等待列表/多重设计功能，36个以前未接受烟草计划资助的学区将被随机分配到项目实施1年、3年或4年后的干预组或无干预对照组。在过去的3年里，所有8年级和11年级学生的年度评估都已经获得，并将在本项目的5年里继续进行。关于方案实施和调解人的数据将从学生、教师、校长、预防协调员、访问购买调查以及学校、警察和市议会的档案记录中获得。这项研究的主要目的是对一个州的项目进行真正的实地试验。在这样做的过程中，它将提供有关由国家管理并由非研究人员提供的全面烟草预防计划的实施和有效性的证据。因此，这既是一项有效性试验，也是一项传播试验。鉴于我们调查工具的全面性，我们还将能够测试针对烟草使用的预防计划是否对年轻人参与其他问题行为产生影响。最后，拟议的研究将允许我们继续分析青少年吸烟与其他健康和有害行为的关系，以及社会背景因素在影响这些行为发展中所起的作用。

DESCRIPTION (provided by applicant): A randomized controlled trial of Oregon's comprehensive preventive intervention is proposed. The project will extend a successful collaboration between state agencies and Oregon Research Institute that for 3 years has measured tobacco control practices, individual risk/protective factors, the prevalence of tobacco use, and other healthy/harmful behaviors of adolescents in a cluster sample of 1/3 of Oregon middle and high schools. Oregon's Tobacco Prevention and Education Program (TPEP) is a tobacco tax-funded intervention that supports school districts and their communities in implementing a prevention program. The components of the program include policies against tobacco use, school-based curricula, youth anti-tobacco activities, family communications about tobacco, and access reduction efforts. Using a group-randomized design, with a waitlist/ multiple design feature, 36 school districts, not previously receiving tobacco program funding, will be randomly assigned either to intervention 1, 3, or 4 years into the project or to a no-intervention control condition. Annual assessments of all 8th and 11th graders have been obtained for the past 3 years and will continue for the 5 years of this project. Data on implementation and mediators of program effects will be obtained from students, teachers, principals, prevention coordinators, access purchase surveys, and archival records from schools, police, and city councils. The primary aim of the study is to conduct a true experimental field trial of a state program. In doing so, it will provide evidence about the implementation and effectiveness of comprehensive tobacco prevention programs when administered by the state and delivered by non-research personnel. It is thus both an effectiveness and a dissemination trial. Given the comprehensive nature of our survey instrument, we will also be able to test whether a prevention program targeting tobacco use has an impact on young people's engagement in other problem behaviors. Finally, the proposed research will permit continuing our analyses of the relationship of adolescent smoking to other healthy and harmful behaviors and of the role played by social context factors in influencing the development of these behaviors.