Promoting Tobacco Control Among Teachers in India

国家癌症研究所将发展中国家的烟草控制研究列为其最重要的烟草研究项目之一。 2006年旁路预算报告中的研究优先事项，反映了对日益增长的全球疾病的担忧 烟草造成的负担。印度提供了一个重要的案例，说明在一个国家内开展的烟草控制工作。 发展中国家作为世界上第二大国家，拥有十多亿人口， 估计有2.5亿10岁及以上的烟草使用者。这项研究旨在测试一个 印度比哈尔邦的教师进行全面的烟草控制干预， 印度烟草消费最高的地区。教师是控烟的重要先锋人群 在社区规范和学生榜样方面，他们努力发挥关键意见领袖的作用。 根据全球学校人员调查，比哈尔邦78%的教师使用某种形式的烟草， 2000年。本研究的具体目的是：（1）评估在何种程度上，一个全面的 烟草控制干预导致比哈尔邦学校教师戒烟人数增加; (2)评估全面的烟草控制干预措施在多大程度上导致学校的变化 烟草控制政策;（3）评估综合烟草控制干预措施的效果 在教师之间定义的调解机制的变化;（4）评估干预的关键指标 分配到干预条件下的学校的执行情况，包括 干预的实施、干预的范围以及对干预协议的保真度。 这项随机对照试验以学校为单位进行干预和随机化。政府 学校（N=100），包括8-10年级（即，年龄在13-15岁之间），将在印度比哈尔邦随机 选择，招募参与研究，并在分层（农村，城市）内随机分配到两个之一 条件（干预与延迟干预控制）。数据将通过教师调查收集， 三个时间点;一项政策评估;一项进程评价。我们在比哈尔邦的初步工作提供了一个 这项工作的关键起点，并证明了拟议研究的可行性。干预 旨在平衡对教师烟草使用模式的潜在干预影响与可行性 在当地资源的限制范围内，从而最大限度地发挥传播的潜力。

The National Cancer Institute places tobacco control research in developing countries among its top tobacco research priorities in its 2006 Bypass Budget Report, reflecting concerns about the growing global disease burden attributable to tobacco. India provides an important case example of tobacco control efforts within a developing country, as the second largest country in the world with a population of over one billion people, and with an estimated 250 million tobacco users age 10 and above. This study proposes to test a comprehensive tobacco control intervention for teachers in the Indian state of Bihar, representing one of the highest tobacco-using regions in India. Teachers are an important vanguard population for tobacco control efforts in their roles as key opinion leaders in relation to community norms and role models for students. According to the Global School Personnel Survey, 78% of teachers in Bihar used some form of tobacco in the year 2000. The specific aims of this study are to: (1) assess the extent to which a comprehensive tobacco control intervention results in increased cessation of tobacco use among teachers in Bihar schools; (2) assess the extent to which a comprehensive tobacco control intervention results in changes in school tobacco control policies; (3) assess the extent to which a comprehensive tobacco control intervention results in changes in defined mediating mechanisms among teachers; and (4) assess key indicators of intervention implementation among schools assigned to the intervention condition, including the extent of the implementation of the intervention, the reach of the intervention, and the fidelity to the intervention protocol. This randomized controlled trial uses the school as the unit of intervention and randomization. Government schools (N=100) including grades 8-10 (i.e., ages 13-15) in the state of Bihar, India, will be randomly selected, recruited to participate in the study, and randomly assigned within strata (rural, urban) to one of two conditions (intervention versus delayed intervention control). Data will be collected by a teacher survey at three time points; a policy assessment; and a process evaluation. Our preliminary work in Bihar provides a critical starting point for this work, and demonstrates the feasibility of the proposed study. The intervention has been designed to balance potential intervention impact on teachers' tobacco use patterns with feasibility within the constraints of local resources, thereby maximizing the potential for dissemination.