Intranet-Based Tobacco Prevention Program for Children

描述（由申请人提供）：本竞赛续篇提议开展一项研究项目的第二阶段，为五年级和六年级学生创建和评估一种新型的基于计算机的烟草预防计划，该计划有效、可传播且高度参与。这项预防计划的目的是减少儿童使用烟草的行为意图和意愿，并防止或推迟他们开始使用烟草。这个项目的创新之处在于，它是通过一个以学校为基础的内部网（连接到一个公共服务器的联网计算机）提供的，它允许体验式学习，并对同学的反应进行即时反馈，而且它本质上是翻译的。项目组件被迭代开发和评估，以确保它们有效地改变基于原型/意愿模型和基于影响的风险感知和决策理论的基于理论的中介机制。最后一个项目涉及全州范围内的烟草预防目标。该项目的第一阶段是一项为期三年的发展研究，目前已接近完成。我们创建了一个令人兴奋的3d环境作为项目的界面，为五年级的项目开发并演示了12个组件的有效性，并预计在未来几个月内成功完成最后的5个组件并进行现场测试。这里提出的第二阶段的目标是：(1)在学校进行随机疗效试验，以评估该计划的有效性；(2)迭代开发和测试7个组件的有效性，包括在六年级的加强环节；(3)为教师制定项目指南和家长通讯；(4)检查从5年级到7年级TFT计划所设计的目标机制的变化，并评估这些认知机制是否有助于调节该计划对吸烟结果的影响。功效试验将在俄勒冈州西部6个县的44所小学和22所中学的3225名儿童中进行，使用该项目提供的计算机和技术支持。项目工作人员将对五年级、六年级和七年级的学生进行基线和后续评估。公共卫生相关性。在4到5年级和6到7年级之间，开始吸烟的人数大幅增加，使这一发展时期成为实施烟草预防计划的理想时期。这项计划的目标是防止儿童在这一脆弱时期变得更容易吸烟。与NCI的使命一致，预防或延迟早期开始吸烟可减少成人吸烟和尼古丁依赖，并相应地带来实质性的健康益处。翻译关于为什么儿童愿意尝试吸烟以及为什么对吸烟有积极的感觉会降低其感知风险的当代理论，导致了新颖有效的项目组成部分的发展，分别证明了改变这些趋势。第二阶段将利用第一阶段的成功，通过评估已完成的项目的有效性，该项目具有未来在全国推广的巨大潜力。

DESCRIPTION (provided by applicant): This competing continuation proposes to conduct the second phase of a research project to create and evaluate a novel computer-based tobacco prevention program for 5th and 6th grade students that is effective, disseminable and highly engaging. The purpose of this prevention program is to decrease children's behavioral intentions and willingness to use tobacco, and to prevent or delay their initiation of tobacco use. The program is innovative in that it is delivered over a school-based intranet (networked computers linked to a common server), which allows experiential learning and immediate feedback on classmates' responses, and it is translational in nature. Program components are iteratively developed and evaluated to assure that they are effective at changing theoretically-based mediating mechanisms derived from the Prototype/Willingness model and affect-based risk perception and decision theory. The final program addresses statewide tobacco prevention objectives. Phase 1 of this project, a 3-year developmental study, is nearing completion. We have created an exciting 3-D environment as the interface of the program, developed and demonstrated the effectiveness of 12 components for the 5th grade program, and anticipate successfully completing the final 5 components and conducting a field test within the next few months. The aims of Phase 2, proposed here, are to: (1) Conduct a randomized efficacy trial in schools to assess the effectiveness of the program; (2) Iteratively develop and test the effectiveness of 7 components to include in the 6th grade booster sessions; (3) Develop a program guide for teachers and parent newsletters; (4) Examine change from 5th to 7th grade in the mechanisms that the TFT program is designed to target, and assess if these cognitive mechanisms serve to mediate the effects of the program on smoking outcomes. The efficacy trial will be conducted with 3,225 children in 44 elementary and 22 middle schools in 6 counties in Western Oregon using computers and technical support supplied by the project. Baseline and follow-up student assessments will be conducted by project staff in 5th, 6th, and 7th grades. Public health relevance. There is a substantial increase in smoking initiation between grades 4 and 5 and grades 6 and 7, making this developmental period an ideal time to deliver a tobacco prevention program. The goal of this program is to prevent children from becoming more susceptible to smoking during this vulnerable period. Consistent with the mission of NCI, preventing or delaying early smoking initiation leads to less adult smoking and nicotine dependence and, correspondingly, to substantial health benefits. Translating contemporary theories about why children are willing to try smoking and why positive feelings about smoking reduce its perceived risk has resulted in the development of novel and effective program components demonstrated individually to change these tendencies. Phase 2 will capitalize on the success of Phase 1 by evaluating the efficacy of the completed program, which has enormous potential for future dissemination nationwide,