Objectives: To develop and evaluate the effectiveness of a school-based intervention for preventing the uptake of smoking among adolescents in the State of Sabah, Malaysia Methods: The study design was a pilot randomised controlled trials with 7 months follow-up. A total of 1971 Form 1 students mostly aged 13 years old involved in the questionnaire. Eight secondary schools were randomly allocated equally to four intervention and control arms. The intervention schools received the health promotion activities as usual care and the peer educator intervention whereas the control schools received just the usual care of the health promotion activities. A total of 73 selected students were trained to be peer educators and given tasks to have an informal conversation and giving opinion about smoking issues and advocating not smoking norms. Individual-level analyses (relative risk and chi square analyses) and multilevel analyses which account for the clustering of students in schools were conducted. Three data sets were used from the complete data set, a data set that was comprised on students who could be matched at both baseline and follow-up and two data sets that were based on one of two assumptions. The first assumption was that baseline participants who could not be matched at follow-up retained their baseline smoking behaviour at follow-up. The second assumption was that baseline participants who could not be matched at follow-up were all regular smokers. Results: The main finding was that the intervention had a significant positive effect on the smoking behaviour of baseline current smokers. That is baseline current smokers were less likely to have continued to be current smokers if they attended an intervention school. Five out of the nine tests supported this proposal including the most rigorous analyses which were all based on multilevel models. The impact of the intervention on baseline never smokers was less obvious as only one of the nine tests of significance indicated that the intervention had a significant positive effect on follow-up smoking behaviour. In relation to baseline occasional smokers only two of the nine analyses indicated that the intervention had a significant positive effect on the smoking behaviour at follow-up. The analysis on interactions with friends in school showed that the intervention schools (43%) had a significantly higher proportion of students than in control schools (38%) who had a conversation about smoking issues. Conclusion: The peer educator intervention is a promising approach in the smoking prevention programmes for adolescents in Malaysia.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:635603 |
| Date | January 2014 |
| Creators | Melson, Elniee |
| Publisher | University of Warwick |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://wrap.warwick.ac.uk/66158/ |
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