Testing a model of avoiding environmental tobacco smoke in young adults

Prevalence and factors associated with second hand smoke exposure among a sample of pregnant women in Cairo, Egypt

PURPOSE

This study estimated the prevalence of and factors associated with secondhand smoke (SHS) exposure, and assessed attitudes and knowledge about SHS among pregnant women in Cairo, Egypt.

METHODS

Pregnant women in the third trimester were recruited to participate in a survey assessing tobacco smoking and SHS exposure during their current pregnancy. Participants were recruited from three antenatal clinics in Cairo, Egypt, from June 2015 to May 2016. We examined differences in sociodemographic characteristics and SHS exposure, attitudes, and knowledge by smoking/SHS status. We used multivariable ordinary least squares regression to examine the association between husbands' smoking and pregnant women's mean daily hours of SHS exposure, adjusting for women's smoking status, age group, education, and urban (vs. suburban/rural) residence.

RESULTS

Of two hundred pregnant women aged 16-37 years, about two-thirds (69%) had a husband who smoked tobacco. During their current pregnancy, most women reported being non-smokers (71%), and 38% of non-smokers reported being SHS-exposed. Non-smokers exposed to SHS tended to live in more rural areas and have husbands who smoked in the home. In adjusted analyses, having a husband who smoked was significantly associated with a greater mean number of hours of SHS exposure per day exposed, and this difference was driven by husbands who smoked in the home (p < 0.001). Women in the SHS-exposed group were less likely than other groups to agree that SHS exposure was harmful to their own or their future child's health; however, all groups agreed that SHS was harmful to newborn health.

CONCLUSION

Among our sample of pregnant women in Cairo, Egypt, there was a high rate of SHS exposure as well as misconceptions about the safety of SHS exposure to a developing fetus. Our findings suggest a need for targeted education and gender-sensitive messaging about SHS exposure, along with improved enforcement of existing tobacco control policies.

Effectiveness of Smoking Prevention Programs on the Knowledge, Attitudes, and Anti-Smoking Exposure Self-Efficacy among Non-Smoking Rural Seventh-Grade Students in Taiwan

The disproportionate smoking prevalence among adolescents in rural Taiwan may be attributed to insufficient anti-smoking education. Increasing access to such education may help reduce initiation and promote smoking cessation in adolescents, particularly in rural areas. However, effects of these programs require verification. This study determined the effectiveness of a school-based prevention program in enhancing knowledge, attitudes, and anti-smoking exposure self-efficacy among seventh-grade non-smoking students. A quasi-experimental design with convenience sampling was employed, where participants included seventh graders from two junior high schools who completed a questionnaire 1−2 weeks before and after the intervention. Furthermore, the intervention group received four smoking and secondhand smoke (SHS) prevention classes, whereas the control group engaged in scheduled school activities. Knowledge on smoking (B = 4.38, p < 0.001) and SHS (B = 2.35, p < 0.001) were significantly greater in the intervention group. Moreover, the groups differed significantly in avoiding SHS exposure (B = 3.03, p = 0.031). Intervention modifications may be necessary to enhance the program’s effect on smoking exposure-related attitudes and self-efficacy. Additionally, cultural and other aspects (or “urban-rural gap”) might influence these results. Future randomized controlled trials should compare urban to rural adolescents, use longitudinal designs, and assess smoking initiation or cessation.

Examining the Effectiveness of 3D Virtual Reality Training on Problem-solving, Self-efficacy, and Teamwork Among Inexperienced Volunteers Helping With Drug Use Prevention: Randomized Controlled Trial

BACKGROUND

Illegal drug usage among adolescents is a critical health problem. The Taiwanese government provides an accompanying volunteer program to prevent students who experiment with drugs from reusing them. An appropriate training program can improve volunteers' abilities to assist students using drugs. Problem-solving, self-efficacy, and teamwork are critical abilities for inexperienced volunteers who help with drug use prevention. By interacting with the animation or 3D virtual reality (VR) in the virtual scene, learners can immerse themselves in the virtual environment to learn, and 3D VR can increase learning opportunities and reduce the cost of human and material resources.

OBJECTIVE

The aim of this study was to examine the effectiveness of spherical video-based virtual reality (SVVR) training in improving problem-solving, self-efficacy, and teamwork among volunteers who helped prevent adolescents from using illegal drugs.

METHODS

This study used a randomized controlled design with a total of 68 participants in the experimental (n=35) and control (n=33) groups. The participants in the experimental group received the SVVR training program and their counterparts in the control group did not receive any training.

RESULTS

Generalized estimating equation analyses indicated that the experimental group showed significant posttraining improvements in problem-solving and self-efficacy but not teamwork when compared with the control group.

CONCLUSIONS

The results of this study revealed that SVVR could improve participants' problem-solving skills and self-efficacy for assisting students in not using illegal drugs. However, future studies are suggested to develop effective SVVR to assist inexperienced volunteers in enhancing their teamwork abilities. We believed that introducing the training program to more sites can enhance volunteer training so that volunteers can have a better companionship effect when helping students quit drugs.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05072431; https://clinicaltrials.gov/ct2/show/NCT05072431.

Exposure to secondhand smoke from neighbours and respiratory symptoms in never-smoking adolescents in Hong Kong: a cross-sectional study

OBJECTIVES

To investigate secondhand smoke (SHS) exposure at home from neighbours in Hong Kong adolescents and its association with respiratory symptoms in never-smokers.

DESIGN

A cross-sectional study.

SETTING

79 randomly selected secondary schools in Hong Kong.

PARTICIPANTS

61,810 secondary 1 (USA grade 7) to 7 students, in which 50,762 never-smokers were identified and included in the analysis of the association between SHS exposure at home from neighbours and respiratory symptoms.

MAIN OUTCOME MEASURES

Smoking status, family smoking status, SHS exposure at home from inside the home and from neighbours in the past 7 days, respiratory symptoms and sociodemographic characteristics were reported. Adjusted ORs (AORs) of respiratory symptoms for SHS exposure from the 2 sources in never-smokers were calculated using logistic regression.

RESULTS

In all students, 33.2% were exposed to SHS at home, including 16.2% from inside the home only, 10.0% from neighbours only and 7.0% from both. The prevalence of SHS exposure from neighbours was 17.1%, including 13.5% for 1-4 days/week and 3.6% for 5-7 days/week. In never-smokers (n=50,762), respiratory symptoms were significantly associated with SHS exposure from neighbours with AORs (95% CI) of 1.29 (1.20 to 1.39) for any exposure (p<0.001), 1.21 (1.12 to 1.31) for 1-4 days/week (p<0.001) and 1.63 (1.44 to 1.86) for 5-7 days/week (p<0.001) (P for trend <0.001). Compared with no SHS exposure at home from any source, the AORs were 1.16 (1.07 to 1.25) for SHS from inside the home only (p<0.001), 1.20 (1.11 to 1.31) from neighbours only (p<0.001), and 1.74 (1.56 to 1.94) from both (p<0.001).

CONCLUSIONS

SHS exposure at home from neighbours was prevalent in Hong Kong adolescents, and was associated with respiratory symptoms in never-smokers. SHS exposure at home may be underestimated by ignoring the neighbouring source. Smoke-free housing policy is needed to protect children and adolescents from harms of SHS.

Developing and testing a measurement tool for assessing predictors of breakfast consumption based on a health promotion model

OBJECTIVE

To develop an instrument for measuring Health Promotion Model constructs in terms of breakfast consumption, and to identify the constructs that were predictors of breakfast consumption among Iranian female students.

DESIGN

A questionnaire on Health Promotion Model variables was developed and potential predictors of breakfast consumption were assessed using this tool.

PARTICIPANTS

One hundred female students, mean age 13 years (SD ± 1.2 years).

SETTINGS

Two middle schools from moderate-income areas in Qom, Iran.

VARIABLES MEASURED

Health Promotion Model variables were assessed using a 58-item questionnaire. Breakfast consumption was also measured.

ANALYSIS

Internal consistency (Cronbach alpha), content validity index, content validity ratio, multiple linear regression using stepwise method, and Pearson correlation.

RESULTS

Content validity index and content validity ratio scores of the developed scale items were 0.89 and 0.93, respectively. Internal consistencies (range, .74-.91) of subscales were acceptable. Prior related behaviors, perceived barriers, self-efficacy, and competing demand and preferences were 4 constructs that could predict 63% variance of breakfast frequency per week among subjects.

CONCLUSIONS AND IMPLICATIONS

The instrument developed in this study may be a useful tool for researchers to explore factors affecting breakfast consumption among students. Students with a high level of self-efficacy, more prior related behavior, fewer perceived barriers, and fewer competing demands were most likely to regularly consume breakfast.

Health promotion and prevention strategies

Opiate dependency is a medical disorder that requires treatment intervention. Primary health care not only entails treatment of illness but also involves disease prevention and health promotion. Based on Pender's revised Health Promotion Model, a descriptive study comparing the health promoting behaviors/practices in abusing and recovering opiate-dependent drug users is analyzed. Using the Health Promoting Lifestyle Profile II, a comparative descriptive, exploratory, nonexperimental design study was conducted to identify key health-promoting behaviors in recovering opiate-dependent drug users. Prevention strategy recommendations are discussed, along with future research recommendations.

Secondhand smoke exposure among young adults in a developing country - a Jordanian case

Secondhand smoke (SHS) exposure is a potentially preventable environmental pollutant that remains a major global public health concern. A descriptive cross-sectional design was used to assess secondhand smoke exposure, knowledge, attitudes, and avoidance behaviors, as well as policy agreements related to SHS among young adult university students in the northern part of Jordan. A convenience sample of 800 university students from three public universities participated in the present study. They completed four questionnaires: the Sociodemographic Questionnaire, the Household SHS Exposure Questionnaire, the Knowledge and Attitudes Toward SHS Exposure Questionnaire, and the Avoidance of SHS Exposure Scale. Findings showed that SHS exposure among nonsmoking university students was 96%. In addition, the mean hours of exposure per day was 4.64 hours (standard deviation = 4.28), and the mean days of exposure per week was 5.14 days (standard deviation = 2.1). Based on the students reported high hours of exposure, our results suggest that even though a student has knowledge of the dangers of SHS and suitable avoidance behaviors, he or she is unable to avoid SHS. Advocacy for effective interventions to avoid exposure to SHS should be initiated for Jordanian society as a whole.

Article Commentary: Secondhand Smoking in Jordan: Clearing the Air for One of the Highest Tobacco Prevalence Countries in the Middle East

As the rate of tobacco consumption in Jordan increases, Jordanian policy makers are urged to develop guidelines on smoking exposures. This paper is concerned with the magnitude of exposure and harm caused by secondhand smoke (SHS) on childbearing women and young children. Despite a strict policy that limits tobacco advertising and efforts by the Ministry of Health, which include cessation programs and education on the adverse effect of smoking, the country sustains its high smoking rate, especially among men. According to the data gathered in this paper, special concern should be directed toward children's SHS exposure. Only four recent studies on SHS exposure among Jordanian women and children were encountered. Moreover, Jordan has legislation that bans smoking in public institutions; however, the enforcement of the law is extremely poor in most locations. Recommendations are presented to aid policy makers and law enforcement agencies in addressing this issue.

Adolescents' avoidance of secondhand smoke exposure: model testing

More than half of young adolescents, 13 to 15 years old, suffer exposure to secondhand smoke (SHS) at home and in public places. Despite threats to adolescent health and well-being, little research has been done to identify factors that enable adolescents to avoid SHS. The objective of this study was to develop a model to predict SHS avoidance behavior among young adolescents. The impact of gender differences on predictor variances was investigated. Model testing was conducted using structural equation modeling on data from 1,291 nonsmoking Taiwanese middle school students. Attitude toward SHS is an important factor influencing the avoidance behavior of adolescents. The explanatory model of SHS avoidance behaviors provides useful information for program development aimed at decreasing adolescent exposure to SHS. Interventions focused on influencing adolescent attitudes toward SHS and supporting avoidance self-efficacy are needed.

Health promotion with adolescents: examining theoretical perspectives to guide research

A guiding theoretical framework in research serves not only to guide a single research study, but also to link previous and future research that is guided by the same framework. Existing theoretical perspectives appropriate for use with adolescent health promotion research were reviewed. Instead of randomly selecting several theories for comparison, an intensive review of the literature was conducted to identify which theories were most commonly used with adolescent health promotion research. The results of this review revealed some interesting and noteworthy information regarding the state of theory use in adolescent health research for the last decade. Information is provided on theoretical perspectives by journal and year of publication. Trends are analyzed so that nurses can evaluate the current state of the science. Social cognitive theory (Bandura, 1986), the health belief model (Becker, 1978), and the health promotion model (Pender, 1996) emerged as the most significant theories for adolescent health promotion research and thus are discussed at the end of the article.

The concept of protection: a dimensional analysis and critique of a theory of protection

Dimensional analysis clarifies the concept of protection, which has a commonly understood definition but is used inconsistently in research literature. Concepts such as protective factors and protective behaviors are often used interchangeably without adequately representing the phenomenon of protection itself. This article critiques a situation-specific theory of protection and presents dimensions of a model with an ecological view of protection. It uses dimensional analysis methods to derive the social construction of protection from its use in a broad range of literature; vigilant management and vigilant communication are salient dimensions of protection. The article compares conceptual literature with research literature to identify inconsistencies in use.

An integrative model for environmental health research

Environmental health research must achieve an integration of understanding, reaching from physiological research on health effects of toxic agents to actions that people may take, individually and collaboratively, to reduce their risks. This article proposes an integrative model of environmental health, encompassing four broad domains and their interrelationships: physiological, vulnerability, epistemological, and health protection. If we wish to empower communities to make the tough decisions necessary to truly protect the well-being of their most vulnerable members, each domain must be attended to, and links between scientific knowledge and social processes must be understood.