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Wu YP, Brady HL, Wankier AP, Tanguy WJ, Smith HJ, Brunsgaard EK, Chipman J, DeSantis S, Abildso C, Haaland B, Schlechter CR, Wetter DW, Tercyak KP. Preliminary effects of a rural skin cancer prevention intervention for youths. Health Psychol 2024; 43:339-351. [PMID: 38206847 PMCID: PMC11031317 DOI: 10.1037/hea0001355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
OBJECTIVES To pilot and assess the feasibility, acceptability, and preliminary effects of the Rural Adult and Youth Sun (RAYS) protection program, a multilevel skin cancer preventive intervention for young children living in rural U.S. communities, delivered through community-organized team sports. METHOD Three rural counties in Utah participated with two receiving the intervention and the third serving as a control. Youth sports leagues were recruited through recreation departments and the study took place from May through October 2021. Intervention leagues received sun protection supplies for players and coaches, educational materials for parents, and coaches were offered training on skin cancer and sun protection behaviors. RESULTS The RAYS program is both feasible to deliver and acceptable to coaches, parents, and players. The intervention also demonstrates beneficial preliminary effects on components of observed child sun-protective behaviors, coach sun protection behaviors, knowledge of skin cancer prevention recommendations, and self-efficacy in skin cancer prevention. CONCLUSIONS Multilevel interventions for skin cancer prevention among young children can be successfully delivered through community organizations and their settings. A priority moving forward is the identification of ways to optimize delivery of such programs to positively influence skin cancer preventive behaviors among children living in diverse rural areas. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Yelena P. Wu
- Department of Dermatology, University of Utah, Salt Lake City, Utah
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Hannah L. Brady
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Ali P. Wankier
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | | | | | - Elise K. Brunsgaard
- Department of Dermatology, University of Utah, Salt Lake City, Utah
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Jonathan Chipman
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Sarah DeSantis
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Christiaan Abildso
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, West Virginia
| | - Benjamin Haaland
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Chelsey R. Schlechter
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - David W. Wetter
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Kenneth P. Tercyak
- Georgetown University Lombardi Comprehensive Cancer Center, Washington, D.C
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Chagué F, Reboursière E, Israël J, Hager JP, Ngassa P, Geneste M, Guinoiseau JP, Garet G, Girardin J, Sarda J, Cottin Y, Zeller M. Smoking and Vaping in Amateur Rugby Players, Coaches and Referees: Findings from a Regional Survey Might Help to Define Prevention Targets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115720. [PMID: 34073509 PMCID: PMC8198015 DOI: 10.3390/ijerph18115720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 01/02/2023]
Abstract
A high prevalence of cigarette smoking has been documented in France, and new patterns of tobacco and nicotine consumption are emerging, especially in some sports. In the amateur rugby population, data are scarce on harmful consumption and on the awareness of the risk of smoking. We analyzed the consumption of tobacco and other nicotine products in French amateur players, coaches and referees. Amateur players (>12 years old), coaches and referees participating in the Burgundy amateur championship were invited to answer an electronic, anonymous questionnaire during the 2017–2018 sport season. Among the 683 subjects (gender ratio M/F = 0.9), 176 (25.8%) were current smokers, including 32.4% of the referees and 28.2% of the coaches. The prevalence of smokers was higher in females (37.5%) than in males (24.6%). Most (86.4%) smoked within 2 h before/after a rugby session. Only 28 subjects (4.1%) usually vaped; 21 of them (75%) vaped within 2 h before/after a rugby session. Other tobacco or nicotine products were infrequent. The awareness about the risks of smoking before/after sport was incomplete, including in coaches and referees. The prevalence of cigarette smoking is alarming across the whole spectrum of rugby amateur actors. Education programs are urgently needed to reduce tobacco consumption in this at-risk population.
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Affiliation(s)
- Frédéric Chagué
- Cardiology Department, University Hospital Center Dijon Bourgogne, 21000 Dijon, France;
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
- Correspondence: ; Tel.: +33-619-748-171
| | - Emmanuel Reboursière
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
- Sport Medicine Department, University Hospital Center, 14000 Caen, France
| | - Jean Israël
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
- Cardiology Department, General Hospital, 91640 Bligny, France
| | - Jean-Philippe Hager
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
- Sport Medicine Department, Centre Orthopédique Santy, 69008 Lyon, France
| | - Patrice Ngassa
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
- Sport Medicine Department, Polyclinique Saint-Laurent, 35700 Rennes, France
| | - Marc Geneste
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
| | - Jean-Pierre Guinoiseau
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
| | - Gilles Garet
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
| | - Jacques Girardin
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
| | - Jacques Sarda
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
| | - Yves Cottin
- Cardiology Department, University Hospital Center Dijon Bourgogne, 21000 Dijon, France;
| | - Marianne Zeller
- Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2), EA 7460 UFR Sciences de Santé, University of Bourgogne Franche Comté, 21000 Dijon, France;
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Burton L, Curran K, Foweather L. Formative Evaluation of Open Goals: A UK Community-Based Multi-Sport Family Programme. CHILDREN-BASEL 2020; 7:children7090119. [PMID: 32882912 PMCID: PMC7552749 DOI: 10.3390/children7090119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 11/23/2022]
Abstract
Community parks provide opportunities for physical activity (PA) and facilitate social interactions. This formative evaluation assesses the implementation of ‘Open Goals’ (OG), a novel multi-sport programme aiming to increase family PA and community cohesion, delivered weekly by Liverpool Football Club’s charitable foundation to local parks in Liverpool, North West England. Three Open Goals parks were chosen for the evaluation settings. Formative evaluation measures included: System for Observing Play and Recreation in Communities (SOPARC) observations (n = 10), direct session observations (n = 8), semi-structured interviews with Open Goals coaching staff (n = 3), and informal feedback from families (n = 5) about their experiences of Open Goals. Descriptive statistics and thematic analysis were applied to quantitative and qualitative data, respectively. Within the three evaluation parks, Open Goals reached 107 participants from May–July 2019, through 423 session attendances. Fidelity of the programme was high (M = 69% of session content delivered as intended). Overall park use when OG was offered compared to when it was not offered was not statistically significant (p = 0.051), however, target area use was significantly increased (p = 0.001). Overall physical activity levels in parks were significantly (p = 0.002) higher when Open Goals was being offered, compared to when it was not. Coaches reported that engagement in OG positively affected family co-participation and children’s behavioural development. Contextual issues included environmental and social barriers to programme engagement, including the co-participation element of the programme and criticism of the marketing of OG. It is evident that community-based multi-sport PA programmes endorsed by professional football clubs are well positioned to connect with local communities in deprived areas and to encourage PA and community engagement. This study suggests that such programmes may have the ability to improve park usage in specific areas, along with improving physical activity levels among families, although further research is required. Effective marketing strategies are needed for promotional purposes. Upskilling of coaches in the encouragement of family co-participation may support regular family engagement in PA in local parks.
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Evaluating the Implementation Quality of a Social and Emotional Learning Program: A Mixed Methods Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093249. [PMID: 32392698 PMCID: PMC7246810 DOI: 10.3390/ijerph17093249] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/21/2020] [Accepted: 05/05/2020] [Indexed: 11/21/2022]
Abstract
School-based social and emotional learning (SEL) programs have been shown to be effective in producing positive outcomes for adolescents. However, variability in implementation quality can have a negative impact on these program effects. The aim of this current study is to examine the variability in implementation quality for schools implementing the MindOut program and to identify factors that were likely to contribute to this variability. Employing a mixed methods approach, quantitative and qualitative implementation data were collected from teachers (n = 16) and students (n = 280) who participated in the MindOut program. Quantitative indicators were used to score schools’ implementation quality across four dimensions (dosage, adherence/fidelity, quality of delivery and participant responsiveness), and these were averaged to determine overall level of implementation (high/low). Qualitative data identified factors that contributed to implementation quality, and factors were then analyzed in accordance with the schools’ implementation level grouping. Findings indicated that variability in implementation quality existed both between and within schools. A total of eight schools were assigned as high implementers and another eight as low implementers. Influencing factors were categorized into five themes: (i) program factors, (ii) participant factors, (iii) teacher factors, (iv) school contextual factors, and (v) organizational capacity factors. Several differences between high and low implementers were found in relation to these influencing factors. The findings contribute to the evidence on implementation quality in schools by advancing knowledge on measuring implementation quality across multiple dimensions and informants successfully. These findings can also inform practitioners of the main influencing factors in schools so that strategies can be developed to optimize implementation quality in the future.
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Ho LYW, Chin KCW, Fung CYY, Lai CKY. Validation of the Chinese Non-pharmacological Therapy Experience Scale in persons with intellectual disability. Nurs Open 2020; 7:390-397. [PMID: 31871724 PMCID: PMC6917964 DOI: 10.1002/nop2.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/25/2019] [Indexed: 11/08/2022] Open
Abstract
Aim To validate the 4- and 7-point Chinese Non-pharmacological Therapy Experience Scales and test the psychometric properties of the scales on persons with intellectual disability. Design A validation study. Methods Sixty-seven persons with intellectual disability were recruited from six hostels or centres for persons with intellectual disability in Hong Kong. A total of 1,163 and 1,161 observations were collected by the trained observers with the 4-point and 7-point scales, respectively. The floor and ceiling effects, inter-rater reliability, internal consistency, responsiveness of both scales and the scale equivalence were examined. Results The Cronbach's α of the 4- and 7-point scales was .762 and .797, respectively. The correlation between the two scales was 0.906. The inter-rater reliability of the 4- and 7-point scales was 0.774 and 0.835, respectively. Neither scale had the floor or ceiling effects. The effect size of the 7-point scale was consistently higher than that of the 4-point scale.
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Affiliation(s)
- Lily Yuen Wah Ho
- School of NursingThe Hong Kong Polytechnic UniversityKowloonHong Kong
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Bast LS, Andersen A, Ersbøll AK, Due P. Implementation fidelity and adolescent smoking: The X:IT study-A school randomized smoking prevention trial. EVALUATION AND PROGRAM PLANNING 2019; 72:24-32. [PMID: 30248621 DOI: 10.1016/j.evalprogplan.2018.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 09/05/2018] [Accepted: 09/12/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Assessing the actual implementation of multi-component interventions can provide important knowledge for future interventions. Intervention components may be implemented differently, knowledge about this can provide an understanding of which components are essential and therefore must be included. The aim of this study was to examine the implementation of one, two, or all three main intervention components at the individual level and to assess the association to current smoking among 13 year-olds in the X:IT study. METHODS Data stems from a cluster-randomized controlled trial in 94 Danish elementary schools (51 intervention; 43 control schools). Implementation was measured by aspects of adherence, dose, quality of delivery, and participant responsiveness based on questionnaire data from 4161 pupils at baseline (mean-age: 12.5 years) and 3764 pupils at first follow-up eight months later. Coordinator responses from 49 intervention schools were also included. Associations between individual level implementation of the three main components and pupil smoking were examined through a 3-level logistic regression model. RESULTS Although implementation fidelity for the three main intervention components was good, only one third (38.8%) of pupils in intervention schools were exposed to full implementation of the intervention. Among these pupils odds ratio for smoking was 0.25 (95% CI: 0.15 - 0.42). CONCLUSIONS School-based programs can be very effective if carefully implemented. Future school-based smoking preventive initiatives should include multiple components, and seek to enhance implementation quality of all components.
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Affiliation(s)
- Lotus Sofie Bast
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | - Anette Andersen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
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de Medeiros ER, Rebouças DGDC, Paiva ACDS, do Nascimento CPA, Silva SYBE, Pinto ESG. Studies evaluating of health interventions at schools: an integrative literature review. Rev Lat Am Enfermagem 2018; 26:e3008. [PMID: 30020339 PMCID: PMC6053286 DOI: 10.1590/1518-8345.2463.3008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 01/04/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to identify and analyze the available evidence on the strategies used in the studies evaluating health interventions at school. METHOD this is an integrative review searching in LILACS, CINAHL, CUIDEN, ScienceDirect, and PubMed. From the pre-defined inclusion and exclusion criteria, there were 121 articles chosen to compose the sample. RESULTS english studies (97.5%), with a quantitative approach (80.2%), related to the interventions carried out in the Region of the Americas (54.6%) and the European Region (23.1%) predominated. For the most part, they are interventions as programs (70.2%), interested in evaluating results (73.5%) from the value judgment (83.4%). Prevalence of interventions focused on efficacy, effects or impact, and activities carried out on interventions were focused on physical activity, healthy eating, sexual and reproductive health, mental health, and use of tobacco, alcohol, and other drugs. They are worked through activities of clinical monitoring, health promotion and disease prevention. CONCLUSION the evidence indicates that the evaluations of health interventions in the school focus the results produced in programs through the judgment of value. The topics most addressed were healthy eating, physical activity, prevention of alcohol and other drugs, among others.
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Affiliation(s)
- Eliabe Rodrigues de Medeiros
- Doctoral student, Departamento de Enfermagem, Universidade Federal
do Rio Grande do Norte, Natal, RN, Brazil. Bolsista do Conselho Nacional de
Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Danielle Gonçalves da Cruz Rebouças
- Cardiology and Hemodynamics Specialist, Specialization student in
Public Health: Oncology Nursing, Escola da Assembleia Legislativa do Rio Grande do
Norte, Natal, RN, Brazil
| | - Alany Carla de Sousa Paiva
- Occupational Health Nursing Specialist, Specialization student in
Higher Education Teaching, Escola de Saúde, Universidade Potiguar, Natal, RN,
Brazil
| | - Camila Priscila Abdias do Nascimento
- Emergency and Trauma Nursing Specialist, Specialization student in
Public Health, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP,
Brazil
| | | | - Erika Simone Galvão Pinto
- PhD, Professor Adjunto, Departamento de Enfermagem, Universidade
Federal do Rio Grande do Norte, Natal, RN, Brazil
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Nielsen G, Mygind E, Bølling M, Otte CR, Schneller MB, Schipperijn J, Ejbye-Ernst N, Bentsen P. A quasi-experimental cross-disciplinary evaluation of the impacts of education outside the classroom on pupils' physical activity, well-being and learning: the TEACHOUT study protocol. BMC Public Health 2016; 16:1117. [PMID: 27776502 PMCID: PMC5078947 DOI: 10.1186/s12889-016-3780-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 10/15/2016] [Indexed: 01/17/2023] Open
Abstract
Background Education Outside the Classroom (EOTC) is a teaching method that aims to promote schoolchildren’s learning, physical activity (PA), social relations, motivation, and well-being. EOTC activities are characterized by teachers using the local environment in their teaching, and involve innovative teaching methods, child-led approaches to problem-solving, experimentation, cooperation, PA, and play. EOTC has become common practice for many teachers in Scandinavia; however, only case studies have evaluated its impacts. The TEACHOUT study aims to evaluate the impacts of EOTC on Danish schoolchildren’s PA, social relations, motivation, well-being, and learning. Methods TEACHOUT is a quasi-experimental, cross-disciplinary study. Sixteen schools participated, containing 19 EOTC school classes and 19 parallel non-EOTC classes, with a total of 834 children aged 9 to 13 years. Measures of the children’s social relations, motivation for school, well-being, and academic performance were collected at the beginning and end of the school year. Data on PA levels were collected over ten-day periods during the school year using accelerometers. The amount and characteristics of the actual EOTC provided in both EOTC and non-EOTC classes were monitored day-to-day throughout the school year, using an online teacher survey platform. The effects of EOTC are mainly analysed by comparing EOTC pupils to non-EOTC (i.e. control) pupils based on their scores on the outcome variables (i.e. school performance, well-being, motivation, and social relations) at the end of the school year, adjusting for the baseline values (from the beginning of the year). The impacts of EOTC on PA are evaluated by comparing the total as well as context-specific amounts of PA of children participating in EOTC to those of children in their parallel non-EOTC classes. Furthermore, the interdependencies between PA, social relations, well-being, motivation, and learning are explored using path analysis. To help describe and understand the processes that have led to the quantitative outcomes, qualitative case observations of children’s practices and interactions in EOTC as well as classroom teaching were carried out and combined with qualitative interviews about children’s perceptions of these practices. Discussion The TEACHOUT study represents a holistic multidisciplinary approach to educational and school health-promotion research through its study design and combination of scientific disciplines and methods, as well as its focus on the interdependent relations between learning, PA, social relations, well-being, and motivation. This will result in a comprehensive picture of school health promotion and children’s health and well-being, which will broaden the understanding of the potential benefits of EOTC in school health promotion and primary education. These results can be used to inform and guide future policy and practice.
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Affiliation(s)
- Glen Nielsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
| | - Erik Mygind
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Mads Bølling
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Camilla Roed Otte
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Copenhagen, Denmark
| | | | - Jasper Schipperijn
- Department of Clinical Biomechanics and Sport Science, University of Southern Denmark, Odense, Denmark
| | - Niels Ejbye-Ernst
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Copenhagen, Denmark.,VIA University College, Aarhus, Denmark
| | - Peter Bentsen
- Health Promotion Research, Steno Diabetes Center, Gentofte, Denmark
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Bast LS, Due P, Bendtsen P, Ringgard L, Wohllebe L, Damsgaard MT, Grønbæk M, Ersbøll AK, Andersen A. High impact of implementation on school-based smoking prevention: the X:IT study-a cluster-randomized smoking prevention trial. Implement Sci 2016; 11:125. [PMID: 27640187 PMCID: PMC5027074 DOI: 10.1186/s13012-016-0490-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 09/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Implementation fidelity describes how well an intervention is implemented in the real-world setting. Assessing implementation fidelity is essential in the understanding of intervention results. In most studies, implementation fidelity is measured insufficiently, though, not taking into account the complexity of the concept nor the intervention. The objective of the present study was to develop an overall quantitative measure of implementation fidelity, to examine the degree of implementation fidelity and the association of implementation and effect of a randomized school-based smoking prevention trial-the X:IT study. METHODS A cluster-randomized trial testing is a multi-component intervention to prevent smoking among adolescents in 94 Danish elementary schools (51 intervention, 43 control schools). Participants were grade 7 pupils (mean age 12.5 years). Data was collected by electronic questionnaires among pupils at baseline (n = 4161), the first follow-up (n = 3764), and the second follow-up (n = 3269) and among school coordinators at intervention schools at the first and second follow-up (50 and 39 coordinators). INTERVENTION The intervention included three components: (1) smoke-free school grounds, (2) smoke-free curriculum, and (3) parental involvement, contracts, and dialogues. Implementation fidelity was assessed by four domains: adherence, dose, quality of delivery, and participant responsiveness. These were combined into an overall school-wise implementation index. The association of implementation and smoking was examined by logistic regression analyses. RESULTS One fourth of the schools was characterized as high implementers of the program (all three components) at both first (12 schools, 24.0 %) and second follow-up (11 schools, 28.2 %). Implementation fidelity was strongly associated with smoking at the first and second follow-up, e.g., the odds for smoking at schools with high implementation both years were OR = 0.44 (95 % CI 0.32 to 0.68). CONCLUSIONS Using an overall measure based on several aspects of implementation fidelity, we showed a negative graded association between implementation and smoking. This study suggests that higher degrees of implementation will improve the effect of the X:IT intervention. Studying the association between implementation and effect is extremely important; only by doing so, we can distinguish the quality of the intervention from the success of the implementation. TRIAL REGISTRATION Current Controlled Trials ISRCTN77415416.
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Affiliation(s)
- Lotus Sofie Bast
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen, Denmark
| | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen, Denmark
| | - Pernille Bendtsen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen, Denmark
| | - Lene Ringgard
- Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Louise Wohllebe
- Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Mogens Trab Damsgaard
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen, Denmark
| | - Morten Grønbæk
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen, Denmark
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen, Denmark
| | - Anette Andersen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen, Denmark
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Garnham-Lee K, Trigwell J, McGee CE, Knowles Z, Foweather L. Impact and Acceptability of the Coach and Teacher Training Within a School-Based Sport-for-Health Smoking Prevention Intervention: SmokeFree Sports. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2016. [DOI: 10.1080/1067828x.2016.1175982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Katy Garnham-Lee
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Joanne Trigwell
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Ciara E. McGee
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Zoe Knowles
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Lawrence Foweather
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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McGee CE, Trigwell J, Fairclough SJ, Murphy RC, Porcellato L, Ussher M, Foweather L. Effect of a sport-for-health intervention (SmokeFree Sports) on smoking-related intentions and cognitions among 9-10 year old primary school children: a controlled trial. BMC Public Health 2016; 16:445. [PMID: 27229464 PMCID: PMC4882812 DOI: 10.1186/s12889-016-3048-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 04/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preventing children from smoking is a public health priority. This study evaluated the effects of a sport-for-health smoking prevention programme (SmokeFree Sports) on smoking-related intentions and cognitions among primary school children from deprived communities. METHODS A non-randomised-controlled trial targeted 9-10 year old children from Merseyside, North-West England. 32 primary schools received a programme of sport-for-health activities over 7 months; 11 comparison schools followed usual routines. Data were collected pre-intervention (T0), and at 8 months (T1) and one year post-intervention (T2). Smoking-related intentions and cognitions were assessed using an online questionnaire. Intervention effects were analysed using multi-level modelling (school, student), adjusted for baseline values and potential confounders. Mixed-sex focus groups (n = 18) were conducted at T1. RESULTS 961 children completed all assessments and were included in the final analyses. There were no significant differences between the two study groups for non-smoking intentions (T1: β = 0.02, 95 % CI = -0.08-0.12; T2: β = 0.08, 95 % CI = -0.02-0.17) or for cigarette refusal self-efficacy (T1: β = 0.28, 95 % CI = -0.11-0.67; T2: β = 0.23, 95 % CI = -0.07-0.52). At T1 there was a positive intervention effect for cigarette refusal self-efficacy in girls (β = 0.72, 95 % CI = 0.21-1.23). Intervention participants were more likely to 'definitely' believe that: 'it is not safe to smoke for a year or two as long as you quit after that' (RR = 1.19, 95 % CI = 1.07-1.33), 'it is difficult to quit smoking once started' (RR = 1.56, 95 % CI = 1.38-1.76), 'smoke from other peoples' cigarettes is harmful' (RR = 1.19, 95 % CI = 1.20-2.08), 'smoking affects sports performance' (RR = 1.73, 95 % CI = 1.59-1.88) and 'smoking makes 'no difference' to weight' (RR = 2.13, 95 % CI = 1.86-2.44). At T2, significant between-group differences remained just for 'smoking affects sports performance' (RR = 1.57, 95 % CI = 1.43-1.72). Focus groups showed that SFS made children determined to remain smoke free and that the interactive activities aided children's understanding of smoking harms. CONCLUSION SFS demonstrated short-term positive effects on smoking attitudes among children, and cigarette refusal self-efficacy among girls. Although no effects were observed for non-smoking intentions, children said that SFS made them more determined not to smoke. Most children had strong intentions not to smoke; therefore, smoking prevention programmes should perhaps target early adolescents, who are closer to the age of smoking onset.
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Affiliation(s)
- Ciara E McGee
- Centre for Public Health, Liverpool John Moores University, Henry Cotton Campus, 15-21 Webster Street, Liverpool, L3 2AT, UK.
| | - Joanne Trigwell
- Centre for Health Promotion Research, Leeds Beckett University, Calverley Building, City Campus, Leeds, LS1 3HE, UK
| | - Stuart J Fairclough
- Department of Sport and Physical Activity, Edge Hill University, St. Helens Road, Ormskirk, Lancashire, L39 4QP, UK
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Rebecca C Murphy
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, UK
| | - Lorna Porcellato
- Centre for Public Health, Liverpool John Moores University, Henry Cotton Campus, 15-21 Webster Street, Liverpool, L3 2AT, UK
| | - Michael Ussher
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Lawrence Foweather
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, UK
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