The program was evaluated in a randomized clinical trial in which 40 classrooms in 14 schools were randomized to receive either the TobaccoWorld program as an adjunct to their helath education class or their usual curriculum (control). While the consumer satisfaction ratings were very positive from students, the data presented below summarizes on the short term (one month) outcome effects of being middle school students exposed for two class periods of the TobaccoWorld program.
Univariate Analysis of Effectiveness of Activities N=757
In addition to collecting demographic data (grade, gender, race/ethnicity), we assessed subjects on key mediating mechanisms of tobacco initiation and use including: intention to use tobacco, willingness to try tobacco, friends’ approval of tobacco use, social images of tobacco users, addictive potential of tobacco, long term health consequences and risks associated with exposure to environmental tobacco smoke.
In order to determine effectiveness of the program components, TobaccoWorld analyses consisted of an initial regression analysis within the intervention group predicting outcome at one month after completing the activity, controlling for the variable of interest at pre-test.
We were able to establish that six of the nine activities had a statistically significant impact on tobacco use variables. This is not to say that the other activities were of no value, rather, there were no scales which measured increased knowledge of subject matter. For example, Island of Addiction, an activity designed to teach tobacco cessation techniques, was one of the most popular games among students. This activity provided a wealth of information, but was not designed to affect the variables measured by our survey data. The following list highlights the activities which had the most impact on the variables of interest and includes beta weight of the activity as well as level of significance. The beta weights are the regression coefficients for standardized data. Beta is the average amount the dependent variable (e.g. follow up measure of willingness to smoke) increases when the independent (e.g. pre test measure of willingness to smoke) increases one standard deviation and other independent variables (e.g. participation in the activity) are held constant. If an independent variable has a beta weight of .5, this means that when other independents are held constant, the dependent variable will increase by half a standard deviation (.5 also). A negative value indicates that there is a decrease in the outcome variable of interest.
| Activity | Outcome Variable | B | p |
|---|---|---|---|
| Alien Autopsy | Willingness to smoke | -.08 | <.001 |
| Clear the Air (ETS) | Perception of risk from Environmental Tobacco Smoke |
.11 | <.001 |
| Simsmoke | Intention to smoke Intention to chew Willingness to smoke -.06 Social images |
-.07 -.07 -.06 -.06 |
<.01 <.05 <.05 <.05 |
| Smokelab | Intention to smoke Social images Risk of addiction . |
-.06 -.07 07 |
<.05 <.05 <.05 |
| Stomp | Intention to smoke Willingness to smoke Social images |
-.05 -.06 -.06 |
<.05 <.05 <.05 |
| You Don’t Know Spit | Willingness to smoke Risk of long term consequences Social images |
-.08 .06 -.09 |
<.01 <.05 <.01 |
Outcome analyses (N = 292)
After concluding which activities were most effective in changing the mediating mechanisms of tobacco use, outcome analyses were conducted including subjects who completed at least three of the most effective six activities. We then compared the intervention group to the control group using analysis of covariance to test each dependent variable of interest, adjusting for the measure at pre-test. When compared to the control group, we found significant effects such that the intervention group was less willing to use tobacco (p<.001), believed that the long term consequences of tobacco use were greater (p<.05), had less favorable images of tobacco users (p<.001), and felt that the risks of environmental tobacco smoke were greater (p<.001).
©Deschutes Research, Inc. 2007