No abstract

Fifty state and local coalitions that carry out the Smoke Free Class of 2000 program of the American Cancer Society, American Heart Association and American Lung Association were surveyed in 1990. Almost all (95%) rated themselves moderately or very active and a total of 88 900 second grade teachers were estimated to have received the materials. The availability of funds, competing priorities, lack of coordination, differences in agency service areas and personnel availability were most frequently cited as areas of concern to the coalitions. Personnel barriers and formality of coalition structure were independently related to perceived coalition effectiveness and, with the number of elementary schools, to perceived coalition activity. General recommendations, that were accepted upon completion of the assessment, included (1) formalization of agreements, mission statements, and goals and objectives, (2) attention to group formation and identification, and (3) clarification of national coalition expectations.

Properly implemented school programs to prevent tobacco use and addiction can lower smoking prevalence up to 60%. However, numerous programs are not successful due to poor implementation. A system for estimating likelihood of future implementation fidelity of school-based prevention programs was tested using data collected at baseline and two year follow-up in 47 middle schools and high schools participating in the Texas Tobacco Prevention Initiative. The Bridge-It system includes an eight-factor, 36-item survey to analyze capacity for program implementation and a companion Bayesian model which provides estimations of likelihood of implementation fidelity several years after program initiation. The survey also asks about amount of implementing activity for each of the multiple components recommended in federal guidelines for school programs to prevent tobacco use. Criterion referenced cross-tabulations showed the system's forecast of implementation fidelity was correct in 74% of cases (p < .01). Model reliability was confirmed in regression analyses. Implementation fidelity at follow-up was predicted by the combination of the model's eight capacity factors at baseline. It includes program, implementation support, and non-program factors. Integration of the Bridge-It system, or comparable tools, into the dissemination and evaluation of school-based prevention programs can help to increase understanding of factors that influence implementation and provide guidance for capacity building. If administrators can identify at baseline schools likely to fall short of implementation goals, plans for resource allocation and provision of guidance, training, and technical assistance can be specifically tailored to identified needs.

No abstract

This study examined the implementation phase of a four-year research project to test the effectiveness of strategies to increase diffusion of Smart Choices, a school-based tobacco prevention program. The impact on curriculum implementation of two approaches to teacher training are compared. School districts were randomly assigned to a live workshop training or video training condition. The outcome of the evaluation was teachers' implementation of Smart Choices. Results show a lower proportion of video-trained teachers implemented the curriculum, but overall completeness and fidelity of implementation for those teachers who did teach the curriculum were comparable for the two groups. Video-trained teachers, however, were less likely to use brainstorming and student presentations/role plays, two of the methods prescribed by the curriculum. Implications of the results for teacher training are discussed.