Effects of the X:IT smoking intervention: a school-based cluster randomized trial

Andersen, Anette; Krølner, Rikke; Bast, Lotus Sofie; Thygesen, Lau Caspar; Due, Pernille

doi:10.1093/ije/dyv145

Cited by 24 publications

(27 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several smoking prevention programs have been introduced to schools during the last decades, but many of them have not been effective. In Denmark, the X:IT study has been the first smoking preventive program which has shown significant effect on adolescent smoking [ 34 ]. Our study demonstrated that the effect of the intervention is strongly and positively associated with the degree to which the schools implement the program as intended by the program developers.…”

Section: Discussionmentioning

confidence: 99%

“…The effect of the program was evaluated using a cluster-randomized controlled trial involving schools from all over Denmark. Intention to treat analyses have shown an overall significant effect of the X:IT intervention [ 34 ], but we do not know whether the effect was differential according to implementation fidelity. In order to investigate whether the full potential of the intervention had been reached, it is therefore important to study implementation of the intervention.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

High impact of implementation on school-based smoking prevention: the X:IT study—a cluster-randomized smoking prevention trial

et al. 2015

Self Cite

View full text Add to dashboard Cite

BackgroundImplementation 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.MethodsA 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.ResultsOne 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).ConclusionsUsing 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 registrationCurrent Controlled Trials ISRCTN77415416

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High impact of implementation on school-based smoking prevention: the X:IT study—a cluster-randomized smoking prevention trial

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…Intention to treat analyses showed an overall effect of the X:IT study after 1 year of intervention: odds ratio for smoking among pupils in intervention schools compared with control schools was 0.61 (95% CI: 0.45‐0.81) . The implementation of the program was assessed through a quantitative evaluation of implementation fidelity based on adherence, dose, quality of delivery, and participant responsiveness as recommended by Dusenbury et al Measures of implementation fidelity were combined into an overall school‐wise implementation index, and showed that the implementation of the intervention components in the X:IT study varied across components and over time, and that the program was implemented with high fidelity at one fourth of the schools.…”

Section: Methodsmentioning

confidence: 99%

Association of School Characteristics and Implementation in the X:IT Study—A School‐Randomized Smoking Prevention Program

Bast

Due

Ersbøll

et al. 2017

Journal of School Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…use, all of which are amenable to prevention. Self-esteem training, 44 sensitization to the influence of tobacco advertising, rehearsal of refusal skills, 41 watching 10 truth campaign ads, 45 and using commitment contracts to delay smoking 46 are strategies that may increase resilience to tobacco smoking.…”

Section: Figurementioning

confidence: 99%

A Tool to Identify Adolescents at Risk of Cigarette Smoking Initiation

Sylvestre¹,

Hanusaik²,

Berger³

et al. 2018

Pediatrics

View full text Add to dashboard Cite

To describe the development of a prognostic tool to identify adolescents at risk for transitioning from never to ever smoking in the next year. METHODS: Data were drawn from the Nicotine Dependence in Teens study, a longitudinal investigation of adolescents (1999 to present). A total of 1294 students initially age 12 to 13 years were recruited from seventh-grade classes in 10 high schools in Montreal. Self-report questionnaire data were collected every 3 months during the 10-month school year over 5 years (1999-2005) until participants completed high school (n = 20 cycles). Prognostic variables for inclusion in the multivariable analyses were selected from 58 candidate predictors describing sociodemographic characteristics, smoking habits of family and friends, lifestyle factors, personality traits, and mental health. Cigarette smoking initiation was defined as taking even 1 puff on a cigarette for the first time, as measured in a 3-month recall of cigarette use completed in each cycle. RESULTS: The cumulative incidence of cigarette smoking initiation was 16.3%. Data were partitioned into a training set for model-building and a testing set to evaluate the performance of the model. The final model included 12 variables (age, 4 worry or stressrelated items, 1 depression-related item, 2 self-esteem items, and 4 alcohol-or tobaccorelated variables). The model yielded a c-statistic of 0.77 and had good calibration. CONCLUSIONS: This short prognostic tool, which can be incorporated into busy clinical practice, was used to accurately identify adolescents at risk for cigarette smoking initiation.

show abstract

Effects of the X:IT smoking intervention: a school-based cluster randomized trial

Cited by 24 publications

References 22 publications

High impact of implementation on school-based smoking prevention: the X:IT study—a cluster-randomized smoking prevention trial

High impact of implementation on school-based smoking prevention: the X:IT study—a cluster-randomized smoking prevention trial

Association of School Characteristics and Implementation in the X:IT Study—A School‐Randomized Smoking Prevention Program

A Tool to Identify Adolescents at Risk of Cigarette Smoking Initiation

Contact Info

Product

Resources

About