Randomized Trials on Consider This, a Tailored, Internet-Delivered Smoking Prevention Program for Adolescents

Abstract

The Internet may be an effective medium for delivering smoking prevention to children. Consider This, an Internet-based program, was hypothesized to reduce expectations concerning smoking and smoking prevalence. Group-randomized pretest-posttest controlled trials were conducted in © 2008 by SOPHE Address correspondence to: David Buller, Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401; dbuller@kleinbuendel.com. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptAustralia (n = 2,077) and the United States (n = 1,234) in schools containing Grades 6 through 9. Australian children using Consider This reported reduced 30-day smoking prevalence. This reduction was mediated by decreased subjective norms. The amount of program exposure was low in many classes, but program use displayed a dose-response relationship with reduced smoking prevalence. American children only reported lower expectations for smoking in the future.Intervening to prevent smoking is a challenge, and this data suggest small benefits from an Internet-based program that are unlikely to be of practical significance unless increased by improved implementation. Implementation remains the major challenge to delivering interventions via the Internet, both for health educators and researchers. Keywordssmoking; prevention; adolescents; Internet Many adolescents will try smoking and eventually become adult smokers in the absence of effective intervention . One possible limitation of past interventions is that most focus on keeping children from trying their first cigarette. They do not talk with the large proportion that has tried smoking and convince them to stop (Buller et al., 2003;Hill, White, & Effendi, 2002; Office on Smoking and Health, CDC, 2002). This article reports on a trial to evaluate the effectiveness of a smoking prevention program, Consider This, that was delivered to schools via the Internet Hall et al., 2001). It was intended to reduce smoking by children in Grades 6 through 9 by convincing those who had not smoked not to start and persuading those who had already tried smoking to stop.A program aimed at both preventing the first cigarette and arresting experimentation needs to acknowledge children's experiences and expectancies and build off them. This presents two major challenges. First, one needs to know children's experiences with, and current plans and activities for, smoking. There may be at least four relevant groups-non-smokers (those who have never tried a cigarette), past users (those who have tried cigarettes but do not currently use them), experimental smokers (those who are smoking sporadically), and regular smokers (those who smoke every day) (Buller et al., 2003). Very few younger adolescents, the audience for Consider This, smoke regularly; thus, program content focused on the other three groups, which display variation in their beliefs and experiences that affects vulnerability to smoking (Buller et al., 2003). In the classroom, it can be difficult for tea...

Strategies to Facilitate Exposure to Internet-Delivered Health Behavior Change Interventions Aimed at Adolescents or Young Adults: A Systematic Review

“…In our zeal to be parsimonious and systematic in our review, we may have discarded other potentially valuable studies (e.g., Buller et al, 2008).…”

Design and results of the pretest of the IDEFICS study

“…As reported by Buller et al (2008), delays during this phase of the programme schedule may result in an extension between pretesting and implementation of a programme. This may cause loss of participants and valuable data.…”

“…This may cause loss of participants and valuable data. 36 In the case of IDEFICS, information on season-specific eating and activity behaviour of the children would have been lost. It is recommended to consider the possibility of delays as part of the development of instruments and procedures, and to foresee sufficient resources in the planning stage of a study.…”

Continued Benefits of a Technical Assistance Web Site to Local Tobacco Control Coalitions During a State Budget Shortfall

“…5,25−27 In the present study, we were interested in whether a rich multimedia Web site containing content that provided training and resources, and facilitated communication, would improve how well local tobacco control coalitions functioned. A growing literature has confirmed that well-designed Web-based programs can be effective in improving the behavior of individual users to prevent or treat several chronic diseases (eg, asthma, 28 breast cancer, 29,30 healthy body image, 31,32 healthy eating behavior, 33−36 HIV, 37 panic disorder, 38 smoking uptake, 39 tinnitus, 40 and weight management 41−45 ). The Internet may be a promising channel for supporting community capacity building and action.…”