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Health Education Research, Vol. 2, No. 4, 385-400, 1987
© 1987 Oxford University Press

research-article

Implementation effectiveness trial of a social influences smoking prevention program using schools and television

Brian R. Flay1,3, William B. Hansen1, C.Anderson Johnson1, Linda M. Collins1, Clyde W. Dent, Kathleen M. Dwyer1, Linda Grossman, Gianna Hockstein, Jill Rauch, Judy L. Sobel, Debra F. Sobol, Steve Sussman1 and Arthur Ulene2

Institute for Health Promotion and Disease Prevention Research, University of Southern California 35 North Lake Avenue, Pasadena, CA 91101, USA
1Also at the Division of Health Behavior Research, Department of Preventive Medicine, School of Medicine, University of Southern California USA
2Also at Feeling Fine Productions and KABC-TV Los Angeles USA

Correspondence to: 3To whom reprint requests should be sent at: Prevention Research Center, School of Public Health, University of Illinois at Chicago, PO Box 6998, Chicago, IL 60680, USA

Results are reported from a quasi-experimental implementation effectiveness trial of a television and school-based smoking prevention program. The program used the social influences approach, focusing on peer, family and media influences on adolescents to become smokers, and providing grade 7 students (age 12–13) with the knowledge and skills to resist them. The evaluation allowed for assessments of: the value of coordinated television programming in increasing school, student and parent availability and acceptance of the program; the effects of program context (whether all or half of a grade cohort received the program in school) on participation and subsequent smoking behavior; and the effects of parental participation in prevention activities on subsequent student smoking. Data on availability, acceptance, participation and implementation are reported and immediate post-test and 1- and 2-year follow-up results. Strong effects of television programming and context on availability, acceptance and participation were found. Significant associations were also found between each television viewing and parental involvement and subsequent student smoking, but a lack of overall program effects on smoking outcomes limit their interpretation. Constraints on programming and research design suggest: (i) possible limitations to program effects we might reasonably expect in real-world applications of the social influences approach and (ii) the need for future true experimental efficacy trials to determine exactly what level of programming will be needed to achieve significant real-world effects.


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