Health Education Research, Vol. 9, No. 3, 365-374, 1994
© 1994 Oxford University Press
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A Dutch social influence smoking prevention approach for vocational school students
Department of Health Education, University of Limburg Maastricht, The Netherlands
1Department of Methodology and Statistics, University of Limburg Maastricht, The Netherlands
2Center for Health Promotion, University of Texas Houston, TX, USA
This study examines the effects of a peer-led smoking prevention program on video for eighth grade Dutch vocational and high school students. A quasi-experimental approach was used with a pre-test and post-tests after 9 and 12 months. The experimental group consisted of three vocational (N = 343) and five high schools (N = 585) who received the program. Three vocational (N = 217) and three high schools (N = 384) served as the control group. Multi-level analyses showed that maximally 6% of the residual variance was due to intra-class and -school effects. Therefore, logistic regressions were run, using students as the unit of analysis. Significant but differential effects were observed for vocational and high school students. Among vocational school students, regular smoking increased by 7.1% in the experimental group compared with 14.1% in the experimental group. Among high school students, a smaller percentage started to experiment with smoking (41.6%) compared with the control group (52.1%). However, the positive effects of the program pertain to a relatively small percentage of the two types of schools. Furthermore, increases in knowledge but few changes in attitudes were found. Self-efficacy expectations improved for students in the experimental condition; however, the improvement was greater for smokers than for non-smokers. Vocational students encountered more smoking within their social environment than high school students. Since the social environment of vocational schools communicates a norm for smoking, it is recommended that programs for this group be embedded in a broader approach which addresses the smoking behavior of important others such as school personnel and parents.
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