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Health Education Research Advance Access published online on March 10, 2006
Health Education Research, doi:10.1093/her/cyl002
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© The Author 2006. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org
Received May 10, 2005
Accepted February 3, 2006

Original article

The interaction of curriculum type and implementation method on 1-year smoking outcomes in a school-based prevention program

Thomas W. Valente 1 *, Jennifer B. Unger 1, Anamara Ritt-Olson 1, Steven Y. Cen 1, and C. Anderson Johnson 1

1 Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Room 5133, Building A, 1000 Fremont Avenue, Alhambra, CA 91803, USA

* To whom correspondence should be addressed.
Thomas W. Valente, E-mail: tvalente{at}usc.edu


  Abstract

Studies have shown that the effectiveness of programs or curricula may depend in part on who delivers the material. In adolescent health education programs, peer leaders are often recruited to implement programs because they are more persuasive to other adolescents than adults. Teachers also systematically vary how groups are constructed in school-based health education programs. This study compared the effects of three leader and group selection methods within the context of two tobacco prevention programs. Eight schools received a social influences program (Chips) and eight received a program with a multicultural emphasis (Flavor). Within these 16 schools 84 classrooms consisting of 1486 students were randomly assigned to one of three leader and group creation conditions: (i) leaders defined as those who received the most nominations by students and groups created randomly (random group), (ii) same as (i) but groups created by assigning students to the leaders they nominated (network), and (iii) leaders and groups created by teachers (teacher). One year follow-up data showed that main effects of the curriculum and network assignments were non-significant on smoking initiation when entered alone. Interaction terms of curriculum and assignment methods, however, were significant such that the network and teacher conditions were less effective than the random group condition with Chips, and more effective than random group condition with Flavor. These data show that school-based prevention programs should be evaluated in light of who implements the program. Even a peer-led program will be differentially effective based on how leaders are selected and how groups are formed, and this effect may be curriculum dependent.


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