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      Tobacco Use Prevention for the Young (TUPY-S): Development, Validity and Reliability of an Interactive Multimedia Strategy from the Adolescents’ Perspective in Malaysia

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          Abstract

          Objective:

          This study aims to develop, validate and determine the reliability of an interactive multimedia strategy to prevent tobacco use among the young (TUPY-S) from an adolescents’ perspective.

          Methods:

          A descriptive study design was utilized. A modular instruction guideline by Russel (1974) was followed in the entire process, comprising a feasibility study, a review of existing modules, specification of the objectives, identification of the construct criterion items, learner analysis and entry behavior specification, establishment of the sequence instruction and media selection, a tryout with students and a field test.

          Result:

          Feasibility was agreed among the researchers and the school authorities. Culturally suitable rigorously developed tobacco use preventive strategies delivered using information technology (IT) are lacking in the literature. The objective of TUPY-S is to prevent tobacco use among adolescents living in Malaysia. Identified construct criterion items include knowledge, attitude, intention to use, self-efficacy, and refusal skill. The target population was early adolescents belonging to generation-Z. Content was developed from the adolescents’ perspective and delivered using IT in Malay language. Content validity, assessed by six experts in the field and module development, was good at 86%. The students’ tryout showed satisfactory face validity subjectively and objectively (85.5%) and high alpha Cronbach reliability (0.91).

          Conclusion:

          TUPY-S was confirmed to suit early adolescents of the current generation living in Malaysia. It demonstrated good content validity among the experts, satisfactory face validity and reliability among the target population. TUPY-S is ready to be evaluated for its effectiveness among early adolescents.

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          Most cited references36

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          Prevalence and predictors of transitions in smoking behavior among college students.

          The prevalence of smoking among college students is surprisingly high and represents a significant public health issue. However, there are few longitudinal studies of smoking in this population. This study examined the prevalence and predictors of transitions in smoking behavior among a cohort of 548 college students. Over the course of 4 years, 87% of daily smokers and almost 50% of occasional smokers continued to smoke. Among nonsmokers, 11.5% began smoking occasionally and none became daily smokers. In general, predictors of smoking behavior change were significant only among baseline occasional smokers and included gender, smoking outcome expectancies, and affect regulation expectations. Peer and parental smoking, demographics, affect, stress, and alcohol use were generally not predictive of change. Tobacco control interventions targeted at college students are clearly warranted.
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            Cluster randomised controlled trial of expert system based on the transtheoretical ("stages of change") model for smoking prevention and cessation in schools.

            To examine whether a year long programme based on the transtheoretical model of behaviour change, incorporating three sessions using an expert system computer program and three class lessons, could reduce the prevalence of teenage smoking. Cluster randomised trial comparing the intervention to a control group exposed only to health education as part of the English national curriculum. 52 schools in the West Midlands region. 8352 students in year 9 (age 13-14 years) at those schools. Prevalence of teenage smoking 12 months after the start of the intervention. Of the 8352 students recruited, 7444 (89.1%) were followed up at 12 months. The intention to treat odds ratio for smoking in the intervention group relative to control was 1.08 (95% confidence interval 0.89 to 1.33). Sensitivity analysis for loss to follow up and adjustment for potential confounders did not alter these findings. The smoking prevention and cessation intervention based on the transtheoretical model, as delivered in this trial, is ineffective in schoolchildren aged 13-14.
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              Two-year effects of a school-based prevention programme on adolescent cigarette smoking in Guangzhou, China: a cluster randomized trial.

              The prevalence of adolescent smoking has been increasing rapidly in China. Theory-based smoking prevention programmes in schools may be an effective approach in preventing smoking among Chinese adolescents. A school-level cluster randomized controlled trial was conducted among 7th and 8th grade students (N = 2343) in four junior high schools in southern China during 2004-06. The theory-based, multi-level intervention was compared with the standard health curriculum. Outcome measures comprised changes in students' smoking-related knowledge, attitudes and behaviour. The mean knowledge scores from baseline to the 1- and 2-year follow-ups increased more in the intervention group than in the control group, whereas there was little change in attitude scores. At the 1-year follow-up (the total sample), the interventions reduced the probability of baseline experimental smokers' escalating to regular smoker [7.9 vs 18.3%; adjusted odds ratio (OR) 0.34, 95% confidence interval (CI) 0.12-0.97, P = 0.043], but did not reduce the probability of baseline non-smokers' initiating smoking (7.9 vs 10.6%; adjusted OR 0.86, 95% CI 0.54-1.38, P = 0.538). At the 2-year follow-up (only 7th grade students), similar proportions of baseline non-smokers initiated smoking in the intervention group and the control group (13.5 vs 13.1%), while a possibly lower proportion of baseline experimental smokers escalated to regular smoking in the intervention group than the control group (22.6 vs 40.0%; adjusted OR 0.43, 95% CI 0.12-1.57, P = 0.199). This multi-level intervention programme had a moderate effect on inhibiting the escalation from experimental to regular smoking among Chinese adolescents, but had little effect on the initiation of smoking. The programme improved adolescents' smoking-related knowledge, but did not change their attitudes towards smoking.
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                Author and article information

                Journal
                Asian Pac J Cancer Prev
                Asian Pac. J. Cancer Prev
                Asian Pacific Journal of Cancer Prevention : APJCP
                West Asia Organization for Cancer Prevention (Iran )
                1513-7368
                2476-762X
                2017
                : 18
                : 5
                : 1435-1443
                Affiliations
                [1 ] Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan
                [2 ] School of Applied Psychology, Social Work and Policy, College of Arts and Sciences, Universiti Utara Malaysia, Kedah, Malaysia
                Author notes
                [* ] For Correspondence: faridahz@ 123456usm.my
                Article
                APJCP-18-1435
                10.22034/APJCP.2017.18.5.1435
                5555559
                28612599
                c181dbe5-b350-41d6-a0af-1c619939e578
                Copyright: © Asian Pacific Journal of Cancer Prevention

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

                History
                Categories
                Research Article

                tobacco,prevention,multimedia,adolescence
                tobacco, prevention, multimedia, adolescence

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