Funds are requested to (a) complete the intervention and evaluation
activities of a community intervention to prevent adolescent tobacco use
and (b) continue the evaluation of intervention effects into young
adulthood. It is proposed that the originally-designed study be completed
and that additional follow-up assessments be conducted over five years.
This will allow completion of the original design of the experiment,
enable assessment of whether intervention effects are maintained, and
permit the use of latent growth structural equation modelling to test
models of the development of tobacco use. Project SixTeen involves a
randomized control trial in which eight pairs of small Oregon communities
have been randomized to receive either a school-based prevention program
or the school-based program plus a community intervention. Preliminary
results of the impact of the overall community intervention indicate that,
after six months of intervention, the prevalence of adolescent tobacco use
is significantly lower in communities receiving the community
intervention. The community intervention consists of sets of module-
defined activities designed to influence each of the known risk factors
for adolescent tobacco use. The written modules cover: (a) youth anti-
tobacco activities, (b) family communication about tobacco, (c) reducing
adolescent access to tobacco, (d) media advocacy, (e) fact sheets about
tobacco, and (f) school and community policies regarding adolescent
possession of tobacco. Three of the modules have been shown by
experimental evaluations to affect their targets. The access intervention
has brought about significant reductions in the proportion of stores that
sell tobacco to minors in each of the eight communities in which it was
introduced. The Youth Anti-Tobacco activities and the Family
Communication activities have been shown to bring about (a) significant
increases in exposure of young people and their parents to anti-tobacco
media and (b) changes in parent and child knowledge and attitudes about
tobacco use, in parent-child communication about tobacco, and in youth
intentions to use tobacco.
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