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StartSMART: Evaluation of a Middle School Tobacco Prevention Program NIDA Grant Number: 5 R44DAO16465-03 October 26, 2006

Danya International, Inc.: 

Founded in 1996 by Dr. Jeffrey Hoffman Guiding values: Integrity, Quality, and Creativity A customer-focused, technology-enabled company Offices in Silver Spring, MD, and Atlanta, GA Extensive experience with SBIRs and product development Danya International, Inc.

Sample of Danya Products: 

Sample of Danya Products

Objectives : 

Objectives Need for Prevention Purpose of Study National Education Guideline Recommendations Components of StartSMART Program Curriculum Session Descriptions Student Advertisements Outcome Evaluation Eligibility Requirements Methods Preliminary Results Limitations Next Steps

Need for Prevention: 

Need for Prevention Tobacco use remains the leading cause of premature death in the United States New data suggests that progress is slowing down Rate of decline in 30-day smoking rates is slowing Exposure to and effectiveness of anti-smoking ads is decreasing State funding down

Purpose of the Study: 

Purpose of the Study StartSMART program acts as a mechanism to reduce tobacco use among youth 11 to 13 years of age by engaging the involvement of students, teachers, administrators, and parents. The program allows students to observe anti-tobacco messages, learn the skills to both identify and resist tobacco use, and participate in delivering prevention messages to their peers.

National Education Guideline Recommendations: 

National Education Guideline Recommendations Develop and enforce a school policy on tobacco use Provide health education about short- and long-term consequences of tobacco use Provide tobacco prevention programs across all school years (K-12) Provide program-specific training for teachers Involve parents and families to support school programs Support cessation efforts for both youth and staff Evaluate prevention programs

Components of StartSMART: 

Components of StartSMART The Facilitator’s Curriculum The Youth Workbook Prevention Video Training Package: Facilitator’s Training Video One-Day Training Option Teacher’s Training Notes Parent Support Booster Sessions Support Web site

StartSMART Curriculum: 

StartSMART Curriculum Session 1: Influence of Big Tobacco Session 2: Environmental Influences of Smoking Session 3: Smoking Misperceptions Session 4: Short- and Long-Term Consequences of Smoking Session 5: Resisting Tobacco Use Session 6: What’s Your Idea? Session 7: Time, Talent, Tools Session 8: Lights, Camera, Action

Session 1: Influence of Big TobaccoTreasure Hunt: 

Session 1: Influence of Big Tobacco Treasure Hunt Identify anti-tobacco and pro-tobacco messages Homework activity Family involvement

Session 1: Influence of Big TobaccoSlick Tricks: 

Session 1: Influence of Big Tobacco Slick Tricks Glamour, sophistication Humor, fun Lies, trickery Celebrity, stardom

Session 1: Influence of Big Tobacco Video Segment – Tobacco: Take One! : 

Session 1: Influence of Big Tobacco Video Segment – Tobacco: Take One! Deconstruct the ad Examples of pro-tobacco advertisements Tobacco industry’s role

Session 1: Influence of Big Tobacco Video Segment – Tobacco: Take One! : 

Session 1: Influence of Big Tobacco Video Segment – Tobacco: Take One!

Session 1: Influence of Big Tobacco That’s a Wrap!: 

Session 1: Influence of Big Tobacco That’s a Wrap! Recap of session’s main points Confirm that students understand concepts Repeats at end of every session

Session 4: Short- and Long-Term Consequences of SmokingSmoking and Addiction: 

Session 4: Short- and Long-Term Consequences of Smoking Smoking and Addiction Why do people continue to smoke even though they know it’s unhealthy to do so? Video Game Example

Session 5: Resisting Tobacco UseTobacco IQ Game: 

Session 5: Resisting Tobacco Use Tobacco IQ Game Interactive Game (recap of the first four sessions): Wordshark Scientist Actor Artist

Session 6: What’s Your IdeaCreating Storyboards: 

Session 6: What’s Your Idea Creating Storyboards

Sessions 7 and 8: 

Sessions 7 and 8

Student Anti-Tobacco Advertisements: 

Student Anti-Tobacco Advertisements Saving your child —The impact of a smoking mother on her asthmatic son’s health. Winded — What happens when two boys, one smoker and one nonsmoker, challenge each other to a race? It’s all about choice — A young person’s decision whether to spend his money on cigarettes or other goods. Why smoking, why not? — Peer influence on teenage girls and the results of their decisions. We told him so! — The effect of a teenage boy’s decision to smoke. Who do you want to be? — Two girls, one homely, sickly, and smoking, the other healthy, popular, and smoke-free, sit uncomfortably beside each other on a park bench. Fun times gone bad — A slumber party quickly takes a turn for the worse after the partiers become ill from smoking. Don’t be a stupid girl — A womanizing lad tries to entice a group of girls to smoke, but is left hanging after the girls realize it’s not their cup of tea. They know — A simple yet chilling message on the true intentions of the tobacco industry. It’s not worth it — A boy will do everything to please his new love — everything, that is, except to buy her a pack of cigarettes. No thanks — Hip teens instruct viewers to say 'No thanks' to peers and the entertainment industry who try to coax them into smoking.

“Who do you want to be?”: 

'Who do you want to be?'

“They know”: 

'They know'

“No thanks”: 

'No thanks'

Outcome Evaluation: 

Outcome Evaluation Randomized control trial (189 enrolled) Seven schools recruited from Washington, D.C., area Data collected at four points in the evaluation: baseline, 8 weeks, and follow-up at 1 month and 6 months Treatment group attended 8-session program

Eligibility Requirements: 

Enrolled in 6th or 7th grade Cannot be participating in other tobacco prevention or cessation programs Able and willing to attend all sessions Able and willing to provide physiological measures (saliva, breath) Eligibility Requirements

Data Collection Methods: 

Data Collection Methods Knowledge Stages of change: Non-smokers Smokers Susceptibility and intentions Attitudes toward smoking Physiological measures

Baseline Demographics and Smoking History: 

Participants 15 female middle school students (subsample) Mean age: 12.3 ± 0.5 years 73% Caucasian 33% reported having at least one parent currently smoking None of the children reported trying cigarettes None of the children reported having siblings or friends who smoked cigarettes Baseline Demographics and Smoking History

Preliminary ResultsEnd of Treatment Analyses for Treatment Group: 

Preliminary Results End of Treatment Analyses for Treatment Group None of the students reported trying smoking Youth improved their scores on the knowledge questionnaire from 8.5 to 9.9 correct answers out of 13 (p andlt; .05) The improvement was largely due to 27%-40% more students getting questions right about how cigarette companies advertise, limitations on counter-marketing ads, and the effects of nicotine (questions 4, 6, and 10; p andlt; .05)


Participants in the StartSMART group reported that activities were helpful (average rating of activities: 3.0) The only activity that was not rated above the midpoint was homework, which was rated at 2.2 on a 5-point scale, with 1 being 'not very helpful or not fun' and 5 being 'very helpful or a lot of fun' Of the other activities, the treasure hunt and developing a counter-marketing ad were reported as being the most helpful Preliminary Results End of Treatment Analyses for Treatment Group

Preliminary Results Importance of StartSMART Exercises : 

Preliminary Results Importance of StartSMART Exercises

Preliminary Results Importance of StartSMART Activities: 

Preliminary Results Importance of StartSMART Activities


Limitations Recruitment Small subsample Biochemical verification not evaluated

Next Steps: 

Next Steps Complete outcome evaluation Facilitator training Booster sessions Parent support Support Web site

Danya Project Team: 

Danya Project Team Henry Wong, Ph.D. — Principal Investigator Susanna Nemes, Ph.D. — Co-Principal Investigator Jeffrey Hoffman, Ph.D. — Corporate Monitor Sharon Zack, MS — Project Director Kelly Munly, MS — Co-Project Director Jenn Weil — Senior Research Associate Jennifer Jones — Research Associate Jeff Owczarazk — Graphic Designer Emily Glaeser — Technology Project Director Suzanne Willis — Editor Kathleen Cooke — Quality Assurance


Thank you!

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