Field trial to test and evaluate primary tobacco prevention methods in clusters of elementary schools in Barbados / Ensayo de campo para probar y evaluar métodos primarios de prevención del consumo de tabaco en grupos de niños de escuelas primarias en Barbados

ABSTRACT

To evaluate methods of preventing young children from experimenting with tobacco and to determine cost effectiveness, students (n = 1005) in 31 primary schools, from randomly selected higher grade-levels were recruited into a partially randomized, single blinded controlled trial in which seven groups of schools were randomly assigned to a combination of teaching, leaflet, and drama, in order to modify students' knowledge, attitudes, beliefs and behaviour (KAB). The eighth group (n = 346) with ten schools, distantly separated from the former, was assigned to be the control, but was dropped from comparison analysis for lack of randomness at baseline. The mean, standard deviation and median age of the intervention groups was 9.94 years (0.81), 10.0 years, (n = 669) at baseline; and 10.62 years (0.66), 11.0 years, (n = 397), at 12 months follow-up. In all, 6.6had ever used tobacco at least once at a median age of seven years. Teaching health education at school when combined with other methods was significantly better at improving KAB. In 2003, after a year post-intervention, the occurrence of experimentation smoking in the last 30 days, dropped from 9.2to 1.2(p = 0.00), equivalent to 87(95CI 78, 93) reduction in the group exposed to health education compared to none in the leaflet-only group and Numbers Needed to Treat (NNT) = 12.5. Due to its cost-effectiveness (comparable to child immunizations) at BDS dollars 1.89 to 2.89 or US dollars 1 to 1.5 per child contacted and BDS dollars 100 to 140 (US dollars 50 to 70) capital investment in other resources per school, the experience could be utilized routinely in elementary schools.

RESUMEN

A fin de evaluar los métodos usados para impedir que los niños en edad escolar experimenten con tabaco, y determinar la efectividad del costo, estudiantes (n = 1005) en 31 escuelas primarias – de los grados más altos seleccionados aleatoriamente – fueron enrolados en una prueba parcialmente aleatoria controlada, de simple ciego. En este ensayo, a siete grupos de escuelas se les asignó aleatoriamente una combinación de instrucción, folletos, y drama, con el propósito de modificar sus conocimientos, actitudes, creencias y comportamiento (CAC). El octavo grupo (n = 346) con diez escuelas, separado a distancia de los anteriores, fue escogido como control, pero fue dejado fuera del análisis comparativo debido a falta de aleatoriedad en la línea de base. La media, la desviación estándar, y la mediana de la edad de los grupos de intervención fue de 9.94 años (0.81), 10.0 años, (n = 669) en la línea de base; y 10.62 años (0.66), 11.0 años, (n = 397), a los 12 meses de seguimiento. En total, 6.6% habían usado por lo menos una vez tabaco a la edad mediana de siete años.