Using drama to prevent teen smoking: development, implementation, and evaluation of crossroads in Hawai'i.

The use of drama as a preventive education measure has demonstrated success in various health promotion venues and offers promise in promoting positive youth attitudes and behavior change related to tobacco use. Especially important is a need to implement culturally relevant methods to reach youth. This article describes the development and implementation of a tobacco prevention drama for Asian and Pacific Islander youth. The resulting play, Crossroads, features a soap opera-style drama interspersed with humorous vignettes and multimedia effects and incorporates cultural cues, mannerisms, dress, and values consistent with Asian and Pacific Islander youth culture. Evaluation data indicate that the drama has an effect on audience knowledge, attitudes, and intended behavior, including a change in future intent to smoke cigarettes and the ability of audience members to develop connections with the characters in the play and apply concepts that are presented in the play to their own lives.

Multi-ethnic adolescents' attitudes toward smoking: a focus group analysis.

PURPOSE: To explore young, multi-ethnic adolescents' attitudes and influences related to cigarette smoking for the purpose of developing and producing a youth-led, tobacco prevention drama. DESIGN: Focus groups and demographic surveys. SETTING: Island of Oahu, Hawaii. PARTICIPANTS: Fifty-four multi-ethnic youth, ranging in age from 10 to 14 years, participated. The study was promoted in schools with a large representation of Hawaiian, Filipino, and Pacific Islander students. METHODS: Each of five focus groups was audio-recorded, and an observer recorded extensive notes throughout the sessions. Content analysis consisted of coding focus group notes for recurrent themes and using the audio recording as confirmation. RESULTS: Just more than one quarter (n = 15) of the youth had tried smoking, and two-thirds (n = 35) currently lived with someone who smoked. Participants expressed the feeling of being surrounded by smoking influences at home, in their communities, and at school. Youth were negatively affected by family members' tobacco use, and they desired skills that could enable them to help family members stop using tobacco. CONCLUSION: Family influences may play an important role in youth attitudes toward tobacco use, especially given the cultural significance of extended family and of filial piety that are reflected in many traditional, Asian and Pacific Islander families. Interventions targeting youth in Asian and Pacific Islander communities should incorporate key cultural references to the extended family and to a respect for elders to establish relevance in the life experiences of young people in these population groups.