Korean Journal of Health Education and Promotion (보건교육건강증진학회지)

Korean Society for Health Education and Promotion (한국보건교육건강증진학회)
권호 표지

A meta-analysis of adolescent psychosocial smoking prevention programs in the United States: Identifying factors associated with program effectiveness

사회 심리 이론에 근거한 학교 흡연 예방 프로그램의 메타분석: 미국 사례와 Explanatory Variables

  • Published : 2007.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Adolescent psychosocial smoking prevention programs have been successful, but limited in the magnitude of program effects. The present study is the secondary analysis after the previous study estimated mean effect sizes in smoking knowledge, attitudes, skills, and behaviors with treatment variables. Regardless of overall program effect estimations that other meta.analysis studies have done, this study is conducted to identify explanatory variables that are likely to increase program effects. A decrease of adolescent smoking behaviors is associated with the following factors: a. Younger students ($5^{th}-7^{th}$) than older students ($8^{th}-12^{th}$). b. Research methodology using true experimental design, quasi experimental design with equivalence between groups, use of random assignment, 10% or less attrition rate, use of a no treatment control group, high implementation fidelity, and/or acceptable instrumentation reliability. c. Programs using trained peer leaders, targeting cigarette smoking only, implementing 10 or more treatment sessions and/ or providing booster sessions.

청소년을 위한 학교 흡연예방 프로그램은 사회심리 이론에 근거한 프로그램이 대체로 성공적이었다고 알려져 있으나, 각 프로그램의 효과 정도에는 많은 차이가 있다. 이 연구는 다른 메타 분석처럼 전체적인 프로그램 효과도를 측정하여 일반적인 결론을 유도한 것이 아니라, 프로그램의 효과와 관계가 깊은 요인 (Explanatory Variables)을 자세히 파악하여 보건교육 담당자, 연구원, 또는 정책 결정자들에게 구체적인 가이드라인을 제공하는 데에 목적을 두고 있다. 주요한 연구결과는 다음과 같다. 1. 8-12학년 학생들보다는 초등학교에서 중등학교로 바뀌는 5-7학년 학생들에게 흡연예방 프로그램은 더 효과가 있었다. 2. 연구 방법론에 있어서는 experimental design, random assignment, 순수 비교그룹을 사용하였을 경우, implementation fidelity와 instrument reliability가 높은 경우, 또는 10% 미만의 attrition rates일 때 프로그램 효과도 (effect size)가 더 높게 나타났다. 3. 프로그램 실행 시 또래 리더를 사용하였을 경우, 알코올 등 다른 약물을 배제한 담배만을 중점적으로 다루었을 경우, 적어도 10회 이상 연속적으로 이루어지거나 프로그램 종료 후 일년 뒤에 추가 프로그램이 주어진 경우가 더욱 효과적이었다.

Keywords

References

  1. Ary, D.V. et al. 1990. The efficacy of social influence prevention programs versus 'standard care': Are new initiatives needed? Journal of Behavioral Medicine 13:281-296 https://doi.org/10.1007/BF00846835
  2. Battjes, R.J. 1985. Prevention of adolescent drug abuse. International Journal of Addiction 20: 1113-1134 https://doi.org/10.3109/10826088509047767
  3. Bangert-Drown, R.L. 1988. The effects of school-based substance abuse education A meta-analysis. Journal of Drug Education 18(3):243-264 https://doi.org/10.2190/8U40-WP3D-FFWC-YF1U
  4. Best, J.A. et al. 1988. Preventing cigarette smoking among school children. Annual Review of Public Health 9: 161-211 https://doi.org/10.1146/annurev.pu.09.050188.001113
  5. Botvin, G.J., and Eng, A. 1982. The efficacy of a multi-component approach to the prevention of cigarette smoking. Preventive Medicine 11: 199-211 https://doi.org/10.1016/0091-7435(82)90018-4
  6. Bruvold W.H. 1993. A meta-analysis of adolescent smoking prevention programs. American Journal of Public Health 83 :872-880 https://doi.org/10.2105/AJPH.83.6.872
  7. Burke, J.A. et al. 1987. The short-term effects of competition and rewards in an adolescent smoking prevention program. Health Education Quarterly 14(2):141-152 https://doi.org/10.1177/109019818701400202
  8. Centers for Disease Control and Prevention. 1994. Content and teaching strategies in 10 selected drug abuse prevention curricula. Morbidity and Mortality Weekly Report 43(RR-2):1-18
  9. Clarke, J.H. et al. 1986. Reducing adolescent smoking: A comparison of peer-led, teacher-led, and expert interventions. Journal of School Health 56: 102-106 https://doi.org/10.1111/j.1746-1561.1986.tb05707.x
  10. Colquhoun, J., and Cullen, K. 1981. Improved smoking habits in 12-to-14-year-old Busselton children after antismoking programs. Medical Journal of Australia 1:586-587
  11. Dusenbury, L. and Falco, M. 1997. School-based drug abuse prevention strategies: From research to policy and practice. Pp.47-75 in Enhancing Children's Wellness edited by R. Weissberg, T. et al. Thousand Oaks: SAGE Publication
  12. Flay B.R. 1985. Psychosocial approaches to smoking prevention: a review of findings. Health Psychology 4:449-488 https://doi.org/10.1037/0278-6133.4.5.449
  13. Glynn T.J. 1989. Essential elements of school-based smoking prevention programs. Journal of School Health 59:181-188 https://doi.org/10.1111/j.1746-1561.1989.tb04698.x
  14. Hedges, L. V., and Olkin, I. 1985. Statistical methods for meta-analysis. Orlando: Academic Press
  15. Hedges, L. V., and Becker, B.J. 1989. Statistical methods in the meta-analysis of research on gender differences. Pp. 14-15 in The psychology of gender: Advances through meta-analysis edited by J.S. Hyde and M.C. Linn. Baltimore: The Johns Hopkins University Press
  16. Hwang, M.S., Yeagley, K.L., and Petosa, R. 2004. A meta-analysis of adolescent psychosocial smoking prevention programs published between 1978 and 1997 in the United States. Health Education & Behavior 31 (6):702-719 https://doi.org/10.1177/1090198104263361
  17. Jason, L.A. et al. 1982. Evaluating an early secondary smoking prevention intervention. Preventive Medicine 11 :96-102 https://doi.org/10.1016/0091-7435(82)90008-1
  18. Lipsey, M.W. 1992. Juvenile delinquency treatment: A meta-anlaytic inquiry into the variability of effects. Pp. 83-128 in Meta-analysis for explanation: A casebook edited by T. Cook, H. et al. New York: Russell Sage Foundation
  19. Lipsey, M.W. 1994. Identifying potentially interesting variables and analysis opportunities. Pp. 111-124 in The handbook of research synthesis edited by H. Cooper and L.V. Hedges. New York: Russell Sage
  20. Lipsey, M.W., and Wilson, D.B. 2001. Practical meta-analysis. Thousand Oaks, CA: SAGE Publications
  21. Lloyd, D.M. et al. 1983. Cigarette smoking and drug use in school children: Ill-Evaluation of a smoking prevention education program. International Journal of Epidemiology 12(1 ):51-58 https://doi.org/10.1093/ije/12.1.51
  22. Rooney B.L., and Murray D.M. 1996. A meta-analysis of smoking prevention programs after adjustment for errors in the unit of analysis. Health Education Quarterly 23:48-64 https://doi.org/10.1177/109019819602300104
  23. Rosenberg, M.S., Adams, D.C., and Gurevitch, J. 1997. MetaWin: Statistical software for meta-analysis with resampling tests. Sunderland: Sinauer Associates Publishing
  24. Rundall T.G., and Bruvold W.H. 1988. A meta-analysis of school-based smoking and alcohol use prevention programs. Health Education Quarterly 15:317-334 https://doi.org/10.1177/109019818801500306
  25. Scanlon J.W. et al. 1977. Evaluability assessment: Avoiding type III and IV errors. In Evaluation Management: A Source Book of Readings edited by G.R. Gilbert and P.J. Conklin. Charlottesville, VA: US Civil Service Commission
  26. Shaffer, H. et al. 1983. The primary prevention of smoking onset: An inoculation approach. Journal of Psychoactive Drugs 15(3): 177-184 https://doi.org/10.1080/02791072.1983.10471946
  27. Snow, W.H., Gilchrist, L.D., and Schinke, S.P. 1985. A critique of progress in adolescent smoking prevention. Children Youth Service Review 7: 1-19 https://doi.org/10.1016/0190-7409(85)90036-2
  28. Tobler, N.S. 1986. Meta-analysis of 143 adolescent drug prevention programs: Quantitative outcome results of program participants compared to a control for comparison group. The Journal of Drug Issues 16(4):537-567 https://doi.org/10.1177/002204268601600405
  29. Tobler, N.S. 1992. Drug prevention programs can work: Research findings. Journal of Addictive Disease 11(3):1-28
  30. Tobler N.S. 1997. Meta-analysis of adolescent drug prevention programs: Results of the 1993 meta-analysis. NIDA Research Monograph. 170:5-68
  31. U.S. Department of Health and Human Services. 1991. Strategies to control tobacco use in the United States: A blueprint for public health action in the 1990's. Washington, DC: U.S. Government Printing Office (NIH Publication No. 92-3316)
  32. Zucker D.M. 1990. An analysis of variance pitfall: The fixed effects analysis in a nested design. Psychological and Educational Measurement and Evaluation 50: 731-738 https://doi.org/10.1177/0013164490504002