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Randomised controlled trial of the effectiveness of a schools-based, peer-led, smoking intervention. ASSIST (A Stop Smoking in Schools Trial)
Principal Investigators Evaluation Team Health Promotion Trainers Start date: February
2001 The Study This project evaluated a different approach: it was not classroom-based or teacher-delivered; instead, peer-nominated students in Year 8 (aged 12-13) were recruited as 'peer supporters' and given intensive training off the school premises by professional health promotion staff. The peer supporters were trained to intervene effectively with their Year 8 peers in everyday situations to discourage them smoking (Audrey et al., 2004). This approach was based on that used in a successful intervention to reduce unsafe sexual behaviour among gay men (http://www.cdc.gov/hiv/projects/rep/pol.htm). Prior to the full-scale trial, this approach was tested in a feasibility study conducted in four South Wales schools in the mid 1990's (Bloor et al, 1999). The large scale effectiveness trial, known as ASSIST, was funded by a grant of £1.5m from the Medical Research Council, and was led by Professor Laurence Moore from Cardiff Institute of Society, Health and Ethics, and by Dr Rona Campbell from the Department of Social Medicine at the University of Bristol. The project aimed to test the effectiveness of the intervention using a pragmatic cluster randomised trial research design. Fifty-nine schools in South Wales and the Bristol area of England were randomly allocated either to continue with their normal smoking education programme, or to do so with additional peer supporter training. Students were followed up for two years to see whether smoking prevalence in the intervention schools was lower than that in the schools which did not receive the training. In addition, the study involved a substantial component of process evaluation, as well as a health economics analysis to assess the gains of the intervention against the costs of achieving them. The analysis of the trial is complete and a number of papers reporting the results of the process, outcome and economic evaluations have been published (see below) or are under preparation. Two dissemination conferences were held in November 2004, in which the results of the trial were fed back to participating schools. These dissemination events also attracted representatives of local, regional and national health authorities, and included discussions on how the ASSIST intervention could be implemented and funded in future. Following positive findings from the evaluation the ASSIST programme is being rolled out in schools in 'Communities First' areas in Wales, in Bristol PCT and in Tower Hamlets PCT in London. References Bloor M, Frankland J, Parry-Langdon N, et al. A controlled evaluation of an intensive, peer-led, schools-based, anti-smoking programme. Health Education Journal 1999;58:17-25. Moore L, Campbell R, Starkey F, Sidaway M, Holliday J, Audrey S, Parry-Langdon N and Bloor M. A schools-based, peer-led, anti-smoking intervention that appears to work! MRC ASSIST trial. Journal of Epidemiology & Community Health 2004;58,supplement 2, A26 - A27. ASSIST Publications/Presentations 2009 2008 Audrey S, Holliday J, Campbell R. Clarity, commitment and compatibility: Teacher perspectives on the implementation of a school-based health promotion programme. Health Education Journal 2008;67:74-90. 2006 Audrey S, Holliday J, Campbell R. It's good to talk: An adolescent perspective of talking to their friends about being smoke-free. Social Science and Medicine 2006;63(2):320-344. 2005 2003 Conference Presentations 2007 Moore L. MRC ASSIST cluster randomised trial of a schools-based peer-led smoking prevention intervention. MRC Social and Public Health Sciences Unit. Glasgow, 2007 (Invited presentation) Moore L. Cluster randomised trial of a schools-based peer-led smoking prevention intervention’ 19th IUHPE World Conference on Health Promotion and Health Education, Vancouver, June 2007. Moore L. ‘Prevention of smoking uptake among adolescents’ 9th Annual Society for Research on Nicotine and Tobacco Europe Conference, Madrid, October 2007. 2006 Holliday J. The ASSIST intervention: Successfully harnessing informal social networks to reduce adolescent smoking. The British Sociological Association’s Social Network Analysis Group Inaugural Meeting, Manchester, 2006. Campbell R, Starkey F, Holliday J, Hughes R, Audrey S, Parry-Langdon N, Bloor M and Moore L. Positive two-year follow-up findings from A Stop Smoking in Schools Trial (ASSIST), the large-scale cluster randomised trial of a peer-led school-based anti-smoking intervention. Society for Social Medicine 50th Annual Scientific Meeting, Leeds, 13-15th September 2006 Starkey F, Holliday J, Audrey S, Moore L and Campbell R, Identifying influential young people for health promotion peer education: the case study of A Stop Smoking in Schools Trial, England and Wales, 2001-2005 Society for Social Medicine 50th Annual Scientific Meeting, Leeds, 13-15th September 2006 Audrey S, Holliday J and Campbell R. Clarity, commitment and compatibility: Teacher perspectives on the implementation of a school-based health promotion programme. Society for Social Medicine 50th Annual Scientific Meeting, Leeds, 13-15th September 2006 Starkey F, Holliday J, Audrey S, Moore L, and Campbell R. Identifying influential young people for smoking prevention peer education: A Stop Smoking in Schools Trial, England and Wales, 2001-2005. 13th World Conference on Tobacco or Health. Washington DC, 2006. (Poster Presentation) Moore L, Campbell R, Starkey F, Holliday J, Audrey S, Parry-Langdon N and Bloor M. Can we successfully harness peer influence to prevent smoking in adolescence? Lessons from A Stop Smoking in Schools Trial, England and Wales, 2001-2005 13th World Conference on Tobacco or Health. Washington DC, 2006. (Poster Presentation) 2005 Campbell R, Moore L, Starkey F, Audrey S, Holliday J, Parry-Langdon N and Bloor M. A school-based, peer led, anti-smoking intervention that appears to work: A Stop Smoking in Schools Trial, England and Wales, 2001-2005. Thirteenth Annual European Public Health Association Meeting, Graz, 2005. Holliday J, Moore L., Campbell R, Starkey F, Audrey S, Parry-Langdon N, Bloor M. The ASSIST intervention: Successfully harnessing informal social networks to reduce adolescent smoking. International Sunbelt Social Network Conference XXV, Los Angeles, 2005. Moore L. A schools-based, peer-led, anti-smoking intervention that appears to work: MRC ASSIST trial. Bradford Hill Seminar, University of Cambridge Institute of Public Health, 2005 (Invited speaker). Moore L. Schools-based peer-led intervention to reduce uptake of smoking in adolescence. European Network on Young People and Tobacco Spring School, National Public Health Institute, Helsinki, 2005 (Invited speaker). Starkey F, Moore L, Campbell R, Holliday J, Audrey S, Parry-Langdon N. A schools-based peer-led anti-smoking intervention: results from MRC trial and issues for implementation. 'Renewing Public Health: Renaissance and Responsibility', 13th Annual Public Health Forum, Gateshead, 2005. Starkey F, Holliday J, Audrey S and Campbell R. Identifying influential young people for peer education: the case study of A Stop Smoking in Schools Trial, England and Wales, 2001-2005. Thirteenth Annual European Public Health Association Meeting, Graz, 2005. 2004 Audrey S, Holliday J, Parry-Langdon N, Campbell R. Implementing process evaluation within a randomised controlled trial to evaluate a schools-based, peer-led smoking intervention. British Sociological Association Medical Sociology Conference. York, 2004. Moore L, Campbell R, Starkey F, Sidaway M, Holliday J, Audrey S, Parry-Langdon N, Bloor M. A schools-based, peer-led, anti-smoking intervention that appears to work! MRC ASSIST trial. Society for Social Medicine 48th Annual Scientific Meeting. Birmingham, 2004. Holliday J, Moore L. on behalf of ASSIST. An intervention using peer supporters to spread anti-smoking messages through their social networks: rationale, implementation and impact in 30 schools. International Sunbelt Social Network Conference XXIV. Slovenia, 2004. Holliday J, Moore L. Peer nomination as a method of selecting socially influential students for peer-led interventions: a social network perspective. International Sunbelt Social Network Conference XXIV. Slovenia, 2004. Moore L, Campbell R, Starkey F, Sidaway M, Holliday J, Audrey S, Parry-Langdon N, Bloor M. MRC cluster randomised trial of a school-based, peer-led anti-smoking intervention. Faculty of Public Health Annual Scientific Meeting. Edinburgh, 2004. 2003 Moore L. Can a schools-based, peer-led intervention reduce the uptake of smoking by adolescents? BSA Medical Sociology Wales Study Group Research Seminar Series. Cardiff, 2003. Moore L, Campbell R, Starkey F, Sidaway M, Holliday J, Audrey S, Parry-Langdon N, Bloor M. MRC cluster randomised trial of a school-based, peer-led anti-smoking intervention. Society for Social Medicine 47th Annual Scientific Meeting. Edinburgh, 2003 (poster presentation). Moore L, Campbell R, Starkey F, Sidaway M, Holliday J, Audrey S, Parry-Langdon N, Bloor M. MRC cluster randomised trial of a school-based, peer-led anti-smoking intervention. World Conference on Tobacco or Health. Helsinki, 2003. Moore L. The MRC funded ASSIST project. World Health Organisation Health Behaviour in School-Aged Children. Conference on Health and Health Behaviours in Context. Bergen, Norway, 2003. Campbell R, Moore L, Starkey F, Audrey S, Holliday J, Sidaway M. The ASSIST project: a cluster randomised trial of a school-based peer-led anti-smoking intervention. 7th Annual South West Public Health Scientific Conference. Weston Super-Mare, 2003. 2002 |
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