Pragmatic pilot cluster randomised control trial of a school-based peer-led anti-smoking intervention for 13-14 year olds in Malaysia: Process evaluation
Abstract
Purpose
The purpose of this paper is to report the process evaluation of a pilot randomised control trial of an anti-smoking intervention for Malaysian 13-14-year olds, conducted in 2011/2012. It was hypothesised that trained peer supporters would promote non-smoking among classmates through informal conversations.
Design/methodology/approach
Smoking-related baseline and follow-up questionnaires were administered, seven months apart, to Form 1 students (n=2,118) attending eight schools across two districts in Sabah (Kota Kinabalu; Keningau). Concealed stratified randomisation assigned two schools per district to the control and intervention arms. Control schools received usual care. Intervention schools received usual care and the peer supporter intervention. Peer supporters completed smoking-related knowledge and attitudes questionnaires before and after peer supporter training and peer supporter training evaluation questionnaires. They also discussed the peer supporter training and role in focus groups immediately following training (n=4) and three months later (n=3), and additionally, recorded post-training anti-smoking activity in diaries.
Findings
The pilot trial found that student recruitment was high (baseline students matched at follow-up n=1,681 (79 per cent of class-registered students). More boys (n=38) than girls (n=35) attended peer supporter training. Post-training, most peer supporters had improved smoking-related knowledge (n=55; 75 per cent) and attitudes (n=57; 78 per cent) and returned diaries (n=49; 67 per cent). Some focus group boys reported they were reluctant peer supporters and/or found resisting smoking difficult.
Practical implications
Future trials would benefit from outlined modifications to peer supporter selection, recruitment and training and additionally, assessments of context and intervention acceptability and reach.
Originality/value
Trials of complex public health interventions are scarce in economically developing countries.
Keywords
Acknowledgements
The authors would like to thank members of staff from the Sabah State Health Department (Sabah Health Promotion Unit and Sabah Non-Communicable Disease Unit) for their support and help during the pilot trial and peer supporter training. The authors would also like to thank Dr Dahlia Janan for back translating the quotes included in this paper.
Citation
Melson, E., Bridle, C. and Markham, W. (2017), "Pragmatic pilot cluster randomised control trial of a school-based peer-led anti-smoking intervention for 13-14 year olds in Malaysia: Process evaluation", Health Education, Vol. 117 No. 6, pp. 599-616. https://doi.org/10.1108/HE-02-2017-0013
Publisher
:Emerald Publishing Limited
Copyright © 2017, Emerald Publishing Limited