Towards ’smoke-free school hours’ as part of routine practice: Examining implementation processes and outcomes related to the Smoke-Free Vocational Schools intervention

Anneke Vang Hjort

doi:10.21996/b71e-z862

Towards ’smoke-free school hours’ as part of routine practice: Examining implementation processes and outcomes related to the Smoke-Free Vocational Schools intervention

Anneke Vang Hjort

Statens Institut for Folkesundhed

Publikation: Afhandling › Ph.d.-afhandling

277 Downloads (Pure)

Abstract

I 2020, røg 29 % af elever på danske erhvervsskoler dagligt; sammenlignet med 13 % i den danske befolkning. Politikken ”røgfri skoletid” forbyder rygning og brug af andre tobaksprodukter i løbet ad skoledagen – både indenfor og udenfor skolens område. Politikken kan derfor potentielt nedbringe rygning på skolerne. Dog afhænger effekten af, hvor godt politikken er integreret (kaldet: implementeret) ind i hverdagen på skolerne.

Dette Phd studie var en del af interventionsprojektet Røgfri Erhvervsskoler, der understøttede syv skoler i at implementere røgfri skoletid. Phd studiet skabte viden, om hvilke samt hvordan interventionsaktiviteter og processer stimulerede implementering af politikken. PhD studiet bestod af fire delstudier.

Studie 1 identificerede barrierer og faciliterende forhold for organisatorisk parathed til at implementere røgfri skoletid. Dette studie blev anvendt til at udvikle interventionsaktiviteterne i Røgfri Erhvervsskoler. Studie 2 demonstrerede en ”programteori” i forhold til hvordan interventionsaktiviteterne var tiltænkt at understøtte implementering. Dette studie muliggjorde en empirisk undersøgelse. Studie 3 kvantificerede associationer mellem interventionsaktiviteter og implementering af politikken. Som en forudsætning, udviklede vi et kvantitativt ”mål” for implementering af politikken. Studie 4 undersøgte de processer, dvs. handlen og måder at tænke på, der skabte implementering af politikken.

Fire processer stimulerede implementering: (1) en fælles forståelse af politikkens formål, (2) at opleve håndhævelse som en legitim del af skolearbejdet, (3) at sikre konsistent håndhævelse, og (4) formelle og uformelle vurderinger af politikkens virkning. Fem interventionsaktiviteter understøttede implementeringen: (1) at indføre strukturelle alternativer til rygning – for at skabe et bedre socialt studiemiljø, (2) en fælles workshop for ansatte og ledere, (3) klare regler og ansvarsfordelinger, (4) hjælp og støtte udefra fx fra andre skoler, kommuner, og NGO’er, og (5) at gennemføre aktiviteter der forbereder ansatte, ledere og elever (før politikken træder i kraft).

Fremtidig forskning bør undersøge både tilsigtede og utilsigtede konsekvenser af implementering af røgfri skoletid, på individ-niveau, herunder virkningen i forhold til rygning, brug af andre tobaksprodukter samt stigmatisering.

Originalsprog	Engelsk
Bevilgende institution	Syddansk Universitet
Vejledere/rådgivere	Tjørnhøj-Thomsen, Tine, Hovedvejleder Pisinger, Charlotta, Bivejleder Klinker, Charlotte, Bivejleder
Udgiver	Syddansk Universitet. Det Sundhedsvidenskabelige Fakultet
DOI	https://doi.org/10.21996/b71e-z862
Status	Udgivet - 21. feb. 2023

Note vedr. afhandling

Den fulde afhandling kan læses på SDUs bibliotek.

Finansiering

This work was funded by the Danish Health Authority as part of the Smoke-Free Vocational Schools intervention (1/3); the Faculty of Health Science, University of Southern Denmark (1/3); and Steno Diabetes Center Copenhagen (1/3).

Dokumenter og links

10.21996/b71e-z862

Open access version (reduced version)Forlagets udgivne version, 12,6 MB

SDU link

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4 Tidsskriftartikel

Unraveling the “black box” of school tobacco policy implementation: A mixed-methods study at Danish vocational schools informed by Normalization Process Theory
Hjort, A. V., Klinker, C. D., Kuipers, M. A. G., Pisinger, C. & Tjørnhøj-Thomsen, T., 2025, I: Implementation Research and Practice. 6, 20 s., 26334895251377658.
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

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Intervention Activities Associated with the Implementation of a Comprehensive School Tobacco Policy at Danish Vocational Schools: A Repeated Cross-Sectional Study
Hjort, A. V., Kuipers, M. A. G., Stage, M., Pisinger, C. & Klinker, C. D., 30. sep. 2022, I: International Journal of Environmental Research and Public Health. 19, 19, 19 s., 12489.
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

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Are Danish vocational schools ready to implement "smoke-free school hours"? A qualitative study informed by the theory of organizational readiness for change
Hjort, A. V., Schreuders, M., Rasmussen, K. H. & Klinker, C. D., 9. apr. 2021, I: Implementation Science Communications. 2, 1, 40.
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

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Citationsformater

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title = "Towards {\textquoteright}smoke-free school hours{\textquoteright} as part of routine practice: Examining implementation processes and outcomes related to the Smoke-Free Vocational Schools intervention",

abstract = "In Denmark, the smoking prevalence among students enrolled in vocational education- and training is high (29 \% smoked daily In 2020; compared to 13 \% in the general population). The {\textquoteleft}smoke-free school hours{\textquoteright} policy stipulates that using any tobacco products is prohibited during school time {\textendash} inside and outside school premises. The policy might be effective to reduce smoking among Danish vocational school students. Yet, the effectiveness depends on how well the policy is implemented into routine practice. Knowledge on implementation is needed. This PhD study was part of the Smoke-Free Vocational Schools intervention, which aimed to support seven schools in implementing the smoke-free school hours policy. Specifically, this PhD study provided knowledge on which and how intervention activities and mechanisms leveraged the implementation of smokefree school hours {\textendash} through four studies. Study 1 identified barriers to and facilitators for organizational readiness to implement the smoke-free school hours policy, which was used to develop the SmokeFree Vocational Schools intervention. Study 2 depicted a programme theory of how the intervention was expected to leverage policy implementation, which constituted a platform for testing activities and mechanisms. Study 3 assessed associations between the intervention activities and policy implementation outcomes. As a prerequisite, we developed a set of implementation outcome measures for the policy. Study 4 investigated the implementation mechanisms, i.e., the reasoning and behavior change, that produced implementation outcomes. Four mechanisms were likely to leverage policy implementation: (1) a shared vision, (2) legitimacy beliefs regarding sanctioning and enforcement, (3) behavior change to ensure consistent enforcement, and (4) formal and informal appraisal of positive impact. Five intervention activities were beneficial implementation strategies: (1) structural means to achieve a better social environment, (2) a joint workshop for all staff and managers, (3) clear rules and responsibilities, (4) external support, and (5) delivering activities before the policy was put into force. Future research should investigate intended and unintended individual-level outcomes associated with policy implementation, namely, cigarette use, smokeless tobacco use, and stigmatization. ",

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Towards ’smoke-free school hours’ as part of routine practice: Examining implementation processes and outcomes related to the Smoke-Free Vocational Schools intervention

Abstract

Note vedr. afhandling

Finansiering

Dokumenter og links

SDU link

Fingeraftryk

Relaterede publikationer

Unraveling the “black box” of school tobacco policy implementation: A mixed-methods study at Danish vocational schools informed by Normalization Process Theory

Intervention Activities Associated with the Implementation of a Comprehensive School Tobacco Policy at Danish Vocational Schools: A Repeated Cross-Sectional Study

Are Danish vocational schools ready to implement "smoke-free school hours"? A qualitative study informed by the theory of organizational readiness for change

Citationsformater