Implementation fidelity and adolescent smoking

The X:IT study-A school randomized smoking prevention trial

Lotus Sofie Bast*, Anette Andersen, Annette Kjær Ersbøll, Pernille Due

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND: Assessing the actual implementation of multi-component interventions can provide important knowledge for future interventions. Intervention components may be implemented differently, knowledge about this can provide an understanding of which components are essential and therefore must be included. The aim of this study was to examine the implementation of one, two, or all three main intervention components at the individual level and to assess the association to current smoking among 13 year-olds in the X:IT study.

METHODS: Data stems from a cluster-randomized controlled trial in 94 Danish elementary schools (51 intervention; 43 control schools). Implementation was measured by aspects of adherence, dose, quality of delivery, and participant responsiveness based on questionnaire data from 4161 pupils at baseline (mean-age: 12.5 years) and 3764 pupils at first follow-up eight months later. Coordinator responses from 49 intervention schools were also included. Associations between individual level implementation of the three main components and pupil smoking were examined through a 3-level logistic regression model.

RESULTS: Although implementation fidelity for the three main intervention components was good, only one third (38.8%) of pupils in intervention schools were exposed to full implementation of the intervention. Among these pupils odds ratio for smoking was 0.25 (95% CI: 0.15 - 0.42).

CONCLUSIONS: School-based programs can be very effective if carefully implemented. Future school-based smoking preventive initiatives should include multiple components, and seek to enhance implementation quality of all components.

Original languageEnglish
JournalEvaluation and Program Planning
Volume72
Pages (from-to)24-32
ISSN0149-7189
DOIs
Publication statusPublished - Feb 2019

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smoking
Pupil
Smoking
adolescent
pupil
school
Logistic Models
trial
Fidelity
logistics
Randomized Controlled Trials
Odds Ratio
elementary school
regression
questionnaire

Cite this

@article{a68c2aa38b63445294d3ef57730a89a1,
title = "Implementation fidelity and adolescent smoking: The X:IT study-A school randomized smoking prevention trial",
abstract = "BACKGROUND: Assessing the actual implementation of multi-component interventions can provide important knowledge for future interventions. Intervention components may be implemented differently, knowledge about this can provide an understanding of which components are essential and therefore must be included. The aim of this study was to examine the implementation of one, two, or all three main intervention components at the individual level and to assess the association to current smoking among 13 year-olds in the X:IT study.METHODS: Data stems from a cluster-randomized controlled trial in 94 Danish elementary schools (51 intervention; 43 control schools). Implementation was measured by aspects of adherence, dose, quality of delivery, and participant responsiveness based on questionnaire data from 4161 pupils at baseline (mean-age: 12.5 years) and 3764 pupils at first follow-up eight months later. Coordinator responses from 49 intervention schools were also included. Associations between individual level implementation of the three main components and pupil smoking were examined through a 3-level logistic regression model.RESULTS: Although implementation fidelity for the three main intervention components was good, only one third (38.8{\%}) of pupils in intervention schools were exposed to full implementation of the intervention. Among these pupils odds ratio for smoking was 0.25 (95{\%} CI: 0.15 - 0.42).CONCLUSIONS: School-based programs can be very effective if carefully implemented. Future school-based smoking preventive initiatives should include multiple components, and seek to enhance implementation quality of all components.",
author = "Bast, {Lotus Sofie} and Anette Andersen and Ersb{\o}ll, {Annette Kj{\ae}r} and Pernille Due",
note = "Copyright {\circledC} 2018 Elsevier Ltd. All rights reserved.",
year = "2019",
month = "2",
doi = "10.1016/j.evalprogplan.2018.09.004",
language = "English",
volume = "72",
pages = "24--32",
journal = "Evaluation and Program Planning",
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Implementation fidelity and adolescent smoking : The X:IT study-A school randomized smoking prevention trial. / Bast, Lotus Sofie; Andersen, Anette; Ersbøll, Annette Kjær; Due, Pernille.

In: Evaluation and Program Planning, Vol. 72, 02.2019, p. 24-32.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Implementation fidelity and adolescent smoking

T2 - The X:IT study-A school randomized smoking prevention trial

AU - Bast, Lotus Sofie

AU - Andersen, Anette

AU - Ersbøll, Annette Kjær

AU - Due, Pernille

N1 - Copyright © 2018 Elsevier Ltd. All rights reserved.

PY - 2019/2

Y1 - 2019/2

N2 - BACKGROUND: Assessing the actual implementation of multi-component interventions can provide important knowledge for future interventions. Intervention components may be implemented differently, knowledge about this can provide an understanding of which components are essential and therefore must be included. The aim of this study was to examine the implementation of one, two, or all three main intervention components at the individual level and to assess the association to current smoking among 13 year-olds in the X:IT study.METHODS: Data stems from a cluster-randomized controlled trial in 94 Danish elementary schools (51 intervention; 43 control schools). Implementation was measured by aspects of adherence, dose, quality of delivery, and participant responsiveness based on questionnaire data from 4161 pupils at baseline (mean-age: 12.5 years) and 3764 pupils at first follow-up eight months later. Coordinator responses from 49 intervention schools were also included. Associations between individual level implementation of the three main components and pupil smoking were examined through a 3-level logistic regression model.RESULTS: Although implementation fidelity for the three main intervention components was good, only one third (38.8%) of pupils in intervention schools were exposed to full implementation of the intervention. Among these pupils odds ratio for smoking was 0.25 (95% CI: 0.15 - 0.42).CONCLUSIONS: School-based programs can be very effective if carefully implemented. Future school-based smoking preventive initiatives should include multiple components, and seek to enhance implementation quality of all components.

AB - BACKGROUND: Assessing the actual implementation of multi-component interventions can provide important knowledge for future interventions. Intervention components may be implemented differently, knowledge about this can provide an understanding of which components are essential and therefore must be included. The aim of this study was to examine the implementation of one, two, or all three main intervention components at the individual level and to assess the association to current smoking among 13 year-olds in the X:IT study.METHODS: Data stems from a cluster-randomized controlled trial in 94 Danish elementary schools (51 intervention; 43 control schools). Implementation was measured by aspects of adherence, dose, quality of delivery, and participant responsiveness based on questionnaire data from 4161 pupils at baseline (mean-age: 12.5 years) and 3764 pupils at first follow-up eight months later. Coordinator responses from 49 intervention schools were also included. Associations between individual level implementation of the three main components and pupil smoking were examined through a 3-level logistic regression model.RESULTS: Although implementation fidelity for the three main intervention components was good, only one third (38.8%) of pupils in intervention schools were exposed to full implementation of the intervention. Among these pupils odds ratio for smoking was 0.25 (95% CI: 0.15 - 0.42).CONCLUSIONS: School-based programs can be very effective if carefully implemented. Future school-based smoking preventive initiatives should include multiple components, and seek to enhance implementation quality of all components.

U2 - 10.1016/j.evalprogplan.2018.09.004

DO - 10.1016/j.evalprogplan.2018.09.004

M3 - Journal article

VL - 72

SP - 24

EP - 32

JO - Evaluation and Program Planning

JF - Evaluation and Program Planning

SN - 0149-7189

ER -