Melson, Elniee, Bridle, Christopher and Markham, Wolfgang A. (2017) Pragmatic pilot cluster randomised control trial of a schoolbased peer-led anti-smoking intervention for 13-14 year olds in Malaysia : process evaluation. Health Education, 117 (6). pp. 599-616. doi:10.1108/HE-02-2017-0013 ISSN 0965-4283.

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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.

Item Type:	Journal Article
Subjects:	H Social Sciences > HV Social pathology. Social and public welfare
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Smoking cessation, School children -- Health and hygiene -- Malaysia
Journal or Publication Title:	Health Education
Publisher:	Emerald Group Publishing Ltd.
ISSN:	0965-4283
Official Date:	2 September 2017
Dates:	Date Event 2 September 2017 Published 9 July 2017 Accepted
Volume:	117
Number:	6
Page Range:	pp. 599-616
DOI:	10.1108/HE-02-2017-0013
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Date of first compliant deposit:	17 July 2017
Date of first compliant Open Access:	23 January 2018
Related URLs:	Other Repository

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