CONDUCT EVALUATION

If you want to know if your program is effective in helping teens cut down or quit smoking altogether, you may want to consider conducting an evaluation. An assessment is a good way to collect information about the success of your intervention. Depending on the level of the evaluation, however, it may require a research staff with expertise in collecting data, creating SPSS databases, and conducting and interpreting analyses.

Other factors to consider when performing the assessment would be:

• Eligibility criteria for participants;
• Recruitment strategies; and
• Participant incentives.

Program goals could address the following questions:

• Did the program have an effect on smoking behavior?
• Did the program assist the participants to progress through the Stages of Change?
• Did the program assist the participants in improving their knowledge about smoking and quitting or intentions to quit?

Many instruments are available to assess these areas. Typically, data collection occurs throughout the program and at follow-up, such as at baseline, the end of the program, and at 1 month, 6 months, and 1 year.

What do you want to measure?

More specifically, you may want to examine whether teens in the ASCENT program at the end points, when compared to teens in a control group (with no intervention), will:

• Smoke less (as measured by self-report or biochemical validation);
• Have a higher quit rate;
• Report greater progression through the Stages of Change; and
• Report greater intentions to quit smoking, more tries to quit, and longer abstinences from smoking.

Potential measures to consider:

1. Contact information to track the participants for follow-up sessions. Information requested would include name, address, phone number, email address, and cell phone numbers of the participant, his or her parents or guardians, and another person who will always know how to contact the participant.



2. Knowledge questions to assess if participants learned the skills necessary to stop smoking.



3. Stages of Change questions to assess the participants' readiness to quit smoking. The ASCENT program was designed using concepts from the Stages of Change Model introduced by Prochaska and DiClemente (two prolific researchers in the area of health behavior) in the early to mid-1980s. The basic premise is that behavior change is a process, not an event, in which individuals are at varying levels of motivation, or readiness, to change. People at different points on the change continuum will benefit from different kinds of interventions matched to their stage at that time.


Listed below are the five distinct stages identified in the Stages of Change Model, the strategies that might be effective, and how ASCENT will reach the youth at each stage:

Pre-contemplation: Unaware of the problem; hasn't thought about change. At this stage, increased awareness of the need for change and personalized information is necessary, perhaps through a risks and benefits analysis. ASCENT helps teens explore the pros and cons of smoking.

Contemplation: Thinking about change in the near future. This is a good time to motivate and encourage the individual to make specific plans. Using youth to convince youth, ASCENT provides teens with the support to motivate and encourage each other to make the decision to quit smoking.

Decision and determination: At this point, an individual is considering trying to quit and is close to being ready to try. This is the right time to help develop concrete action goals and intermediate goals. ASCENT educates youth in how to identify their smoking triggers and various strategies to cope with these triggers. By providing specific strategies, youth are armed with the confidence to try to quit.

Action: Implementation of specific action plans. At this stage, the individual needs feedback, assistance with problem solving, social support, and reinforcement. Provide specific strategies in relation to quitting and use the youth dynamic to motivate and reinforce this important behavior change. The ASCENT curriculum gives students the knowledge and support to quit.


4. The Minnesota Nicotine Withdrawal Questionnaire (NWQ) (Hughes and Hatsukami 1986) assesses self-report ratings of eight nicotine withdrawal symptoms on a scale from 0 to 4. This measure has been shown to be valid and sensitive to withdrawal effects in smokers.



5. The Fagerstrom Tolerance Questionnaire (FTQ, Fagerstrom 1978) has been extensively used and validated for measuring nicotine dependence for adults. A modified version, the Stanford Dependence Inventory, has been validated for use with adolescents (Rojas, Killen, Haydel, and Robinson 1998).

In addition, physiological measures of nicotine intake such as saliva cotinine levels and expired carbon monoxide levels could also be collected to validate self-report. For more information on measuring outcomes for ASCENT, please refer to the CDC's Website at: http://www.cdc.gov/tobacco/evaluation_manual/ch4.html or feel free to contact us at info@teenquit.com.