Abstract
Background: The purpose of this study was to develop a structured and individualized smoking prevention program for adolescents by utilizing a multimedia computer-assisted instruction model and to empirically assess its effect. Method: For the purpose of this study, a guide book of smoking prevention program for middle and high school students was developed as the first step. The contents of this book were summarized and developed into an actual multimedia CAI smoking prevention program according to the Gane & Briggs instructional design and Keller's ARCS motivation design models as the second step. At the final step, the short-tenn effects of this program were examined by an experiment. This experiment were made for middle school and high school students and the quasi experimental design was the pretest - intervention - posttest. The measured data was attitude, belief, and knowledge about smoking, interest in the program, and learning motivation. Result: The results of this study were as follows: First, the guide book of a smoking prevention program was developed and the existing literature on adolescent smoking was analyzed to develop the content of the guide book. Then the curriculum was divided into three main domains on tobacco and smoking history, smoking and health, adolescent smoking and each main domain was divided into sub-domains. Second, the contents of the guide book were translated into a multimedia CAI program of smoking prevention througn Powerpoint software according to the instructional design theory. The characteristics of this program were interactive, learner controllable, and structured The program contents consisted of entrance(5.6%), history of tobacco(30%), smoking and health(38.9%), adolescent smoking(22.2%), video(4.7%), and exit(1.6%). Multimedia materials consisted of text(121), sound and music, image(still 84, dynamic 32), and videogram(6). The program took about 40 minutes to complete. Third, the results on analysis of the program effects were as follows: 1) There was significant knowledge increase between the pre-test and post-test with total mean difference 3.44, and the highest increase was in the 1st grade students of high school(p<0.001). 2) There was significant decrease in general belief on smoking between the pre-test and post-test with total mean difference 0.28. In subgroup analysis, the difference was significantly higher in the 1st grade of high school (p<0.001), low income class (p<0.001), and daily smokers (p<0.01). 3) There was no significant difference in attitudes on his personal smoking between the pre-test and post-test. 4) The interest in the program seemed to lower as students got older. The score of motivation toward this prevention program was the highest in the middle school 3rd grade. Among sub-domains of motivation, the confidence score was the highest. Conclusion: To be most effective, the smoking prevention program for adolescents should utilize the most up-to-date and accurate information on smoking, and then instructional material should be developed so that the learners can approach the program with enjoyment. Through this study, a guide book with the most up-to-date information was developed and the multimedia CAI smoking prevention program was also developed based on the guide book. The program showed positive effect on the students' knowledge and belief in smoking.