Descriptive literature review on the evaluation of the youth smoking prevention program effectiveness

청소년 흡연중재 교육프로그램의 효과평가에 관한 설명적 문헌고찰

The age of the very first smoking is a significant indicator of life-long health status. Smoking prevention intervention was actively conducted based in middle and high schools with the support of the Korean Act for Health Promotion since 1998. These governmental supports became large and various smoking prevention programs were developed and conducted in diverse standards and perspectives. This study made a comprehensive descriptive literature review on smoking prevention educational programs for youth in Korea to identify the intervention quality and effectiveness of them for future smoking prevention program development. A total of 28 peer-reviewed journal articles published between May, 1995 and May 2005 (for the last 10 years) were finally included in this review process. The study participants should be adolescences in middle or high schools in Korea and the intervention types of the review studies should be smoking prevention or cessation educational programs. The outcomes of the reviewed studies were reanalyzed by the participants' characteristics, theory basement, evaluation design, intervention period, evaluation outcomes, and program effectiveness Most smoking intervention programs were not specified by sex and smoking status. Largely most intervention programs focused on male students although female students' smoking percent is increasing including both smokers and nonsmokers. Based on the school grades, the large percents of smoking intervention were conducted to the first grade of middle school and the first grade of high school. Almost 70% of the reviewed studies did not apply any health behavior change theories and the Transtheoretical model and social cognitive theory were utilized in 7 studies among the last reviewed 30%. The theory-based intervention studies had greater effectiveness than the non-theory based studies. More than 90% had quasi-experimental evaluation design and the effectiveness of the non-experimental designed study seemed over estimated than the quasi-experimental or experimental designed studies. More than 60% of the reviewed studies made their education for less than j days, over a short period and the evaluation factors were knowledge and attitude in general which can be obtained in short intervention period. Therefore, smoking intervention programs for youth in Korea need to be modified in terms of research design such as the intervention period, intervention-evaluation design, theory-based approach, and population-focused intervention specification.