Research
Bihar School Teacher study

This study is a Five year (2008-2013) collaborative effort with the Dana-Farber Cancer Institute, Boston MA, USA. Additional collaborators are the University of Minnesota, the New England Research Institute, and Harvard School of Public Health.

This project involved testing a behavioral intervention among Bihar School teachers for tobacco cessation using a Randomized Control Trial design.

Objectives:

Assess the extent to which a comprehensive tobacco control intervention results in increased cessation of tobacco use among teachers in Bihar schools along with changes in school tobacco control policies.

Assess the extent to which a comprehensive tobacco control intervention results in changes in defined mediating mechanisms among teachers.

Assess key indicators of intervention implementation among schools assigned to the intervention condition.

Research methodology:

This randomized controlled trial uses the school as the unit of intervention and randomization. Government schools (N=72) including grades 8-10 in the state of Bihar, India, were randomly selected, recruited to participate in the study, and randomly assigned within two strata (rural/urban) to one of two conditions: an intervention condition or a delayed intervention control condition. The study was conducted on a rolling basis in the two waves, each with 36 randomly selected schools initiating the study over two consecutive academic years. A nine-month (July-March) intervention conducted throughout a single academic year included promotion of tobacco control policy adoption and enforcement, and educational programming and cessation assistance for teachers. Three surveys of teachers was conducted: at baseline at the beginning of the school year (June), immediately post-intervention at the end of the school year (March), and six months post-intervention (September). The primary outcome was six-month continuous abstinence from tobacco use among teachers at the six-month post intervention assessment.

Intervention development: The intervention had been designed on the basis of well-established tobacco control principles, using evidence-based best practices from the US and elsewhere, on extensive preliminary studies and on a firm understanding of the local setting. We systematically incorporated themes identified in our formative research in developing this intervention.  Thereafter, a six-month intervention was conducted throughout a single academic year that included promotion of tobacco control policy adoption and enforcement, and educational programs & cessation assistance for teachers.

Schools randomly assigned to the delayed intervention control condition received no intervention until after the completion of the final six-month post-intervention survey. The abbreviated intervention will followed the protocol for the intervention schools, benefiting from lessons learned during the implementation of the intervention.

Current status:

At present, the program phase has been completed and data analysis is ongoing for measurement of tobacco prevalence; impact of the intervention in tobacco cessation & policy implementation and various other topics.

 
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