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The 13th World Conference on Tobacco OR Health
Building capacity for a tobacco-free world
July 12-15, 2006, Washington, DC, USA
Objective: Peer education is a smoking prevention approach often used with adolescents, but attention is rarely given to how peer educators are selected to maximise interventions' impact. This school-based study aimed to develop an effective ‘whole community' process for identifying influential Year 8 students to train and act as ‘peer supporters', intervening informally to reduce smoking amongst their peers. The intervention was evaluated as part of ASSIST, a cluster randomised controlled trial involving 10,370 12 to 13 year-olds at baseline in 59 Welsh and English schools.
Methods: Rather than staff- or self-selection, the intervention used young people themselves to identify peers they viewed as influential. Preliminary piloting work was undertaken to identify characteristics students associated with ‘influence'. From these, several questions to identify influential peers were developed and piloted. The three most ‘successful' questions were used in the main trial to identify potential peer supporters.
Results: The peer nomination process succeeded in identifying a diverse and representative group of students, 87% (816 of 942) of whom did undertake the peer supporter role. One-year follow-up results, whereby regular smoking prevalence by treatment group was 23.1% (C: 95% CI=19.9-26.6) and 18.8% (I: 95% CI=15.7-22.4) among the ‘high-risk' group of experimental, occasional and ex-smokers (the trial's primary outcome measure), suggest that the peer supporters succeeded in reducing smoking uptake. Given the increasing popularity of smoking prevention peer education, yet the scarcity of carefully developed peer educator identification processes, ASSIST's experience can inform other peer education projects aiming to influence smoking behaviour.