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311493
Implementing a nationwide school-based waterpipe tobacco smoking prevention intervention: Challenges and lessons learned
Monday, November 17, 2014
Rima Afifi, PhD, MPH
,
Faculty of Health Sciences, Dept of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
Rima Nakkash, DrPH
,
Health Promotion and Community Health Department, American University of Beirut, Beirut, Lebanon
Dima Bteddini, MS
,
Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
Ahmad Al Mulla, MD
,
Hamad Medical Corporation, Doha, Qatar
Waterpipe tobacco smoking (WTS) is a growing epidemic worldwide; and systematic reviews have shown deleterious health effects. Among youth populations in the Eastern Mediterranean Region, WTS is surpassing cigarettes smoking. To date, no school-based intervention for WTS has been evaluated. We implemented and evaluated a school-based WTS intervention in a random representative sample of 32 schools all over Lebanon (15 intervention/ 17 control schools) in 2011-2012. Results indicated significant changes in knowledge and attitudes compared to students in control schools, and some trends towards smoking cessation. The implementation of the intervention faced many challenges documented in journals kept by the facilitators and through observations - including those related to (1) the school setting such as small rooms, lack of heating, electricity, and resources; (2) methods of learning: the intervention used interactive participatory methods in a very traditional school system; (3) the socio-political situation of the country including teachers strikes, and political violence; (4) the wide social acceptance of waterpipe smoking; (5) implementation of school-based intervention within an academic year which makes any delays costly; (6) the scope of the intervention including the scheduling of ten sessions, and the national reach; and (7) the difficult social situations of students including death of family members, involvement in drugs, abject poverty. Lessons learned include the critical acknowledgement of context in success of an intervention program, the necessity of engaging various levels of influence, and the importance of a multi--disciplinary team in school-based interventions - even for interventions that seem ‘health’ focused.
Learning Areas:
Implementation of health education strategies, interventions and programs
Learning Objectives:
Describe the health effects of waterpipe smoking
Explain the components of a school-based intervention program to prevent waterpipe smoking
Identify the main barriers to implementation of the school-based intervention
Discuss lessons learned in implementing school-based waterpipe prevention programs with consideration of context
Keyword(s): School-Based Health, Tobacco Control
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am the principal investigator on this grant and a professor in the Faculty of Health Sciences at the American University of Beirut
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
