National Institute of Health Research

PHR - 13/42/02: The Filter FE Challenge: pilot trial and process evaluation of a multi-level smoking prevention intervention in further education settings

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Project title The Filter FE Challenge: pilot trial and process evaluation of a multi-level smoking prevention intervention in further education settings
Research type Primary Research
Status Research in progress
Start date July 2014
Publication date

January 2017

This is the estimated publication date for this report, but please note that delays in the editorial review process can cause the forecast publication date to be delayed.

Cost £ 339,604.00
Chief Investigator Dr Adam Fletcher
Co-investigators Professor Christopher Bonell (London School of Hygiene & Tropical Medicine), Professor William Hollingworth (University of Bristol), Dr Beki Langford (University of Bristol), Professor Simon Murphy (Cardiff University), Dr James White (Cardiff University), Ms Julia Townson (Cardiff University), Professor Rona Campbell (University of Bristol), Dr Graham Moore (Cardiff University), Dr Annie Williams (Cardiff University)
Contractor Cardiff University
Plain English summary Smoking remains the leading cause of ill health and early death in the UK. Preventing young people from taking up smoking is vital to improve public health. More than 1.5 million 16-18 year olds are now enrolled on further education (FE) courses in the UK but there remains very little investment in smoking prevention activities in FE settings such as general FE colleges and sixth form colleges. Yet this is the precise time when many people start to smoke, with over 40% of adult smokers reporting they started smoking aged between 16 and 19. The transition to FE itself will increase the risk of starting smoking for some young people as they make new friends and have more independence from their parents. This research will evaluate a new smoking prevention project for 16-18 year olds that has been designed to be delivered in both general FE colleges and sixth form colleges to address the lack of prevention activities in these settings at present. The project is called The Filter FE Challenge . We will evaluate this project over one college-year (2014-15) initially to check if it is delivered as planned and how acceptable (or not) it is with staff and students in different colleges. To do this, researchers will work with Action on Smoking and Health (ASH) Wales and six colleges (including large FE colleges as well as smaller sixth form colleges) in Wales, with three participating in the project and the other three continuing with their normal practice and acting as a control group . At the three colleges where the project is delivered, ASH Wales will provide project managers, education officers, social media experts and trained youth workers to help these colleges to implement a range of new smoking prevention activities. First, the project manager will work with the college and local officials to ensure those under age 18 cannot buy tobacco products in the surrounding shops. Second, the project manager will work with college staff to implement smoke-free policies. Third, education officers will train college staff to teach students about the harms of smoking and how to change their campus environment. Fourth, existing web-based information, social media campaigns and on-line services designed for young people will be integrated with the college s website and social media. Fifth, youth workers will provide credible messages about smoking and resisting peer pressure, and signpost support services. At the moment we don t know if it will be possible to implement all these activities in full in different types of FE colleges, or if these activities will prove acceptable to staff and students. There may even be unintended consequences that no-one has anticipated and the project may need to be revised. We will therefore assess if the activities were delivered as intended, if and how this varied in different colleges, and find out people s views about the process and consequences of this. We also don t know whether colleges will be willing to be allocated to a control group at random, so we will assess this, and also how many young people are willing to take part in the study. We will also try to estimate the costs of these smoking prevention activities prior to any further research. If the project activities and research are delivered as planned then we intend to proceed to a much larger evaluation to see if the project reduces the uptake of smoking among 16-18 year-olds, by how much, and at what cost.
Scientific summary Aim: To evaluate the feasibility and acceptability of implementing and trialling a new multi-level smoking prevention intervention in FE settings. Design: Pilot cluster RCT and process evaluation. Intervention: The Filter FE Challenge is a universal, multi-level smoking prevention intervention that is intended to be adaptable for use in all FE settings (i.e. general FE colleges/campuses, sixth form colleges, etc.), delivered by trained staff, using resources developed by ASH Wales for The Filter youth project. Informed by evidence of effective smoking prevention methods and approaches, the intervention aims to prevent the uptake of smoking among FE students aged 16-18 at multiple levels via: (1) restricting the sale of tobacco to under 18 year-olds; (2) implementing tobacco-free campus policies; (3) training FE staff to deliver anti-smoking messages and support institutional change; (4) publicising The Filter youth project s online social marketing campaigns, advice and support services; and (5) youth work activities to provide credible educational messages, modify perceived norms,and promote social/situational resistance skills, as well signposting cessation services if necessary. Control group: Standard practice. Setting: Six FE settings (purposively sampled for a pilot trial to examine delivery and trial methods in a range of institutional contexts). Target population: FE students aged 16-18 Objectives of the pilot trial: (1) examine the feasibility, fidelity and acceptability of delivering and trialling the intervention according to pre-specified progression criteria; (2) explore student, staff and intervention team experiences of implementing and trialling the intervention, and how this varies, in order to refine the logic model, intervention and methods prior to progressing to any subsequent evaluation phases; and (3) pilot the primary outcome measure (transition to smoking weekly or more), secondary outcome measures (ever smoked, frequent cannabis use, high risk alcohol use, health-related quality of life, and cessation/reduction in smoking), process measures (community-level tobacco availability, institutional environment, students knowledge, attitudes and skills) and economic evaluation methods. Data sources: New students enrolling at the participating FE settings for the 2014-15 academic year (approx. 2500) will complete an online survey at baseline (September 2014) and 1-year follow-up (September 2015). Other quantitative (process) data will be collected via: structured observations; intervention team delivery checklists; mystery shopper audits of local shops; analysis of college policy documents; and a staff training evaluation survey. Qualitative data will be collected via: interviews with FE college managers (n=12/2 per college) and the delivery team (min. 6); focus groups with intervention college students (n=12/4 per college) and staff (n=6/2 college). After the follow-up survey, 200 students will be recruited via stratified, random sampling to provide a saliva sample for cotinine testing to examine the validity of the self-reported smoking outcome. Governance: A trial steering committee (TSC) will be established, including South East Wales Trials Unit (SEWTU) representatives. A study protocol and pre-specified trial progression criteria will be agreed by the TSC, the NIHR, ASH Wales and the investigators.

Protocol (PDF File - 811.2 KB)

Commissioning Brief (PDF File - 79.0 KB)


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