July 2008

Grant Results

SUMMARY

Between May 2001 and June 2005, the Robert Wood Johnson Foundation (RWJF) supported project staff led by Caroline H. Sparks, Ph.D., at the Prevention Research Center of the School of Public Health and Health Services at the George Washington University to evaluate Kids ACT!, a tobacco control advocacy curriculum for students in grades six through eight.

The evaluation sought to determine the curriculum's effect on students' ability to act as tobacco control advocates in their communities.

Key Findings

  • Students in schools that adopted the tobacco advocacy curriculum had significantly more confidence in their ability to advocate for tobacco control, expressed greater intent to advocate against tobacco use and were more likely to have taken advocacy action than were students in schools that did not adopt the curriculum.
  • Exposure to the curriculum had no effect on experimentation with tobacco over time.

Funding
The Robert Wood Johnson Foundation (RWJF) made a $946,368 grant, running from May 1, 2001, to June 30, 2005, to support this solicited project.

 See Grant Detail & Contact Information
 Back to the Table of Contents


THE PROBLEM

Between October 1997 and January 2001, RWJF provided a grant to the National Education Association Health Information Network to design and field-test Kids Act to Control Tobacco (Kids ACT!) (see Grant Results on ID# 032193), a pilot school-based curriculum focused on promoting tobacco control advocacy among sixth-, seventh- and eighth-graders in Connecticut and Maryland. The Health Information Network, an affiliate of the National Education Association, provides health and safety information to school personnel and students.

Field testing, interviews and feedback forms revealed that many students and teachers had difficulty understanding the concept of advocacy, prompting project staff to revise the curriculum. The revised curriculum consisted of the following four units, taught in 12 or 13 class sessions lasting 45 minutes:

  • Develop a conviction to act publicly. This step builds motivation to take public action.
  • Prepare and plan to act. This step teaches students to develop an action plan and to produce an advocacy product.
  • Act publicly. This step teaches students to carry out their advocacy plans.
  • Evaluate one's action. This step engages students in assessing the success of their advocacy actions.

The revised curriculum needed rigorous evaluation so that it could be replicated more broadly.

 Back to the Table of Contents


THE PROJECT

Between May 2001 and June 2005, Caroline H. Sparks, Ph.D., and her team at the Prevention Research Center of the School of Public Health and Health Services at the George Washington University, in collaboration with staff of the National Education Association Health Information Network, evaluated Kids ACT! The purpose of the evaluation was to determine whether, and to what extent, middle-school students would become advocates for tobacco control after being exposed to the curriculum.

According to Sparks, this was the first large-scale study to assess the value of training youths to advocate for tobacco control. Approximately 4,600 students in 31 schools in Delaware, Maryland, New York and Virginia completed a questionnaire that asked about:

  • Knowledge of advocacy.
  • Attitude toward action and tobacco control.
  • Perceptions of the advantages of tobacco control.
  • Self-efficacy to act as an advocate.
  • Intent to act as an advocate.

After the pretest, half the students were taught the tobacco advocacy curriculum (intervention group) and half were not (control group). All students completed another questionnaire after the intervention group had been exposed to the curriculum and again six months later.

Communications

Sparks and research team members presented their findings at meetings of the American Public Health Association, the American School Health Association and the National Conference on Tobacco or Health. They have written two articles that are under submission, and Sparks wrote a chapter in a National Academies Press report. See the Bibliography.

 Back to the Table of Contents


FINDINGS

The evaluators reported to RWJF that:

  • Students who completed the curriculum scored higher than students in the control group on most measures of advocacy. Their responses indicated greater confidence in their ability to act as advocates for tobacco control, greater intent to become advocates and greater likelihood of having taken advocacy action.
  • Students who had been exposed to the curriculum had different attitudes toward a tobacco-free society than did those who had not. Among the differences, they saw greater value to a tobacco-free society.
  • The effects of the curriculum declined six months after the intervention group had completed it. Nonetheless, there continued to be statistically significant differences between the two groups in terms of belief in their capacity to make a difference, their intent to act as advocates and the advocacy action they actually took. Differences between the two groups in their attitudes toward a tobacco-free society and the advantages they saw in a tobacco-free environment were not significant after six months.
  • Exposure to the curriculum had no effect on students' experimentation with tobacco over time.

Limitations

The researchers recognized two limitations to the effectiveness of the Kids ACT! curriculum from the outset:

  • Few opportunities exist for middle-school students to act independently as advocates outside the school environment.
  • A six-month follow-up was not adequate to determine whether students ultimately engaged in advocacy action.

The evaluation, therefore, focused on whether the program achieved immediate goals, not whether it effectively laid the groundwork for subsequent advocacy.

 Back to the Table of Contents


LESSONS LEARNED

  1. Create opportunities for students to participate in advocacy activities after school or in the community. The decline in scores six months following completion of the curriculum suggested that students need to build on what they have learned and continue using their advocacy skills in order to maintain interest. (Project Director)
  2. Allow plenty of time to recruit participating schools. Given other curriculum demands and the limited amount of time allotted to health education in middle school, it was difficult to find schools willing to devote classroom time to teaching health advocacy. Recruitment involved individual negotiation with each school and proved to be time consuming. (Project Director)
  3. Recognize the parameters of school scheduling. It is best to approach school systems before their curricula are set and to coordinate evaluation-related testing with the school's testing schedule. (Project Director)
  4. Introduce advocacy programs to engage youth in becoming proponents of a tobacco-free community, not to influence their decisions about smoking. Building public advocacy skills and influencing individual tobacco use require different curricula. (Project Director)

 Back to the Table of Contents


AFTER THE GRANT

The project ended with this grant. Researchers are preparing their findings for publication.

 Back to the Table of Contents


GRANT DETAILS & CONTACT INFORMATION

Project

Evaluating the Kids Act to Control Tobacco Program

Grantee

George Washington University (Washington,  DC)

  • Amount: $ 946,368
    Dates: May 2001 to June 2005
    ID#:  038897

Contact

Caroline H. Sparks, Ph.D.
(202) 467-2277
ihochs@gwumc.edu

 Back to the Table of Contents


BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Book Chapters

Sparks CH. "Advocacy as a Tobacco Use Prevention Strategy." In Ending the Tobacco Problem: A Blueprint for the Nation, Bonnie R and Stratton K (eds.). Washington: IOM Report, National Academy of Sciences Press, 2007.

Articles

Sparks C, Simmens S, Frazier J and Pearson E. "Concurrent Validity of Two Measures of Self-Efficacy for Advocacy Action." Unpublished.

Sparks C, Simmens S, Klouj A and Jones K. "Evaluation of the Kids Act to Control Tobacco Program." Unpublished.

Survey Instruments

"Kids ACT! Questionnaire." George Washington University, fielded 2002–04.

"Alternative Self-Efficacy Supplement to the Kids ACT! Questionnaire." George Washington University, fielded 2004.

Presentations and Testimony

Sparks C, Hodak M, Klouj A, Simmens S, Leep C, Williams K and Pierce B. "Pilot evaluation of Kids ACT!: A Tobacco Control Advocacy Program for Middle Schools," at the 130th National Meeting of the American Public Health Association, November 13, 2002, Philadelphia. Abstract available online. Also presented at the National Tobacco Prevention Conference, November 19, 2002, San Francisco.

 Back to the Table of Contents


Report prepared by: Eve Shapiro
Reviewed by: Karyn Feiden
Reviewed by: Molly McKaughan
Program Officer: Karen K. Gerlach