Abstract
Smoking prevention among adolescents is a public health challenge that is even more significant in low- and middle-income countries where local evidence is limited and smoking rates remain high. Evidence-based interventions could be transferred to low- and middle-income country settings but only after appropriate cultural adaptation. This paper aims to describe the process of the cultural adaptation of two school-based smoking prevention interventions, A Stop Smoking in Schools Trial and Dead Cool, to be implemented in Bogotá, Colombia. A recognized heuristic framework guided the cultural adaptation through five stages. We conducted a concurrent nested mixed-methods study consisting of a qualitative descriptive case study and a quantitative pre- and post quasi-experiment without a control. Contextual, content, training, and implementation modifications were made to the programs to address cultural factors, to maintain the fidelity of implementation, and to increase the pupils’ engagement with the programs. Modifications incorporated the suggestions of stakeholders, the original developers, and local community members, whilst considering the feasibility of delivering the programs. Involving stakeholders, original program developers, and community members in the cultural adaptation of evidence-based interventions is essential to properly adapt them to the local context, and to maintain the fidelity of program implementation.
Highlights
Tobacco is a major risk factor for several noncommunicable diseases and causes 8.1 million global deaths annually [1]
The MECHANISMS study aims to improve the measurement of social norms for smoking behaviors in adolescents in Northern Ireland (UK) and Bogotá (Colombia), and to characterize the mechanisms of action of two smoking prevention interventions in schools: A Stop Smoking in Schools Trial (ASSIST) and Dead Cool [14]
The local stakeholder committee included: (i) an expert in public health and economics with 14 years of experience on assessing tobacco control policies in Colombia and Latin America (LA); (ii) an expert in psychological therapy with 6 years of experience on psychoactive substance use prevention in adolescents in Colombia; and (iii) an expert in health behavior with 5 years of experience working with schools and children in Colombia
Summary
Tobacco is a major risk factor for several noncommunicable diseases and causes 8.1 million global deaths annually [1]. Adolescence is the most critical life stage for tobacco consumption because: (i) young people are more susceptible to social influence [2]; (ii) 90% of smokers start smoking before they are 19 years old [3]; and (iii) adolescent smoking is associated with risky and violent behaviors [4]. Preventing tobacco consumption among adolescents is a priority for public health. There are several strategies at the individual, community, and policy level to prevent and reduce smoking among youth, endorsed by the Framework Convention on Tobacco Control (WHO-FCTC) [4]. Implications Practice: A systematic process for cultural adaptation of school-based smoking prevention programs, including a strategy for maintaining the fidelity, can be used in other countries of Latin America and the global south. Policy: Evidence-based and culturally adapted strategies promote awareness of tobacco control within school environments, contributing to the global effort toward tobacco control
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
