Abstract

Investigating the current, intended and potential reach of two effective smoking prevention programs in Dutch vocational schools and identifying determinants of school directors' intention to adopt these programs. Cross-sectional survey. Two questionnaires were developed based on the Diffusion of Innovation theory and the I-Change model, focussing on either the 'Healthy School and Stimulants program' (HSS program) or the 'Out-of-school Computer Tailoring program' (CT program). The questionnaires were distributed amongst all Dutch vocational school directors (n=452) of which 34% completed the questionnaire. The potential reach of the HSS program was 29% whereas the potential reach of the CT program was 5%. Regression analyses revealed that being female, perceiving a higher percentage of smoking students in school, having a personality more open towards change, perceiving a low need for a smoking prevention program, fewer disadvantages of the program, a higher level of self-efficacy towards adopting the program and a more positive social norm towards adopting a smoking prevention program from other school directors resulted in a positive intention towards adopting either program. The present study showed that the reach of effective smoking prevention programs is fairly low. School-based smoking prevention efforts are likely to improve if schools choose to use programs that are proven to be effective, which can be encouraged by adapting existing and newly designed programs to school directors' characteristics and providing easy access to reliable information regarding available programs.

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