The impact of a family-empowerment program on smoking prevention among elementary student in Indonesia: a cluster randomized controlled trial

Abstract

ABSTRACT Smoking among adolescents is prevalent and a significant public health issue associated with premature death. Family has a vital role in smoking prevention and quitting smoking; however, parents frequently question their ability to positively influence their children in this area, believing that such advice is ignored or despised by their children. Family empowerment is important enhance the role of family participation in child care. The goal of this study was to examine the impact of family empowerment on smoking prevention. A cluster randomized controlled trial (RCT) was conducted between January to April 2020. Parallel assignment was used in this cluster RCT. Family empowerment program included five intervention steps, including needs assessment, bonding process, problem-solving, educational participation method, process and outcome evaluations. At enrollment, approximately 500 students participated (response rate was 67 % at baseline and 90 % at follow-up). The family empowerment program improved outcomes relative to the control at time one (T1) across four outcomes: 1) family empowerment increased 0.08 (95% confident of interval (CI) 0.01 to 0.15), 2) Intention to smoke score saw a modest increased 0.07 (95% CI 0.02 to 0.12), 3) self-efficacy increased 0.26 (95% CI 0.07 to 0.69) and skill to refuse also saw a modest increase of 0.19 (95% CI 0.05 to 0.37). This study takes a significant step toward establishing an empowering and low-cost approach to delivering preventive interventions, while also elevating the voice of adolescents in health policy advocacy efforts..