The proposed study builds on the growing recognition that despite the development in a range of health/tobacco curricula, and the expanding documentation of their efficacy, most of the nation's youth have limited exposure to such programs. The problem appears to be one of effective implementation and institutionalization in school systems, which this study is designed to address. The purpose of this four year study is to implement and evaluate the effectiveness of a diffusion strategy to facilitate school districts becoming aware of, adopting, implementing, and institutionalizing health/tobacco curricula. A secondary purpose is to assess the impact of the curricula on students tobacco knowledge, attitudes and behavior. The main study hypothesis is that, """"""""school districts that receive the diffusion strategy, in comparison to those that do not, are significantly more likely to become aware of, adopt, implement, and institutionalize health/tobacco curricula."""""""" This hypothesis is divided into four subhypotheses with will be tested in the study. The diffusion strategy consists of four interventions: (1) a four- day conference for teachers and other school personnel designed to increase their health awareness (""""""""Seaside Conference""""""""); (2) a consultation process designed to facilitate curriculum adoption (""""""""Process Consultation for Adoption""""""""); (3) training of teachers and district coordinators in how to teach the health/tobacco curricula; and, (4) a consultation designed to facilitate the long-term maintenance of the curricula (""""""""Process Consultation for Institutionalization""""""""). Two existing, well tested curricula will be disseminated: Growing Healthy, and Project Smart. The study design to test the diffusion strategy is an experimental design, with random assignment of school districts to the intervention and comparison conditions. Eight school districts will be in each condition. The North Carolina Department of Public Instruction will work closely with the University of North Carolina at Chapel Hill, and the University of North Carolina at Greensboro (the subcontractor), in planning and conducting the four interventions. The universities' long-standing close relationship with the Department of Public Instruction, and the senior investigators' previous experience in working with local school systems assures access to school districts for purpose of this important study.
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