) Tobacco use is the single most preventable cause of death in the United States, with four out of five persons beginning tobacco use as children or adolescents. The literature suggests that programs for school-age children have an impact by reducing tobacco use and decreasing initiation of tobacco use. Further research is required to determine how to improve this reduction as well as how to increase dissemination of proven interventions that will have a significant impact on tobacco use. This application examines how Internet technology can be used to improve dissemination of a tobacco-use prevention curriculum for elementary students. The first study year involves development and analysis of an Internet delivered computer-based program for fifth grade students. This includes examining presentation and educational strategies for the Internet as well as identifying environmental barriers that may impede use of the Internet technology. The second study year is an evaluation of the expected educational outcomes (e.g., increased knowledge and non-use intentions, confidence in refusal/decision making skills) from the Internet-based curriculum. Additionally, analysis will be done on how effective the Internet program is in delivering different health information messages. Study designs include a descriptive, qualitative study in the first year and a pre-post comparison group experimental research design in the second year. The development study for the Internet-based program will occur in one suburban and one urban school of similar size. In study year two, the Internet-based and health educator-based schools will continue to receive the intervention and an additional matched suburban school will continue to serve as a comparison. Data collection includes observations, focus groups, questions in the computer program, and a questionnaire designed for the study that has content validity and produces consistency in response.
