Funds are requested to (a) complete the intervention and evaluation activities of a community intervention to prevent adolescent tobacco use and (b) continue the evaluation of intervention effects into young adulthood. It is proposed that the originally-designed study be completed and that additional follow-up assessments be conducted over five years. This will allow completion of the original design of the experiment, enable assessment of whether intervention effects are maintained, and permit the use of latent growth structural equation modelling to test models of the development of tobacco use. Project SixTeen involves a randomized control trial in which eight pairs of small Oregon communities have been randomized to receive either a school-based prevention program or the school-based program plus a community intervention. Preliminary results of the impact of the overall community intervention indicate that, after six months of intervention, the prevalence of adolescent tobacco use is significantly lower in communities receiving the community intervention. The community intervention consists of sets of module- defined activities designed to influence each of the known risk factors for adolescent tobacco use. The written modules cover: (a) youth anti- tobacco activities, (b) family communication about tobacco, (c) reducing adolescent access to tobacco, (d) media advocacy, (e) fact sheets about tobacco, and (f) school and community policies regarding adolescent possession of tobacco. Three of the modules have been shown by experimental evaluations to affect their targets. The access intervention has brought about significant reductions in the proportion of stores that sell tobacco to minors in each of the eight communities in which it was introduced. The Youth Anti-Tobacco activities and the Family Communication activities have been shown to bring about (a) significant increases in exposure of young people and their parents to anti-tobacco media and (b) changes in parent and child knowledge and attitudes about tobacco use, in parent-child communication about tobacco, and in youth intentions to use tobacco.
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