ArticleBMC public health2025
Developing a theory-based health education intervention to prevent adolescent students from smokeless tobacco use.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSmokeless tobacco is a kind of tobacco that is chewed or sniffed in the forms of khaini, gutkha, pan parag and zarda paan with tobacco constituents. Although these products are harmful to health, over 300 million people worldwide use them. Its use among adolescent students in Nepal is increasing. A theory-based health education intervention is needed to prevent students from consuming smokeless tobacco.
methodFour focus group discussions were conducted among ninth-grade students following guidelines based on the constructs of protection motivation theory. Based on a rigorous review of the literature and feedback from the supervisor, a module of protection motivation theory-based health education intervention was drafted. Subsequently, a pilot test of the intervention was conducted among the students of grade 9. Data from 16 students who participated in the pilot test were analyzed to identify the reliability and face validity of the intervention. The content validity of the intervention was assured through feedback from the supervisor and the literature. Subsequently, the final draft of the theory-based health education intervention was prepared.
resultsStudents who participated in focus group discussions had insufficient knowledge regarding smokeless tobacco and its harmful effects. They had many misconceptions regarding smokeless tobacco use. They recognized the necessity of acquiring skills to prevent smokeless tobacco use. They voiced that strict rules should be implemented on school premises to control tobacco use. Drawing on such information and findings derived from the needs assessment, a protection motivation theory-based health education intervention was developed. Cronbach’s alpha values of each objective of each session were greater than 0.8. More than 80% of participants in the pilot test agreed with the effectiveness and appropriateness of the components of the intervention.
conclusionWe developed a highly reliable and valid protection motivation theory-based health education intervention. Its proper implementation might raise students’ knowledge regarding smokeless tobacco and its effects and enhance their skills to prevent its use.
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