Abstract
Objectives:
In order to prevent people from taking up smoking on a daily basis, the P2P program has been developed based on the Theory of Planned Behavior (TPB) and relying on the peer-to-peer method. A cluster randomized controlled trial involving 1573 high school students in the Occitanie region of France showed a reduction in the increase in daily smoking. Given the effectiveness observed, the aim was to assess the transferability of P2P to two other French regions (Ile-de-France and Auvergne).
Method:
The RE-AIM (Recruitment, Effectiveness, Adoption, Implementation, Maintenance) methodology was used. A total of 190 interviews were conducted with school referents, peer educators, peer receivers and regional coordinators. A self-questionnaire (before and after the intervention) assessed changes in daily smoking habits.
Results:
P2P has been implemented faithfully in 29 vocational high schools, with adaptations to suit different contexts and actors. The main obstacles were organizational (timetable and school career). The levers are the support provided by prevention structures. Recruiting pairs of nurse referents and improving the pedagogical guide, which is recognized as a support tool, will be necessary. In terms of effectiveness, more than 3229 students in 10th Grade in vocational high schools were followed for 1 year. The prevalence rates of daily smoking changed by −1.6%, +2.9% and +0.7%, respectively, showing no significant difference between these regions, with no difference in effect depending on the place of implementation.
Discussion:
The P2P program is transferable to other regions despite differences in how the organizations and high schools involved operate, and differences in the characteristics of the high school students targeted. It is also reproducible, maintaining a beneficial effect in preventing increased daily smoking among vocational high school students.
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