Curtailing tobacco use among youth: evaluation of project 4-health

This article reports the development and evaluation of Project 4-Health, a theory-driven, research-based program to prevent tobacco use among youth enrolled in 4-H clubs throughout California. Additional goals were to involve youth in discouraging others' tobacco use and to develop youth leadership for tobacco control. To assess program effectiveness, 72 clubs were matched and randomly assigned to the program or control condition. Of 1,853 eligible club members, 88.6% completed the pretest. Of these, 79.5% completed a posttest 4 months after conclusion of program delivery, and 77.6% completed a second posttest 2 years later.Short-term effects were found on 7 of 24 outcome measures, indicating changes in knowledge, attitudes, and behavioral intention, but not in social influence variables or behaviors. No long-term effects were observed. Discussion considers how the challenges of designing, delivering, and evaluating the intervention influenced results and implications for preventing tobacco use through community-based youth groups.