Children Learning About Second-hand Smoke (CLASS II): a mixed methods process evaluation of a school-based...

Area of Science:

• Public Health
• Child Health
• Intervention Studies

Background:

• Children face significant health risks from second-hand smoke exposure.
• Smoke-free homes are crucial for mitigating these risks.
• A novel smoke-free intervention (SFI) was developed, empowering children to advocate for smoke-free environments.

Purpose of the Study:

• To conduct a process evaluation of a pilot smoke-free intervention (SFI) delivered in schools.
• To assess the feasibility, acceptability, and initial implementation of the SFI.
• To gather data for refining the SFI for a larger, definitive trial.

Main Methods:

• A mixed-methods approach combining qualitative interviews and quantitative fidelity assessments.
• Interviews with headteachers and teachers explored experiences, barriers, and facilitators.
• Fidelity of SFI delivery was measured through observation and scoring.

Main Results:

• The smoke-free intervention (SFI) was found to be acceptable to school staff.
• Fidelity scores indicated variable implementation, with didactic elements better realized than interactive ones.
• Key challenges included session timing, duration, and scheduling within the school year.

Conclusions:

• The process evaluation provides valuable insights for refining the SFI's content and delivery.
• Embedding the intervention into the curriculum is a potential strategy to overcome implementation barriers.
• Findings will inform the scale-up of the SFI in an ongoing definitive trial.