Upscaling a behavioural intervention program for tobacco use cessation - A randomised controlled study.

Area of Science:

• Public Health
• Health Education
• Intervention Science

Background:

• Tobacco use remains a significant public health concern, necessitating effective intervention strategies.
• Scaling up evidence-based interventions is crucial for widespread impact but often faces resource limitations.

Purpose of the Study:

• To evaluate the effectiveness of a train-the-trainer model for upscaling a tobacco intervention among school teachers in Bihar, India.
• To assess the feasibility of implementing the intervention using existing resources within the school system.

Main Methods:

• A randomized control trial was conducted across six blocks in three districts.
• Intervention and control blocks were established, with cluster coordinators and headmasters in intervention blocks receiving training.
• Post-intervention surveys assessed implementation fidelity and outcomes among teachers and headmasters.

Main Results:

• High training attendance and teacher involvement were observed among headmasters in intervention schools.
• Significantly higher odds of carrying out recommended activities were found in intervention schools compared to control schools.
• Intervention schools spontaneously adopted additional activities like classroom integration and parent communication.

Conclusions:

• The train-the-trainer model is a feasible and effective strategy for upscaling evidence-based health interventions.
• Leveraging existing human resources and materials within educational systems can facilitate successful intervention scale-up.
• This model offers a sustainable approach to public health program dissemination in resource-constrained settings.