[A proposal for monitoring smoking prevention programs with the use of indicators]

Health administrators are aware that the adoption of prevention programs of proven efficacy does not, by itself, guarantee good results as several factors can reduce effectiveness in a specific contest. Outcome evaluation and performance monitoring is thus growing, also with the aim of a more efficient resource use. On these premises, we describe a proposal for performance monitoring of smoking prevention programs, developed from literature and original data from the authors. The system is made of three components: a) five questions to assess smoking behavior (internal coherence, (Cronbach alpha = 0.731; k ranging from 0.39 to 0.76): b) two indicators (smoking prevalence and precentage of students reached): c) theorical and practical (number to sample according to population size) information for homogeneous and efficient cluster sampling. Performance is evaluated on account of three possible determinants of the results and explicit criteria are given to reach five possible decisions. The system was tested in five Health Districts of the Emilia Romagna Region with a population of 6370 8th class students and guided further planning and implementation. Further implementation and use of the system will give us information about the utility of this proposal, that could also be adopted as a model for the evaluation of other school prevention programs.