Guide to Effective Programs
for Children and Youth

PROJECT 4-HEALTH

OVERVIEW

Project 4-Health is a 5-session educational program aimed at preventing tobacco use among 10-14 year-old in California in 1987 enrolled in 4-H clubs. Additional goals of the program are to involve participants in keeping others from using tobacco and to develop youth leadership for tobacco control. An evaluation showed that some short-term effects were found. An evaluation of the program showed changes in knowledge about smoking, attitudes toward smoking, and in intention to smoke in the future. There were no significant changes in social influence variables or smoking behaviors. No long-term effects were observed.

DESCRIPTION OF PROGRAM

Target population: Adolescents enrolled in 4-H clubs

The program is designed to help youth develop personal rules about tobacco use and to help them work with others to develop and implement tobacco policies and programs within the home, the 4-H club, the school, and the community. The overall goal of the program is to prevent and reduce tobacco use.

During the intervention program, teams of trained adult volunteers and older 4-H youth led sets of five sessions at monthly 4-H club meetings. During the sessions, members interacted with each other about issues surrounding tobacco use. Between meetings, club members completed supplemental activities that were designed to reinforce major concepts from each session. Each member received an illustrated, self-guided booklet that reviewed the five club sessions and provided the materials for the supplemental activities.

EVALUATION(S) OF PROGRAM

Evaluated population: 1,853 club members who were 10 to 14 years of age at pretest were evaluated. This included, 1,066 (57.5%) girls and 787 boys (42.5%).

Approach: The racial/ethnic composition of the sample was 89.4% White, non-Hispanic, 6.5% Latino, 1.1% Asian/Pacific Islander, 0.6% Native Americans, 0.3% African American, and 2.1% missing. The average age was 12.11 years. 88.6% of club members completed the pretest. Of those 79.5% completed a posttest and 77.6% completed a second posttest.

The evaluation was based on 72 clubs in California. After pretest data was collected in the fall of 1987 using computer-assisted telephone interviews, the 72 clubs were matched into 36 pairs based on geographic region and club size. One club from each pair was randomly assigned to the program condition and the other was assigned to a control condition. The program was delivered to the 36 clubs receiving the program during the five monthly community club meetings occurring between January and May 1988, while adolescents in the control club attended their regular club meetings. Data were collected two times after the intervention. The first post-test was completed in fall 1988, approximately 4 months after the end of the program. For this test clubs were randomly assigned to one of three survey administration modes: computer-assisted telephone interviews alone, computer-assisted telephone interviews and mail survey, or small group administration in a community setting. The second post-test, a 2-year follow-up, was completed in summer 1990 by using a mail survey to assess behavior and behavioral intentions. During this post-test, computer-assisted telephone interviews were also used to assess other variables.

Results: Results of the program show that there were short-term benefits, however, the program did not show any long-term benefits. 7 of the 24 program effect estimates were significant at the first post-test. Compared with club members in the control condition, adolescents in the program clubs had more knowledge of tobacco use among high school students, were more likely to report that smokeless tobacco is addictive, and were more likely to report that the first use of cigarettes or smokeless tobacco is harmful to one’s body. They were also more likely to report that quitting cigarette and smokeless tobacco use is difficult, that tobacco companies try to sell their products to children, and that smokeless tobacco use is not safer than cigarette smoking. In addition, they were more likely to indicate that they did not intend to smoke cigarettes in the future. However, by the second post-test, none of the 24 program effect estimates were significant. The results show that the program was somewhat effective in the short term, but not in the long term. Evaluators note that the duration and intensity of the Project 4-Health intervention may have been too limited to modify tobacco-use behavior.

SOURCES FOR MORE INFORMATION

References

D’Onofrio, C.N., Moskowitz, J.M., Braverman, M.T. (2002). Curtailing tobacco use among youth: Evaluation of Project 4-Health. Health Education and Behavior, 29(6). 656-682.

Program categorized in this guide according to the following:

Evaluated participant ages: 10 to 14 years of age

Program age ranges in the Guide: Mid. Childhood (6-11), Adolescence (12-14), Youth (15-21)

Program components: Clinic/provider-based