Jul 19, 2004


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.


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.


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.



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.

KEYWORDS: Middle Childhood (6-11), Adolescence
(12-17), Children, Community-based, Physical Health, Behavioral Problems,
Substance Use, Tobacco Use, Education, White or Caucasian, Hispanic or Latino,
Asian, Native Hawaiian or Pacific Islander, American Indian or Alaska Native,
Black or African-American.

Program information last updated 07/19/04.

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