Implementation of an evidence-based tobacco control intervention for school teachers in India: Evaluating the effects of a capacity-building strategy
Background Tobacco-Free Teachers, Tobacco-Free Society (TFT-TFS) is an evidence-based intervention that promotes tobacco use cessation among teachers and tobacco control policies among schools in India. This study tested an implementation model to build Bihar Department of Education (DOE) capacity t...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-03-01
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| Series: | Implementation Research and Practice |
| Online Access: | https://doi.org/10.1177/26334895231159428 |
| _version_ | 1797845339448803328 |
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| author | Eve M. Nagler Mangesh Pednekar Dhirendra Narain Sinha Anne M. Stoddard Sameer Narake Keyuri Adhikari Leah Jones Harry Lando Mary Vriniotis Prakash Gupta Glorian Sorensen |
| author_facet | Eve M. Nagler Mangesh Pednekar Dhirendra Narain Sinha Anne M. Stoddard Sameer Narake Keyuri Adhikari Leah Jones Harry Lando Mary Vriniotis Prakash Gupta Glorian Sorensen |
| author_sort | Eve M. Nagler |
| collection | DOAJ |
| description | Background Tobacco-Free Teachers, Tobacco-Free Society (TFT-TFS) is an evidence-based intervention that promotes tobacco use cessation among teachers and tobacco control policies among schools in India. This study tested an implementation model to build Bihar Department of Education (DOE) capacity to support and deliver TFT-TFS within schools, leveraging DOE training infrastructure. Method We used a training-of-trainers (TOT) “cascade” implementation strategy to embed the TFT-TFS program into the Bihar DOE infrastructure. We trained 46 Cluster Coordinators to train and support Headmasters to implement TFT-TFS in their schools over one academic year. We selected three school districts, representing approximately 46 clusters and 219 schools. We used the RE-AIM framework to assess program adoption (Headmaster participation in at least one of six TFT-TFS trainings), implementation (of four core program components), and reach (teachers' participation in three or more group discussions). Using a non-inferiority design, we hypothesized that program adoption, implementation, and reach would not be inferior to the high standards demonstrated when TFT-TFS was originally tested in the Bihar School Teachers Study. We used self-reported checklists to measure outcomes and SPSS Version 25 to analyze data. Results For adoption, 94% of Headmasters attended the first training, although participation declined by the sixth training. Among the 112 schools out of 219 with complete Headmaster checklist data, all met our minimum criteria for implementing TFT-TFS. Over 99% of schools posted a school tobacco control policy and distributed quit booklets. However, only 69% of schools met our criteria for program reach. Conclusions This study outlines the processes for taking a tobacco control intervention to scale and implementing it through the Bihar DOE infrastructure. These findings provide a foundation for other Indian states and low- and middle-income countries to implement tobacco control and other health programs for schoolteachers. Trial registration NCT05346991. |
| first_indexed | 2024-04-09T17:37:25Z |
| format | Article |
| id | doaj.art-80e2d5abdfaa4417a6d97850fa1546ac |
| institution | Directory Open Access Journal |
| issn | 2633-4895 |
| language | English |
| last_indexed | 2024-04-09T17:37:25Z |
| publishDate | 2023-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Implementation Research and Practice |
| spelling | doaj.art-80e2d5abdfaa4417a6d97850fa1546ac2023-04-17T11:03:25ZengSAGE PublishingImplementation Research and Practice2633-48952023-03-01410.1177/26334895231159428Implementation of an evidence-based tobacco control intervention for school teachers in India: Evaluating the effects of a capacity-building strategyEve M. Nagler0Mangesh Pednekar1Dhirendra Narain Sinha2Anne M. Stoddard3Sameer Narake4Keyuri Adhikari5Leah Jones6Harry Lando7Mary Vriniotis8Prakash Gupta9Glorian Sorensen10 Department of Social and Behavioral Sciences, , Boston, MA, USA , Navi Mumbai, India , Navi Mumbai, India Center for Community-Based Research, , Boston, MA, USA , Navi Mumbai, India School of Pharmacy, , Morgantown, WV, USA Center for Community-Based Research, , Boston, MA, USA , Minneapolis, MN, USA Brown-Lifespan Center for Digital Health, , Providence, RI, USA , Navi Mumbai, India Department of Social and Behavioral Sciences, , Boston, MA, USABackground Tobacco-Free Teachers, Tobacco-Free Society (TFT-TFS) is an evidence-based intervention that promotes tobacco use cessation among teachers and tobacco control policies among schools in India. This study tested an implementation model to build Bihar Department of Education (DOE) capacity to support and deliver TFT-TFS within schools, leveraging DOE training infrastructure. Method We used a training-of-trainers (TOT) “cascade” implementation strategy to embed the TFT-TFS program into the Bihar DOE infrastructure. We trained 46 Cluster Coordinators to train and support Headmasters to implement TFT-TFS in their schools over one academic year. We selected three school districts, representing approximately 46 clusters and 219 schools. We used the RE-AIM framework to assess program adoption (Headmaster participation in at least one of six TFT-TFS trainings), implementation (of four core program components), and reach (teachers' participation in three or more group discussions). Using a non-inferiority design, we hypothesized that program adoption, implementation, and reach would not be inferior to the high standards demonstrated when TFT-TFS was originally tested in the Bihar School Teachers Study. We used self-reported checklists to measure outcomes and SPSS Version 25 to analyze data. Results For adoption, 94% of Headmasters attended the first training, although participation declined by the sixth training. Among the 112 schools out of 219 with complete Headmaster checklist data, all met our minimum criteria for implementing TFT-TFS. Over 99% of schools posted a school tobacco control policy and distributed quit booklets. However, only 69% of schools met our criteria for program reach. Conclusions This study outlines the processes for taking a tobacco control intervention to scale and implementing it through the Bihar DOE infrastructure. These findings provide a foundation for other Indian states and low- and middle-income countries to implement tobacco control and other health programs for schoolteachers. Trial registration NCT05346991.https://doi.org/10.1177/26334895231159428 |
| spellingShingle | Eve M. Nagler Mangesh Pednekar Dhirendra Narain Sinha Anne M. Stoddard Sameer Narake Keyuri Adhikari Leah Jones Harry Lando Mary Vriniotis Prakash Gupta Glorian Sorensen Implementation of an evidence-based tobacco control intervention for school teachers in India: Evaluating the effects of a capacity-building strategy Implementation Research and Practice |
| title | Implementation of an evidence-based tobacco control intervention for school teachers in India: Evaluating the effects of a capacity-building strategy |
| title_full | Implementation of an evidence-based tobacco control intervention for school teachers in India: Evaluating the effects of a capacity-building strategy |
| title_fullStr | Implementation of an evidence-based tobacco control intervention for school teachers in India: Evaluating the effects of a capacity-building strategy |
| title_full_unstemmed | Implementation of an evidence-based tobacco control intervention for school teachers in India: Evaluating the effects of a capacity-building strategy |
| title_short | Implementation of an evidence-based tobacco control intervention for school teachers in India: Evaluating the effects of a capacity-building strategy |
| title_sort | implementation of an evidence based tobacco control intervention for school teachers in india evaluating the effects of a capacity building strategy |
| url | https://doi.org/10.1177/26334895231159428 |
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