title: Short-term effects of a randomized computer-based out-of-school smoking prevention trial aimed at elementary schoolchildren.
abstract: BACKGROUND
  Smoking prevention programs usually run during school hours. In our study, an out-of-school program was developed consisting of a computer-tailored intervention aimed at the age group before school transition (11- to 12-year-old elementary schoolchildren). The aim of this study is to evaluate the additional effect of out-of-school smoking prevention.
  
  
  METHODS
  One hundred fifty-six participating schools were randomly allocated to one of four research conditions: (a) the in-school condition, an existing seven-lesson program; (b) the out-of-school condition, three computer-tailored letters sent to the students' homes; (c) the in-school and out-of-school condition, a combined approach; (d) the control condition. Pretest and 6 months follow-up data on smoking initiation and continuation, and data on psychosocial variables were collected from 3,349 students.
  
  
  RESULTS
  Control and out-of-school conditions differed regarding posttest smoking initiation (18.1 and 10.4%) and regarding posttest smoking continuation (23.5 and 13.1%). Multilevel logistic regression analyses showed positive effects regarding the out-of-school program. Significant effects were not found regarding the in-school program, nor did the combined approach show stronger effects than the single-method approaches.
  
  
  CONCLUSIONS
  The findings of this study suggest that smoking prevention trials for elementary schoolchildren can be effective when using out-of-school computer-tailored interventions.
authors.affiliation: The Maastricht Health Research Institute for Prevention and Care, Maastricht University, Maastricht, 6200 MD, The Netherlands. m.ausems@gvo.unimaas.nl
authors.forename: Marlein
authors.initials: M
authors.lastname: Ausems
authors.forename: Ilse
authors.initials: I
authors.lastname: Mesters
authors.forename: Gerard
authors.initials: G
authors.lastname: van Breukelen
authors.forename: Hein
authors.initials: H
authors.lastname: De Vries
mesh_terms: D001290:Attitude; D002648:Child; D003201:Computers; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D009426:Netherlands; D012907:Smoking / Q000523:psychology; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires