title: Smoking prevention for ethnically diverse adolescents: 2-year outcomes of a multicultural, school-based smoking prevention curriculum in Southern California.
abstract: BACKGROUND
  Effective school-based curricula are needed to prevent smoking among ethnically diverse adolescents. This study evaluated a multicultural smoking prevention curriculum in ethnically diverse Southern California middle schools.
  
  
  METHODS
  Students in 24 middle schools (N = 3157 sixth graders) received the multicultural curriculum, a similar curriculum without references to cultural issues, or a control condition. Odds ratios for experimentation with smoking over a 2-year period were calculated.
  
  
  RESULTS
  The multicultural program was associated with a lower risk of smoking between sixth and eighth grade, relative to the control group. Program effects varied according to the ethnic composition of the schools. In schools with predominantly Hispanic populations, the multicultural curriculum was more effective than the control, but the standard curriculum was not. In schools with predominantly Asian or multicultural populations, the standard curriculum was more effective than the control, but the multicultural curriculum was not. Analyses stratified by ethnicity within the schools revealed that the multicultural curriculum was effective among Hispanic students within predominantly Hispanic schools, but not among Hispanic students within predominantly Asian/multicultural schools.
  
  
  CONCLUSIONS
  Smoking prevention for adolescents in culturally diverse school contexts is a challenge. In this study, a multicultural curriculum was most effective among Hispanic students in predominantly Hispanic schools. Further research is needed to determine the best ways to prevent smoking in predominantly Asian and multicultural schools.
authors.affiliation: University of Southern California Keck School of Medicine, Institute for Prevention Research, 1000 S. Fremont, PO Box 8, Alhambra, CA 91803, USA.
authors.forename: C Anderson
authors.initials: CA
authors.lastname: Johnson
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Unger
authors.forename: Anamara
authors.initials: A
authors.lastname: Ritt-Olson
authors.forename: Paula H
authors.initials: PH
authors.lastname: Palmer
authors.forename: Steven Y
authors.initials: SY
authors.lastname: Cen
authors.forename: Peggy
authors.initials: P
authors.lastname: Gallaher
authors.forename: Chih-Ping
authors.initials: CP
authors.lastname: Chou
mesh_terms: D000293:Adolescent; D001213:Asian / Q000193:education / Q000706:statistics & numerical data; D001294:Attitude to Health / Q000208:ethnology*; D002140:California; D016022:Case-Control Studies; D003479:Curriculum; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D006630:Hispanic or Latino / Q000193:education / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011322:Primary Prevention / Q000458:organization & administration*; D015397:Program Evaluation; D018570:Risk Assessment; D012572:School Health Services / Q000458:organization & administration*; D012907:Smoking / Q000208:ethnology*; D000074606:Smoking Prevention; D013334:Students; D011795:Surveys and Questionnaires