title: Use of interactive health communication to affect smoking intentions in middle school students: a pilot test of the "Headbutt" risk assessment program.
abstract: OBJECTIVE
  Developing and disseminating innovative and effective approaches for smoking prevention among middle school children remains a public health priority. This pilot study evaluates the use of a Web-based tobacco prevention program, Headbutt, to change intentions of middle school children to smoke tobacco.
  
  
  METHODS
  Headbutt was implemented with the use of a single-group pretest-posttest study design in sixth grade classes of nine middle schools in Texas (student n = 2227). The program assesses cognitive determinants of smoking and provides intervention feedback tailored to the child's responses.
  
  
  RESULTS
  Headbutt significantly affected smoking intentions, prosmoking attitudes, self-efficacy expectations, and knowledge of negative consequences (all p < or = .001) measured with scales adopted from the Texas Tobacco Initiative Survey. Change in prosmoking attitudes had the greatest predictive effect on smoking intentions (p < .001). These results were moderated by ethnicity and age of students.
  
  
  CONCLUSIONS
  Findings need to be interpreted in the light of study design limitations. However, strong associations between the Headbutt program and intention change suggests that a more rigorous effectiveness trial is indicated.
authors.affiliation: Center for Health Promotion and Prevention Research, University of Texas School of Public Health, 7000 Fannin, Suite 2668, Houston, TX 77030, USA. Ross.Shegog@uth.tmc.edu
authors.forename: Ross
authors.initials: R
authors.lastname: Shegog
authors.forename: Alfred L
authors.initials: AL
authors.lastname: McAlister
authors.forename: Shoahua
authors.initials: S
authors.lastname: Hu
authors.forename: Kentya C
authors.initials: KC
authors.lastname: Ford
authors.forename: Angela F
authors.initials: AF
authors.lastname: Meshack
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Peters
mesh_terms: D002648:Child; D003142:Communication; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D020407:Internet; D008297:Male; D018570:Risk Assessment; D012574:Schools; D012907:Smoking / Q000523:psychology; D000074606:Smoking Prevention