title: A mediation analysis of a tobacco prevention program for adolescents in India: how did project MYTRI work?
abstract: This article presents the results of a mediation analysis of Project MYTRI (Mobilizing Youth for Tobacco Related Initiatives in India), a randomized, controlled trial of a multiple-component, school-based tobacco prevention program for sixth- to ninth-graders (n = 14,085) in Delhi and Chennai, India. A mediation analysis identifies how an intervention achieves its effects. In MYTRI, changes in students' (a) knowledge about the negative health effects of tobacco, (b) beliefs about its social consequences, (c) reasons to use tobacco, (d) reasons not to use tobacco, (e) advocacy skills self-efficacy, and (f) normative beliefs about tobacco use were significantly associated with reductions in students' intentions to use tobacco and tobacco use behaviors. In contrast, changes in students' perceptions of the prevalence of smoking and chewing tobacco were significantly related to increases in students' intentions to use and use of tobacco. Implications for intervention design are considered.
authors.affiliation: Michael & Susan Dell Center for Healthy Living, Austin, TX 78701, USA. melissa.h.stigler@uth.tmc.edu
authors.forename: Melissa Harrell
authors.initials: MH
authors.lastname: Stigler
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Perry
authors.forename: Derek
authors.initials: D
authors.lastname: Smolenski
authors.forename: Monika
authors.initials: M
authors.lastname: Arora
authors.forename: K Srinath
authors.initials: KS
authors.lastname: Reddy
mesh_terms: D000293:Adolescent; D003625:Data Collection; D003627:Data Interpretation, Statistical; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India; D033182:Intention; D008297:Male; D012572:School Health Services; D020377:Self Efficacy; D014029:Tobacco Use Disorder / Q000517:prevention & control*