Smoking Programme for Adolescents Aged 16-19 Years Old in the Borough of Barnet - Research Proposal Example

Proposal for Smoking Programme for Adolescents Aged 16-19 Years Old in the Borough of Barnet (London) Barnet Borough is ranked as the 20th "most ethically diverse borough in England (Barnet, 2008, "Executive Summary," p. 5). It is considered a prosperous borough and the unemployment rate is lower than England's national average. The youth in Barnet have several health problems that are of concern. In 2005, women between the ages of 15 and 17 have an overall conception rate of 28.7% per 1,000 women, which is an increase from 19.9% from 1998-2004 (Barnet, p. 7). Barnet teen boys also have health challenges in the Borough, with 2,200 boys who are abusing alcohol and another 4,000 children (mostly boys) who suffer from mental health disorders. Many young mothers are also smoking when they are pregnant and this amounts to 15.2%. Among secondary school children regular smoking has been seen in children ages 11-15 and have remained "stable" since 1998(Barnet, 2008, "Profile", p. 25). There is also 78% of children who report they have never smoked and another25% that say they would like to see more information and advice about smoking (Barnet, "Profile", p. 25). Barnet is also the "second largest population in London" according to the Office of National Statistics (Barnet, "Profile", p. 13). They are second in the population for children and young people in London. They have an estimated 82,400 children between the ages of birth and 91 as of 2007, which is about one forth of Barnet's total population; in the 15-19 year old group there are approximately 19,600 (Barnet, p. 13). Lung Cancer and respiratory diseases are common in Barnet and they are common causes of death. Many people, adults and children alike, will suffer from these diseases. This is one of the reasons that a smoking cessation program with a healthy lifestyle component is essential to the health of Barnet's youth. Statement of the Problem Teenagers are still smoking regardless of the programs that have been presented for them. Studies have shown that teens between the ages of 15 and 16 are more prone to start smoking although some will start as early as 11 and 12. A study done by the University of Leeds was done with 1,134 teens. In this study they found that girls were more prone to start smoking than boys and many started when they were 11 or 12. As very young children, many reported that they were "regular smokers" but by the time they were 15 or 16. Park Weaver and Romer (2008) studied the factors that would predict how teens would move from experimental smoking to daily smoking. They studied data from the National Longitudinal Study of Adolescent Health. They studied American teens and found that many smoked because their friends smoked or because they were depressed or using alcohol. The results of the study showed that a multifaceted intervention is the best way to approach teens with information on smoking. Smoking in teens is cause for alarm because they are not listening to the dangers of smoking. Many teens have parents who smoke or who are smokers and they are the more prone to smoke than those who have parents who do not smoke. Another challenge is that as adults stop smoking, the statistics for teens who smoke are going up instead of down (BBC News). The need is to design a program has studied a variety of programs and interventions to stop teen smoking. Programs that have Worked Mermelstein (2009) provided an overview of smoking cessation interventions that have worked. School based clinics are often where programs are created for teens. One program that is spotlighted is the American Lung Association's Not on Tobacco Programme. This program is a 10 week programme that has 50 minute group sessions that are conducted during school hours. They found that of the 566 participants, they had 21% of the students stop smoking (Mermelstein, p. 129). Pharmacological approaches have not worked well with teens. There were studies done that used the nicotine patch with many teens. They found that although the patch generally works with adults, the "quit rate" for adolescents was lower than with adults (Mermelstein, p. 129). Perry, Killen et al. reported on a school-based intervention that was geared towards modifying smoking behaviour. This program interjected facilitation from teachers with a variety of group discussions and presentations from students. The program was also an intense type of involvement from the students so that they invested in their learning and their behaviour change. The study also showed that the programme also changed the attitudes of students (p. 724). Another interesting programme was the 5-4-3-2-1 Go! Program researched by Evans (2007). This programme has as its primary goal to bring information to teenagers about the resources in their community that can provide healthful lifestyles for themselves and their families and engage teens in the process of learning about stop smoking. This model is also geared towards brining change into the individual's life. When looking at these programmes it is important to understand that the programmes that are working are those that combine smoking information with other types of education. Rationale of the Program Smoking has become a problem for many people today although the act of smoking is a health hazard. Many adults began smoking when they were in their teens and some were smoking by the age of ten. According to Boyles (1997), the idea of smoking cessation began in the 1960s. At that time the emphasis was on education and providing ways for people to stop. Most people understand that the alternative to quitting is death, but most do not think about it and continue to smoke. Many teens start smoking to "look cool" or because some of their friends have pushed them to take a cigarette with them. According to the Centers for Disease Control (CDC) a study of 9,965 teenagers and 12 year olds, found that 38% said they could quit "Whenever they wanted to" (Boyles, 1). The challenge to this answer was that 86% of the teens who were answering the question and already tried to use a method to stop smoking at least once. Many studies have been done that tell of programs that assist teenagers in smoking cessation. The programs always work for some children but they do not work for every teen. The challenge becomes what to do in order to help the majority of teens who are ready to stop and how to find these students. Teenagers are still smoking regardless of the programs that have been presented for them. Studies have shown that teens between the ages of 15 and 16 are more prone to start although some will start as early as 11 or 12. A study done by the University of Leeds was done with 1,124 teens. In this study, they found that girls were more prone to start smoking than boys and many started when they were 11 or 12. As very young children, many reported that they were "regular smokers" but by the time they were 15 or 16, 31% of girls and 16% of boys in the study suggested that healthy education by itself is not helping teens to keep them from smoking. Aims and Objectives The aim of this proposal is to create a smoking cessation programme for teens, ages 16-19, and to teach them how to lead a healthier lifestyle. Central to the progress of the program is to have motivation from these teens to stop smoking. This can be achieved through education about behavioural and lifestyle changes. Objectives of program 1. Create an eight week program that emphasizes healthy lifestyles for teens that can be done after school and during the summer months. 2. Improve the intentions of 100 teens to live a healthier lifestyle by emphasizing good nutrition and exercise. Teens will self-report their new habits throughout the program. 3. Create within the program educational videos and interactive programs that will engage teens in learning as well as give them a basis for forming new attitudes around healthier lifestyles. 4. Create a team of 15 teens who will teach other teens about nutrition and healthy choices. 5. Involve teens in developing a program for helping their peers quit smoking. The goals of the program are to make sure that teens understand that their bodies must be healthy and strong if they want to develop their minds and create the life they want later in life. Topics will include nutrition, staying away from drugs including alcohol and cigarettes. In Gratton, Povey and Clark-Carter (2007), a program similar to this encouraged children to eat more fruits and vegetables. The researchers used a questionnaire that would enable students to understand nutrition and begin to create times during the day when they could consume healthier habits for eating. The study found that when students were motivated to eat more fruits and vegetables, their intake did increase. Method Because the target market group for this proposal programme is 16-19 year olds, teens will be recruited from five different educational establishments. We will recruit from three secondary schools (compulsory education) and two, sixth form colleges. The names of these are yet to be identified. The theory that will be used is the Health Belief Model (HBM). The primary aim of this model is to "explain and predict" health behaviours (University of Twente, 2004, p. 1). This theory presupposes that a person will take a healthy action if they 1) feel that they can avoid a negative health condition 2) they expect in a positive way that if they take an action that was not recommended, they will avoid this negative health condition and 3) they can believe that they will be successful when they take the health action that was recommended (University of Twente, p. 1). We expect that through our method 3-5% of the teens who attend our program will stop smoking. Six Main Constructs of HBM The HBM Model has six main ideas that they use. We will use them with teens as follows: 1. Perceived susceptibility. This is an individual's perception of whether they will get a condition. Teens that smoke will need to have a perception that they personally can get cancer or the other diseases or challenges that can come if they continue to smoke. 2. Perceived severity. The action they take will have to do with how they perceive the seriousness of the condition and its seriousness to them personally. Teens must believe that if they continue to smoke, they are risking their lives and this will produce consequences. 3. Perceived benefits. The individual must perceive that the advised action will reduce their risk of getting negative health or that it will have a serious impact on their health. Teen smokers must understand the benefits of quitting smoking and how it will impact their health if they stop smoking now. Also, the programme will clarify the positive aspects of what they can expect from better health. 4. Perceived barriers. The individual must have a positive perception that there are tangible and psychological costs to the advised actions that will benefit the individual and not create barriers. Teens will need to have incentives, assistance and reassurance throughout the programme. 5. Cues to action. This construct will help the individual create the tools and strategies they need to activate the "readiness" or motivation for the process to work. The way we will do this for teens is to create the "how-to" information that they will need, promote the awareness of smoking cessation throughout the process and keep reminders. 6. Self-efficacy. This part of the programme promotes an individual's confidence in their own ability to take action. For teens we will provide guidance throughout the program and assist them with resources to keep them taking the actions they need to take to continue to abstain from smoking. Staff and Timeline There will be five staff who will help in the organization of the program. There will be two facilitators who will present the information and the other three will pass out materials and circulate the room for questions during the process of the small group exercises. We expect that this will be an eight week program that we will first do as a pilot project and then we will present the project over a years time. Cost of the Programme The programme has little overhead because the organisations have donated space and they are doing the advertising. The approximate cost of the entire programme will be $25,000 (see appendix for budget). Ethics of the Intervention The HBM is a very ethical programme because it does not force the individual to accept anything. The theory creates an opportunity for teens to examine their own lifestyle as it is now and make different choices. They can chose to change their behaviours and therefore change their lives because of they information they were given. Evaluation Strategy We will do a pre-test when teens first come into the program that will tell us what the student already knows about healthy lifestyle and smoking. We will also test their knowledge at the end of the first four weeks and again at the end. We will ask them to self-report their information. Conclusion The is a need for a smoking cessation programme that works in the Borough of Barnet. Because of the high rate of health challenges within the Borough, teens will also need the information on healthier lifestyles. Because the program will be after school and during the summer there can be a way for teens to bring in other friends and family to take the programme once the first group has gone through it. References Barnet London Bourough. 2008. A health profile of Barnet. Retrieved December 8, 2009 from URL: . Barnet London Borough. 2008. Profile of children and young people in Barnet. Retrieved December 8, 2009 from URL: . BBC NEWS. "Teenagers 'ignore smoking advice'". 22 September 2004. BBC News online. Accessed 06 December 2009. URL: . Evans, D. 2007. The 5-4-3-2-1 Go! Intervention: Social marketing strategies for nutrition. Gem no: 436. Nutritional Education Behavior. p. S55-S59. Gratton, L., Povey, R. and Clark-Carter, D. 2007. Promoting children's fruit and vegetable consumption: Interventions using the Theory of Planned Behavior as a framework. British Journal of Health Psychology. 12. p. 639-650. Mermelstein, R. 2003. Teen smoking cessation. Tobacco Control. 12 (Suppl 1). P. 125-134. Park, S., Weaver, T.E. and Romer, D. 2009. Predictors of the transition from experimental to daily smoking among adolescents in the United States. Journal for Specialists in Pediatric Nursing. 14 (2). p102-111. Academic Search Premier AN: 37307847. Accessed: 03 December 2009. Perry, C., Killen, J., Telch, M., Slinkard, A., Danaher, B.G. 1980. Modifying smoking behavior of teenagers: A school-based intervention. American Journal of Public Health. 70. p. 722-725. University of Twente 2004. Health Behaviour Model. Accessed: 04 December 2009. URL: Read More