This project will strengthen and improve an existing tailored interactive Internet-based multimedia self-help expert system smoking intervention (Adolescent Smoking Health Education Source - ASHES) and evaluate its effectiveness in a large school-based trial among middle school students in grades 6, 7 and 8.

cancer prevention, tobacco, smoking cessation, smoking prevention, students, youth, school-based program, tailored, self-help, Internet, web

1. Design and program a tailored interactive self-help smoking prevention and cessation expert system for the target audience.
2. Field test students' reactions to the anti-smoking expert system in a school setting.
3. Strengthen and improve the existing tailored intervention for adolescent smoking prevention and cessation implementing the intervention among a large number of middle school students.
4. Evaluate the effectiveness of the tailored intervention compared to the non-intervention condition.
5. Examine new feedback components of the tailored intervention.
6. Prepare the of the tailored smoking education program to be integrated into the Michigan Model.

Twenty-seven middle school students to participate in the ASHES focus group.

This project's theory-driven self-help expert system has been designed for all types of teens:

• non-smokers - to reduce the onset of their cigarette smoking
• smokers and experimenting teens - to accelerate any smoking cessation
• ex-smokers - to enhance their ability to remain ex-smokers

The core idea of the program is to tailor the content of the intervention to each individual's characteristics, behaviors, attitudes, and beliefs. Students are assessed on smoking status, attitudes about smoking, and perceptions and experiences with smoking.

Focus groups determine the acceptability of the web as a delivery medium for a smoking prevention intervention for middle school students. Secondarily, focus groups will identify design elements for inclusion in a web-based smoking prevention intervention that are appealing to adolescents.

To date, the study's focus group findings have been reviewed and published, as noted below. Due to state budgetary constraints and other unforeseen issues, a full trial of this ASHES intervention was not conducted.

Focus Group Findings:

• There is a need for program developers to involve members of the target audience in program conceptualization, and formative evaluation measures.
  
• The Internet is a viable choice for students seeking out smoking information.
• Given the student identified appeal of a human aspect to the Internet (chat rooms, expert guides etc.), programs aimed toward this age group should contain some type of human interaction, as opposed to creating an environment where students are expected to navigate toward information on their own.
• Interactivity was a reoccurring theme with regards to appealing Web design elements. Music videos, desk-top and hand held computer games all use a dynamic approach that appeals to the teen population. By providing a like experience through the Internet, teens will be more drawn to accessing, utilizing, and interacting with smoking prevention interventions.

The Internet provides innovative opportunities for reaching the teen population. For this to be an effective medium for the delivery of smoking prevention information, it is imperative that the target population has input into the design and functionality of the program.<br><br>

Because the Internet is such a new option for prevention programs, the possibilities for future exploration in this area are vast. This study and its results suggest future research in a number of areas including the quantification of various design elements for inclusion in an adolescent smoking prevention website and the examination of differences in efficacy between web-based prevention interventions and traditional programs.

Parlove, A.E., Cowdery, J. E., Hoerauf, S.L. (2004). Acceptability and Appeal of a Web-based Smoking Prevention Intervention for Adolescents. The International Electronic Journal of Health Education (www.iejhe.org), 7: 1-8.