Developing a Theory-based Health Education Intervention to Prevent Adolescent Students from Smokeless Tobacco Consumption

Background Smokeless tobacco is a kind of tobacco that is chewed or sniffed; e.g., khaini , gutkha , paan-parag , and paan . It is harmful to health, but over 300 million people in the world consume it. Its consumption among the adolescent students of Nepal is increasing. It needs to develop a theory-based health education intervention to prevent students from consuming smokeless tobacco. Method Four focus group discussions were conducted among the students of Class 9 by following the guidelines based on constructs of protection motivation theory. Based on the rigorous review of literature and feedback from the supervisor, a module of theory-based health education intervention was drafted. After that, a pilot test of the intervention was conducted among the students of Class 9. Data from 16 students who participated in the pilot test was analyzed to identify reliability and face validity of the intervention. The content validity of the intervention was assured through feedback from the supervisor and literature. After that, the final draft of the theory-based health education intervention was prepared. Results We found students who participated in focus group discussions had insufficient knowledge regarding smokeless tobacco and its harmful effects. They had many misconceptions related to smokeless tobacco consumption. They accepted the need for skills to prevent themselves from smokeless tobacco consumption. They voiced that the strict rules should be implemented in the school premises to control tobacco consumption. Including the information related to these findings, the protection motivation theory-based health education intervention was developed. Cronbach’s alpha values of each objective of each session were more than .8. More than 80% of participants of the pilot test agreed with the effectiveness and appropriateness of the components of the intervention. Conclusion We developed a highly reliable and valid protection motivation theory-based health education intervention. Its proper implementation might raise knowledge of students regarding smokeless tobacco and its effects and enhance their skills to prevent its consumption.