Clinical Trial Details
— Status: Enrolling by invitation
Administrative data
NCT number |
NCT05500235 |
Other study ID # |
IRB20-2157 |
Secondary ID |
|
Status |
Enrolling by invitation |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
June 27, 2023 |
Est. completion date |
July 2025 |
Study information
Verified date |
September 2023 |
Source |
Harvard School of Public Health (HSPH) |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
This study aims to compare the implementation and effectiveness of the Tobacco-Free Teachers,
Tobacco-Free Society (TFT-TFS) program when delivered through in-person training vs. a
smartphone-based training model. Investigators will conduct a comparative effectiveness trial
using a cluster-randomized design in which headmasters at schools in the Indian state of
Madhya Pradesh (MP) will be trained in person or via a smartphone to deliver TFT-TFS in their
schools. Schools will be randomly assigned to each training arm, and investigators will
compare program effectiveness (tobacco use cessation), implementation outcomes, and program
cost and reach.
Description:
Tobacco-related deaths are rising rapidly in low and middle-income countries (LMICs). India's
population is the second largest consumer of tobacco products in the world: 29% of the adult
population uses smoked, smokeless, or both forms of tobacco, and around 1.2 million die each
year from tobacco-related causes. Reducing tobacco-related deaths in LMICs will require
large-scale implementation of evidence-based interventions (EBIs) that promote tobacco
control. Currently, the implementation of tobacco control EBIs in LMICs relies on in-person
training, which has inherent logistical challenges that limit the ability to scale up these
programs. New training models are needed to ensure tobacco control EBIs can be implemented
broadly, rapidly, and at low cost, especially in rural and under-resourced areas where
tobacco use is prevalent.
The long-term goal is to identify effective, low-resource strategies to promote the
broad-based implementation of tobacco control EBIs in LMICs. In India, school teachers are
respected community leaders, role models, and an important channel for promoting tobacco
control in schools and society. Investigators previously demonstrated the effectiveness of
the Tobacco-Free Teachers, Tobacco-Free Society (TFT-TFS) program in a cluster-randomized
study of schoolteachers in Bihar state, India. Tobacco use cessation rates were doubled among
teachers in intervention schools compared to control schools, along with significant
improvements in the adoption and implementation of tobacco control policies. As a critical
next step in scaling up the TFT-TFS tobacco control EBI, investigators are focusing on
expanding the training of those implementing the program in schools, i.e., school
headmasters. The investigators will compare two models of TFT-TFS training of
headmasters-in-person vs. smartphone-based-and the effect of each approach on TFT-TFS program
implementation and effectiveness. India has the world's second-largest mobile phone user
subscription base of 1.2 billion, with good penetration even in rural areas. The use of
smartphones in educational settings is already pervasive in India, offering a readily
available, low-cost strategy for expanding training of the TFT-TFS program. Training via
smartphones can be delivered anytime and anywhere and allows flexibility and
individualization of the learning experience through on-demand access to training content and
virtual interactions among trainees. By delivering TFT-TFS training through smartphones, the
program's potential reach can be multiplied over what can be achieved with in-person
training.
Investigators will conduct a comparative effectiveness trial using a cluster-randomized
design in which headmasters of schools in the Indian state of Madhya Pradesh (MP) will be
randomly assigned to receive in-person training or training via smartphone for the TFT-TFS
program. Once trained, headmasters in both groups will implement the TFT-TFS program within
schools. Investigators will compare the training arms regarding program effectiveness
(tobacco use cessation), implementation, cost, and reach.