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Peer-reviewedCC BY 4.0MethodsX

Effectiveness of facilitator-driven and peer-led educational interventions on tobacco use intention among adolescents: a school-based cluster randomized trial protocol

  1. 1Department of Community Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
  2. 2Department of Community Medicine, ESIC Medical College and Hospital, Bengaluru, India

Abstract

Tobacco use remains a major preventable risk factor for non-communicable diseases (NCDs), with initiation frequently occurring during adolescence. Despite the implementation of several school-based tobacco prevention programmes, evidence on the effectiveness of peer-led educational approaches in the Indian context remains limited. This study aims to evaluate the effectiveness of a combined facilitator-driven and peer-led educational intervention in reducing the intention to use tobacco among school-going adolescents. The study will be conducted in 2 phases: Phase 1 will involve a qualitative study using in-depth interviews (IDI)with key stakeholders, including teachers, parents, psychologists, medico-social workers, students, and representatives of the national health programmes. The findings from this phase will be used to develop a culturally appropriate, evidence-based educational module. Phase 2 will comprise a school-based cluster randomized controlled trial involving 400 Class 8 students from 10 private English-medium schools in Mangalore. Schools will be randomly allocated to intervention and control arms. Both groups will receive facilitator-driven tobacco prevention education, while the intervention group will additionally receive peer-led reinforcement sessions delivered by trained peer educators. The primary outcome will be the change in intention to use tobacco, assessed using a validated Likert-scale instrument. Secondary outcomes will include changes in knowledge, attitudes, perceptions, risk perception, and patterns of tobacco use from baseline. The findings are expected to generate evidence on the effectiveness of integrating peer-led reinforcement with facilitator driven education and may inform the development of scalable and sustainable school-based tobacco prevention strategies in India.

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BibTeX
@article{sreeram2026effectiveness,
  title = {{Effectiveness of facilitator-driven and peer-led educational interventions on tobacco use intention among adolescents: a school-based cluster randomized trial protocol}},
  author = {Sreeram RV and Rajath Rao and Nithin Kumar and Bhaskaran Unnikrishnan and Rekha Thapar and Prasanna Mithra and Ramesh Holla and Aishwarya L},
  journal = {MethodsX},
  year = {2026},
  month = oct,
  doi = {10.1016/j.mex.2026.104214},
  url = {https://doi.org/10.1016/j.mex.2026.104214},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Effectiveness of facilitator-driven and peer-led educational interventions on tobacco use intention among adolescents: a school-based cluster randomized trial protocol
AU  - Sreeram RV
AU  - Rajath Rao
AU  - Nithin Kumar
AU  - Bhaskaran Unnikrishnan
AU  - Rekha Thapar
AU  - Prasanna Mithra
AU  - Ramesh Holla
AU  - Aishwarya L
PY  - 2026
DA  - 2026/10/19
JO  - MethodsX
DO  - 10.1016/j.mex.2026.104214
UR  - https://doi.org/10.1016/j.mex.2026.104214
AB  - Tobacco use remains a major preventable risk factor for non-communicable diseases (NCDs), with initiation frequently occurring during adolescence. Despite the implementation of several school-based tobacco prevention programmes, evidence on the effectiveness of peer-led educational approaches in the Indian context remains limited. This study aims to evaluate the effectiveness of a combined facilitator-driven and peer-led educational intervention in reducing the intention to use tobacco among school-going adolescents. The study will be conducted in 2 phases: Phase 1 will involve a qualitative study using in-depth interviews (IDI)with key stakeholders, including teachers, parents, psychologists, medico-social workers, students, and representatives of the national health programmes. The findings from this phase will be used to develop a culturally appropriate, evidence-based educational module. Phase 2 will comprise a school-based cluster randomized controlled trial involving 400 Class 8 students from 10 private English-medium schools in Mangalore. Schools will be randomly allocated to intervention and control arms. Both groups will receive facilitator-driven tobacco prevention education, while the intervention group will additionally receive peer-led reinforcement sessions delivered by trained peer educators. The primary outcome will be the change in intention to use tobacco, assessed using a validated Likert-scale instrument. Secondary outcomes will include changes in knowledge, attitudes, perceptions, risk perception, and patterns of tobacco use from baseline. The findings are expected to generate evidence on the effectiveness of integrating peer-led reinforcement with facilitator driven education and may inform the development of scalable and sustainable school-based tobacco prevention strategies in India.
SN  - 2215-0161
ER  -