Groundwork and preparation for a research study to adapt, develop and test the implementation effectiveness of ‘A Stop Smoking In Schools Trial’ (ASSIST) in LMIC settings

ASSIST is an effective theory-based early secondary-schools-based smoking prevention intervention implemented in UK and France. Drawing on Diffusion of Innovation Theory, ASSIST trains students voted as influential by their year group, to support/promote anti-smoking messages and norms among peers.

Research in higher income countries suggests that interventions based on diffusion of innovation are particularly effective among adolescents. The ASSIST intervention developed techniques to identify influential adolescents, who are recruited and trained as ‘peer supporters’ to spread/sustain non-smoking norms through role-modelling and informal conversations. ASSIST was developed and evaluated in a MRC funded trial led by Moore and is now recommended by NICE and implemented across the UK, supported by Evidence-Into-Impact Ltd. Various UK adaptations (sexual health, drug use, physical activity) are being developed.

The ASSIST model has significant potential to be effective in LMICs, particularly because it invests in peer supporters embedded within school systems and adolescent social networks. Provided school systems are significantly developed and attendance high, the model has potential for relatively low-cost sustained effects.

This proposal lays foundations for future GCRF-funded work to transfer the model to a range of LMIC partner countries.  Longer term, this work would seek to broaden to a ‘Health Ambassador’ model where anti-smoking peer supporters are subsequently trained to tackle other adolescent health issues in later school years and cascade training onwards to future ambassadors.

To undertake preparatory research and build research partnerships ahead of a proposal to a larger GCRF call to undertake implementation trials of ASSIST in two/more settings.

1. Scoping work in four regions/countries to: establish and synthesise available research evidence on: adolescent smoking behaviour/demand for smoking prevention; school setting readiness; and public health research capacity. 
2. Build collaborations with research partners in up to three countries where feasibility established.
3. Support research partners in these countries to identify local delivery organisations, stakeholders and collaborators.
4. Facilitate research partner-led PPI/scoping work to further understand need, school context and potential facilitators/barriers to intervention.
5. Set out a (costed/deliverable) framework for a proposal to a larger GCRF call.

Lead Applicants: 

Kirstin Mitchell (Senior Research Fellow)
Helen Sweeting [budget holder] (Reader)

Lead School/Research Institute:  MRC/CSO SPHSU, Institute of Health and Wellbeing, University of Glasgow

Carolyn Blake - Consultant on International Adolescent Health
Kate Reid - Lecturer and Chartered Health Psychologist, CR&DALL, School of Education.

University of Glasgow collaborators:
Laurence Moore - Director, MRC/CSO SPHSU
Lisa McDaid - Professor of Social Sciences and Health, MRC/CSO SPHSU.
Sharon Simpson - Professor of Behavioural Sciences and Health MRC/CSO SPHSU.
Daniel Wight - Workstream lead on Transferability of Interventions, MRC/CSO SPHSU,

External collaborators:
Sally Good - Decipher Impact Ltd.

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