Building Consensus on Indicators for Youth Cessation

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Building Consensus on Indicators for Youth
Cessation

• National Conference on Tobacco or Health
• Steve Manske, Chris Lovato, Tobin Copley, Wendy
  Cressman-Zehr for the Youth Tobacco Cessation
  Collaborative
• Edmonton October 3, 2007

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Using Common Indicators to Improve Your Tobacco
Control Initiatives

• Building Consensus on Indicators for Youth
  Cessation
• Steve Manske, Scientist, Centre for Behavioural
  Research Program Evaluation, University of
  Waterloo
•  Using Performance Measurement for Macro-level
  Surveillance
• Robert Schwartz, Associate Director of
  Evaluation, Ontario Tobacco Research Unit,
  University of Toronto
•  Tobacco control evaluation in Canada Current
  status and next steps
• Shawn OConnor, Senior Research Associate,
  Ontario Tobacco Research Unit, University of
  Toronto

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Outline of Talk

• Phase I description
• Approach in Phase II
• Findings Youth Consultation Sessions
• Findings Expert Review Consensus Building
• Recommendations
• Discussion
• Opportunities for Pilot Testing
• Opportunities to Use Indicators

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Previous Work on Youth Cessation Indicators
Measures

• Value of common indicators / NAGME
• 2004 Health Canada Youth Cessation Roundtable
  definitions, minimal data set
• Phase 1 report
• Logic model of behaviours / indicators
• Scan of measures available
• Recommended measures to adopt
• Identified gaps

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Approach Youth consultation

• 5 locations BC, AB, ON, QC, NB
• 73 youth aged 13-18 who smoke or had quit
• 2 focus groups / location Gr. 9/10, 11/12
• Discussion content
• Perception of what it means to be a smoker
• Experiences smoking and attempts to quit
• Feedback on a draft measurement tool
• Grace Maddox conducted focus groups

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Approach Expert Review, Consensus Building

• 6 US 15 Canadian experts research, practice
• 1-day workshop
• Purposes
• Reach consensus on core indicators / measures to
  evaluate smoking interventions
• Identify conditions when core items useful
• Recommend additional indicators
• Recommend research agenda for gaps
• Recommend how to promote adoption

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Findings Youth Consultations

• Fewer words, clear instructions, repetition
• Tend not to read question carefully
• Puffs, drags, partial cigarettes dont count
• Use familiar visual presentations (wheel)
• Define potentially confusing terms e.g., smoking
  cigarettes
• Use actual day names, not 1 day ago
• Use daily averages, not daily count
• Clarify if part cigarettes count
• Use familiar terms

puff not bouffee
quit not stop
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Expert Review 7 day prevalence

• Think back over the past 7 days. On how many
  days did you smoke cigarettes, even a puff?
• 0 days
• 1 day
• Etc
• All 7 days
• B. Think back over the past 7 days. On the days
  you smoked, how many cigarettes did you smoke per
  day on average?
• __ Average of cigarettes per day (past 7 days)

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Expert Review 30 Day Prevalence

• Think back over the past 30 days. On how many
  days did you smoke cigarettes, even a puff?
• 0 days
• 1 or 2 days
• 3 to 5 days
• 6 to 9 days
• 10 to 19 days
• 20-29 days
• All 30 days

Indicator continues on next slide
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30 Day Prevalence Continued

• Think back over the past 30 days. On the days you
  smoked, how many cigarettes did you smoke per day
  on average?
• I did not smoke cigarettes during the past 30
  days.
• One or more puffs but less than one cigarette per
  day.
• 1 to 5 cigarettes per day
• 6 to 10 cigarettes per day
• 11 to 15 cigarettes per day
• 16 to 20 cigarettes per day
• More than 20 cigarettes per day

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Items with Major Agreement

• Quit attempts are a core indicator
• Requires hierarchical set of questions
• Minimal agreement how to ask the question
• Better suited to surveillance than evaluation

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Recommendations

• Use the 4 agreed upon indicators but
• Test in real world setting
• Test wording to ensure youth interpret it as
  expected
• Test the format (open ended vs. categorical)

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Next Steps

• Create an actual survey
• Pilot test
• Conduct expert workshop
• Process evaluation expert review consensus
  building
• Evaluation guide develop a guide to promote
  indicators and make them accessible to community
  users
• Communication plan / Dissemination
• Web Survey Constructor Application

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Questions

• Are there persons in the audience aware of
  opportunities to test these items?
• What input do you have on the next steps?
• What opportunities are you aware of to
  incorporate indicators?

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• The Centre for Behavioural Research and Program
  Evaluation is supported by the National Cancer
  Institute of Canada with funds from the Canadian
  Cancer Society.
• We are located at the University of Waterloo.

Email Contact manske_at_uwaterloo.ca