Use of Interactive Health Communication to Affect Smoking Intentions in Middle School Students: A Pilot Test of the 'Headbutt' Risk Assessment Program

Purpose. Developing and disseminating innovative and effective approaches for smoking prevention among middle school children remains a public health priority. This pilot study evaluates the use of a Web-based tobacco prevention program, Headbutt, to change intentions of middle school children to smoke tobacco. Methods. Headbutt was implemented with the use of a single-group pretest-posttest study design in sixth grade classes of nine middle schools in Texas (student n = 2227). The program assesses cognitive determinants of smoking and provides intervention feedback tailored to the child's responses. Results. Headbutt significantly affected smoking intentions, prosmoking attitudes, self-efficacy expectations, and knowledge of negative consequences (all p ≤ .001) measured with scales adopted from the Texas Tobacco Initiative Survey. Change in prosmoking attitudes had the greatest predictive effect on smoking intentions (p < .001). These results were moderated by ethnicity and age of students. Conclusion. Findings need to be interpreted in the light of study design limitations. However, strong associations between the Headbutt program and intention change suggests that a more rigorous effectiveness trial is indicated.