An RCT of a Smartphone-based TID Programme

Study Overview
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Brief Summary
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The study aims to test the effect a smartphone-based intervention on primary school students and their parents' attitudes towards tobacco industry and their tobacco-related communications.

Official Title
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A Smartphone Messaging Programme for Tobacco Industry Denormalisation - a Randomised Controlled Trial

Conditions
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Tobacco Industry Denormalisation Beliefs, Tobacco-related Communications

Intervention / Treatment
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* Other: Smartphone-based messages


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Parents and children should all understand Chinese. Parents should have a smartphone and use WhatsApp (a smartphone-based app) Exclusion Criteria: n/a
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: TID<br>Messages will be sent 1-2 times per week containing information that aims to denormalise the tobacco industry. | Other: Smartphone-based messages<br>* For the TID arm, the messages' contents include the tobacco industry's (TI's) anti-smoking campaigns that made smoking more grown-up and more appealing to youth; the TI's role in smoking in movies; etc. For the sugar sweetened beverage (SSB) arm, the messages' contents include the disease conditions linked to SSBs, and the interference of sugar industry in scientific research.<br>|
| Other: Sugar sweetened beverages<br>Messages will be sent 1-2 times per week containing information on the adverse health effects of sugar sweetened beverages. | Other: Smartphone-based messages<br>* For the TID arm, the messages' contents include the tobacco industry's (TI's) anti-smoking campaigns that made smoking more grown-up and more appealing to youth; the TI's role in smoking in movies; etc. For the sugar sweetened beverage (SSB) arm, the messages' contents include the disease conditions linked to SSBs, and the interference of sugar industry in scientific research.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| TID beliefs in parents | Parents will report their opinions towards 4 sentences: 1) Tobacco companies are a respectable industry; 2) the tobacco industry does everything it can to get young people to smoke; 2) the tobacco industry use many tactics to resist tobacco control regulations; 4) the tobacco industry deceived the public for financial interests. All the 4 questions have 5 options from definitely yes to definitely no. The options will be recoded into 0-4 or 4-0, as appropriate, with higher scores indicating more negative attitudes towards the industry. A sum of scores from the 4 questions will be deemed a measurement of TID beliefs. | 1 month | 
| TID beliefs in children | Students will report their opinions towards 4 sentences: 1) Tobacco companies are a respectable industry; 2) the tobacco industry does everything it can to get young people to smoke; 2) the tobacco industry use many tactics to resist tobacco control regulations; 4) the tobacco industry deceived the public for financial interests. All the 4 questions have 5 options from definitely yes to definitely no. The options will be recoded into 0-4 or 4-0, as appropriate, with higher scores indicating more negative attitudes towards the industry. A sum of scores from the 4 questions will be deemed a measurement of TID beliefs. | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tobacco related communication reported by parents | Parents will report whether they said the following to children in the past 30 days: 1) harm of smoking 2) harm of secondhand smoking 3) criticise smoking behaviour 4) approve tobacco control measures. Each of the messages will be analyse as a binary outcome. | 1 month | 
| Sugar sweetened beverage (SSB) related communication reported by parents | Parents will report whether they said the following to children in the past 30 days: 1) harm of SSB 2) certain kind of drinks contain sugar 3) don't drink or drink less SSB. Each of the messages will be analyse as a binary outcome. | 1 month | 
| Tobacco related communication reported by children | Students will report whether they heard the following from parents in the past 30 days: 1) harm of smoking 2) harm of secondhand smoking 3) criticize smoking behaviour 4) approve tobacco control measures. Each of the messages will be analyse as a binary outcome. | 1 month | 
| SSB related communication reported by children | Students will report whether they heard the following from parents in the past 30 days: 1) harm of SSB 2) certain kind of drinks contain sugar 3) don't drink or drink less SSB. Each of the messages will be analyse as a binary outcome. | 1 month | 
| Intention to smoke in children | Two questions will be used to assess this outcome: 1) do you think you will smoke in the next 12 months? 2) If one of your good friends offers you a cigarette, will you smoke it? Response options are definitely not/probably not/probably yes/definitely yes. Those choosing options other than definitely not for either of the questions will be deemed having intention to smoke; the other students will be deemed having no intention to smoke. | 1 month | 
| Home exposure to secondhand smoke in children reported by children | One question will be asked: 1) On how many of the past 7 days did someone smoke near you at home? (Options 0 day/1/2/3/4/5/6/7). The responses will dichotomised into a binary indicator of secondhand smoke exposure (no/any) and analysed as an outcome. | 1 month | 
| Home exposure to secondhand smoke in children reported by parents | One question will be asked: 1) On how many of the past 7 days did someone smoke near your children at home? (Options 0 day/1/2/3/4/5/6/7). The responses will dichotomised into a binary indicator of secondhand smoke exposure (no/any) and analysed as an outcome. | 1 month | 
| Parents' support for tobacco control | Parents will report their opinions towards 4 sentences: 1) government should adopt plain packaging; 2) government should impose stronger regulation on tobacco; 3) government should strengthen the prevention of the harm of tobacco. The options were strongly support/support/neutral/oppose/strongly oppose. The options will be recoded into 4-0, with higher scores indicating stronger support for tobacco control. A sum of scores from the 4 questions will be deemed a measurement of parents' support for tobacco control. | 1 month | 
| Negative attitude towards smoking in parents | Parents will be asked your attitude towards smoking is with options of very positive/positive/neutral/negative/very negative. The options will be dichotomised as very negative vs others (negative/neutral/positive/very positive) for analysis. | 1 month | 
| Negative attitude towards smoking in children | Children will be asked your attitude towards smoking is with options of very positive/positive/neutral/negative/very negative. The options will be dichotomised as very negative vs others (negative/neutral/positive/very positive) for analysis. | 1 month | 
| Past 7-day consumption of SSB and water in children reported by children | Children will be asked On how many of the past 7 days did you drink SSBs? and On how many of the past 7 days did you drink water? For both questions, the options were 0/1/2/3/4/5/6/7 days. These two variables will be analysed as both binary (No (0 day) vs any (1/2/3/4/5/6/7 days)) and continuous variables. | 1 month | 
| Past 7-day consumption of SSB and water in children reported by parents | Parents will be asked On how many of the past 7 days did you drink SSBs? and On how many of the past 7 days did you drink water? For both questions, the options were 0/1/2/3/4/5/6/7 days. These two variables will be analysed as both binary (No (0 day) vs any (1/2/3/4/5/6/7 days)) and continuous variables. | 1 month |