A school-based universal prevention intervention for children aged between 12 and 13 years. It is delivered by qualified trainers to a selected group of peer supporters across six sessions.
The information above is as offered/supported by the intervention provider.
12 to 13 years old
Group
ASSIST (named for its trial: A Stop Smoking in Schools Trial), is a schools-based smoking prevention intervention It is a universal intervention for children between the ages of 12 and 13. It is delivered in secondary schools and aims to improve resilience and reduce the take-up of smoking.
The intervention involves using a questionnaire to identify influential students within schools, and then recruiting them into the intervention and delivering interactive skills and information training. These influential peer supporters then disseminate information positively and effectively to empower their friendship groups not to take up smoking.
12 to 13 years
All school children aged 12 to 13 years
Disclaimer: The information in this section is as offered/supported by the intervention provider.
Science-based assumption
Smoking in adolescence can cause long-term health problems.
Science-based assumption
Smoking-related behavioural change in adolescents is propagated by trained peer supporters who promote the benefits of remaining smoke-free and the risks of smoking.
Science-based assumption
Smoking behaviour in adolescents can be influenced positively or negatively by peers.
Intervention
The intervention teaches influential peer supporters ways of disseminating information positively and effectively, alongside conflict resolution methods, to empower their friendship groups not to take up smoking.
Short-term
Peer supporters learn about the risks of smoking and the benefits of being smoke-free, and are trained to disseminate these messages in an ad hoc way by looking for opportunities to include smoking facts in their everyday conversations with their friends.
Medium-term
Peer supporters develop leadership and communication skills and build personal resilience, and are more confident and less likely to take up smoking.
Long-term
There is a reduction in long-term health problems caused by smoking.
All school children aged 12 to 13.
ASSIST is delivered in six sessions of varying length of one 20-minute session, three 60-minute sessions, and two full school day sessions. It is delivered to groups of peer supporters by a qualified trainer.
The intervention is delivered in four structured phases:
Nomination and Recruitment: To start, students are nominated by their peers through a questionnaire filled out by the entire year group. The top 18% of students, with a balanced representation by gender, are then selected to join the intervention as peer supporters.
Training: These peer supporters attend a two-day training session held offsite. The training is highly interactive, engaging students in activities to build empathy, non-judgement, and an understanding of the reasons behind smoking, as well as promoting healthier choices. The student-led sessions emphasise skills in influence and persuasion.
School-Based Follow-Up Sessions: After training, peer supporters participate in follow-up sessions within the school. Here, they review and reinforce their skills and share progress. Students keep a diary to record their conversations, which they bring to each session for group reflection and trainer support.
Completion and Certification: At the end of the intervention, students are awarded a certificate, recognising them and their achievements. The school is left with a group of well-trained young health ambassadors ready to support their peers.
The practitioner who delivers this intervention is a lead trainer
The practitioners have 21 hours of intervention training. Booster training of practitioners is not required.
It is recommended that practitioners are supervised by one host-agency supervisor, in addition to one intervention developer supervisor.
Intervention fidelity is maintained through the following processes:
Contact person: Sally Good
Organisation: Evidence to Impact
Email address: Sally.good@evidencetoimpact.com
Website: www.evidencetoimpact.com
*Please note that this information may not be up to date. In this case, please visit the listed intervention website for up to date contact details.
ASSIST’s most rigorous evidence comes from a cluster RCT which was conducted in the UK consistent with Foundations’ Level 3 evidence strength threshold.
This study identified a statistically significant reduction in smoking prevalence in the past week at one-year follow-up.
ASSIST can be described as evidence-based: it has evidence from at least one rigorously conducted RCT or QED demonstrating a statistically significant positive impact on at least one child outcome.
Reduced prevalence of smoking in the past week
Long-term: A year later
Improvement index
Interpretation
Study
| Identified in search | 12 |
| Studies reviewed | 1 |
| Meeting the L2 threshold | 0 |
| Meeting the L3 threshold | 1 |
| Contributing to the L4 threshold | 0 |
| Ineligible | 11 |
| Study design | RCT |
| Country | UK |
| Sample characteristics | This study involved a sample of 10,730 students aged 12 to 13 years from 59 secondary schools across England and Wales. The schools were diverse in terms of size, language spoken (English or Welsh), and free school meal entitlement. |
| Race, ethnicities, and nationalities | Not described |
| Population risk factors | None reported |
| Timing |
|
| Child outcomes | Reduced prevalence of smoking in the past week (child report) |
| Other outcomes | None reported |
| Study rating | 3 |
| Citations | Campbell, R., Starkey, F., Holliday, J., Audrey, S., Bloor, M., Parry-Langdon, N., … & Moore, L. (2008) An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST): A cluster randomised trial. The Lancet. 371 (9624), 1595–1602. |
The following studies were identified for this intervention but did not count towards the intervention’s overall evidence rating. An intervention receives the same rating as its most robust study or studies.
Audrey, S., Cordall, K., Moore, L., Cohen, D. & Campbell, R. (2004) The development and implementation of a peer-led intervention to prevent smoking among secondary school students using their established social networks. Health Education Journal. 63 (3), 266–284
Audrey, S., Holliday, J. & Campbell, R. (2008) Commitment and compatibility: Teachers’ perspectives on the implementation of an effective school-based, peer-led smoking intervention . Health Education Journal. 67 (2), 74–90.
Audrey, S., Holliday, J., Parry-Langdon, N. & Campbell, R. (2006) Meeting the challenges of implementing process evaluation within randomized controlled trials: The example of ASSIST (A Stop Smoking in Schools Trial). Health Education Research. 21 (3), 366–377.
Holliday, J. C., Rothwell, H. A. & Moore, L. A. (2010) The relative importance of different measures of peer smoking on adolescent smoking behavior: Cross-sectional and longitudinal analyses of a large British cohort. Journal of Adolescent Health. 47 (1), 58–66.
Holliday, J., Audrey, S., Moore, L., Parry-Langdon, N. & Campbell, R. (2009) High fidelity? How should we consider variations in the delivery of school-based health promotion interventions?. Health Education Journal. 68 (1), 44–62.
Hollingworth, W., Cohen, D., Hawkins, J., Hughes, R. A., Moore, L. A., Holliday, J. C., … & Campbell, R. (2011) Reducing smoking in adolescents: cost-effectiveness results from the cluster randomized ASSIST (A Stop Smoking In Schools Trial). Nicotine & Tobacco Research. 14 (2), 161–168.
Mercken, L., Moore, L., Crone, M. R., De Vries, H., De Bourdeaudhuij, I., Lien, N., … & Van Lenthe, F. J. (2012) The effectiveness of school-based smoking prevention interventions among low-and high-SES European teenagers. Health Education Research. 27 (3), 459–469.
Starkey, F., Audrey, S., Holliday, J., Moore, L. & Campbell, R. (2009) Identifying influential young people to undertake effective peer-led health promotion: The example of A Stop Smoking In Schools Trial (ASSIST). Health Education Research. 24 (6), 977–988.
Starkey, F., Moore, L., Campbell, R., Sidaway, M. & Bloor, M. (2005) Rationale, design and conduct of a comprehensive evaluation of a school-based peer-led anti-smoking intervention in the UK: The ASSIST cluster randomised trial [ISRCTN55572965]. BMC Public Health. 5 (1), 43.
Starkey, F., Moore, L., Campbell, R., Sidaway, M. & Bloor, M. (2007) Erratum to: Rationale, design and conduct of a comprehensive evaluation of a school-based peer-led anti-smoking intervention in the UK: The ASSIST cluster randomised trial [ISRCTN55572965]. BMC Public Health. 7 (1), 301.
Steglich, C., Sinclair, P., Holliday, J. & Moore, L. (2012) Actor-based analysis of peer influence in A Stop Smoking In Schools Trial (ASSIST). Social Networks. 34 (3), 359–369.
Note on provider involvement: This provider has agreed to Foundations’ terms of reference (or the Early Intervention Foundation's terms of reference), and the assessment has been conducted and published with the full cooperation of the intervention provider.
Rated 1: Set up and delivery is low cost, equivalent to an estimated unit cost of less than £100.
Rated 2: Set up and delivery is medium-low cost, equivalent to an estimated unit cost of £100–£499.
Rated 3: Set up and delivery is medium cost, equivalent to an estimated unit cost of £500–£999.
Rated 4: Set up and delivery is medium-high cost, equivalent to an estimated unit cost of £1,000–£2,000.
Rating 5: Set up and delivery is high cost. Equivalent to an estimated unit cost of more than £2,000.
Set up and delivery cost is not applicable, not available, or has not been calculated.
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Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing child maltreatment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Enhancing school achievement & employment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing crime, violence and antisocial behaviour: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing substance abuse: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing risky sexual behaviour & teen pregnancy: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing obesity and promoting healthy physical development: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Rated 2: Has preliminary evidence of improving a child outcome from a quantitative impact study, but there is not yet evidence of causal impact.
Rated 2+: Meets the level 2 rating and the best available evidence is based on a study which is more rigorous than a level 2 standard but does not meet the level 3 standard.
Rated 3: Has evidence of a short-term positive impact from at least one rigorous study.
Rated 3+: Meets the level 3 rating and has evidence from other studies with a comparison group at level 2 or higher.
Rated 4: Has evidence of a long-term positive impact through at least two rigorous studies.
Rated 4+: Meets the level 4 rating and has at least a third study contributing to the Level 4 rating, with at least one of the studies conducted independently of the intervention provider.
Rating has a *: The evidence base includes mixed findings i.e., studies suggesting positive impact alongside studies, which on balance, indicate no effect or negative impact.
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