Social-Ecological Framework to Improve Youth Smoking Outcomes

DESCRIPTION (provided by applicant): The proposed study is guided by a Social-Ecological Model, with the goal to rapidly uncover optimal conditions for effectiveness, reach, and adoption of the American Lung Association's Not On Tobacco teen smoking cessation program, the most widely used teen cessation program in the US. Our proposal capitalizes on existing data from multiple sources, forming a unique N-O-T Social Ecological Relational Database. Central to the relational database is our newly-formed N-O-T Master Dataset that aggregates 12 years (1998-2010) of N-O-T efficacy and effectiveness trials with a heterogeneous sample of N=11,000 teens from CO, FL, NC, NJ, WI, and WV. The overriding research question is: What factors favorably moderate the relationship between macro-level economic, political, and demographic conditions and N-O-T effectiveness, reach, and adoption outcomes as identified in the RE-AIM framework? As a theory-driven, cost effective program N-O-T has received multiple federal model designations for effectiveness and scalability. Yet, program reach is a significant problem, with hundreds of thousands of teen smokers left unserved. To illustrate, N-O-T reaches