Effectiveness of a Health Literacy Promotion Program Applying Self-Efficacy Theory to Prevent New Smokers in Lower Secondary School Students in Kae Dam District, Maha Sarakham Province: A Quasi-Experimental Research

Abstract

The objective of this research article aimed to evaluate the effectiveness of a health literacy promotion program applying self-efficacy theory to prevent new smokers in lower secondary school students. The research methodology was a quasi-experimental design using a two-group pretest-posttest design. The sample consisted of 70 lower secondary school students from Kaedam District, Maha Sarakham Province, selected using purposive sampling. They were divided into an experimental group and a control group, with 35 students in each group. The experimental group received a program of four sessions over eight weeks, including education and attitude modification, training in decision-making skills and refusal behavior, group counseling and support, and follow-up. The research instrument had an IOC value of 0.75 and a Cronbach's alpha coefficient of 0.86. Data were analyzed using descriptive statistics, the Wilcoxon test, and the Mann-Whitney U test. The research findings indicated that a health literacy promotion program applying self-efficacy theory was effective in preventing new smokers. After participating in the program, the experimental group's average score on awareness of the dangers of e-cigarettes increased from 19.03±1.20 to 19.89±0.32, and their average self-efficacy score increased from 82.63±1.90 to 99.06±1.00. The average score for preventive behaviors among new smokers increased from 82.60±2.13 to 98.69±1.25, significantly higher than before the experiment (p<.001) for all three variables. When comparing the groups after the experiment, the experimental group had a higher average self-efficacy perception score (Z=-5.006, p<.001, r=.60). And the average score for preventive behaviors against new smokers (Z=-4.953, p<.001, r=.59) was significantly higher than the control group. While the average scores on awareness of the dangers of e-cigarettes were not significantly different between the two groups (Z=0.21, p=.723). The research results showed that the program was effective in enhancing self-efficacy and preventive behaviors against new smokers, and therefore, it should be integrated into the education system and public health work in the area.