The St-Louis du Parc Heart Health Project: a critical analysis of the reverse effects on smoking
Bibliographic record
Abstract
OBJECTIVES: Although some school based smoking prevention programmes have shown positive impacts, others have had only short term effects, no effects, and in some cases reverse effects. The St-Louis du Parc Heart Health Project was a five year heart health promotion programme targeting children in eight elementary schools aged 9-12 years in disadvantaged multiethnic neighbourhoods in Montreal. In a controlled, longitudinal evaluation, the programme produced reverse effects on smoking--children exposed to the programme were more likely to initiate and to continue smoking than control children. This article explores hypotheses to explain the reverse effects. DESIGN: Following work by an in-house committee, a consensus workshop with international experts was conducted to develop hypotheses to explain the reverse effects. This was complemented by an analysis of the programme's concordance with the standard guidelines on the school based prevention of tobacco use, and discussions with experts at the Centers for Disease Control and Prevention. RESULTS: The programme respected most standard guidelines for smoking prevention programmes with respect to content and mode of delivery. Hypotheses to explain the reverse effects include: an unfavourable environment characterised by strong pro-smoking models and resistance to environmental interventions; heightened sensitivity to smoking among children most exposed to the programme; defence mechanisms among children stimulated by cognitive dissonance or anxiety; unanticipated effects associated with the health educator who delivered the programme; inadequate attention in programme development to the diverse cultural origins of the population targeted; and intervention content inappropriately targeted to children's stages of cognitive development. CONCLUSION: Elementary school based interventions should aim to develop a clear and coherent social norm about the non-use of tobacco, as a precursor to or in close conjunction with having children as their primary target. Programme design should take key student characteristics into consideration and ensure that the modes of communication are adapted to the targeted group's characteristics. Neighbourhood level interventions should be orchestrated to complement regional, provincial, and national programmes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".