Context matters in smoking prevention: evaluating smoke-free school hours in Danish vocational schools.

Youth is a crucial period for smoking preventive interventions. School-based interventions targeting the policy level and the sociocultural processes of smoking show promising effects in reducing smoking uptake and prevalence. This study presents findings from the qualitative process evaluation of a smoking preventive intervention, Focus, in the vocational school (VET) setting. Specifically, the study focused on contextual factors affecting the implementation of smoke-free school hours (SFSH). Participant observations and focus groups were conducted in four VETs during the implementation period October-December 2018. The data encompass participant observation field notes (n = 21 school days), student focus groups (n = 8) (aged 16-20), teacher focus groups (n = 5) and semi-structured individual interviews with VET leaders (n = 3). The study found that SFSH was not clearly communicated to students due to the educational structure and chaotic rhythm of the school days, ambivalent attitudes among teachers toward enforcement of smoking rules and lack of clear managerial support. The interplay of these factors counteracted the implementation of SFSH in the VET context. The presented contextual factors are important when interpreting the effectiveness of the Focus intervention and for informing future preventive efforts aiming to reduce smoking among youth in high risk of smoking cigarettes.

Youth represents a crucial period for smoking prevention. School-based interventions show promising effects in this respect. This study presents findings from the qualitative process evaluation of a smoking preventive intervention, Focus, in the vocational school (VET) setting. The aim was to examine the role of context in the implementation process. The data consist of participant observation field notes (n = 21 school days), focus groups (n = 8 with students and n =  5 with teachers) and semi-structured individual interviews with VET leaders (n = 3). The study found that smoke-free school hours was not clearly communicated to students due to several contextual factors, namely an unclear structure and purpose of the school day, ambivalent attitudes among teachers toward smoking rules and lack of managerial support. These factors are important when interpreting the effectiveness of the Focus intervention and for informing future smoking preventive efforts among youth in high risk of smoking cigarettes.

Well-being of women referred due to suspected side effects after human papilloma virus vaccination.

INTRODUCTION: Due to increased reporting of presumed side effects following human papilloma virus (HPV) vaccination, the Danish Health Authority established five HPV clinics aiming to improve the diagnostics and treatment of affected women. Here, we aimed to describe characteristics of affected women 1-2 years after they attended an HPV clinic and to explore whether women who believed their symptoms were caused by the HPV vaccine were less likely to report symptom improvement than those who did not. METHODS: A hospital-based, cross-sectional study was conducted at the HPV clinic in Silkeborg, 2017-2018. Information on symptoms, HPV vaccination, basic characteristics, etc. was retrieved using a validated questionnaire. Data were analysed descriptively and by logistic regression. RESULTS: A total of 120 women were included. The median age at the first vaccine dose and the first visit to the clinic was 15 years (interquartile range (IQR): 13-23) and 23 years (IQR: 20-27), respectively. The median time from the first visit to the time the questionnaire was completed was 1.3 years (IQR: 1-1.6). At the time of the questionnaire, most women reported a wide range of symptoms, with physical symptoms being more common than psychological symptoms, and 70% of the reported symptoms had not improved over time. Of note, 90% believed that their symptoms were caused by the HPV vaccine. No difference in symptom improvement was found between women who believed that their symptoms occurred because of the HPV vaccine and those who did not. CONCLUSIONS: Most women did not experience any improvement in their symptoms over time, and no association was found between lack of symptom improvement and believing that the HPV vaccine was causing the symptoms. FUNDING: funded by the Danish Cancer Society. TRIAL REGISTRATION: not relevant.