The integrity of smoking prevention curriculum delivery

Abstract
This paper describes a study of integrity of delivery of one component of a social resistance smoking prevention curriculum-resistance skills training. The subjects were instructors (n = 15) who had delivered the curriculum during a largescale efficacy trial 2 months earlier. An analogue procedure was used in which subjects led two role plays in a classroom with students who had received the curriculum. The role plays were videotaped and later rated by five individuals. Twocomponents of integrity were measured: the degree to which instructors followed curriculum guidelines for role plays (adherence)and quality of delivery. An Integrity Index was created (1.4 = minimum, 15.3 = maximum), representing the degree of adherence, overall ability to use the Socratic method, and overall skill as a leader of role plays. Instructors' scores onthe index ranged from 4.04 to 12.65, with a mean of 9.27. Integrity scores were related to self-reported measures of instructorcharacteristics and quality of program delivery. Those who were above the median on the Integrity Indexwere more animated, articulate, and confident during program delivery and were less authoritarian than those with low integrity. The implications of these results for instructor recruitment, training, and monitoring of program implementation are discussed.

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