The Effect of the Education Program Based on the PRECEDE-PROCEED Model on the Smoking Behaviors of Nursing Students

The Effect of the Program Based on the PRECED-PROCEED Model "I am Giving up Smoking, I am Protecting My Future and My Health" on Smoking Behaviour of Nursing Students

The causes of death due to smoking are responsible for 11.5% of the total deaths in the world. Smoking causes lung cancer, chronic obstructive pulmonary disease (COPD), ischemic heart disease and cerebrovascular diseases. In some studies on nursing students in the world, the prevalence of smoking is between 13.9% and 32%; It is known that it varies between 12.9% and 28% in Turkey. At the end of this study, nursing students are supported in smoking cessation by providing smoking cessation training, they become a role model for the society by gaining the right behavior, creating a society that smokes less, reducing the financial burden on the state as a result of protecting individuals from possible chronic diseases, and guiding health trainings on this subject. It is foreseen that it will be a guide in its implementation in the whole country. The aim of this study is to determine the effect of the I Stop Smoking, Protecting My Future and Health program based on the Preced-Proceed Model on the smoking behavior of nursing students.

This study will be conducted in non-randomized groups in a quasi-experimental fashion as pre-test-post-test.

The population of the research was formed by the students in the Nursing Department of the Faculty of Health Sciences of Kırşehir Ahi Evran University. There are two branches of daytime education and two branches of secondary education, and the total number of students in the nursing department is 802. The sample size of the study was calculated using the G*Power (v3.1.9.6) package program. The power of the study was 80% and the sample size was α =0.05; It was calculated as a total of 64 people, 32 of which were interventions and 32 were control groups. However, considering the losses, 20% more than the calculated value was included in the sample and it was planned to include a total of 80 students, 40 of whom were in the intervention group and 40 in the control group.

Selection and Assignment of Individuals to the Intervention and Control Group Before being divided into intervention and control groups, students' consent was obtained and a pre-test was applied. Formal education and secondary education students were coded as A and B. For example, formal education A, secondary education B. The students in the related group were stratified by gender and the layer weight was determined. Random numbers were created in the Excel program and it was determined who would be in the groups with the simple random sampling method. In addition, which of the previously coded groups A and B would be the intervention group and which one would be the control group was determined by drawing lots. All these procedures were carried out by a person other than the researcher. Thus, it was determined who would be in the intervention and control group, and it was explained to the researcher before the training whether group A or group B was the intervention or control group.

Dependent variables:

• Behavior modification level
• Decision equilibrium level
• Self-efficacy level
• Level of encouraging factors
• Level of stages of change
• Number of people who quit smoking
• Nicotine addiction level
• Health perception level

Independent variables:

"I Stop Smoking, I Protect My Future and My Health" program based on the PRECEDE-PROCEED Model.

As data collection tools; Smoker identification form, individual information form, Behavior change process scale, Decision balance scale, Self-efficacy scale, Encouraging factors scale, Classification of stages of change scale, Fagerström nicotine addiction test will be used. The data were also planned to be collected in this environment before the first training (pretest), and after the second and third training (posttest). The first session will be held immediately after the pre-test, the second session will be held 15 days after the first session, and the last session will be held 15 days after the second session. A total of 40 messages will be sent to the students in the initiative group through the WhatsApp program, taking into account the factors that affect, strengthen and enable the main

Inclusion Criteria:

• Approving to participate in the study,
• Smoker (according to WHO, a person who smokes at least one cigarette per day),
• According to the Fagerström Test for Nicotine Dependence, nicotine addiction is at least "very low" or higher*,
• Not having any communication barriers to participate in the study,
• Those who are in the stages of "thinking" and "preparation" of the stages of change according to the Classification of Stages of Change Scale for smoking cessation**,
• Not taking any smoking cessation treatment at the time of the study,
• Having a smart mobile phone and using the WhatsApp program,
• Consists of students who have not received training in smoking cessation before

Exclusion Criteria:

• Non-smokers
• Those who do not plan to quit smoking (those who are at the stage of "not thinking" according to the Classification of Stages of Change Scale)