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Development and Reach of the Stanford Tobacco Prevention Toolkit: Implementation of a Community-Based Participatory Approach.

BACKGROUND
We developed the Tobacco Prevention Toolkit (Toolkit) to enhance the impact of school-based tobacco education. This study describes the process of developing the Toolkit, its contents, and reach.


METHODS
Qualitative community-based participatory research (CBPR), including focus group discussions (N = 152) and working groups with parents, educators, researchers, and youth (N = 87) were used to develop the Toolkit and design its implementation. Toolkit reach was assessed through number of trained educators using the Toolkit, estimated number of youth recipients of the Toolkit resources, and using Google Analytics for online engagement.


RESULTS
The Toolkit is a free, online resource aimed at preventing tobacco use by middle and high school students. Toolkit content addresses varied forms of tobacco including electronic cigarettes, hookah, smokeless tobacco, and cigarettes; addiction; and positive youth development; and is available in multiple interactive formats such as real-time quizzes, factsheets, activities, and presentations. The Toolkit is mainly delivered by trained educators, who adapt its content and duration to tailor their drug prevention teaching to student needs. As of April 2020, when data for this paper were collected, 4,750 educators have reached an estimated 1.3 million youth. The Toolkit website has 186,116 users and 802,602 page views, growing steadily since 2016. As of August 2021, additional students have been reached, for now a total of 1.85 million students reached.


CONCLUSION
The Toolkit resources are evidence-based, comprehensive, responsive, interactive, easily accessible, and flexible. Applying CBPR was instrumental in developing the Toolkit and expanding its reach.