Effectiveness of the Portuguese version of Fume in adolescents’ health literacy about tobacco

Pinto, Daniela Lourenço; Parisod, Heidi; Nyman, Johanna; Barroso, Tereza Maria Mendes Dinis de Andrade

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 30 • 2022 • https://doi.org/10.1590/1518-8345.5455.3513 copy

Effectiveness of the Portuguese version of Fume in adolescents’ health literacy about tobacco^* * Paper extracted from master’s thesis “Efeito da versão portuguesa do jogo de saúde Fume na literacia em saúde acerca do tabaco de adolescentes”, presented to Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To evaluate the effectiveness of the version translated into European Portuguese of the Fume mobile health game (No Fume), with regard to the health literacy of adolescents in the school context on tobacco-related issues.

Method

A quantitative and quasi-experimental study, with pre-test and post-test evaluation, conducted with a convenience sample of 144 adolescents, divided into an experimental group and a control group, carried out in two public schools serving the 2^nd and 3^rd cycles of elementary education from a city in the district of Coimbra, central region of Portugal.

Results

Among the adolescents who used No Fume (experimental group), a statistically significant and favorable evolution was verified in the negative expectations about smoking (p = 0.033).

Conclusion

No Fume revealed a positive effect on the negative expectations about smoking among the adolescents. Investments should be made in developing No Fume in order to maximize its potential for use since, as an educational technology based on gamification, it may come to contribute to the expansion and dissemination of innovative interventions that promote adolescents’ mental health.

Descriptors:
Health Literacy; Mobile Applications; Adolescent; Tobacco; Self Efficacy; Nursing

Variable		Control Group (n=87)	Experimental Group (n=57)	p ^*
Gender	Female	52 (59,8%)	32 (56,1%)	0,666^†
Gender	Male	35 (40,2%)	25 (43,9%)	0,666^†
Age	10 years old	2 (2,3%)	0 (0%)	0,407⁺⁺
	11 years old	51 (58,6%)	32 (56,1%)
	12 years old	32 (36,8%)	22 (38,6%)
	13 years old	2 (2,3%	2 (5,3%)
Nationality	Portuguese	85 (97,8%)	47 (82,4%)	0,002^§
Nationality	Foreign	2 (2,2%)	10 (17,6%)	0,002^§
Allowance	Yes	25 (28,7%)	19 (33,3%)	0,431^†
Allowance	No/No answer	73 (83,9%)	47 (82,4%)	0,431^†
*Smartphone*	Yes	73 (83,9%)	47 (82,4%)	0,750^†
*Smartphone*	No/No answer	14 (16,1%)	10 (17,6%)	0,750^†

Variable of Interest	Pre-test						Post-test
	Control Group (n = 87)		Experimental Grup (n = 57)		U ^§	p ^\|\|	Control Group (n = 87)		Experimental Grup (n = 57)		U ^§	p ^\|\|
	M^*(SD^†)	MR^‡	M^*(SD^†)	MR^‡	U ^§	p ^\|\|	M^*(SD^†)	MR^‡	M^*(SD^†)	MR^‡	U ^§	p ^\|\|
Attitudes towards Tobacco Use	1,25 (0,533)	70,22	1,39 (0,701)	75,97	2281,500	0,275	1,20 (0,478)	69,25	1,42 (0,801)	77,46	2196,500	0,098
Reasons for Tobacco Use	3,45 (1,097)	68,09	3,65 (1,308)	76,89	2096,000	0,100	3,44 (1,178)	69,32	3,70 (1,336)	77,36	2202,500	0,128
Motivation to Refuse Tobacco Use in the Future	1,22 (0,562)	69,08	1,30 (0,499)	76,40	2200,000	0,148	1,23 (0,522)	69,45	1,29 (0,497)	74,74	2214,500	0,304
Positive Expectations about Smoking (Scale)	4,40 (1,689)	67,00	4,79 (1,578)	79,54	2021,000	0,066	4,34 (1,938)	67,16	4,58 (1,569)	79,31	2034,500	0,070
Negative Expectations about Smoking (Scale)	10,79 (1,639)	69,46	11,02 (1,768)	75,83	2232,500	0,332	10,57 (2,631)	67,40	11,40 (1,557)	80,29	2035,500	0,031
Anti-Tobacco Self-Efficacy (Scale)	54,52 (7,187)	76,48	52,84 (6,548)	60,11	1766,000	0,018	56,26 (6,392)	77,93	54,74 (5,921)	61,91	1876,000	0,020

	Control Group (CG) (n = 87)					Experimental Group (EG) (n = 57)
Variable of Interest	Status	n ^*	MR^†	Z ^‡	p ^§	Status	n ^*	MR^†	Z ^‡	p ^§
Attitudes towards Tobacco Use^\|\|	Better	8	6,75	-1,291	0,197	Better	9	9,28	-0,092	0,927
	Worse	4	6,00			Worse	9	9,72
	No change	75				No change	39
Reasons for Tobacco Use^\|\|	Better	9	9,11	-0,272	0,786	Better	11	8,27	-0,165	0,869
	Worse	8	8,88			Worse	8	12,38
	No change	70				No change	36
Motivation to Refuse Tobacco Use in the Future^\|\|	Better	7	7,50	0,000	1,000	Better	4	5,00	-0,333	0,739
	Worse	7	7,50			Worse	5	5,00
	No change	72				No change	46
Positive Expectations about Smoking (Scale)^\|\|	Better	19	17,45	-0,275	0,783	Better	27	17,67	-1,257	0,209
	Worse	16	18,66			Worse	12	25,25
	No change	50				No change	18
Negative Expectations about Smoking (Scale)^¶	Better	26	19,77	-0,499	0,617	Better	19	11,76	-2,134	0,033
	Worse	17	25,41			Worse	5	15,30
	No change	43				No change	33
Anti-Tobacco Self-Efficacy (Scale)^¶	Better	35	28,34	-2,766	0,006	Better	33	23,50	-2,582	0,010
	Worse	17	22,71			Worse	13	23,50
	No change	30				No change	9

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[1] * Corresponding Author: Daniela Lourenço Pinto. Email: danielapinto@esenfc.pt