Final TPS Oral Cancer Presentation on July 21, 2011 in Chennai on the Concluding Day of the Trans Disciplinary Problem Solving Course: co-taught by Washington University in St. Louis and ICTPH.

1. Reducing the Burden of Oropharyngeal
Cancer by Tobacco Reduction in
Tamil Nadu, India
Sonia Sequeira
Megan Fecht
Whitney Key

2. Overview
Background
Intervention
Implementation
Evaluation

3. Background
Highest incidence in the world
Most common form of cancer in India
Burden
physical
emotional
financial

4. Determinants
Alcohol Use
Sexual behavior
Diet
Tobacco Use

5. Tobacco Use
Most important determinant
90% are linked to tobacco use
35 children lived in a home where at least one
adult used tobacco

6. Intervention Overview
School-based tobacco education
1 and prevention program
2 Parental education in household
Oral health screening in
3 household
4 Cessation services at RMHC

7. Implementation:
School-based Program
Education on the negative effects of tobacco
use and self-efficacy techniques
Curriculum adapted from Project MYTRI
Teachers trained to deliver curriculum with
assistance from peer leaders
One hour lessons held once weekly for 6-8
weeks

8. Implementation:
Parental Education
Education on the negative effects of tobacco
use
Students disseminate educational materials to
parents at household level

9. Implementation:
Oral Health Screening
Community Health Workers (CHWs) trained
to screen for precancerous lesions
CHWs conduct screenings in the household
for parents who use tobacco
Referral to RMHC upon detection of
abnormalities

10. Implementation:
Cessation Services
Provide cessation services for tobacco users
interested in quitting
Bupropion offered at the RMHC
Cessation self-help groups developed

11. Formative Evaluation
Focus groups and interviews conducted to:
Assess current knowledge and attitudes
regarding tobacco use
Develop understanding of existing structure

12. Process Evaluation
Assess implementation process by:
Documenting development processes
Tracking training attendance
Delivery of services
Completing audits

13. Impact Evaluation
School-based Program Objectives:
Increased knowledge of health effects of tobacco
use
Increased self-efficacy
Decreased intention to use
Parental Education Objectives:
Increased knowledge of health effects of tobacco
use
Increased intention to quit

14. Impact Evaluation
Oral Health Screening Objectives:
Increased detection of precancerous lesions
Cessation Services Objectives:
Increased enrollment in cessation services
Increased number of tobacco-free days
Increased attempts to quit lasting longer than 6
months

15. Impact Evaluation
Prospective Cohort Study
Convenience sample
KABP surveys
Baseline, midline, endline

16. Acknowledgements
Residents of Karambayam
Teachers and administrators of the
Karambayam schools
ICTPH and SughaVazhvu staff

17. Contact
Megan Fecht, MSW/MPH Candidate 2012
mfecht@wustl.edu
Whitney Key, MSW/MPH Candidate 2012
wkey@wustl.edu
Sonia Sequeira, MSW/MPH Candidate 2013
soniasequeira@wustl.edu
Washington University in Saint Louis
1 Brookings Drive
Saint Louis MO 63130

18. Thank you