{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T18:09:07Z","timestamp":1777745347300,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["5R01CA200691-01A1"],"award-info":[{"award-number":["5R01CA200691-01A1"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Implementation Research and Practice"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tobacco-Free Teachers, Tobacco-Free Society (TFT-TFS) is an evidence-based intervention that promotes tobacco use cessation among teachers and tobacco control policies among schools in India. This study tested an implementation model to build Bihar Department of Education (DOE) capacity to support and deliver TFT-TFS within schools, leveraging DOE training infrastructure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We used a training-of-trainers (TOT) \u201ccascade\u201d implementation strategy to embed the TFT-TFS program into the Bihar DOE infrastructure. We trained 46 Cluster Coordinators to train and support Headmasters to implement TFT-TFS in their schools over one academic year. We selected three school districts, representing approximately 46 clusters and 219 schools. We used the RE-AIM framework to assess program adoption (Headmaster participation in at least one of six TFT-TFS trainings), implementation (of four core program components), and reach (teachers' participation in three or more group discussions). Using a non-inferiority design, we hypothesized that program adoption, implementation, and reach would not be inferior to the high standards demonstrated when TFT-TFS was originally tested in the Bihar School Teachers Study. We used self-reported checklists to measure outcomes and SPSS Version 25 to analyze data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For adoption, 94% of Headmasters attended the first training, although participation declined by the sixth training. Among the 112 schools out of 219 with complete Headmaster checklist data, all met our minimum criteria for implementing TFT-TFS. Over 99% of schools posted a school tobacco control policy and distributed quit booklets. However, only 69% of schools met our criteria for program reach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study outlines the processes for taking a tobacco control intervention to scale and implementing it through the Bihar DOE infrastructure. These findings provide a foundation for other Indian states and low- and middle-income countries to implement tobacco control and other health programs for schoolteachers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>NCT05346991.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26334895231159428","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T21:04:36Z","timestamp":1679519076000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Implementation of an evidence-based tobacco control intervention for school teachers in India: Evaluating the effects of a capacity-building strategy"],"prefix":"10.1177","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8661-178X","authenticated-orcid":false,"given":"Eve M.","family":"Nagler","sequence":"first","affiliation":[{"name":"Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, USA"},{"name":"Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mangesh","family":"Pednekar","sequence":"additional","affiliation":[{"name":"Healis-Sekhsaria Institute for Public Health, Navi Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhirendra Narain","family":"Sinha","sequence":"additional","affiliation":[{"name":"Healis-Sekhsaria Institute for Public Health, Navi Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne M.","family":"Stoddard","sequence":"additional","affiliation":[{"name":"Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameer","family":"Narake","sequence":"additional","affiliation":[{"name":"Healis-Sekhsaria Institute for Public Health, Navi Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keyuri","family":"Adhikari","sequence":"additional","affiliation":[{"name":"School of Pharmacy, West Virginia University, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah","family":"Jones","sequence":"additional","affiliation":[{"name":"Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry","family":"Lando","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Vriniotis","sequence":"additional","affiliation":[{"name":"Brown-Lifespan Center for Digital Health, Rhode Island Hospital, Providence, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prakash","family":"Gupta","sequence":"additional","affiliation":[{"name":"Healis-Sekhsaria Institute for Public Health, Navi Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glorian","family":"Sorensen","sequence":"additional","affiliation":[{"name":"Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, USA"},{"name":"Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,3,22]]},"reference":[{"key":"bibr1-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-018-0791-0"},{"key":"bibr2-26334895231159428","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.00218"},{"key":"bibr3-26334895231159428","doi-asserted-by":"publisher","DOI":"10.18332\/popmed\/125912"},{"key":"bibr4-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-010-9739-3"},{"key":"bibr5-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3182408812"},{"key":"bibr6-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2020.09.001"},{"key":"bibr7-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1007\/s13224-021-01596-6"},{"key":"bibr8-26334895231159428","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301299"},{"key":"bibr9-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01169-7"},{"key":"bibr10-26334895231159428","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.89.9.1322"},{"key":"bibr11-26334895231159428","unstructured":"IBM Corp. (2017).\n                      SPSS Statistics for Windows\n                      (Version 25.0) [Computer software]."},{"key":"bibr12-26334895231159428","unstructured":"India Growing\n                      . (2022). Bihar. https:\/\/www.indiagrowing.com\/Bihar"},{"issue":"2","key":"bibr13-26334895231159428","first-page":"10","volume":"17","author":"Jalaluddin A. K.","year":"1991","journal-title":"Health for the Millions"},{"key":"bibr14-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa0707719"},{"key":"bibr15-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1308383"},{"key":"bibr16-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.012809.103705"},{"key":"bibr17-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2019.112513"},{"key":"bibr18-26334895231159428","volume-title":"The trainer\u2019s handbook","author":"Lawson K.","year":"2009"},{"issue":"6","key":"bibr19-26334895231159428","first-page":"2821","volume":"17","author":"Mathur N.","year":"2016","journal-title":"Asian Pacific Journal of Cancer Prevention"},{"key":"bibr20-26334895231159428","unstructured":"Ministry of Health and Family Welfare. (2018). GATS2: Global adult tobacco survey fact sheet India 2016\u201317. Government of India. https:\/\/www.mohfw.gov.in\/sites\/default\/files\/GATS-2%20FactSheet.pdf"},{"key":"bibr21-26334895231159428","unstructured":"Ministry of Health and Family Welfare. (2019). Guidelines for tobacco free educational institution (Revised). Government of India. https:\/\/ntcp.nhp.gov.in\/assets\/document\/TEFI-Guidelines.pdf"},{"key":"bibr22-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1186\/s12992-020-00614-y"},{"key":"bibr23-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1186\/s12992-018-0420-3"},{"key":"bibr24-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1016\/j.jana.2008.06.001"},{"key":"bibr25-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1111\/apa.14662"},{"key":"bibr26-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1093\/her\/cyv039"},{"key":"bibr27-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1093\/her\/cyy011"},{"key":"bibr28-26334895231159428","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2019.00389"},{"key":"bibr29-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1093\/tbm\/ibz197"},{"key":"bibr30-26334895231159428","volume-title":"Report on tobacco control in India (No. 1)","author":"Reddy K. S.","year":"2004"},{"key":"bibr31-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0566-z"},{"issue":"1","key":"bibr32-26334895231159428","doi-asserted-by":"crossref","first-page":"S73","DOI":"10.4103\/0019-509X.147477","volume":"51","author":"Sinha D. N.","year":"2014","journal-title":"Indian Journal of Cancer"},{"key":"bibr33-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2004.09.047"},{"key":"bibr34-26334895231159428","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301303"},{"key":"bibr35-26334895231159428","volume":"356","author":"StaRI Group","year":"2017","journal-title":"BMJ"},{"key":"bibr36-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2011-200271"},{"key":"bibr37-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0558-z"},{"key":"bibr38-26334895231159428","volume-title":"On teaching and learning: Putting the principles and practices of dialogue education into action","author":"Vella J.","year":"2008"},{"key":"bibr39-26334895231159428","unstructured":"World Health Organization. (2021).\n                      Tobacco\n                      . https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/tobacco"},{"key":"bibr40-26334895231159428","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2019.1670449"}],"container-title":["Implementation Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26334895231159428","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/26334895231159428","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26334895231159428","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:40:29Z","timestamp":1777462829000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/26334895231159428"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":40,"alternative-id":["10.1177\/26334895231159428"],"URL":"https:\/\/doi.org\/10.1177\/26334895231159428","relation":{},"ISSN":["2633-4895","2633-4895"],"issn-type":[{"value":"2633-4895","type":"print"},{"value":"2633-4895","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]},"article-number":"26334895231159428"}}