A Pilot RCT on the Feasibility of an Online Quiz Game to Promote Tobacco-related Knowledge, Attitudes and Behaviours Among Primary School Students

The goal of this pilot RCT is to test the feasibility of an online quiz game to promote tobacco-related knowledge, attitudes and behaviours in local primary 5-6 school students. The main question it aims to answer is:

• Feasibility of intervention
• Acceptance of intervention by schools, teachers, parents and teachers
• Adherence to the 4-week intervention
• Functional online quiz platform
• Satisfaction of students and parents towards intervention Researchers will compare the questionnaire results from students to see if students doing tobacco-related questions on the online quiz platform will have better tobacco-related knowledge, higher anti-tobacco attitudes and lower intention to smoke.

Students will engage in an online quiz competition for 4 weeks on tobacco-related topics for the intervention group and on healthy eating for the control group. They will complete pre-test and post-test questionnaires before and after the online quiz competition.

Study Overview

• Status: Completed
• Conditions: Tobacco Prevention
• Intervention / Treatment: Other: Online quiz competition

• Study Type: Interventional
• Enrollment (Actual): 921
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Hong Kong
  • Hong Kong, Hong Kong
    • Local primary schools

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Primary 5-6 students from local primary schools
• Able to read and communicate in Chinese
• Have a digital device for online access to the quiz game at home

Exclusion Criteria:

-

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention; Students will engage in an online quiz competition for 4 weeks on tobacco-related topics. Each day, students could answer a maximum of 5 questions.	Other: Online quiz competition; The intervention and control students participated in an online quiz game on tobacco and healthy eating topics, respectively. Each day, students could answer a maximum of 5 questions randomly selected from the respective pool of questions by the platform. The students logged onto the online platform and played the quiz competition on weekdays for 4 weeks (i.e. total of 20 days).
Active Comparator: Control; Students will engage in an online quiz competition for 4 weeks on healthy eating-related topics. Each day, students could answer a maximum of 5 questions.	Other: Online quiz competition; The intervention and control students participated in an online quiz game on tobacco and healthy eating topics, respectively. Each day, students could answer a maximum of 5 questions randomly selected from the respective pool of questions by the platform. The students logged onto the online platform and played the quiz competition on weekdays for 4 weeks (i.e. total of 20 days).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility of intervention	Students and parents will be asked their comments towards intervention in the phone interview: [Students] 1) Did you find the quiz platform interesting or engaging? Why? 2) On a scale of 0 to 10, how much did you enjoy using the quiz platform? [Parents] 1) Do you think using a quiz competition format increases your child's motivation to learn? 2) Are there specific features or functionalities you think would enhance the platform for both parents and students? Students will be asked 'Do you think the interface of the online quiz competition platform is easy to use?' We will measure the number of times that the website developer or the students reported technical problems. We will also measure the participation rate of students during the online quiz competition period.	During the post-questionnaire at 5th-6th weeks and during the phone interview at 10th-16th weeks.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Effectiveness of intervention on tobacco-related knowledge (including ASPs)	Students reported their opinions towards 5 statements in pre and post tests: [Pre-test] 1) Tar causes addiction; 2) Exposure to secondhand smoke increases the risk of cancer; 3) The harm from e-cigarettes is less than that of traditional cigarettes; 4) Tobacco companies use various flavours to attract children to use e-cigarettes; 5) The Hong Kong government has already banned the sale of heated tobacco products. [Post-test] 1) Occasional smoking is harmless to health; 2) Exposure to secondhand smoke increases the risk of death; 3) E-cigarettes contain carcinogens; 4) Tobacco companies promote heated tobacco products through social media platforms; 5) The Hong Kong government has already banned the sale of e-cigarettes. All the statements have 5 options from definitely no to definitely yes. The options were recoded, as appropriate, with higher scores indicating knowing more about the harms and misleading marketing strategies of ASPs.	During the pre-questionnaire right before the intervention and post-questionnaire at 5th-6th weeks.
Effectiveness of intervention on tobacco-related attitudes (including ASPs)	Students will report their opinions towards 5 statements: 1) Smokers are more stylish; 2) Adults should have the freedom to smoke in their homes; 3) Using e-cigarettes can bring a bit of enjoyment; 4) Tobacco companies have a contribution to society; 5) The government should implement a total ban on smoking. All the statements have 5 options from definitely no to definitely yes. The options will be recoded, as appropriate, with higher scores indicating knowing more about the harms and misleading marketing strategies of ASPs.	During the pre-questionnaire right before the intervention and post-questionnaire at 5th-6th weeks.
Effectiveness of intervention on tobacco-related intentions (including ASPs)	Students were asked: If one of your good friends offers you an e-cigarette or heated tobacco product, ask you to have a few puffs, and no one will know about this as no more smoking in the future. Will you use them? There will be 5 options from definitely no to definitely yes.	During the pre-questionnaire right before the intervention and post-questionnaire at 5th-6th weeks.
Effectiveness of intervention on SHS and THS exposure at home	Students were asked: In the past 7 days, how many days (0-7) 1) was someone smoking next to you when you were at home? 2) do you smell secondhand smoke drifting in from outside when you were at home? 3) was someone smoking next to you when you were outside home? 4) you can smell cigarette smoke on objects or people when you are at home and no one is smoking, and you don't see any smoke?	During the pre-questionnaire right before the intervention and post-questionnaire at 5th-6th weeks.
Effectiveness of intervention on tobacco use	Students were asked: 1) Which of the following tobacco products have you ever used? 2) In the past 30 days, which of the following tobacco products have you used?	During the pre-questionnaire right before the intervention and post-questionnaire at 5th-6th weeks.

Collaborators and Investigators

• Sponsor: The University of Hong Kong

Study record dates

Study Major Dates

• Study Start (Actual): April 15, 2024
• Primary Completion (Actual): June 30, 2024
• Study Completion (Actual): September 1, 2024

Study Registration Dates

• First Submitted: February 2, 2025
• First Submitted That Met QC Criteria: February 2, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 2, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: coshdrama2324

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No