Development and Evaluation of an Interactive Online Game-Based Learning Program on Knowledge, Attitudes, Subjective Norms, Perceived Behavioral Control, and Intention to Use E-Cigarettes among Lower Secondary School Students

Pramote Thangkratok; Thepwinphan  Theppitak; Panasun  Ngamsirijit; Natchaya  Palacheewa; Pornpimol  Apartsakun; Supavit  Manusook; Chatpeerat  Songsoontorn; Watcharin  Satjamukda; Phattharaphon  Udson; Atiphan  Rattanakarn

doi:10.33192/smj.v78i10.282775

Authors

Pramote Thangkratok Department of Community Health Nursing, Srisavarindhira Thai Red Cross Institute of Nursing, Thai Red Cross Society, Bangkok, Thailand https://orcid.org/0000-0001-8169-411X
Thepwinphan Theppitak Faculty of Education, Chulalongkorn University, Bangkok, Thailand
Panasun Ngamsirijit Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
Natchaya Palacheewa Department of Community Health Nursing, Srisavarindhira Thai Red Cross Institute of Nursing, Thai Red Cross Society, Bangkok, Thailand
Pornpimol Apartsakun Department of Maternal-Newborn Nursing and Midwifery, Srisavarindhira Thai Red Cross Institute of Nursing, Thai Red Cross Society, Bangkok, Thailand
Supavit Manusook Vajiravudh College, Bangkok, Thailand
Chatpeerat Songsoontorn Vajiravudh College, Bangkok, Thailand
Watcharin Satjamukda Vajiravudh College, Bangkok, Thailand
Phattharaphon Udson Vajiravudh College, Bangkok, Thailand
Atiphan Rattanakarn Vajiravudh College, Bangkok, Thailand

DOI:

https://doi.org/10.33192/smj.v78i10.282775

Keywords:

Electronic nicotine delivery systems, vaping, adolescents, students, prevention program, intention

Abstract

Objective: This study aimed to examine the effectiveness of an interactive online game-based learning program on knowledge, attitudes, subjective norms, perceived behavioral control, and intention to use e-cigarettes among lower secondary school students.

Materials and Methods: A quasi-experimental study was conducted in two lower secondary schools, with one school assigned to the intervention condition and the other to the comparison condition. Ninety-three students participated (intervention, n = 47; comparison, n = 46). Knowledge, attitudes, subjective norms, perceived behavioral control, and intention to use e-cigarettes were assessed at pretest, posttest, and follow-up. Longitudinal changes were analyzed using repeated-measures models. Because each condition included only one school, between-group findings were considered exploratory and may reflect school-level effects.

Results: Compared with the comparison school, students in the intervention school showed greater improvements in knowledge at posttest and follow-up. Attitudes, subjective norms, and intention scores decreased at both assessments, indicating less favorable attitudes toward e-cigarette use, lower perceived social pressure to use e-cigarettes, and lower intention to use e-cigarettes. Perceived behavioral control showed little immediate change but increased at follow-up.

Conclusion: Participation in the interactive online game-based learning program was associated with favorable changes in knowledge and psychosocial determinants related to e-cigarette use. However, the observed differences cannot be separated from school-level effects. Studies involving multiple schools in each condition are needed to confirm intervention effectiveness.

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