Evaluation of a Mass Media Educational Campaign to Increase Secondary School Students' Awareness of Health Risks of Khat Chewing: A Quasi-Experimental Pre-Post Study in Aden, Yemen.

BACKGROUND Khat is a green leaf with amphetamine-like effects. Khat chewing was once a socially acceptable behavior but has come to involve children and affects oral and general health. We evaluated an awareness program addressing the adverse health risks of khat chewing (AHRKC) among secondary school students, in addition to exploring the variables associated with post-intervention awareness. MATERIAL AND METHODS A quasi-experimental pre-post study design was used. A total of 450 secondary school students were recruited (intervention, n=225; control, n=225) using multistage random sampling. Self-administered questionnaires were used for data collections. For the intervention group, the khat chewing educational program included lectures and seminars, posters, billboards, and brochures. Statistical analyses included chi-squared tests, t tests, and logistic regression modelling. RESULTS A total of 427 students completed both baseline and follow-up surveys. The overall levels of exposure to anti-khat messages and awareness were significantly higher in the intervention group than in the control group after the program (P<0.001). The multivariable analysis revealed that older students (odds ratio (OR)=3.35; 95% confidence interval (CI)=1.11-10.14, P=0.031), students' monthly pocket money (OR=2.39; 95% CI=1.04-5.47, P=0.018), and frequent exposure to mass media channels (OR=2.40; 95% CI=1.06-5.46, P=0.023) were significantly associated with enhanced awareness of the AHRKC in the intervention group. CONCLUSIONS The customized educational program improved awareness of AHRKC among secondary school students. Age, pocket money, and message exposure frequency were among the factors that influenced the observed program outcomes.