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Pradhan AM, Park L, Shaya FT, Finkelstein J. Consumer Health Information Technology in the Prevention of Substance Abuse: Scoping Review. J Med Internet Res 2019; 21:e11297. [PMID: 30698526 PMCID: PMC6372939 DOI: 10.2196/11297] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/08/2018] [Accepted: 10/20/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Addiction is one of the most rapidly growing epidemics that currently plagues nations around the world. In the United States, it has cost the government more than US $700 billion a year in terms of health care and other associated costs and is also associated with serious social, physical, and mental consequences. Increasing efforts have been made to tackle this issue at different levels, from primary prevention to rehabilitation across the globe. With the use of digital technology rapidly increasing, an effort to leverage the consumer health information technologies (CHITs) to combat the rising substance abuse epidemic has been underway. CHITs are identified as patient-focused technological platforms aimed to improve patient engagement in health care and aid them in navigating the complex health care system. OBJECTIVE This review aimed to provide a holistic and overarching view of the breadth of research on primary prevention of substance abuse using CHIT conducted over nearly past five decades. It also aimed to map out the changing landscape of CHIT over this period. METHODS We conducted a scoping review using the Arksey and O'Malley's modified methodological framework. We searched 4 electronic databases (PubMed, Cochrane, Scopus, and EMBASE). Papers were included if the studies addressed the use of CHIT for primary prevention of substance abuse and were published in English between 1809 and 2018. Studies that did not focus solely on primary prevention or assessed additional comorbid conditions were eliminated. RESULTS Forty-two papers that met our inclusion criteria were included in the review. These studies were published between 1970 and 2018 and were not restricted by geography, age, race, or sex. The review mapped studies using the most commonly used CHIT platforms for substance abuse prevention from mass media in the 1970s to mobile and social media in 2018. Moreover, 191 studies that were exclusively focused on alcohol prevention were excluded and will be addressed in a separate paper. The studies included had diverse research designs although the majority were randomized controlled trials (RCT) or review papers. Many of the RCTs used interventions based on different behavioral theories such as family interactions, social cognitive theories, and harm-minimization framework. CONCLUSIONS This review found CHIT platforms to be efficacious and cost-effective in the real-world settings. We also observed a gradual shift in the types and use of CHIT platforms over the past few decades and mapped out their progression. In addition, the review detected a shift in consumer preferences and behaviors from face-to-face interactions to technology-based platforms. However, the studies included in this review only focused on the aspect of primary prevention. Future reviews could assess the effectiveness of platforms for secondary prevention and for prevention of substance abuse among comorbid populations.
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Affiliation(s)
- Apoorva Milind Pradhan
- Department of Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, United States
| | - Leah Park
- Department of Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, United States
| | - Fadia T Shaya
- Department of Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, United States
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Noar SM, Bell T, Kelley D, Barker J, Yzer M. Perceived Message Effectiveness Measures in Tobacco Education Campaigns: A Systematic Review. COMMUNICATION METHODS AND MEASURES 2018; 12:295-313. [PMID: 31428217 PMCID: PMC6699787 DOI: 10.1080/19312458.2018.1483017] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Target audience ratings of the likely impact of persuasive messages, known as perceived message effectiveness (PME), are commonly used during message development and selection. PME is also used to examine receptivity of messages after they are fully developed or deployed. Despite this, we know little about the conceptual and methodological characteristics of extant PME measures used in the literature. We conducted a systematic review of tobacco education video, print, and audio campaign studies to examine conceptual and methodological characteristics of PME measures. One hundred twenty-six PME measures from 75 studies conducted in 21 countries with more than 61,000 participants were reviewed. Results indicated considerable variability in measures' focus on general perceptions of a message (i.e., message perceptions) versus perceptions of expected message effects (i.e., effects perceptions). Considerable variability was also found on underlying persuasive constructs, use of referents, and referencing of behavior in PME items and measures. We conclude with several recommendations for future research on PME measurement and validation.
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Affiliation(s)
- Seth M. Noar
- School of Media and Journalism, University of North Carolina at Chapel Hill
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill
| | - Trevor Bell
- School of Media and Journalism, University of North Carolina at Chapel Hill
| | - Dannielle Kelley
- School of Media and Journalism, University of North Carolina at Chapel Hill
| | - Joshua Barker
- School of Media and Journalism, University of North Carolina at Chapel Hill
| | - Marco Yzer
- Hubbard School of Journalism and Mass Communication, University of Minnesota
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Hagues R, Stotz S, Childers A, Phua J, Hibbs J, Murray D, Lee JS. Social marketing nutrition education for low-income population. SOCIAL WORK IN PUBLIC HEALTH 2018; 33:317-328. [PMID: 29757116 DOI: 10.1080/19371918.2018.1469065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
As access to healthy food (or lack thereof) could be considered a social justice issue, social workers should be concerned about this issue and willing to collaborate with colleagues of various disciplines to address it. This study was a formative evaluation conducted to understand best practices, recommendations, and feasibility of a social-marketing-based nutrition education program tailored to the needs of adults with limited income. The authors report findings from focus groups conducted with Cooperative Extension Agents (CEAs) and region coordinators (n = 45) and Supplemental Nutrition Assistance Program Education (SNAP-Ed) (n = 69) eligible participants to inform the development of a social marketing nutrition intervention for SNAP-Ed in Georgia. Barriers to healthy eating included cultural preferences, costs of healthy food, lack of time, and lack of availability. Social marketing has a potential to deliver effective and efficient SNAP-Ed targeted to large, limited-resource Georgians. Segmenting the low-income population based on geographical location as well as best methods for outreach can allow tailored messages to meet identified needs, lifestyles, and other variables that make these individuals most likely to respond to the program. Food security and nutrition education are topics of concern for all health care professionals interested in addressing complex health issues of many low-income adults.
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Affiliation(s)
- Rachel Hagues
- a Samford University , Department of Social Work , Birmingham , Alabama , USA
| | - Sarah Stotz
- b Department of Foods and Nutrition , The University of Georgia , Athens , Georgia , USA
| | - Austin Childers
- c Department of Foods and Nutrition & Cooperative Extension and Outreach , The University of Georgia , Athens , Georgia , USA
| | - Joe Phua
- d Department of Advertising & Public Relations , The University of Georgia , Athens , Georgia , USA
| | - Judy Hibbs
- c Department of Foods and Nutrition & Cooperative Extension and Outreach , The University of Georgia , Athens , Georgia , USA
| | - Deborah Murray
- e Cooperative Extension and Outreach , The University of Georgia , Athens , Georgia , USA
| | - Jung Sun Lee
- b Department of Foods and Nutrition , The University of Georgia , Athens , Georgia , USA
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Carson‐Chahhoud KV, Ameer F, Sayehmiri K, Hnin K, van Agteren JEM, Sayehmiri F, Brinn MP, Esterman AJ, Chang AB, Smith BJ. Mass media interventions for preventing smoking in young people. Cochrane Database Syst Rev 2017; 6:CD001006. [PMID: 28574573 PMCID: PMC6481357 DOI: 10.1002/14651858.cd001006.pub3] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Mass media interventions can be used as a way of delivering preventive health messages. They have the potential to reach and modify the knowledge, attitudes and behaviour of a large proportion of the community. OBJECTIVES To assess the effects of mass media interventions on preventing smoking in young people, and whether it can reduce smoking uptake among youth (under 25 years), improve smoking attitudes, intentions and knowledge, improve self-efficacy/self-esteem, and improve perceptions about smoking, including the choice to follow positive role models. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialized Register, with additional searches of MEDLINE and Embase in June 2016. This is an update of a review first published in 1998. SELECTION CRITERIA Randomized trials, controlled trials without randomization and interrupted time-series studies that assessed the effect of mass media campaigns (defined as channels of communication such as television, radio, newspapers, social media, billboards, posters, leaflets or booklets intended to reach large numbers of people and which are not dependent on person-to-person contact) in influencing the smoking behaviour (either objective or self-reported) of young people under the age of 25 years. We define smoking behaviour as the presence or absence of tobacco smoking or other tobacco use, or both, and the frequency of tobacco use. Eligible comparators included education or no intervention. DATA COLLECTION AND ANALYSIS Two review authors independently extracted information relating to the characteristics and the content of media interventions, participants, outcomes, methods of the study and risks of bias. We combined studies using qualitative narrative synthesis. We assessed the risks of bias for each study using the Cochrane 'Risk of bias' tool, alongside additional domains to account for the nature of the intervention. We assessed the quality of evidence contributing to outcomes using GRADE. MAIN RESULTS We identified eight eligible studies reporting information about mass media smoking campaigns, one of which is new for this update. Seven of the studies used a controlled trial design and one an interrupted time-series analysis. Risks of bias were high across all included studies and there was considerable heterogeneity in study design, intervention and population being assessed.Three studies (n = 17,385), one of which compared a mass media intervention to no intervention and two of which evaluated mass media interventions as adjuncts to school-based interventions, found that the mass media interventions reduced the smoking behaviour of young people. The remaining five studies (n = 72,740) did not detect a significant effect on smoking behaviour. These included three studies comparing a mass media intervention to no intervention, one study evaluating a mass media intervention as an adjunct to a school-based intervention, and one interrupted time-series study of a social media intervention. The three campaigns which found a significant effect described their theoretical basis, used formative research in designing the campaign messages, and used message broadcast of reasonable intensity over extensive periods of time. However, some of the campaigns which did not detect an effect also exhibited these characteristics. Effective campaigns tended to last longer (minimum 3 years) and were more intense (more contact time) for both school-based lessons (minimum eight lessons per grade) and media spots (minimum four weeks' duration across multiple media channels with between 167 and 350 TV and radio spots). Implementation of combined school-based components (e.g. school posters) and the use of repetitive media messages delivered by multiple channels (e.g. newspapers, radio, television) appeared to contribute to successful campaigns. AUTHORS' CONCLUSIONS Certainty about the effects of mass media campaigns on smoking behaviour in youth is very low, due to inconsistency between studies in both design and results, and due to methodological issues amongst the included studies. It would therefore be unwise to offer firm conclusions based on the evidence in this review. Methodologically rigorous studies investigating the effect of social media and novel forms of technology as part of tobacco prevention campaigns for youth are needed.
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Affiliation(s)
| | | | - Kourosh Sayehmiri
- Ilam University of Medical SciencesDepartment of BiostatisticsIlamIran
| | - Khin Hnin
- Flinders UniversityAdelaideAustralia
| | | | - Fatemeh Sayehmiri
- Shahid Beheshti University of Medical SciencesNeuroscience Research CenterTehranIran
| | - Malcolm P Brinn
- Faculty of Medicine, University of QueenslandHabit Research Group, School of Public HealthBrisbaneAustralia
| | - Adrian J Esterman
- University of South AustraliaSansom Institute of Health Service ResearchAdelaideAustralia
- James Cook UniversityAustralian Institute of Tropical Health and MedicineCairnsAustralia
| | - Anne B Chang
- Menzies School of Health Research, Charles Darwin UniversityChild Health DivisionPO Box 41096DarwinNorthern TerritoriesAustralia0811
| | - Brian J Smith
- The Queen Elizabeth Hospital, Central Adelaide Local Health NetworkRespiratory Medicine UnitAdelaideAustralia
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Brinn MP, Carson KV, Esterman AJ, Chang AB, Smith BJ. Cochrane Review: Mass media interventions for preventing smoking in young people. ACTA ACUST UNITED AC 2012. [DOI: 10.1002/ebch.1808] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Brinn MP, Carson KV, Esterman AJ, Chang AB, Smith BJ. Mass media interventions for preventing smoking in young people. Cochrane Database Syst Rev 2010:CD001006. [PMID: 21069667 DOI: 10.1002/14651858.cd001006.pub2] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The mass media have been used as a way of delivering preventive health messages. They have the potential to reach and to modify the knowledge, attitudes and behaviour of a large proportion of the community. OBJECTIVES To evaluate the effectiveness of mass media interventions to prevent smoking in young people in terms of reduced smoking uptake, in addition to secondary outcomes including improved smoking outcomes, attitudes, behaviours, knowledge, self-efficacy and perception. SEARCH STRATEGY We searched the Cochrane Tobacco Addiction Group Specialised Register and conducted additional searches of MEDLINE and EMBASE in July 2010. SELECTION CRITERIA Randomized trials, controlled trials without randomization and time series studies that assessed the effectiveness of mass media campaigns (defined as channels of communication such as television, radio, newspapers, bill boards, posters, leaflets or booklets intended to reach large numbers of people and which are not dependent on person to person contact) in influencing the smoking behaviour (either objective or self-reported) of young people under the age of 25 years. DATA COLLECTION AND ANALYSIS Information relating to the characteristics and the content of media interventions, participants, outcomes, methods of the study and risk of bias was abstracted by two independent reviewers. Studies were combined using qualitative narrative synthesis. MAIN RESULTS Seven out of a total of 84 studies reporting information about mass media smoking campaigns met all of the inclusion criteria. All seven studies used a controlled trial design. Three studies concluded that mass media reduced the smoking behaviour of young people. All of the effective campaigns had a solid theoretical basis, used formative research in designing the campaign messages, and message broadcast was of reasonable intensity over extensive periods of time. AUTHORS' CONCLUSIONS There is some evidence that mass media can prevent the uptake of smoking in young people, however the evidence is not strong and contains a number of methodological flaws.
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Affiliation(s)
- Malcolm P Brinn
- Clinical Practice Unit, The Queen Elizabeth Hospital, 4A Main Building, 28 Woodville Road Woodville South, Adelaide, South Australia, Australia, 5011
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Lin CA, Hullman GA. Tobacco-prevention messages online: social marketing via the Web. HEALTH COMMUNICATION 2005; 18:177-93. [PMID: 16083410 DOI: 10.1207/s15327027hc1802_5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Antitobacco groups have joined millions of other commercial or noncommercial entities in developing a presence on the Web. These groups primarily represent the following different sponsorship categories: grassroots, medical, government, and corporate. To obtain a better understanding of the strengths and weaknesses in the message design of antitobacco Web sites, this project analyzed 100 antitobacco Web sites ranging across these four sponsorship categories. The results show that the tobacco industry sites posted just enough antismoking information to appease the antismoking publics. Medical organizations designed their Web sites as specialty sites and offered mostly scientific information. While the government sites resembled a clearinghouse for antitobacco related information, the grassroots sites represented the true advocacy outlets. In general, the industry sites provided the weakest persuasive messages and medical sites fared only slightly better. Government and grassroots sites rated most highly in presenting their antitobacco campaign messages on the Web.
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Affiliation(s)
- Carolyn A Lin
- Department of Communication Sciences, University of Connecticut, Storrs, CT 06269-1085, USA.
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Snyder LB, Hamilton MA, Mitchell EW, Kiwanuka-Tondo J, Fleming-Milici F, Proctor D. A meta-analysis of the effect of mediated health communication campaigns on behavior change in the United States. JOURNAL OF HEALTH COMMUNICATION 2004; 9 Suppl 1:71-96. [PMID: 14960405 DOI: 10.1080/10810730490271548] [Citation(s) in RCA: 264] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
A meta-analysis was performed of studies of mediated health campaigns in the United States in order to examine the effects of the campaigns on behavior change. Mediated health campaigns have small measurable effects in the short-term. Campaign effect sizes varied by the type of behavior: r=.15 for seat belt use, r=.13 for oral health, r=.09 for alcohol use reduction, r=.05 for heart disease prevention, r=.05 for smoking, r=.04 for mammography and cervical cancer screening, and r=.04 for sexual behaviors. Campaigns with an enforcement component were more effective than those without. To predict campaign effect sizes for topics other than those listed above, researchers can take into account whether the behavior in a cessation campaign was addictive, and whether the campaign promoted the commencement of a new behavior, versus cessation of an old behavior, or prevention of a new undesirable behavior. Given the small campaign effect sizes, campaign planners should set modest goals for future campaigns. The results can also be useful to evaluators as a benchmark for campaign effects and to help estimate necessary sample size.
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Affiliation(s)
- Leslie B Snyder
- Department of Communication Sciences, University of Connecticut, Storrs, Connecticut 06269-1085, USA.
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How do Adolescents Process Smoking and Antismoking Advertisements? A Social Cognitive Analysis with Implications for Understanding Smoking Initiation. REVIEW OF GENERAL PSYCHOLOGY 2001. [DOI: 10.1037/1089-2680.5.4.429] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Youth tobacco use has increased substantially in the United States during the past decade. This increase can be attributed, in part, to the potency of cigarette advertising and relative ineffectiveness of antismoking advertising. In this article, the authors argue that an understanding of the effects of these 2 competing forms of advertising on youth smoking is limited in current theoretical treatments and that an integrative theoretical perspective has yet to be advanced. The authors argue that the elaboration likelihood model ( R.E. Petty & J.T. Cacioppo, 1986 ) offers a framework with sufficient explanatory power in this domain. Prevention and legislative interventions may benefit from this analysis, which ultimately may help to decrease youth tobacco use.
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Hopkins DP, Briss PA, Ricard CJ, Husten CG, Carande-Kulis VG, Fielding JE, Alao MO, McKenna JW, Sharp DJ, Harris JR, Woollery TA, Harris KW. Reviews of evidence regarding interventions to reduce tobacco use and exposure to environmental tobacco smoke. Am J Prev Med 2001; 20:16-66. [PMID: 11173215 DOI: 10.1016/s0749-3797(00)00297-x] [Citation(s) in RCA: 324] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This report presents the results of systematic reviews of effectiveness, applicability, other effects, economic evaluations, and barriers to use of selected population-based interventions intended to reduce tobacco use and exposure to environmental tobacco smoke. The related systematic reviews are linked by a common conceptual approach. These reviews form the basis of recommendations by the Task Force on Community Preventive Services (TFCPS) regarding the use of these selected interventions. The TFCPS recommendations are presented on page 67 of this supplement.
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Affiliation(s)
- D P Hopkins
- Division of Prevention Research and Analytic Methods, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Wakefield M, Chaloupka F. Effectiveness of comprehensive tobacco control programmes in reducing teenage smoking in the USA. Tob Control 2000; 9:177-86. [PMID: 10841854 PMCID: PMC1748334 DOI: 10.1136/tc.9.2.177] [Citation(s) in RCA: 168] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To describe the extent to which comprehensive statewide tobacco control programmes in the USA have made progress toward reducing teenage smoking. DATA SOURCES Literature search of Medline for reviews of effectiveness of programme and policy elements, plus journal articles and personal request for copies of publicly released reports and working papers from evaluation staff in each of the state programmes of California, Massachusetts, Arizona, Oregon, and Florida. STUDY SELECTION All studies, reports, and commentaries that provided information on aspects of programme implementation and evaluation. DATA SYNTHESIS Statewide comprehensive programmes show high levels of advertising recall and generally positive improvement in smoking related beliefs and attitudes among teenagers. More fully funded programmes lead to increased mass media campaign advertising and community initiatives; a greater capacity to implement school based smoking prevention programmes; and an increase in the passage of local ordinances that create smoke free indoor environments and reduce cigarette sales to youth. The combination of programme activity and increased tobacco tax reduce cigarette consumption more than expected as a result of price increases alone, and these effects seem to apply to adolescents as well as adults. Programmes are associated with a decline in adult smoking prevalence, with these effects observed to date in California, Massachusetts, and Oregon. Arizona and Florida have yet to examine change in adult prevalence associated with programme exposure. California and Massachusetts have demonstrated relative beneficial effects in teenage smoking prevalence, and Florida has reported promising indications of reduced prevalence. Arizona has yet to report follow up data, and Oregon has found no change in teenage smoking, but has only two years of follow up available. One of the most critical factors in programme success is the extent of programme funding, and consequent level of programme implementation, and the degree to which this is undermined by the tobacco industry and other competitors for funding. CONCLUSIONS Despite the different strengths and combinations of programme messages and strategies used in these comprehensive programmes, there is evidence that they lead to change in factors that influence teenage smoking, and to reductions in teenage smoking.
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Affiliation(s)
- M Wakefield
- Health Research and Policy Centers, University of Illinois at Chicago, 60607, USA.
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Pechmann C, Reibling ET. Anti-smoking advertising campaigns targeting youth: case studies from USA and Canada. Tob Control 2000; 9 Suppl 2:II18-31. [PMID: 10841588 PMCID: PMC1766281 DOI: 10.1136/tc.9.suppl_2.ii18] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To assist in planning anti-smoking advertising that targets youth. Using five US state campaigns, one US research study, and a Canadian initiative as exemplars, an attempt is made to explain why certain advertising campaigns have been more cost effective than others in terms of reducing adolescent smoking prevalence. Several factors which prior research and theory suggest may be important to cost effectiveness are examined. Specifically, three variables pertaining to the advertising message (content, consistency, and clarity) and two variables related to the advertising execution or style (age of spokesperson and depiction of smoking behaviour) are studied. DESIGN A case study approach has been combined with supplemental data collection and analysis. To assess campaign effects, published articles and surveys of adolescent smoking prevalence in campaign versus control (non-campaign) locations were utilised. Adolescent subjects provided supplemental data on the advertising message variables. Trained adults content analysed each advertisement to assess the executional variables. SUBJECTS A total of 1128 seventh grade (age 12-13 years) and 10th grade (age 15-16 years) students participated in the supplemental data collection effort. RESULTS An anti-smoking advertising campaign initiated by Vermont researchers was found to be the most cost effective in that it significantly reduced adolescent smoking prevalence at a low per capita cost. Next in order of cost effectiveness were California, Massachusetts, and Florida because behavioural outcomes were inconsistent across time and/or grades. California was ranked higher than the other two because it spent less per capita. Minnesota and Canada were ineffective at reducing adolescent smoking prevalence, and no comparison outcome data were available for Arizona. Four factors were found to be associated with increased cost effectiveness: (1) a greater use of message content that prior research suggests is efficacious with youth; (2) a more concentrated use of a single efficacious message; (3) an avoidance of unclear messages; and (4) an increased use of youthful spokespeople that adolescents could more readily identify with. No indication was found that depictions of smoking undermined campaign effectiveness by inadvertently implying that smoking was prevalent. CONCLUSIONS The highly cost effective Vermont campaign can be used as a model for future efforts. It is estimated that 79% of the Vermont advertisements conveyed efficacious messages, 58% concentrated on a single efficacious message, 70% showed youthful spokespeople, and only 4% contained unclear messages. The results suggest that, in the less effective campaigns, as few as 25% of the advertisements contained messages that prior research indicates should be efficacious with youth, as few as 10% of the advertisements focused on one efficacious message, and up to 32% of the advertisements lacked clearcut messages.
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Affiliation(s)
- C Pechmann
- Graduate School of Management, University of California-Irvine, 92697, USA.
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Abstract
BACKGROUND The mass media have been used as a way of delivering preventive health messages. They have the potential to reach and to modify the knowledge, attitudes and behaviour of a large proportion of the community. OBJECTIVES To determine the effectiveness of mass media campaigns in preventing the uptake of smoking in young people. SEARCH STRATEGY We searched Medline, and 28 other electronic databases. Handsearching of key journals was also carried out, the bibliographies of identified studies were checked for additional references and contact with content area specialists was made. Date of last search June 1998. SELECTION CRITERIA Randomised trials, controlled trials without randomisation and time series studies that assessed the effectiveness of mass media campaigns (defined as channels of communication such as television, radio, newspapers, bill boards, posters, leaflets or booklets intended to reach large numbers of people and which are not dependent on person to person contact) in influencing the smoking behaviour (either objective or self-reported) of young people under the age of 25 years. DATA COLLECTION AND ANALYSIS Information relating to the characteristics and the content of media interventions, participants, outcomes and methods of the study was abstracted by one reviewer and checked by a second. Studies were combined using qualitative narrative synthesis. MAIN RESULTS Six out of a total of 63 studies reporting information about mass media smoking campaigns met all of the inclusion criteria. All six studies used a controlled trial design. Two studies concluded that the mass media were effective in influencing the smoking behaviour of young people. Both of the effective campaigns had a solid theoretical basis, used formative research in designing the campaign messages and message broadcast was of reasonable intensity over extensive periods of time. REVIEWER'S CONCLUSIONS There is some evidence that the mass media can be effective in preventing the uptake of smoking in young people, but overall the evidence is not strong.
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Affiliation(s)
- A J Sowden
- NHS Centre for Reviews and Dissemination, University of York, York, UK, YO10 5DD.
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14
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Abstract
During the field work to control oral cancer, difficulty in communication was encountered with illiterates. A study to define the role of illiteracy, ignorance and willingness to quit smoking among the villagers was undertaken in a rural area surrounding Doddipatla Village, A.P., India. Out of a total population of 3,550, 272 (7.7%) persons, mostly in the age range of 21-50 years, attended a cancer detection camp. There were 173 (63.6%) females and 99 (36.4%) males, among whom 66 (M53 + F13) were smokers; 36.4% of males and 63% of females were illiterate. Among the illiterates, it was observed that smoking rate was high (56%) and 47.7% were ignorant of health effects of smoking. The attitude of illiterate smokers was encouraging, as 83.6% were willing to quit smoking. Further research is necessary to design health education material for 413.5 million illiterates living in India (1991 Indian Census). A community health worker, trained in the use of mass media coupled with a person-to-person approach, may help the smoker to quit smoking.
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Affiliation(s)
- S Gavarasana
- Lions Cancer Treatment & Research Center, Visakhapatnam, India
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Headen SW, Bauman KE, Deane GD, Koch GG. Are the correlates of cigarette smoking initiation different for black and white adolescents? Am J Public Health 1991; 81:854-8. [PMID: 2053660 PMCID: PMC1405188 DOI: 10.2105/ajph.81.7.854] [Citation(s) in RCA: 97] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Studies of adolescent smoking suggest that the causes of smoking initiation may differ for Blacks and Whites. METHODS Correlates of smoking initiation were examined among 1,277 nonsmokers, ages 12-14, who completed questionnaires in their homes. The analyses examined relationships between smoking initiation and 11 explanatory variables using logistic regression with the combined sample and with Black and White samples. RESULTS Over two years, 24 percent of Whites and 14 percent of Blacks started to smoke. Whites were more likely to start smoking at age 12 and Blacks at age 14. Having a best friend who smoked increased the odds of initiating smoking over twofold for Whites but had no effect on the odds of smoking for Blacks. CONCLUSIONS Whites initiate smoking earlier than Blacks and are more likely to be influenced by friend behavior.
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Affiliation(s)
- S W Headen
- Department of Health Behavior and Health Education, University of North Carolina, Chapel Hill 27599-7400
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16
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Bauman KE, LaPrelle J, Brown JD, Koch GG, Padgett CA. The influence of three mass media campaigns on variables related to adolescent cigarette smoking: results of a field experiment. Am J Public Health 1991; 81:597-604. [PMID: 2014859 PMCID: PMC1405075 DOI: 10.2105/ajph.81.5.597] [Citation(s) in RCA: 91] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND This paper reports findings from a field experiment that evaluated mass media campaigns designed to prevent cigarette smoking by adolescents. METHODS The campaigns featured radio and television messages on expected consequences of smoking and a component to stimulate personal encouragement of peers not to smoke. Six Standard Metropolitan Statistical Areas in the Southeast United States received campaigns and four served as controls. Adolescents and mothers provided pretest and posttest data in their homes. RESULTS AND CONCLUSIONS The radio campaign had a modest influence on the expected consequences of smoking and friend approval of smoking, the more expensive campaigns involving television were not more effective than those with radio alone, the peer-involvement component was not effective, and any potential smoking effects could not be detected.
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Affiliation(s)
- K E Bauman
- Department of Health Behavior and Health Education, School of Public Health, University of North Carolina, Chapel Hill 27599-7400
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Brown JD, Bauman KE, Padgett CA. A validity problem in measuring exposure to mass media campaigns. HEALTH EDUCATION QUARTERLY 1990; 17:299-306. [PMID: 2228632 DOI: 10.1177/109019819001700306] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Recognition of radio and television messages included in three mass media campaigns designed to keep adolescents from starting to smoke cigarettes was measured in six treatment and four control cities (Standard Metropolitan Statistical Areas) in the southeastern United States. The telephone survey of 574 randomly selected adolescents found high recognition of campaign messages even in the areas where the campaigns had not been broadcast. Campaign messages that differed significantly from other anti-smoking messages were less likely to be falsely recognized. These results reinforce the need to include true control groups in mass media evaluations and to construct distinctive messages if exposure is an important aspect of campaign evaluation.
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Affiliation(s)
- J D Brown
- School of Journalism, University of North Carolina, Chapel Hill
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18
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Bettinghaus EP. A mass media campaign. Using the mass media in smoking prevention and cessation programs: an introduction to five studies. Prev Med 1988; 17:503-9. [PMID: 3237654 DOI: 10.1016/0091-7435(88)90049-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- E P Bettinghaus
- College of Communication Arts and Sciences, Michigan State University 48824
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