Effect of web-based messages on girls' knowledge and risk perceptions related to cigarette smoke and breast cancer: 6-month follow-up of a randomized controlled trial

Details of Cancer Education Programs for Adolescents and Young Adults and Their Effectiveness: A Scoping Review

The purpose of this review was to establish what cancer education programs have been carried out aimed at adolescents and young adults (AYAs) and what outcomes they achieved. The databases used were MEDLINE, CINAHL, and Web of Science, and the search period was set as 2011-2020. The extracted literature was evaluated for quality using the Joanna Briggs Institute's critical appraisal tools. The subjects of the analysis were 29 studies: 10 randomized controlled trials and 19 quasi-experimental designs. Regarding the varieties of cancers found in the data, in descending order, 10 documents looked at cervical cancer, 9 looked at cancer in general, and 4 looked at breast cancer. Most studies focused on AYAs exclusively, with just three studies involving their parents simultaneously. Many studies used lecture-based intervention, with information technology-based interventions using websites and cell phones. Topics included in the program were cancer epidemiology, cancer risk factors, cancer warning signs and symptoms, prevention methods, and screening methods. After the intervention, all studies showed statistically significant improvements in at least one outcome measure, which included knowledge and awareness of cancer, health beliefs, and intent to take preventive action, demonstrating a basis for educational intervention. Educating AYAs about cancer at a time when their ways of life are becoming more concrete can be expected to have a positive impact on cancer preventing behaviors in adulthood, increase their parents' awareness of cancer, and have a positive impact on behavior around screening.

Familiarity with the internet and health apps, and specific topic needs are amongst the factors that influence how online health information is used for health decisions amongst adolescents

BACKGROUND

Many adolescents believe that online health information is reliable, particularly when they are familiar with the source of information.

OBJECTIVE

To analyse the degree of influence of online health information on high school students' health decisions and examine whether socio-demographic characteristics, digital literacy, use of different websites and interest in specific health topics are associated with a stronger influence of online health information on adolescents' health-related decisions.

METHODS

Participants were students from four public high schools in Belgrade, Serbia. Socio-demographic and behavioural questionnaire as well as the e-health literacy scale (eHEALS) were used to collect data.

RESULTS

The study sample comprised 702 students. A total of 79.6% of students reported that online health information influenced their health decisions to a certain extent (from 'a little' to 'a lot'). Being a boy, using the internet since younger age, better self-perceived e-health literacy, using health apps, Google, health forums, websites of health institutions, social media and YouTube, being interested in diet/nutrition, sexually transmitted infections and cigarettes were the characteristics associated with a stronger influence of online health information on students' health decisions.

CONCLUSION

This study provides clues about how online health-related information can be used to adjust and enhance health promotion amongst adolescents.

Technology-Based Substance Use Interventions: Opportunities for Gender-Transformative Health Promotion

Drawing on data from a scoping review on sex, gender and substance use, this narrative review explores the use of gender-informed and technology-based approaches in substance use prevention and health promotion interventions. With an ever-changing landscape of new technological developments, an understanding of how technology-based interventions can address sex, gender, and intersecting equity considerations related to substance use is warranted. Current technology-based approaches to substance use prevention and health promotion are described and assessed for gender-specific and gender transformative outcomes, and limitations are discussed related to inclusivity, access, confidentiality, and a dearth of research on technological approaches that integrate gender-based analysis. A call for action designed to advance technology-based health promotion, prevention and brief interventions that address gender equity simultaneously with substance use is proposed.

Comparison of Developers' and End-Users' Perspectives About Smoking Cessation Support Through the Crush the Crave App

Background

High smoking rates among end-users, combined with their high rates of app use, render this age group as a particularly captive audience for quit smoking apps. There is emerging evidence that apps are an effective way to support smoking cessation among end-users. How the expectations behind the design of apps align with the needs and preferences of end-users, and if this differs by gender, is poorly understood, limiting the ability to evaluate and scale these interventions.

Objective

The objective of this qualitative case study was to detail how the overall design approach of Crush the Crave (CTC), a quit smoking app that targets end-users, compares with young adult women’s and men’s perspectives and experiences, with consideration for the influence of gender.

Methods

Semistructured interviews were conducted with 15 developers involved in the development of CTC and 31 young adult CTC users. Data were analyzed inductively to derive thematic findings of the perceived pros and cons of CTC by both developers and end-users. Findings were grouped under 4 categories (1) technology and platforms utilized for the app, (2) foundation of app content, (3) underlying focus of the app, and (4) look, feel and functionality of the app.

Results

Under the category, technology and platforms utilized for the app, it was found that both developers and end-users agreed that apps aligned with the needs and preferences of young adult smokers. Major limitations with the technology identified by end-users were the frequent “glitches” and requirement for internet or data. For the category, foundation of app content,developers agreed that the strength of CTC was in its strong evidence-base. What mattered to end-users, however, was that the content was packaged positively, focusing on the benefits of quitting versus the consequences of smoking. It was found under the category, underlying focus of the app, that the individually-led focus of the app resonated with both developers and end-users, especially young men. Under the final category, look, feel and functionality of the app, it was found that developers were very positive about the app's aesthetics but end-users thought that the aesthetics incited a negative effect. Also, while end-users found it easy to use, they did not find the app intuitive. Finally, end-users thought that, because the app functions were largely based on a user’s quit date versus their ongoing efforts, this often lent to unmeaningful data.

Conclusions

The current study findings highlight the importance of understanding multiple perspectives of stakeholders involved in a mobile-based intervention. By gathering the viewpoints of developers and end-users, both problematic and effective approaches that underlie development goals were revealed as a means of informing the development, implementation, and evaluation of future electronic health (eHealth) interventions.

The Crush the Crave Quit Smoking App and Young Adult Smokers: Qualitative Case Study of Affordances

Background

Mobile phone apps have emerged as a promising way to reach young adult smokers, given their high mobile phone ownership rates and openness to receiving cessation support via digital technologies. Although emerging evidence indicates that quit smoking apps are an effective way to reduce smoking among young adults, lacking is formative evaluative research that captures the perspectives of end-users.

Objective

The objective of this study was to contribute insights toward understanding how young adults interact with the Crush the Crave (CTC) app, and how this interaction shapes young adults’ smoking cessation experiences and practices, with consideration of the influence of gender.

Methods

Semistructured interviews were conducted with 31 young adult CTC end-users. Guided by sociomateriality theory and an affordances approach, data were inductively analyzed to derive thematic findings in relation to the impacts of CTC on quit efforts, and to expose the underlying affordances (mechanisms) that lend to these outcomes. Findings were grouped according to the 4 design components of CTC: credibility, social support, task support, and dialogue support.

Results

The credibility component of CTC played an important role in harnessing the trust of young adults because it afforded them promise in relation to its potential effectiveness in assisting them with quitting smoking. The social support component lent to various end-user practices and experiences that rendered this aspect as the weakest component in supporting quit efforts. Although most functions situated in the task and dialogue support components were found to be helpful, there were a few affordances in CTC that resulted in negative experiences, notably weaning from smoking. Gender-related influences were also evident. For example, young men preferred to control and self-manage their quitting and, therefore, did not engage with functions that afforded journaling or reminding to stay on track. Women, in contrast, were more likely to benefit from these affordances.

Conclusions

An affordances approach is productive for gaining an in-depth understanding of how mobile apps interact with end-users to lend to particular outcomes. The study findings have implications for developing and improving apps for helping young adults quit smoking, as well as apps that target other health behaviors. Productive affordances may also serve as a framework for leveraging apps for smoking cessation.