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Wu J, Benjamin EJ, Ross JC, Fetterman JL, Hong T. Health Messaging Strategies for Vaping Prevention and Cessation Among Youth and Young Adults: A Systematic Review. HEALTH COMMUNICATION 2024:1-19. [PMID: 38742648 DOI: 10.1080/10410236.2024.2352284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
This systematic review evaluates health messaging strategies for the prevention and cessation of e-cigarette use among youth and young adults. Health messaging strategies were defined as the strategic process of developing messages with the intent to shape, reinforce, or change recipients' health attitudes and behaviors. McGuire's Communication/Persuasion Model guided the analysis of the messaging strategies, focusing on the model's five communication inputs (i.e. source, message, channel, audience, destination) and 14 persuasive outcomes. Nine databases were searched from January 2007 to September 2023. The inclusion criteria encompassed studies in English that presented quantitative data on messaging strategies aimed at discouraging vaping among youth and young adults. Each study was also coded for study characteristics and the utilization of theory. Out of 6,045 studies, 25 met the inclusion criteria. The reviewed studies exhibit a diverse array of research methods and a consistent integration of theories. The review emphasizes the nuanced main and interaction effects of various communication inputs, such as message features and audience characteristics, while also pointing out a research gap in message sources. In addition, the utilization of social media for effective messaging to engage the audience requires further research. Only one study specifically evaluated messaging strategies for vaping cessation. More research is imperative to develop targeted and tailored messages that effectively prevent and reduce vaping, especially among populations at higher risk of vaping-related harms, while also leveraging effective channels and innovative communication technologies to engage the audience.
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Affiliation(s)
- Jiaxi Wu
- Annenberg School for Communication, University of Pennsylvania
| | - Emelia J Benjamin
- Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine
- Department of Epidemiology, Boston University School of Public Health
| | | | - Jessica L Fetterman
- Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University Chobanian & Avedisian School of Medicine
| | - Traci Hong
- College of Communication, Boston University
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Hong SJ, Low BYF. Use of Internet Memes in PSAs: Roles of Perceived Emotion, Involvement with Memes, and Attitudes Toward the Issuing Organization in Perceived PSA Effectiveness. HEALTH COMMUNICATION 2024; 39:1185-1197. [PMID: 37143295 DOI: 10.1080/10410236.2023.2207283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
To help solve the diabetes problem in Singapore, we developed humorous and fearful public service announcements (PSAs) based on popular Internet memes and investigated how the emotions derived from PSAs affect Singaporean millennials' perceptions of PSAs' effectiveness. In total, 416 people participated in the study through a Singaporean online survey company. Multivariable linear regression methods with SPSS were used to examine our hypotheses and research questions. According to the results, message manipulation significantly increased participants' perceived emotion (i.e. perceived humor and fear). Moreover, the results showed that perceived humor and fear were positively associated with perceived PSA effectiveness in both models, testing the humor effect and fear effect separately. As per the moderation analysis, the association between the perceived emotion (i.e. humor and fear) and the perceived PSA effectiveness is likely to increase when attitudes toward the organization are less positive. Moreover, the association between perceived fear and perceived PSA effectiveness is likely to increase when participants' involvement with memes is low. Our findings highlight important theoretical and practical implications for future studies investigating the effectiveness of Internet meme-based PSA messages regarding serious health issues.
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Affiliation(s)
- Soo Jung Hong
- Department of Communications and New Media, National University of Singapore
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Galper EF, Gottfredson O'Shea N, Ritchie C, Kresovich A, Ma H, Sutfin EL, Sheeran P, Noar SM. Identifying promising themes and messages for youth vaping prevention: A national study. Soc Sci Med 2024; 348:116864. [PMID: 38608483 PMCID: PMC11056295 DOI: 10.1016/j.socscimed.2024.116864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/29/2023] [Accepted: 04/02/2024] [Indexed: 04/14/2024]
Abstract
Use of e-cigarettes and vapes among adolescents continues to be a major public health concern. Health communication efforts can discourage e-cigarette use among adolescents by influencing beliefs and behavior. However, to do so, studies need to identify the most promising themes and messages based on the latest evidence about the harms of e-cigarettes and vaping. Participants were a nationally representative sample of 1,603 US adolescents aged 13-17 years, recruited in the summer of 2022. Adolescents were randomly assigned to view 7 vaping prevention statements (one from each theme: nicotine addiction, chemical harms, health symptoms, mental health, organ effects, cosmetic effects, and monetary cost) and 1 control statement (vape litter theme) from a pool of 46 statements that were developed through a systematic process. Participants rated each statement on perceived message effectiveness (PME), awareness, and believability. Results of linear mixed models indicated that all vaping prevention themes out-performed control messages on PME, with chemical harms and organ effects having the largest effects, followed by nicotine addiction and then other themes. For most message themes, PME effects were stronger for youth susceptible to vaping compared to non-susceptible youth and users. Both awareness and believability predicted higher levels of PME. In secondary analyses, we found that statements specifying the target ("you") and longer statements were also rated higher on PME. Results suggests that the most potent vaping prevention messages for adolescents are those that focus on vape chemicals and the potential of vaping to damage organs and increase disease risk.
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Affiliation(s)
- Emily F Galper
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | | | - Caroline Ritchie
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alex Kresovich
- Public Health Department, NORC at the University of Chicago, Chicago, IL, USA
| | - Haijing Ma
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Paschal Sheeran
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Eggers ME, Nonnemaker JM, Kelly LK, Ortega-Peluso C, Anker E, Lee J, Fajobi O, Swires NB. It's Not Just: Evaluation of a Media Campaign to Motivate Action Around Targeting of Menthol Tobacco in Black Communities. Prev Chronic Dis 2024; 21:E24. [PMID: 38603518 PMCID: PMC11048315 DOI: 10.5888/pcd21.230237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
Introduction For more than 60 years, tobacco companies have aggressively marketed menthol tobacco products in Black communities. In 2021, New York State Department of Health-funded grantees launched a media campaign aimed toward civically engaged New York adults to educate and mobilize community action to prevent targeted marketing of menthol tobacco. This study examined audience reactions to the campaign and associations between campaign awareness and key outcomes. Methods Following campaign implementation, we administered 2 online, cross-sectional surveys to 2,000 civically engaged New York adults to assess campaign awareness, audience reactions, and campaign-related attitudes and behaviors. We examined sociodemographic differences in audience reactions and assessed multivariate associations between campaign awareness and key outcomes. Results Overall, 40% of respondents were aware of the campaign. Perceived advertisement (ad) effectiveness was higher among Black, Hispanic, and nonsmoking respondents and those aware of the campaign. Negative reactions to ads were higher at wave 1, among non-Hispanic White and male respondents, and among current smokers. Campaign awareness was positively associated with campaign-related beliefs. The association between campaign awareness and support for a menthol ban varied by survey wave and race, with positive associations at wave 2 and among non-Hispanic White respondents only. Among wave 2 respondents only, campaign awareness was positively associated with actions to reduce the targeting of menthol in Black communities. Conclusion Media campaigns can play an important role in raising awareness of menthol tobacco product targeting in Black communities and building public support for local and statewide menthol restrictions that may be implemented before federal product standards are in place.
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Affiliation(s)
- Matthew E Eggers
- RTI International, 3040 E Cornwallis Dr, Research Triangle Park, NC 27709
| | | | - Lisa K Kelly
- New York State Department of Health, Albany, New York
| | | | | | - Jennifer Lee
- New York State Department of Health, Albany, New York
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Donaldson SI, Dormanesh A, Majmundar A, Pérez C, Lopez H, Saghian M, Beard TA, Unger JB, Allem JP. Examining the Peer-Reviewed Literature on Tobacco-Related Social Media Data: Scoping Review. Nicotine Tob Res 2024; 26:413-420. [PMID: 37795944 DOI: 10.1093/ntr/ntad186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 09/07/2023] [Accepted: 09/27/2023] [Indexed: 10/06/2023]
Abstract
INTRODUCTION Tobacco researchers have used social media data to examine tobacco industry marketing practices (eg, influencers), and to document user experience with tobacco products. This study summarized the literature that analyzed tobacco-related social media data, including domain, social media platform, tobacco product type, and themes of findings, among other variables. AIMS AND METHODS PubMed, PsycINFO, Web of Science, and Communication Source were searched between 2004 and 2022. Peer-reviewed articles were included if they were written in English, included at least one tobacco-related term, and one social media-related term, and analyzed a social media post. Two coders screened all-titles and abstracts. The final sample consisted of (n = 255) articles. Studies were coded for domain, social media platform, tobacco product type, data source, type of data, coding and analytic method, and presence of validation procedure, among other variables. RESULTS A total of 10 504 820 581 tobacco-related social media posts were assessed across 255 studies. User experience (54.1%) and promotion (23.1%) were the most researched domains. Researchers used data from Twitter the most (42.7%). Text (43.1%) was the most common type of data analyzed. Thematic analysis (80.8%) was the most common analytic technique. Themes of findings from content analyses often pertained to the health effects of tobacco use (61.0%) and promotion (44.2%). CONCLUSIONS Researchers have analyzed billions of tobacco-related social media posts to describe user experience with, and promotions related to, tobacco products like e-cigarettes on platforms like Twitter. Future research may examine tobacco-related social media data from newer platforms like TikTok. IMPLICATIONS Real-time surveillance of tobacco-related content on social media can keep the tobacco control community abreast of tobacco industry promotional strategies, user experience with tobacco products, and perceived health effects of tobacco use. A framework may be developed to establish best-practices for social media data collection and analysis, including strategies to identify posts from bot accounts and validate methodological approaches used in thematic analysis.
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Affiliation(s)
- Scott I Donaldson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Allison Dormanesh
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Anuja Majmundar
- Tobacco Control Research, Surveillance and Health Equity Science, American Cancer Society, Inc., Kennesaw, GA, USA
| | - Cindy Pérez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Heather Lopez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Megan Saghian
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Trista A Beard
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jon-Patrick Allem
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Freeman B, Daube M. Reaching everyone: tobacco control must remain a health priority. Med J Aust 2024; 220:136-137. [PMID: 38368553 DOI: 10.5694/mja2.52214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/18/2023] [Indexed: 02/19/2024]
Affiliation(s)
- Becky Freeman
- School of Public Health, University of Sydney, Sydney, NSW
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Kcomt L, Evans-Polce RJ, Engstrom CW, Takahashi J, Matthews PA, Veliz PT, West BT, McCabe SE. Social Ecological Influences on Nicotine/Tobacco Use Among Gender-Varying and Gender-Stable Adolescents and Adults in the USA. Ann Behav Med 2024; 58:1-11. [PMID: 37983126 PMCID: PMC10729790 DOI: 10.1093/abm/kaad066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND AND PURPOSE Our study examined individual-, interpersonal-, community-, and policy-level associations with nicotine/tobacco use among gender-varying and gender-stable U.S. individuals. METHODS Data from Waves 2-4 (2014/15-2016/18) of the Population Assessment of Tobacco and Health (n = 33,197 U.S. adolescents and adults aged ≥14 years) and state-level gender minority policy data were used. Using multivariable logistic regression, the odds of past-30-day nicotine/tobacco use at W4 were estimated as a function of gender stability/variability, psychological distress, number of tobacco products used by family/friends, anti-tobacco marketing exposure, and change in gender minority-related policies from 2015 to 2017. RESULTS Gender-varying individuals had higher odds of nicotine/tobacco use compared with gender-stable individuals (AOR range = 1.7-2.3, p < .01). In the overall sample, positive change in gender minority policy protections (tallied from medium to high) was associated with lower odds of any nicotine/tobacco, other tobacco, and poly-tobacco use (AOR = 0.8, p < .05) compared to states with no change in their negative policies. Anti-tobacco marketing exposure was associated with lower odds of any tobacco, cigarette, e-cigarette, and poly-tobacco use compared with those who had no anti-tobacco marketing exposure (AOR = 0.9, p < .05). Higher psychological distress (AOR range = 1.7-2.4, p < .001) and an increasing number of tobacco products used by family/friends (AOR range = 1.1-1.3, p < .001) were associated with increased odds of nicotine/tobacco use. CONCLUSIONS Multilevel prevention and intervention strategies are needed to reduce the risk of nicotine/tobacco use among gender-varying and gender-stable individuals.
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Affiliation(s)
- Luisa Kcomt
- School of Social Work, Wayne State University, Detroit, MI, USA
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Rebecca J Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Curtiss W Engstrom
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Phil T Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA
| | - Brady T West
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, North Campus Research Complex, Ann Arbor, MI, USA
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, North Campus Research Complex, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
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Zhao X, Cai X, Malterud A. Framing Effects in Youth E-Cigarette Use Prevention: Individual Text Messages Versus Simulated Text Exchanges. HEALTH EDUCATION & BEHAVIOR 2023; 50:683-692. [PMID: 36722218 DOI: 10.1177/10901981221148965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Electronic cigarettes are the most widely used tobacco product among youth in the United States. Although rapidly growing, research on effective message strategies for e-cigarette use prevention is still limited. This study examined the relative effectiveness of gain framing versus loss framing in youth-targeting prevention text messages delivered either as individual expository texts or simulated text exchanges between a youth patient and a pediatrician. A national sample of 1,084 youth susceptible to future e-cigarette use was randomized to condition in an online message testing experiment featuring a 2 (framing: gain vs. loss) × 2 (format: individual texts vs. simulated exchange) factorial design. Results revealed a consistent interaction between framing and messaging format in message liking, positive affect, attitude toward e-cigarette use, and future e-cigarette use intentions. The gain frame outperformed the loss frame in the simulated exchange conditions while the reverse trend was true for the individual text conditions. Furthermore, the main effect of messaging format was significant on multiple outcomes in favor of simulated text exchanges. The main effect of framing was only significant on negative affective response with the loss frame eliciting stronger responses. These findings suggest that the relative effectiveness of gain framing versus loss framing depends on how messages are presented in youth-targeting text messaging interventions. When messages are likely to be delivered in a discrete manner, the loss frame should be preferred. When greater interactivity and narrative development are possible, the gain frame should be favored. E-cigarette prevention efforts should leverage these insights to enhance message effectiveness.
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Boynton MH, Sanzo N, Brothers W, Kresovich A, Sutfin EL, Sheeran P, Noar SM. Perceived effectiveness of objective elements of vaping prevention messages among adolescents. Tob Control 2023; 32:e228-e235. [PMID: 35534230 PMCID: PMC9643679 DOI: 10.1136/tobaccocontrol-2021-057151] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/30/2022] [Indexed: 01/19/2023]
Abstract
INTRODUCTION In recent years, vaping prevention campaigns have proliferated in response to a surge of e-cigarette use among adolescents in the USA. To date, the research literature has provided minimal guidance as to what vaping prevention message elements have the greatest potential for discouraging vaping, are ineffective or have unintended negative effects. The purpose of the current study was to identify and test a large set of vaping prevention ads used by federal, state, local and non-governmental agencies, examining how objectively coded message elements of vaping prevention messages might affect youth. METHODS A convenience sample of adolescents (N=1501) completed an online survey with each participant rating seven randomly selected vaping prevention ads from a pool of 220 ads on perceived message effectiveness (PME) and vaping appeal. Ads were coded on 37 objective elements in three message categories: themes, imagery and other features. Analyses examined how objective elements predicted PME. RESULTS Addiction, chemicals, negative health symptoms and effects, and cigarette comparison themes were associated with higher PME, as were graphic images and warning symbols. Industry targeting, environmental impact, flavour themes, images of food and people's faces were associated with lower PME, as were hashtags, statistics and first-person language or the word 'teen'. Most elements were not associated with appeal, but ads with a flavour theme were associated with increased vaping appeal. CONCLUSION Promising vaping prevention messages focus on the adverse consequences of vaping, use negative imagery and avoid speaking for teens using their vernacular or perspective.
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Affiliation(s)
- Marcella H Boynton
- Division of General Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
- NC TraCS Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Nora Sanzo
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Whitney Brothers
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Alex Kresovich
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Paschal Sheeran
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Seth M Noar
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
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Ma H, Kieu TKT, Ribisl KM, Noar SM. Do Vaping Prevention Messages Impact Adolescents and Young Adults? A Meta-Analysis of Experimental Studies. HEALTH COMMUNICATION 2023; 38:1709-1722. [PMID: 36882378 PMCID: PMC10258164 DOI: 10.1080/10410236.2023.2185578] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Vaping prevention messages are widely used to communicate the health harms and addiction risks of vaping and discourage vaping among adolescents and young adults. We conducted a meta-analysis of experimental studies to examine the effects of these messages and to understand their theoretical mechanisms. Systematic, comprehensive searches generated 4,451 references, among which 12 studies (cumulative N = 6,622) met inclusion criteria for the meta-analysis. Across these studies, a total of 35 different vaping-related outcomes were measured, and 14 outcomes assessed in two or more independent samples were meta-analyzed. Results showed that compared to control, exposure to vaping prevention messages led to higher vaping risk perceptions, including harm perceptions (d = 0.30, p < .001), perceived likelihood of harm (d = 0.23, p < .001), perceived relative harm (d = 0.14, p = .036), addiction perceptions (d = 0.39, p < .001), perceived likelihood of addiction (d = 0.22, p < .001), and perceived relative addiction (d = 0.33, p = .015). Also, compared to control, exposure to vaping prevention messages led to more vaping knowledge (d = 0.37, p < .001), lower intentions to vape (d = -0.09, p = .022), and higher perceived message effectiveness (message perceptions; d = 0.57, p < .001; effects perceptions; d = 0.55, p < .001). Findings suggest vaping prevention messages have an impact, yet may operate through different theoretical mechanisms than cigarette pack warnings.
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Affiliation(s)
- Haijing Ma
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Talia Klm-Thanh Kieu
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Kurt M. Ribisl
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Seth M. Noar
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA
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Dudley MZ, Squires GK, Petroske TM, Dawson S, Brewer J. The Use of Narrative in Science and Health Communication: A Scoping Review. PATIENT EDUCATION AND COUNSELING 2023; 112:107752. [PMID: 37068426 DOI: 10.1016/j.pec.2023.107752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Many people deny science and reject health recommendations despite widely distributed facts and statistics. Didactic science and health communication is often dry, and relies on the false assumption that people make purely evidence-based decisions. Stories can be a powerful teaching tool by capturing attention and evoking emotion. OBJECTIVE We explore the impact and appeal of, and describe best practices for, using narrative (storytelling) versus didactic methods in science and health communication. PATIENT INVOLVEMENT No patients were involved in the review process. METHODS We searched PubMed and Web of Science for articles either: assessing effectiveness of narrative science/health communication; assessing acceptability of (or preference for) narrative science/health communication; giving advice on how best to use narrative; and/or providing science-based explanations for how/why narrative succeeds. RESULTS Narrative science/health communication is effective and appealing for audiences across a variety of topics and mediums, with supporting evidence across fields such as epidemiology, neuroscience, and psychology. Whether narrative or didactic messaging is most effective depends on the topic, audience, and objective, as well as message quality. However, combining narrative with didactic methods is likely to be more effective than using either strategy alone. DISCUSSION Narrative science/health communication merits wider implementation and further research. Narrative communication creates openness to information by delaying the formulation of counterarguments. PRACTICAL VALUE Science and health communicators should collaborate with cultural and storytelling experts, work directly with their target audiences throughout the message development and testing processes, and rely on popular story elements (e.g., first-person point of view, relatable protagonists) to improve the comprehension, engagement, and thoughtful consideration of their intended audience. FUNDING This work was funded by Thirty Meter Telescope, with which two authors (GKS and SD) were affiliated. Otherwise, the funding organization had no role in the study and/or submission.
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Affiliation(s)
- Matthew Z Dudley
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA.
| | - Gordon K Squires
- California Institute of Technology / IPAC, 1200 E California Blvd, 315 Keith Spalding, Pasadena, CA 91125, USA
| | | | - Sandra Dawson
- Thirty Meter Telescope International Observatory, Pasadena, CA, USA
| | - Janesse Brewer
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA
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Gosselin S, Thaivalappil A, Papadopoulos A, McWHIRTER JE. Public Health Messaging to Address Indoor Tanning: A Scoping Review. JOURNAL OF HEALTH COMMUNICATION 2023; 28:241-253. [PMID: 36992625 DOI: 10.1080/10810730.2023.2196519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Indoor tanning (IT) is an avoidable skin cancer risk. Although numerous communication interventions have been assessed for IT deterrence, less attention has been paid to the persuasive messages within these interventions. This scoping review summarizes the current peer-reviewed literature on persuasive messages for IT. Overall, 20 articles (21 studies) were included. Most were experimental or quasi-experimental and conducted in the US. Participants were mostly young women who had tanned indoors before. Few studies evaluated persuasive theme; in those that did, health and appearance themes were effective. Narrative and statistical evidence formats were also effective. The included studies also supported normative messages, loss-framed messages, and images. Improved reporting on message design and evaluation would be beneficial for future evidence synthesis. Our understanding of persuasive messages for IT has expanded in recent years, but more research is needed to optimize them.
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Affiliation(s)
- Sydney Gosselin
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Abhinand Thaivalappil
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Andrew Papadopoulos
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jennifer E McWHIRTER
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Cai X, Zhao X. Framing Youth Vaping Prevention Messages: The Role of Uncertainty Tolerance. HEALTH COMMUNICATION 2023; 38:670-680. [PMID: 34378472 DOI: 10.1080/10410236.2021.1966181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Vaping is the most prevalent form of tobacco use among youth in the United States. Motivated by the certainty effect in prospect theory, this study investigated the role of uncertainty tolerance as a potential moderator of the effects of gain- vs. loss-framed text messages for youth vaping prevention. Youth susceptible to future vaping (N = 536) were randomized to view a series of eight gain- or loss-framed text messages about the health consequences of vaping. Cognitive and affective responses to the messages as well as beliefs, attitude, and intentions about vaping were assessed post-exposure. Results showed an overall advantage of the loss frame on several outcomes. Additionally, an interaction between framing and uncertainty tolerance was observed for most outcomes such that the loss frame was more effective for those high in uncertainty tolerance, while the gain frame held a slight edge for those low in uncertainty tolerance. Findings from this study have implications for further engaging prospect theory in message framing research. They may also inform audience segmentation and targeted message design for youth vaping prevention efforts.
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Affiliation(s)
- Xiaomei Cai
- Department of Communication, George Mason University
| | - Xiaoquan Zhao
- Department of Communication, George Mason University
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14
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Record RA, Greiner LH, Wipfli H, Strickland J, Owens J, Pugel J, Matt GE. Evaluation of a Social Media Campaign Designed to Increase Awareness of Thirdhand Smoke among California Adults. HEALTH COMMUNICATION 2023; 38:437-446. [PMID: 34320896 DOI: 10.1080/10410236.2021.1954760] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Despite a growing body of research outlining the harms of thirdhand smoke (THS), the public remains generally unaware of risks and exposure routes. This project built on past tobacco prevention campaigns and the tenants of McGuire's input-output model to implement and evaluate a seven-month Facebook-disseminated campaign seeking to improve THS awareness among California adults (n = 1087). Multilinear regression showed that THS-related knowledge (χ2[6] = 19.31, p < .01), attitude (χ2[6] = 13.88, p < .05), and efficacy (χ2[6] = 13.81, p < .05) significantly increased by the campaign's end, with messages highlighting children's health (r = .110, p < .05), pets (r = .145, p < .01), and dust reservoirs (r = .144, p < .01) as the most persuasive. Path analysis modeling found campaign recall to be associated with changes in knowledge (β = .161, p < .01), which predicated attitude change (β = .614, p < .001) and, in turn, behavior change (β = .149, p < .05). Findings suggest social media campaigns should continue to educate diverse populations about new tobacco risks and that tobacco control advocates should consider integrating educational THS messages.
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Affiliation(s)
| | | | - Heather Wipfli
- Keck School of Medicine, University of Southern California
| | | | - James Owens
- School of Communication, San Diego State University
| | - Jessica Pugel
- Department of Psychology, San Diego State University
| | - Georg E Matt
- Department of Psychology, San Diego State University
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15
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Hair EC, Kreslake JM, Rath JM, Pitzer L, Bennett M, Vallone D. Early evidence of the associations between an anti-e-cigarette mass media campaign and e-cigarette knowledge and attitudes: results from a cross-sectional study of youth and young adults. Tob Control 2023; 32:179-187. [PMID: 34290134 DOI: 10.1136/tobaccocontrol-2020-056047] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 06/15/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Antismoking mass media campaigns have contributed to significant declines in combustible tobacco use among young people. This study evaluates a national anti-e-cigarette campaign to determine its association with knowledge, attitudes and beliefs in the context of increasing e-cigarette use in the USA. METHODS A national sample of respondents aged 15-24 years (n=8421) was drawn from a repeated cross-sectional online panel survey (220 participants/week) (October 2018 to December 2019). Self-reported exposure to the truth anti-e-cigarette campaign was measured according to level of ad awareness. Outcomes were subjective knowledge of campaign-targeted facts about e-cigarettes and attitudinal constructs about perceived e-cigarette harm, social unacceptability and anti-industry sentiments. Covariates included respondent demographics, current e-cigarette use and cigarette use, parental smoking, sensation seeking, mental health and growth in e-cigarette sales. RESULTS Ad awareness was associated with knowledge that e-cigarette users are more likely to start smoking (low OR: 1.28, 95% CI 1.14 to 1.44; high OR: 1.88, 95% CI 1.66 to 2.13) and of the nicotine content of JUUL compared with cigarettes (low OR: 1.63, 95% CI 1.45 to 1.82; high OR: 2.50, 95% CI 2.21 to 2.84). High ad awareness was associated with knowledge that the long-term health effects of JUUL use are unknown (OR: 1.88, 95% CI 1.57 to 2.28). High ad awareness was associated with significantly higher perceived product harm (OR: 1.35, 95% CI 1.18 to 1.54), social unacceptability (OR: 1.32, 95% CI 1.15 to 1.53) and anti-industry attitudes (OR: 1.40, 95% CI 1.21 to 1.62), compared with respondents with no awareness. CONCLUSIONS Young people with awareness of anti-e-cigarette ads demonstrate higher levels of campaign-targeted knowledge, attitudes and beliefs. Future campaign evaluation priorities include measuring the campaign effects on e-cigarette use behaviours.
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Affiliation(s)
- Elizabeth C Hair
- Truth Initiative Schroeder Institute, Washington, DC, USA .,Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,School of Global Public Health, New York University, New York, NY, USA
| | - Jennifer M Kreslake
- Truth Initiative Schroeder Institute, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jessica Miller Rath
- Truth Initiative Schroeder Institute, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lindsay Pitzer
- Truth Initiative Schroeder Institute, Washington, DC, USA
| | | | - Donna Vallone
- Truth Initiative Schroeder Institute, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,School of Global Public Health, New York University, New York, NY, USA
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16
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Kowitt SD, Mendel Sheldon J, Vereen RN, Kurtzman RT, Gottfredson NC, Hall MG, Brewer NT, Noar SM. The Impact of The Real Cost Vaping and Smoking Ads across Tobacco Products. Nicotine Tob Res 2023; 25:430-437. [PMID: 36006858 PMCID: PMC9910139 DOI: 10.1093/ntr/ntac206] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 07/07/2022] [Accepted: 08/24/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Little research has examined the spillover effects of tobacco communication campaigns, such as how anti-smoking ads affect vaping. AIMS AND METHODS Participants were a national sample of 623 U.S. adolescents (ages 13-17 years) from a probability-based panel. In a between-subjects experiment, we randomly assigned adolescents to view one of four videos online: (1) a smoking prevention video ad from the Food and Drug Administration's (FDA) The Real Cost campaign, (2) a neutral control video about smoking, (3) a vaping prevention video ad from The Real Cost campaign, or (4) a neutral control video about vaping. We present effect sizes as Cohen's d, standardized mean differences, with 95% confidence intervals (CIs). RESULTS Exposure to The Real Cost vaping prevention ads led to more negative attitudes toward vaping compared with control (d = 0.30, 95% CI: 0.07, 0.53), while exposure to The Real Cost smoking prevention ads did not affect smoking-related outcomes compared with control (p-values > .05). Turning to spillover effects, exposure to The Real Cost smoking prevention ads led to less susceptibility to vaping (d = -0.34, 95% CI: -0.56, -0.12), more negative attitudes toward vaping (d = 0.43, 95% CI: 0.20, 0.65) and higher perceived likelihood of harm from vaping (d = 0.26, 95% CI: 0.04, 0.48), compared with control. Exposure to The Real Cost vaping prevention ads did not affect smoking-related outcomes compared with control (p-values > .05). CONCLUSIONS This experiment found evidence of beneficial spillover effects of smoking prevention ads on vaping outcomes and found no detrimental effects of vaping prevention ads on smoking outcomes. IMPLICATIONS Little research has examined the spillover effects of tobacco communication campaigns, such as how anti-smoking ads affect vaping. Using a national sample of 623 U.S. adolescents, we found beneficial evidence of spillover effects of smoking prevention ads on vaping outcomes, which is promising since it suggests that smoking prevention campaigns may have the additional benefit of reducing both smoking and vaping among adolescents. Additionally, we found that vaping prevention campaigns did not elicit unintended consequences on smoking-related outcomes, an important finding given concerns that vaping prevention campaigns could drive youth to increase or switch to using combustible cigarettes instead of vaping.
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Affiliation(s)
- Sarah D Kowitt
- Department of Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Jennifer Mendel Sheldon
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Rhyan N Vereen
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA
| | - Rachel T Kurtzman
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Nisha C Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Marissa G Hall
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Noel T Brewer
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Seth M Noar
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
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Stalgaitis CA, Jordan JW, Isaac K. Creating More Effective Vape Education Campaigns: Qualitative Feedback from Teens in Nine U.S. States. Subst Use Misuse 2023; 58:406-418. [PMID: 36621518 DOI: 10.1080/10826084.2023.2165411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Successful media campaigns to reduce teen cigarette smoking indicate a similar approach may work for vaping, though message testing research is necessary to identify effective topics and approaches. Leveraging data from message testing studies across nine U.S. states, we identify promising topics and approaches and explore how the COVID-19 pandemic affected teens' reactions to vape education commercials. Methods: Teens ages 13-18 (N = 337) who vaped or were susceptible nonusers participated in focus groups and interviews (2018-2021) to review 35 creative concepts and commercials for Behind the Haze (BTH), a vaping education campaign. After viewing each video, participants assessed its perceived effectiveness (PE) and discussed their reactions. We conducted a reflexive thematic analysis of transcripts to identify crosscutting themes and compared PE scores for each video. Results: Key features of effective commercials included detailed facts accompanied by explanatory visuals, metaphors, and empathy. Promising topics included chemicals, physical consequences, and mental health, while addiction and industry deception messages were less impactful. The pandemic drew attention to mental health and immunity messages. Impact of one's vaping on friends emerged as a promising topic. Conclusions: While some tactics from successful cigarette prevention campaigns apply to vaping, others like anti-industry messaging do not. Fact-focused messaging on chemicals, physical consequences, and mental health accompanied by impactful graphics and attention-grabbing twists should be the focus of vape education campaigns. Frequent message testing research such as that conducted to inform BTH is necessary to identify promising and sometimes unexpected messaging approaches for timely and relevant teen vaping education materials.
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18
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Adams ET, Nabi RL, Noar SM, Evans R, Widman L. How Emotional Shifts Effect Youth Perceptions of Opioid Risk and Efficacy: Testing a Know the Truth Campaign Narrative. HEALTH COMMUNICATION 2022; 37:1820-1831. [PMID: 33977833 PMCID: PMC8887820 DOI: 10.1080/10410236.2021.1921349] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Integrating the extended parallel process model (EPPM) and the emotional flow hypothesis, we tested the persuasive effect of emotional shifts during exposure to a Know the Truth anti-opioid campaign narrative in a sample of middle-school students (n = 480). Testing two emotional flow sequences (threat to efficacy and efficacy to threat) of the Know the Truth narrative against a static (threat-only) emotional condition, we found that youth exposed to any emotional flow narrative reported higher levels of hope and lower levels of fear than those exposed to a threat-only narrative. We also found that a threat to efficacy narrative elicited higher levels of self-efficacy than an efficacy to threat emotional flow condition, suggesting that the emotional sequence influences self-efficacy, a well-established predictor of health behavior change. We conclude that the traditional threat to efficacy emotional flow may be superior to its inverse (efficacy to threat) when communicating with young people about opioid addiction. Implications for message design are discussed.
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Affiliation(s)
| | - Robin L. Nabi
- Department of Communication, University of California at Santa Barbara
| | - Seth M. Noar
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill
| | - Reina Evans
- Department of Psychology, North Carolina State University
| | - Laura Widman
- Department of Psychology, North Carolina State University
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19
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Park-Lee E, Ren C, Cooper M, Cornelius M, Jamal A, Cullen KA. Tobacco Product Use Among Middle and High School Students - United States, 2022. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2022; 71:1429-1435. [PMID: 36355596 PMCID: PMC9707354 DOI: 10.15585/mmwr.mm7145a1] [Citation(s) in RCA: 82] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
Tobacco use* is the leading cause of preventable disease, disability, and death among adults in the United States (1). Youth use of tobacco products in any form is unsafe, and nearly all tobacco use begins during youth and young adulthood (2). The Food and Drug Administration (FDA) and CDC analyzed data from the 2022 National Youth Tobacco Survey (NYTS) to estimate current (past 30-day) use of eight tobacco products among U.S. middle (grades 6-8) and high school (grades 9-12) students. In 2022, approximately 11.3% of all students (representing 3.08 million persons) reported currently using any tobacco product, including 16.5% of high school and 4.5% of middle school students (2.51 million and 530,000 persons, respectively). Electronic cigarettes (e-cigarettes) were the most commonly used tobacco product among high school (14.1%; 2.14 million) and middle school (3.3%; 380,000) students. Approximately 3.7% of all students (representing 1 million persons) reported currently smoking any combustible tobacco product. Current use of any tobacco product was higher among certain population groups, including 13.5% of non-Hispanic American Indian or Alaska Native (AI/AN)† students; 16.0% of students identifying as lesbian, gay, or bisexual (LGB); 16.6% of students identifying as transgender; 18.3% of students reporting severe psychological distress; 12.5% of students with low family affluence; and 27.2% of students with low academic achievement. Implementation of comprehensive evidence-based tobacco control strategies, combined with FDA regulation, is important for preventing and reducing youth tobacco product use (1,2).
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20
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Kowitt SD, Cox MJ, Jarman KL, Kong AY, Sivashanmugam A, Cornacchione Ross J, Goldstein AO, Ranney LM. Communicating the risks of tobacco and alcohol co-use. Addict Behav 2022; 134:107383. [PMID: 35700653 PMCID: PMC9708929 DOI: 10.1016/j.addbeh.2022.107383] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/18/2022] [Accepted: 05/29/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND While tobacco and alcohol co-use is highly prevalent across the United States, little experimental research has examined ways to counter such dual use. We developed and tested messages about the risks of co-using tobacco and alcohol among adults who used a combustible tobacco product and drank alcohol within the 30 days. METHODS In an online experiment, 1,300 participants were randomly assigned to read different messages about tobacco and alcohol co-use (e.g., Alcohol and tobacco cause throat cancer). Three between-subjects experiments manipulated the presence of: 1) a marker word (e.g., Warning), 2) text describing the symptoms of health effects and a quitting self-efficacy cue, and 3) an image depicting the health effect. Participants rated each message using a validated Perceived Message Effectiveness (PME) scale. We used independent samples t-tests to examine differences between experimental conditions. Results include effect sizes (Cohen's d) to compare standardized mean differences. RESULTS Our sample was 64% male, 70% white, 23% Black, and 17% Hispanic/Latino with a mean age of 42.4 (SD = 16.4) years. Messages that described the symptoms of the health effect (d = 0.17, p = 0.002) and included an image (d = 0.11, p = 0.04) were rated significantly higher in PME compared with messages that did not describe symptoms and were text-only. We found no significant effects of a marker word or self-efficacy cue on PME. CONCLUSIONS Messages that describe the symptoms of health effects and include text and images may be particularly effective for communicating the risks of tobacco and alcohol co-use and decreasing adverse health effects from co-use.
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Affiliation(s)
- Sarah D Kowitt
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States.
| | - Melissa J Cox
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Kristen L Jarman
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Amanda Y Kong
- Department of Family and Preventive Medicine, College of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, United States; TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States
| | - Arvind Sivashanmugam
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Jennifer Cornacchione Ross
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston Salem, NC 27157, United States
| | - Adam O Goldstein
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Leah M Ranney
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
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21
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Tulsiani S, Ichimiya M, Gerard R, Mills S, Bingenheimer JB, Hair EC, Vallone D, Evans WD. Assessing the Feasibility of Studying Awareness of a Digital Health Campaign on Facebook: Pilot Study Comparing Young Adult Subsamples. JMIR Form Res 2022; 6:e37856. [PMID: 36036974 PMCID: PMC9468914 DOI: 10.2196/37856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Mass media campaigns for preventive health messaging have been shown to be effective through years of research. However, few studies have assessed the effectiveness of campaigns on digital media, which is currently how youths and young adults are primarily consuming media. In particular, a platform that can accurately assess exposure to digital messaging in a real-life setting has yet to be developed.
Objective
This study examines the feasibility of a unique survey platform, Virtual Lab, to conduct a study on exposure to a media campaign within Facebook using a chatbot-style survey administration technique.
Methods
Virtual Lab is a survey platform that was used to recruit and survey participants within Facebook and Facebook Messenger, respectively. We created a Facebook business account with 2 Facebook pages: one for recruitment and disseminating the survey and the other one for serving the target advertisements. Pre- and postexposure surveys were administered via Facebook Messenger using a chatbot-style questionnaire 1 week apart. During this time, the target advertisements were shown to participants who completed the pre-exposure survey. The total time from recruitment to completion of the postexposure survey was 13 days, and incentive costs were US $10 per participant. Survey data were compared between those who completed both pre- and postexposure surveys and those who only completed the pre-exposure survey; that is, those who were lost to follow-up. The demographics of the complete cases were also compared to the US census data.
Results
A total of 375 Facebook users aged between 18 and 24 years met eligibility requirements and consented to the study, which consisted of complete cases (n=234) and participants lost to follow-up (n=141). A few differences between complete cases and participants lost to follow-up were observed. Regarding gender, complete cases comprised 40.2% males and 59.4% females, and among participants lost to follow-up, 44.0% were male and 50.4% were female (P=.003). Differences were also observed for e-cigarette use status, where a greater number of current users and fewer past and never users were lost to follow-up than complete cases (P=.01).
Conclusions
The use of Virtual Lab yielded a diverse sample quickly and cost-effectively. Demographic characteristics of participants who completed the study and those who were lost to follow-up were similar, indicating that no biases were caused by the platform during recruitment or testing. This study suggests the feasibility of the Virtual Lab survey platform for studies of media campaign exposure within Facebook. This platform can advance health campaign research by providing more accurate data to inform digital messaging.
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Affiliation(s)
- Shreya Tulsiani
- Schroeder Institute, Truth Initiative, Washington, DC, United States
| | - Megumi Ichimiya
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Raquel Gerard
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Sarah Mills
- Schroeder Institute, Truth Initiative, Washington, DC, United States
| | - Jeffrey B Bingenheimer
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Elizabeth C Hair
- Schroeder Institute, Truth Initiative, Washington, DC, United States
- Global Institute of Public Health, New York University, New York City, NY, United States
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Donna Vallone
- Schroeder Institute, Truth Initiative, Washington, DC, United States
- Global Institute of Public Health, New York University, New York City, NY, United States
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - W Douglas Evans
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
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22
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Exploring Definitions of "Addiction" in Adolescents and Young Adults and Correlation with Substance Use Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138075. [PMID: 35805733 PMCID: PMC9266281 DOI: 10.3390/ijerph19138075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022]
Abstract
(1) Background: Young people engage in addictive behaviors, but little is known about how they understand addiction. The present study examined how young people describe addiction in their own words and correlations between their definitions and substance use behaviors. (2) Methods: Young adults (n = 1146) in the PACE Vermont Study responded to an open-ended item “what does “addiction” mean?” in 2019. Responses were coded using three inductive categories and fifteen subcategories. Quantitative analyses examined correlations between addiction theme definitions, demographics, and substance use behaviors. (3) Participants frequently defined addiction by physiological (68%) and psychological changes (65%) and less by behavioral changes (6%), or all three (3%); young adults had higher odds of defining addiction as physiological or behavioral changes than adolescents. Participants who described addiction as “psychological changes” had lower odds of ever electronic vapor product use (OR 0.75, 95% CI 0.57−1.00) than those using another definition, controlling for age and sex. (4) Perceptions of addiction in our sample aligned with existing validated measures of addiction. Findings discriminated between familiar features of addiction and features that may be overlooked by young adults. Substance users may employ definitions that exclude the symptoms they are most likely to experience.
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Pourkarim M, Nayebzadeh S, Alavian SM, Hataminasab SH. Digital Marketing: A Unique Multidisciplinary Approach towards the Elimination of Viral Hepatitis. Pathogens 2022; 11:pathogens11060626. [PMID: 35745480 PMCID: PMC9228079 DOI: 10.3390/pathogens11060626] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/17/2022] [Accepted: 05/27/2022] [Indexed: 12/16/2022] Open
Abstract
New technologies are supported by the global implementation of the internet. These improvements have deeply affected various disciplines of sciences and consequently changed services such as daily business, particularly health sectors. Innovative digital marketing strategies utilize the channels of social media and retrieved user data to analyze and improve relevant services. These multidisciplinary innovations can assist specialists, physicians and researchers in diagnostic, prophylaxis and treatment issues in the health sector. Accordingly, compared to recent decades, health decision makers are more accurate and trustful in defining new strategies. Interestingly, using social media and mobile health apps in current pandemics of SARS-CoV-2 could be an important instance of the key role of these platforms at the local and global level of health policies. These digital technologies provide platforms to connect public health sectors and health politicians for communicating and spreading relevant information. Adding influencers and campaigns to this toolbox strengthens the implementation of public health programs. In 2016, the WHO adopted a global program to eliminate viral hepatitis by 2030. Recent constructive measures that have been used in the battle against COVID-19 could be adopted for the elimination of viral hepatitis program. The presented evidence in our narrative review demonstrates that the application of digital marketing tools to create campaigns on social media, armed with professional influencers, can efficiently consolidate this program. The application of different strategies in using these popular tools will raise the public awareness about viral hepatitis. Subsequently, the availability of an effective vaccine for HBV and antiviral medication for HCV can motivate the audience to take steps towards prophylaxis and screening methods against these infectious illnesses. The encouragement of health policy makers to apply digital communication technologies and comprehensive roadmaps to implement this global program will certainly decrease the burden of viral hepatitis worldwide.
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Affiliation(s)
- Mohammadreza Pourkarim
- Department of Management, Yazd Branch, Islamic Azad University, Yazd P.O. Box 89195/155, Iran; (M.P.); (S.H.H.)
| | - Shahnaz Nayebzadeh
- Department of Management, Yazd Branch, Islamic Azad University, Yazd P.O. Box 89195/155, Iran; (M.P.); (S.H.H.)
- Correspondence: ; Tel.: +98-351-8211391; Fax: +98-351-8214810
| | | | - Seyyed Hassan Hataminasab
- Department of Management, Yazd Branch, Islamic Azad University, Yazd P.O. Box 89195/155, Iran; (M.P.); (S.H.H.)
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24
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Gentzke AS, Wang TW, Cornelius M, Park-Lee E, Ren C, Sawdey MD, Cullen KA, Loretan C, Jamal A, Homa DM. Tobacco Product Use and Associated Factors Among Middle and High School Students - National Youth Tobacco Survey, United States, 2021. MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES (WASHINGTON, D.C. : 2002) 2022; 71:1-29. [PMID: 35271557 PMCID: PMC8923300 DOI: 10.15585/mmwr.ss7105a1] [Citation(s) in RCA: 202] [Impact Index Per Article: 101.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PROBLEM/CONDITION Commercial tobacco use is the leading cause of preventable disease, disability, and death in the United States. Most tobacco product use begins during adolescence. In recent years, tobacco products have evolved to include various combusted, smokeless, and electronic products. PERIOD COVERED 2021. DESCRIPTION OF SYSTEM The National Youth Tobacco Survey (NYTS) is an annual, cross-sectional, school-based, self-administered survey of U.S. middle school (grades 6-8) and high school (grades 9-12) students. A three-stage cluster sampling procedure is used to generate a nationally representative sample of U.S. students attending public and private schools. NYTS is the only nationally representative survey of U.S. middle and high school students that focuses exclusively on tobacco use patterns and associated factors. NYTS provides data to support the design, implementation, and evaluation of comprehensive youth tobacco use prevention and control programs and to guide tobacco regulatory activities. Since 2019, NYTS has been administered electronically via tablet computers. Because of emergency COVID-19 protocols that were in place across the United States during the 2021 NYTS fielding window (January 18-May 21, 2021), the 2021 survey was administered using a web URL to allow participation by eligible students learning under varying instructional models (in-person, distance/virtual, and hybrid). In total, 50.8% of student respondents reported completing the survey in a school building or classroom and 49.2% at home or some other place. CDC and the Food and Drug Administration (FDA) analyzed data from the 2021 NYTS to assess tobacco product use patterns and associated factors among U.S. middle and high school students. Overall, 20,413 students (out of 25,149 sampled students; student response rate: 81.2%) completed the questionnaire from 279 schools (out of 508 sampled schools; school response rate: 54.9%). The overall response rate, defined as the product of the student and school response rates, was 44.6%. The sample was weighted to represent approximately 11.97 million middle school students and 15.44 million high school students. Students with missing information about grade level were excluded from the school-level analyses (n = 135). RESULTS In 2021, an estimated 34.0% of high school students (5.22 million) and 11.3% of middle school students (1.34 million) reported ever using a tobacco product (i.e., electronic cigarettes [e-cigarettes], cigarettes, cigars, smokeless tobacco, hookahs, pipe tobacco, heated tobacco products, nicotine pouches, and bidis [small brown cigarettes wrapped in a leaf]). Current (past 30-day) use of a tobacco product was 13.4% for high school students (2.06 million) and 4.0% for middle school students (470,000). E-cigarettes were the most commonly currently used tobacco product, cited by 11.3% of high school students (1.72 million) and 2.8% of middle school students (320,000), followed by cigarettes, cigars, smokeless tobacco, hookahs, nicotine pouches, heated tobacco products, and pipe tobacco. Current use of any tobacco product was reported by 14.2% of students identifying as lesbian, gay, or bisexual (LGB) (versus 7.9% of heterosexual); 18.9% of students identifying as transgender (versus 8.2% of not transgender); and 14.2% of students reporting severe psychological distress (versus 5.5% with no distress). Among students who currently used each respective tobacco product, frequent use (on ≥20 days of the past 30 days) ranged from 17.2% for nicotine pouches to 39.4% for e-cigarettes. Among current users of any tobacco product, 79.1% reported using a flavored tobacco product; by product, e-cigarettes were the most commonly used flavored tobacco product. Among current users of any tobacco product, the most commonly reported source of access was from a friend (32.8%). Among students who currently used e-cigarettes, 53.7% used a disposable device, 28.7% used a prefilled/refillable pod or cartridge device, 9.0% used a tank or mod system (a system that can be customized by the user), and 8.6% did not know the device type. Among students who had ever used e-cigarettes, the most common reason for first trying them was "a friend used them" (57.8%); among current e-cigarette users, the most commonly cited reason for current use was "I am feeling anxious, stressed, or depressed" (43.4%). Among all middle and high school students, 75.2% reported past-year recognition of any antitobacco public education campaign ads. Exposure to marketing or advertising for any tobacco product was reported by 75.7% of students who had contact with an assessed potential source of tobacco product advertisements or promotions (going to a convenience store, supermarket, or gas station; using the Internet; watching television or streaming services or going to the movies; or reading newspapers or magazines). Among students who reported using social media, 73.5% had ever seen e-cigarette-related content. Among all students, perceiving "no" or "little" harm from intermittent tobacco product use was highest for e-cigarettes (16.6%) and lowest for cigarettes (9.6%). Among students who currently used any tobacco product, 27.2% had experienced cravings during the past 30 days; 19.5% reported wanting to use a tobacco product within 30 minutes of waking. Moreover, 65.3% of students who currently used tobacco products were seriously thinking about quitting the use of all products, and 60.2% had stopped using all products for ≥1 day because they were trying to quit during the past 12 months. INTERPRETATION In 2021, approximately one in 10 U.S. middle and high school students (9.3%) had used a tobacco product during the preceding 30 days. By school level, this represented more than one in eight high school students (13.4%) and approximately one in 25 middle school students (4.0%). E-cigarettes were the most commonly used tobacco product in 2021. Tobacco product use was higher among certain subpopulations, such as those identifying as LGB or transgender, or those reporting psychological distress. Importantly, approximately two thirds of students who currently used tobacco products were seriously thinking about quitting. However, factors that might continue to promote tobacco product use among U.S. youths, such as the availability of flavors, access to tobacco products, exposure to tobacco product marketing, and misperceptions about harm from tobacco product use, remained prevalent in 2021. PUBLIC HEALTH ACTION The continued monitoring of all forms of youth tobacco product use and associated factors through surveillance efforts including NYTS is important to the development of public health policy and action at national, state, and local levels. The 2021 NYTS was successfully administered during the COVID-19 pandemic using a web URL to allow participation by eligible students learning under varying instructional models. As a result of these modifications to the fielding procedures, any comparison of results between 2021 NYTS findings with previous years, including the direct attribution of any potential changes in tobacco product use, is not possible. Parents, educators, youth advocates, and health care providers can help protect youths from the harms of tobacco products, including e-cigarettes. In addition, the comprehensive and sustained implementation of evidence-based tobacco control strategies, combined with FDA's regulation of tobacco products, is important for reducing all forms of tobacco product use among U.S. youths.
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Durkin SJ, Brennan E, Wakefield MA. Optimising tobacco control campaigns within a changing media landscape and among priority populations. Tob Control 2022; 31:284-290. [PMID: 35241601 DOI: 10.1136/tobaccocontrol-2021-056558] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/17/2021] [Indexed: 11/04/2022]
Abstract
Reviews published over the past decade confirm tobacco control campaigns can be effective for influencing adult and youth tobacco use behaviours, with strengthening evidence for high cost-effectiveness. Evidence is also accumulating for positive campaign effects on interpersonal discussions, social norms and policy support that can help motivate and sustain quitting and reduce uptake. Research needs over the next decade centre on the rapidly changing media environment and the equity of campaign effects among high smoking prevalence communities. The field needs specific evidence on: how to measure total campaign reach and frequency across the diverse range of media platforms and channels; the optimum mix of traditional, digital and social media to achieve behaviour change, especially among high smoking prevalence communities; the relative reach and impact of the wide variety of integrated, digital and social media message delivery methods; the relative effectiveness of messages that aim to build capacity to quit and optimum methods for combining motivational and capacity-building messages, especially for high prevalence groups who face additional barriers to staying quit; the ongoing effectiveness of traditional versus new versions of messages highlighting tobacco industry practices; the influence of e-cigarette use on tobacco control campaign effects; and the effectiveness of different types of campaigns aiming to prevent e-cigarette uptake and motivate e-cigarette cessation. Research is also needed to investigate the potential for campaigns to influence the public's understanding and support for endgame tobacco control policies and for campaign elements that may influence the social and environmental contexts surrounding smokers that support and maintain behaviour change.
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Affiliation(s)
- Sarah J Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Emily Brennan
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Melanie A Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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MacFarlane D, Hurlstone MJ, Ecker UKH, Ferraro PJ, Linden S, Wan AKY, Veríssimo D, Burgess G, Chen F, Hall W, Hollands GJ, Sutherland WJ. Reducing demand for overexploited wildlife products: Lessons from systematic reviews from outside conservation science. CONSERVATION SCIENCE AND PRACTICE 2022. [DOI: 10.1111/csp2.627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Douglas MacFarlane
- Conservation Science Group, Department of Zoology University of Cambridge Cambridge UK
- School of Psychological Science University of Western Australia Crawley Western Australia Australia
| | - Mark J. Hurlstone
- School of Psychological Science University of Western Australia Crawley Western Australia Australia
- Department of Psychology Lancaster University Lancaster UK
| | - Ullrich K. H. Ecker
- School of Psychological Science University of Western Australia Crawley Western Australia Australia
| | - Paul J. Ferraro
- Carey Business School and the Department of Environmental Health and Engineering, A Joint Department of the Bloomberg School of Public Health and the Whiting School of Engineering Johns Hopkins University Baltimore Maryland USA
| | - Sander Linden
- Department of Psychology, Social Decision‐Making Laboratory University of Cambridge Cambridge UK
| | - Anita K. Y. Wan
- Socio‐Ecological and Conservation Science Laboratory, School of Life Sciences, Sun Yat‐Sen University Guangzhou Guangdong China
| | - Diogo Veríssimo
- Oxford Martin Program on the Illegal Wildlife Trade, Oxford University Oxford UK
- Department of Zoology University of Oxford Oxford UK
| | - Gayle Burgess
- TRAFFIC, The Wildlife Trade Monitoring Network Cambridge UK
| | - Frederick Chen
- Department of Economics Wake Forest University Winston‐Salem North Carolina USA
| | - Wayne Hall
- National Centre for Youth Substance Use Research, University of Queensland Brisbane Queensland Australia
| | - Gareth J. Hollands
- Behaviour and Health Research Unit, University of Cambridge Cambridge UK
| | - William J. Sutherland
- Conservation Science Group, Department of Zoology University of Cambridge Cambridge UK
- BioRISC, St. Catharine's College Cambridge UK
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Borah P, Xiao X, Lai Lee DK. Narrative messages, information seeking and COVID-19 vaccine intention: The moderating role of perceived behavioral control. Am J Health Promot 2022; 36:923-933. [PMID: 35081757 PMCID: PMC8960749 DOI: 10.1177/08901171221075019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Purpose The main purposes of the current study are to examine 1) the influence of narrative vs statistics messages on COVID-19 related information seeking and COVID-19 vaccine intention and 2) the moderating role of perceived behavioral control (PBC). Design Data for a between-subject randomized experiment were collected online. The manipulation messages were presented as screenshots from the CDC’s Facebook page. Setting The participants were recruited from Amazon MTurk. Subjects A total of 300 subjects participated in the study, who were 18 years and above (M = 38.40). Measures Intention to seek information, COVID-19 vaccine intention, and PBC. Analysis To test the hypotheses, we utilized Hayes’s (2014) PROCESS for SPSS (Model 1). For intention to seek information, the main effect of the message manipulation (narrative vs statistics) [b = −2.10, t (300) = −4.14, P < .001] and the interaction [b = .41, t (300) = 3.88, P < .001] were significant. For vaccine intention, the main effects of message manipulation [b = 1.64, t (300) = −2.61, P < .005] and the interaction [b = .34, t (300) = 2.64, P < .005] were significant. Results Our research found that narrative messages were more persuasive for both information seeking and vaccine intention. But this was true only in the case of individuals whose PBC was low. Conclusions Our findings have critical implications for vaccine promotion research.
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Affiliation(s)
| | - Xizhu Xiao
- School of Journalism and Communication12593Qingdao University
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Vallone DM, Perks SN, Pitzer L, Liu M, Kreslake JM, Rath JM, Hair EC. Evidence of the impact of a national anti-tobacco prevention campaign across demographic subgroups. HEALTH EDUCATION RESEARCH 2022; 36:412-421. [PMID: 34219169 DOI: 10.1093/her/cyab025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 05/19/2021] [Accepted: 06/04/2021] [Indexed: 06/13/2023]
Abstract
Mass media campaigns are an effective population-level intervention for preventing tobacco use. However, little evidence exists for whether these campaigns similarly influence demographic subgroups. This study examined the effects of the truth® campaign to reduce tobacco use among demographic subgroups. We used data from a national, continuous, cross-sectional tracking survey of 15-24-year-olds (n = 32 331). We used a measure of weekly aggregated campaign exposure to assess whether cigarette smoking intentions and current cigarette use varied by race/ethnicity, financial situation and population density subgroups, controlling for factors known to be associated with tobacco use. Examining estimates across subgroup categories in light of the overall model estimates revealed that the effects of week-level campaign exposure on cigarette smoking intentions and current cigarette use were similar across subgroups. Wald tests of equality across estimates in each subgroup suggested that the estimates did not differ from one another in any given instance. The truth campaign does not differ significantly in its capacity to prompt declines in tobacco use across a broad spectrum of US youth and young adults. Mass media tobacco prevention campaigns can be an effective and critical component of a comprehensive tobacco control program, particularly with respect to reducing tobacco-related disparities among demographic subgroups.
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Rath JM, Romberg AR, Perks SN, Edwards D, Vallone DM, Hair EC. Identifying message themes to prevent e-cigarette use among youth and young adults. Prev Med 2021; 150:106683. [PMID: 34119596 DOI: 10.1016/j.ypmed.2021.106683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022]
Abstract
In 2020, almost 20% of high school students reported current e-cigarette use. Mass media tobacco prevention campaigns are effective for preventing tobacco use among youth and young adults but selecting messages that will have maximum impact on the target audience is a significant challenge for campaign developers. This study describes the method for identification of potential messaging targets for a national anti-vape mass media campaign using criteria proposed by Hornik and Woolf in their health communication framework. A national sample of 15- to 24-year-olds (N = 1564) was recruited via an online panel in May 2020. Participants endorsed a series of vape-related attitudinal items. Items were considered potential message targets if they distinguished between the four vape use groups (current users, ever users, susceptible never-users, and non-susceptible never-users) and if less than 70% of respondents endorsed the anti-vape item response. The resulting items targeted five potential message themes, each forming a scale measured with three to four individual items. Message themes included social acceptability of vaping, anti-vape industry sentiment, independence from vaping, non-vaping identity, and perceived risk of harm. Findings were used to inform the development of truth® campaign messaging focused on reducing the prevalence of e-cigarette use among youth and young adults.
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Affiliation(s)
- Jessica M Rath
- Schroeder Institute at Truth Initiative, 900 G Street, NW, Fourth Floor, Washington, DC 20001, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA; Department of Behavioral and Community Health, University of Maryland School of Public Health, 4200 Valley Drive, Suite 2242, College Park, MD 20742, USA.
| | - Alexa R Romberg
- Schroeder Institute at Truth Initiative, 900 G Street, NW, Fourth Floor, Washington, DC 20001, USA; School of Global Public Health, New York University, 665 Broadway, Eleventh Floor, New York, NY 10012, USA
| | - Siobhan N Perks
- Schroeder Institute at Truth Initiative, 900 G Street, NW, Fourth Floor, Washington, DC 20001, USA.
| | - Domonique Edwards
- Schroeder Institute at Truth Initiative, 900 G Street, NW, Fourth Floor, Washington, DC 20001, USA
| | - Donna M Vallone
- Schroeder Institute at Truth Initiative, 900 G Street, NW, Fourth Floor, Washington, DC 20001, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA; School of Global Public Health, New York University, 665 Broadway, Eleventh Floor, New York, NY 10012, USA.
| | - Elizabeth C Hair
- Schroeder Institute at Truth Initiative, 900 G Street, NW, Fourth Floor, Washington, DC 20001, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA; School of Global Public Health, New York University, 665 Broadway, Eleventh Floor, New York, NY 10012, USA.
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Posner H, Romm KF, Henriksen L, Bernat D, Berg CJ. Reactions to sales restrictions on flavored vape products or all vape products among young adults in the US. Nicotine Tob Res 2021; 24:333-341. [PMID: 34331447 DOI: 10.1093/ntr/ntab154] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 07/30/2021] [Indexed: 11/14/2022]
Abstract
SIGNIFICANCE Despite increases in e-cigarette sales restrictions, support for sales restrictions and perceived impact on young adult use are unclear. METHODS We analyzed Feb-May 2020 data from a longitudinal study of 2,159 young adults (ages 18-34; Mage=24.75±4.71; n=550 past 30-day e-cigarette users) in 6 metropolitan areas (Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, Seattle). We examined support for e-cigarette sales restrictions and - among e-cigarette users - perceived impact of flavored vape product and all vape product sales restrictions on e-cigarette and cigarette use (and potential correlates; i.e., e-cigarette/tobacco use, use-related symptoms/health concerns). RESULTS 24.2% of e-cigarette users (and 57.6% of non-users) supported (strongly/somewhat) sales restrictions on flavored vape products; 15.1% of e-cigarette users (45.1% of non-users) supported complete vape product sales restrictions. If restricted to tobacco flavors, 39.1% of e-cigarette users reported being likely (very/somewhat) to continue using e-cigarettes (30.5% not at all likely); 33.2% were likely to switch to cigarettes (45.5% not at all). Considering complete vape product sales restrictions, equal numbers (~39%) were likely vs. not at all likely to switch to cigarettes. Greater policy support correlated with being e-cigarette non-users (aR 2=.210); among users, correlates included fewer days of use and greater symptoms and health concerns (aR 2=.393). If such restrictions were implemented, those less likely to report continuing to vape or switching to cigarettes used e-cigarettes on fewer days, were never-smokers, and indicated greater health concern (aR 2=.361). CONCLUSIONS While lower-risk users may be more positively impacted by such policies, other young adult user subgroups may not experience benefit. IMPLICATIONS Young adult e-cigarette users indicate low support for e-cigarette sales restrictions (both for flavored products and complete restrictions). Moreover, if vape product sales were restricted to tobacco flavors, 39.1% of users reported being likely to continue using e-cigarettes but 33.2% were likely to switch to cigarettes. If vape product sales were entirely restricted, e-cigarette users were equally likely to switch to cigarettes versus not (~40%). Those most likely to report positive impact of such policies being implemented were less frequent users, never-smokers, and those with greater e-cigarette-related health concerns. This research should be considered in future tobacco control initiatives.
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Affiliation(s)
- Heather Posner
- Global Health Epidemiology and Disease Control, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Katelyn F Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health; George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Lisa Henriksen
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Debra Bernat
- Department of Epidemiology, Milken Institute School of Public Health; George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health; George Washington Cancer Center, George Washington University, Washington, DC, USA
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Guignard R, Andler R, Richard JB, Pasquereau A, Quatremère G, Arwidson P, Gallopel-Morvan K, Nguyen-Thanh V. Effectiveness of 'Mois sans tabac 2016': A French social marketing campaign against smoking. Tob Induc Dis 2021; 19:60. [PMID: 34305506 PMCID: PMC8288465 DOI: 10.18332/tid/139028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/09/2021] [Accepted: 06/15/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION In October 2016, the first edition of Mois sans tabac (Tobacco-Free Month) was launched, a campaign which had invited French smokers to challenge themselves to quit smoking for the whole month of November. We aimed to study the effectiveness of this social marketing intervention on quit attempts (QA) in the general French population, and to study possible differences according to sociodemographic characteristics. METHODS This study used data from the 2017 Health Barometer survey, a random survey conducted by telephone on 25319 individuals. It included 6341 respondents who reported that they were daily smokers when the Mois sans tabac campaign was launched in 2016. The association between self-declared exposure to the campaign and making a QA has been studied using multivariate logistic regressions. RESULTS Exposure to the 2016 Mois sans tabac campaign is associated with a QA lasting at least 24 hours in the final quarter of 2016 (AOR=1.32; 95% CI: 1.07- 1.63, p<0.01), with a QA lasting at least 30 days (AOR=1.95; 95% CI: 1.31-2.91, p<0.001), and being abstinent at the time of the interview in 2017 (AOR=2.39; 95% CI: 1.37-4.15, p<0.01). A dose-effect relationship is observed between the frequency of exposure to the campaign and QA, which is mostly explained by the number of sources of exposure (television, radio, posters, the press, the internet and social networks). Although certain priority groups (e.g. manual workers, the unemployed) had poorer recall of the campaign than other groups, the impact of self-reported exposure to the campaign on QA in unemployed people or those with less than high school educational level appears to have been greater. CONCLUSIONS These analyses suggest the effectiveness of the 2016 Mois sans tabac intervention, in a context of strengthening public tobacco control policies in France, which may have contributed to the drop in smoking observed between 2016 and 2019.
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Affiliation(s)
- Romain Guignard
- Prevention and Health Promotion Department, Santé publique France, the French National Public Health Agency, Saint-Maurice, France
| | - Raphaël Andler
- Prevention and Health Promotion Department, Santé publique France, the French National Public Health Agency, Saint-Maurice, France
| | - Jean-Baptiste Richard
- Prevention and Health Promotion Department, Santé publique France, the French National Public Health Agency, Saint-Maurice, France
| | - Anne Pasquereau
- Prevention and Health Promotion Department, Santé publique France, the French National Public Health Agency, Saint-Maurice, France
| | - Guillemette Quatremère
- Prevention and Health Promotion Department, Santé publique France, the French National Public Health Agency, Saint-Maurice, France
| | - Pierre Arwidson
- Prevention and Health Promotion Department, Santé publique France, the French National Public Health Agency, Saint-Maurice, France
| | | | - Viêt Nguyen-Thanh
- Prevention and Health Promotion Department, Santé publique France, the French National Public Health Agency, Saint-Maurice, France
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Mills SD, Wiesen CA. Beliefs About the Health Effects of Smoking Among Adults in the United States. HEALTH EDUCATION & BEHAVIOR 2021; 49:497-505. [PMID: 33870757 PMCID: PMC9150142 DOI: 10.1177/10901981211004136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The majority of U.S. adults believe that smoking is a cause of lung cancer, but research suggests that the percentage of adults who believe smoking causes other types of cancers and chronic disease is lower. This study examines the correlates of beliefs about several established health effects of smoking in a nationally representative sample of U.S. adults. Data for this study come from Wave 4 of the Population Assessment of Tobacco and Health Study conducted from December 2016 to January 2018. Participants responded to questions assessing their beliefs about the health effects of smoking. Logistic regression models were used to examine the relationship between beliefs about the health effects of smoking and sociodemographic characteristics (smoker status, age, sex, education, race/ethnicity), exposure to antitobacco campaigns, smokers' health, and nicotine dependence. The percentage of U.S. adults who endorsed a health effect can be caused from smoking ranged from 56.4% for blindness to 97.4% for lung disease. Respondents who were older, less educated, current or former smokers, and had less exposure to antitobacco campaigns were generally less likely (p < .05) to endorse that an established health effect was caused by smoking. Smokers with lower nicotine dependence and worse health were generally more likely (p < .05) to endorse that an established health effect was caused by smoking. In summary, knowledge about the health effects of smoking varies across health conditions. Public health would benefit from campaigns targeting segments of the population with less knowledge about the health effects of smoking.
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Affiliation(s)
- Sarah D Mills
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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Lefebvre RC, Chandler RK, Helme DW, Kerner R, Mann S, Stein MD, Reynolds J, Slater MD, Anakaraonye AR, Beard D, Burrus O, Frkovich J, Hedrick H, Lewis N, Rodgers E. Health communication campaigns to drive demand for evidence-based practices and reduce stigma in the HEALing communities study. Drug Alcohol Depend 2020; 217:108338. [PMID: 33152673 PMCID: PMC7534788 DOI: 10.1016/j.drugalcdep.2020.108338] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/25/2020] [Accepted: 09/25/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The HEALing Communities Study (HCS) is testing whether the Communities that Heal (CTH) intervention can decrease opioid overdose deaths through the implementation of evidence-based practices (EBPs) in highly impacted communities. One of the CTH intervention components is a series of communications campaigns to promote the implementation of EBPs, increase demand for naloxone and medications for opioid use disorder (MOUD), and decrease stigma toward people with opioid use disorder and the use of EBPs, especially MOUD. This paper describes the approach to developing and executing these campaigns. METHODS The HCS communication campaigns are developed and implemented through a collaboration between communication experts, research site staff, and community coalitions using a three-stage process. The Prepare phase identifies priority groups to receive campaign messages, develops content for those messages, and identifies a "call to action" that asks people to engage in a specific behavior. In the Plan phase, campaign resources are produced, and community coalitions develop plans to distribute campaign materials. During the Implement stage, these distribution plans guide delivery of content to priority groups. Fidelity measures assess how community coalitions follow their distribution plan as well as barriers and facilitators to implementation. An evaluation of the communication campaigns is planned. CONCLUSIONS If successful, the Prepare-Plan-Implement process, and the campaign materials, could be adapted and used by other communities to address the opioid crisis. The campaign evaluation will extend the evidence base for how communication campaigns can be developed and implemented through a community-engaged process to effectively address public health crises.
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Affiliation(s)
- R. Craig Lefebvre
- Center for Communication Science, RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA,Corresponding author
| | - Redonna K. Chandler
- National Institute on Drug Abuse, 3WFN RM 09D02, 301 North Stonestreet Ave, Bethesda, MD, 20892, USA
| | - Donald W. Helme
- Department of Communication, University of Kentucky, 271 Blazer Dining, Lexington, KY, 40506-0042, USA
| | - Robin Kerner
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, Suite 810, New York, NY, 10027, USA.
| | - Sarah Mann
- Center for Clinical and Translational Science, College of Medicine, The Ohio State University, 376 W 10th Avenue, Columbus, OH, 43210, USA.
| | - Michael D. Stein
- School of Public Health, Boston University, 715 Albany Street, Boston, MA, 02118, USA
| | - Jennifer Reynolds
- Health Communications and Marketing, Oak Ridge Institute for Science and Education (ORAU), 100 ORAU Way, Oak Ridge, TN, 37830, USA.
| | - Michael D. Slater
- School of Communication, The Ohio State University, 3016 Derby Hall, Columbus, OH, 43210, USA
| | - Amarachi R. Anakaraonye
- Center for Communication Science, RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Dacia Beard
- School of Public Health, Boston University, 715 Albany Street, Boston, MA, 02118, USA.
| | - Olivia Burrus
- Center for Communication Science, RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA.
| | - Jenna Frkovich
- Center for Communication Science, RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA.
| | - Haley Hedrick
- Center for Communication Science, RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA.
| | - Nicky Lewis
- Department of Communication, University of Kentucky, 363 S. Martin Luther King Blvd., Lexington, KY 40526, USA.
| | - Emma Rodgers
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, Suite 810, New York, NY, 10027, USA.
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McMahon B, Rudella JL, McMahon M, Wendling K, Paredes A, Register M. Community-Based Participatory Research: Engaging Youth to Provide Perspective on Risk and Protective Factors. THE JOURNAL OF SCHOOL HEALTH 2020; 90:673-682. [PMID: 32686848 DOI: 10.1111/josh.12928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 09/25/2019] [Accepted: 05/25/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The Pennsylvania Youth Survey (PAYS) is administered biennially to adolescents; it covers knowledge, attitudes, and behaviors about risk and protective factors. PURPOSE This study explored 8th, 10th, and 12th grade students' attitudes and beliefs about current trends regarding drugs, alcohol, and mental health. METHODS We asked persons a series of questions in semi-structured focus groups (102 participants) while they were being presented with the PAYS data. RESULTS Participants expressed significant insight on root causes of risk behaviors. They recommended a decreased emphasis on grades and class rank, and recommended addressing mental health stigma, educating about vaping and marijuana effects, and obtaining support from families, schools, and communities. CONCLUSION Youth expressed interest in being an integral part of the planning and decision-making efforts that impact them. Our results support the Whole School, Community, and Child (WSCC) model.
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Affiliation(s)
- Beth McMahon
- Lock Haven University, 131 Willis Health Professions, Lock Haven, PA, 17728
| | - Jennifer L Rudella
- Lock Haven University, 131 Willis Health Professions Building, Lock Haven, PA, 17745
| | - Mary McMahon
- University of Pittsburgh, Cogan Station, PA, 17728
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LA TORRE G, D’EGIDIO V, GUASTAMACCHIA S, BARBAGALLO A, MANNOCCI A. Diffusion of the Italian social media campaign against smoking on a social network and YouTube. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E200-E204. [PMID: 32803006 PMCID: PMC7419133 DOI: 10.15167/2421-4248/jpmh2020.61.2.1419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 04/02/2020] [Indexed: 11/16/2022]
Abstract
Introduction Recently, the Italian Ministry of Health developed a health prevention campaign against tobacco smoking entitled "Ma che sei scemo? Il fumo fammale" (Are you stupid? Smoking is bad). The aim of this study was to evaluate the diffusion of the ministerial campaign by analyzing data from two web platforms, Facebook and YouTube. Method The study evaluated the dissemination of the campaign using the number of users reached, interactions and the interaction index (interactions/users reached) on the web platform Facebook and YouTube. A qualitative analysis of the text comments left by the users was also carried out. Result The average number of interactions on Facebook was 6,087 and 400 for YouTube while the total views were 356,967 for Facebook and 174,763 for YouTube. The interaction index was very low for both platforms, between 0 and 1%. A total number of 156 comments were obtained on Facebook and 37 on YouTube, most of which were negative, or comments not related to the campaign. Conclusions The Italian campaign had low diffusion on the web platforms investigated. Evidence-based public health interventions can play a central role in the prevention field but must be based on elements of scientific effectiveness. Further research should analyze the effects of social media campaigns on direct health related outcomes.
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Affiliation(s)
- G. LA TORRE
- Correspondence: Giuseppe La Torre, Department of Public Health and Infectious Disease, Sapienza University of Rome, piazzale Aldo Moro 5, 00185 Rome - Tel. +39 06 49694308 - E-mail:
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Chung C, Park J, Song JE, Park S. Determinants of Protective Behaviors Against Endocrine Disruptors in Young Korean Women. Asian Nurs Res (Korean Soc Nurs Sci) 2020; 14:165-172. [PMID: 32653667 DOI: 10.1016/j.anr.2020.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 06/20/2020] [Accepted: 07/03/2020] [Indexed: 01/02/2023] Open
Abstract
PURPOSE A convenience-oriented lifestyle in young people is accompanied by greater consumption of and exposure to endocrine disruptors, which can affect reproductive health, especially in women. We aimed to identify factors that influence protective behaviors against endocrine disruptors among female college students in South Korea. METHODS Using a cross-sectional survey design, we recruited 199 female college students. A self-administered questionnaire was used, and data were collected at the site. RESULTS A healthy lifestyle, information utilization, receiving peer advice on avoiding exposure to endocrine disruptors, and a history of environmental illnesses were found to be significant factors, explaining 42.0% of the variance in protective behaviors against endocrine disruptors. CONCLUSION Health consequences of environmental hazards and importance of maintaining a healthy lifestyle need to be emphasized in young women's healthcare. Health professionals should advocate for and empower women to protect themselves against endocrine disruptors.
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Affiliation(s)
- ChaeWeon Chung
- College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| | - Jeongok Park
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Ju-Eun Song
- College of Nursing, Institute of Nursing Science, Ajou University, Suwon, Republic of Korea
| | - SoMi Park
- Department of Nursing, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea.
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Delahanty J, Ganz O, Bernat JK, Trigger S, Smith A, Lavinghouze R, Rao P. Awareness of "The Real Cost" Campaign Among US Middle and High School Students: National Youth Tobacco Survey, 2017. Public Health Rep 2020; 135:82-89. [PMID: 31835009 DOI: 10.1177/0033354919889992] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Monitoring awareness of a public education campaign can help to better understand the extent of sustained population-level exposure to the campaign. We examined unaided awareness (awareness that does not include a visual image to remind the respondent of the campaign or advertisement) and correlates of unaided awareness of "The Real Cost," a national youth tobacco education campaign developed by the US Food and Drug Administration and implemented in 2014. METHODS This secondary analysis examined unaided campaign awareness by using data from the 2017 National Youth Tobacco Survey, a nationally representative school-based sample of young persons aged 9-19 years (n = 17 269) surveyed approximately 3 years after campaign launch. We compared unaided campaign awareness among various cigarette user groups (experimenters, susceptible nonsmokers, current or former smokers, and nonsusceptible nonsmokers). We examined associations between unaided campaign awareness and demographic and tobacco-related correlates, overall and by cigarette user group. RESULTS Three years after "The Real Cost" campaign was launched, most middle and high school students (58.5%) still reported unaided campaign awareness. Of 17 269 middle and high school students in the sample, 62.0% of susceptible nonsmokers and 64.5% of experimenters reported unaided campaign awareness. Among susceptible nonsmokers, unaided campaign awareness differed by age and race/ethnicity and was higher among students with greater tobacco-related harm perceptions (vs lower harm perceptions) and exposure to pro-tobacco marketing (vs no exposure). CONCLUSIONS Future surveillance and research could examine awareness of "The Real Cost" campaign and effects of the campaign on young persons' knowledge, attitudes, and beliefs to further assess the public health impact of tobacco prevention campaigns.
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Affiliation(s)
- Janine Delahanty
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Ollie Ganz
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Jennifer K Bernat
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Sarah Trigger
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Alexandria Smith
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - René Lavinghouze
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pamela Rao
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA.,Akira Technologies, Washington, DC, USA
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Validating Self-Reported Ad Recall as a Measure of Exposure to Digital Advertising: An Exploratory Analysis Using Ad Tracking Methodology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072185. [PMID: 32218265 PMCID: PMC7177256 DOI: 10.3390/ijerph17072185] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/19/2020] [Accepted: 03/22/2020] [Indexed: 02/07/2023]
Abstract
Many mass media campaigns aimed at changing young people’s health behavior air on digital platforms rather than on broadcast media (e.g., television), given the intended audience’s preference for web-based communication. While research suggests self-reported ad recall correlates with exposure to television advertising, it remains unclear whether self-report measures are correlated with exposure to digital advertising. This study examined the association between an objective measure of digital ad exposure and self-reported recall of digital ads from the truth® tobacco prevention campaign. Digital ad tracking methodology was employed to identify members of an online panel (ages 18−34) who had been exposed to ads during their regular web browsing. Demographics of exposed participants were used to develop a matched control group of non-exposed panel members. Members of the Exposed group (n = 458) and matched Control participants (n = 506) were surveyed on recall of truth ads, media use, and demographics. Results indicated that Exposed participants had significantly higher odds of reporting ad recall compared to Control participants. With each additional ad exposure, the odds of self-reporting higher frequency of ad exposure increased by 8% (OR = 1.08, 95% CI = 1.01−1.16). Findings suggest self-reported measures of ad recall are a valid measure of campaign exposure in a digital media environment.
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Johnson RM, Fleming CB, Cambron C, Dean LT, Brighthaupt SC, Guttmannova K. Race/Ethnicity Differences in Trends of Marijuana, Cigarette, and Alcohol Use Among 8th, 10th, and 12th Graders in Washington State, 2004-2016. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 20:194-204. [PMID: 29633175 DOI: 10.1007/s11121-018-0899-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Accurate estimates of substance use in the teenage years by race/ethnicity may help identify when to intervene to prevent long-term substance use disparities. We examined trends in past 30-day use of marijuana, cigarette, and alcohol among 8th, 10th, and 12th graders in Washington State, which passed a recreational marijuana law in 2012 and initiated retail marijuana sales in 2014. Data are from the 2004-2016 Washington Healthy Youth Surveys (n = 161,992). We used time series regression models to assess linear and quadratic trends in substance use for the full sample and stratified on race/ethnicity and grade level and examined relative differences in prevalence of use by race/ethnicity. In Washington, across all racial/ethnic groups, marijuana use peaked in 2012. Although there was not a significant overall change in marijuana use for the full sample across the study period, there was a statistically significant increase in use among 12th graders and a statistically significant decrease among 8th graders. Relative to Whites, Asians had a lower prevalence of marijuana use, whereas all other race/ethnicity groups had a higher prevalence of use. Prevalence of marijuana use is particularly high among American Indian/Alaska Native and Black youth and has increased most rapidly among 12th grade Hispanic/Latinx youth. There were large and statistically significant decreases in alcohol and cigarette use across the study period for the full sample, as well as for each race/ethnicity group. These findings highlight the need for continued monitoring of trends in use among these groups and potentially warrant consideration of selective interventions that specifically focus on students of color and that include developmentally-appropriate strategies relevant to each grade.
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Affiliation(s)
- Renee M Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, 8th Floor, Room 898, Baltimore, MD, 21205-1999, USA. .,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Charles B Fleming
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Christopher Cambron
- School of Social Work, University of Washington, Seattle, WA, USA.,Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Lorraine T Dean
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sherri-Chanelle Brighthaupt
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, 8th Floor, Room 898, Baltimore, MD, 21205-1999, USA
| | - Katarina Guttmannova
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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Weiger CV, Alexander TN, Moran MB. Are national antitobacco campaigns reaching high-risk adolescents? A cross-sectional analysis from PATH Wave 2. HEALTH EDUCATION RESEARCH 2020; 35:44-59. [PMID: 31965169 PMCID: PMC6991619 DOI: 10.1093/her/cyz036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023]
Abstract
Smoking education and prevention campaigns have had marked success in reducing rates of tobacco use among adolescents, however, disparities in use continue to exist. It is critical to assess if adolescents at risk for tobacco use are being exposed to antitobacco campaigns. We used data from Wave 2 of the Population Assessment of Tobacco and Health Study to assess the relationship between exposure to three antitobacco campaigns and key characteristics related to higher risk of cigarette use using full-sample weights and Poisson regression models with robust variance. Adjusted models identified that exposure to antitobacco campaigns was more common among racial and sexual minority adolescents and adolescents who: reported exposure to tobacco marketing, spent more time using media and had household income greater than $25 000. While some high-risk youth are more likely to report exposure to campaigns, there are some priority groups that are not being reached by current efforts compared with non-priority groups, including youth living in households with income below the poverty line and adolescents who are susceptible to cigarette smoking. Future campaigns should consider targeting these groups specifically in order to reduce tobacco use disparities.
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Affiliation(s)
- C V Weiger
- Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - T N Alexander
- Public Health Research and Translational Science, Battelle Memorial Institute, Battelle Public Health Center for Substance Use Research, 6115 Falls Rd #200, Baltimore, MD 21209, USA
| | - M B Moran
- Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Duke JC, MacMonegle AJ, Nonnemaker JM, Farrelly MC, Delahanty JC, Zhao X, Smith AA, Rao P, Allen JA. Impact of The Real Cost Media Campaign on Youth Smoking Initiation. Am J Prev Med 2019; 57:645-651. [PMID: 31443954 DOI: 10.1016/j.amepre.2019.06.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 06/05/2019] [Accepted: 06/06/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purpose of this study was to assess the relationship between youth exposure to the U.S. Food and Drug Administration's national tobacco public education campaign, The Real Cost, and changes in smoking initiation. METHODS From November 2013 to November 2016, a longitudinal study of youth was conducted with a baseline and 4 post-campaign follow-up surveys. The sample consisted of nonsmoking youths from 75 U.S. media markets (n=5,103) who completed a baseline and at least 1 follow-up survey. Exposure was measured by media market-level target rating points and self-reported ad exposure frequency. Smoking initiation was examined among youths who had never smoked at baseline and defined as first trial of a cigarette. Discrete-time survival models using logistic regression and controlling for confounding influences were estimated. Analyses were conducted in 2018. RESULTS The odds of reporting smoking initiation at follow-up was lower among youths in media markets with higher levels of campaign advertisements than among those with less. Both between-wave and cumulative target rating points were associated with decreased risk of smoking initiation (AOR=0.69 [p<0.01] and AOR=0.89 [p<0.05], respectively); for every 3,500 between-wave target rating points on air, there was an associated 30% reduction in the hazard of smoking initiation among youths. Results from self-reported recall of the campaign advertisements found similar dose-response effects. The campaign is associated with an estimated 380,000-587,000 youths aged 11-19 years being prevented from initiating smoking nationwide. CONCLUSIONS Sustained national tobacco public education campaigns like The Real Cost can change population-level smoking initiation among youths, preventing future generations from tobacco-related harms.
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Affiliation(s)
| | | | | | | | - Janine C Delahanty
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Xiaoquan Zhao
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland; Department of Communication, George Mason University, Fairfax, Virginia
| | - Alexandria A Smith
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Pamela Rao
- Kavali Consulting, Washington, District of Columbia
| | - Jane A Allen
- RTI International, Research Triangle Park, North Carolina
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Rath JM, Green MP, Vallone DM, Briggs J, Palmerini M, Geraci J, Pitzer L, Hair EC. The Role of Emotions and Perceived Ad Effectiveness: Evidence From the Truth FinishIt Campaign. Am J Health Promot 2019; 33:1152-1158. [PMID: 31337224 DOI: 10.1177/0890117119864919] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Examine association between emotional valence and intensity prompted by anti-tobacco advertising messages and perceived ad effectiveness among youth/young adults. DESIGN Online forced-exposure survey data from a nationally weighted, cross-sectional sample of youth/young adults, collected periodically over a 4-year period. SETTING National. PARTICIPANTS Thirty-seven cross-sectional surveys conducted online from June 2015 to January 2018; total N = 9534. All participants, aged 15 to 21, were in the intervention; no control group. INTERVENTION Individuals participating in premarket testing of truth ads were forced exposed to one of 37 anti-tobacco ads. MEASURES Emotional response, emotional intensity, and perceived ad effectiveness. Emotional response has been previously studied and measured. Including the discrete measure of "concerned" in positive emotions is unique to our study. It patterned with the other positive emotions when each ad was examined by each emotion. Intensity as measured in this study through the 5-point scale ("how much does this ad make you feel") is unique in the anti-tobacco ad literature. Although several past studies ranked the degree of emotion elicited by ads, they have not incorporated the intensity of emotion as reported by the participant themselves. The scale was used to determine whether perceived ad effectiveness is similar to those used in previous studies. ANALYSIS Linear regressions were estimated to assess type of emotional sentiment and level of intensity in relation to perceived effectiveness of the message. RESULTS All 9534 participants were exposed; no control group. The βs indicate how strongly the emotion variable influences the study outcome of perceived ad effectiveness. Positive emotions (β = .76) were more highly associated with perceived ad effectiveness (β = .06). Higher intensity with positive emotional sentiment and high-intensity negative produced the highest scores for perceived ad effectiveness (β = .30). CONCLUSION Eliciting a positive, high-impact emotional response from viewers can help improve perceived effectiveness, and in turn, overall ad effectiveness.
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Affiliation(s)
- Jessica M Rath
- Schroeder Institute at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Molly P Green
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Donna M Vallone
- Schroeder Institute at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Social and Behavioral Sciences, NYU College of Global Public Health, New York University, New York, NY, USA
| | - Jodie Briggs
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | | | - John Geraci
- Crux Research, Honeoye Falls, New York, NY, USA
| | - Lindsay Pitzer
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Elizabeth C Hair
- Schroeder Institute at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Differential associations of health literacy with Austrian adolescents' tobacco and alcohol use. Public Health 2019; 174:74-82. [PMID: 31323600 DOI: 10.1016/j.puhe.2019.05.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 05/20/2019] [Accepted: 05/28/2019] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Tobacco use and alcohol use have their origin in adolescence, and risky use of these substances is amongst the leading preventable causes of morbidity and mortality. Health literacy (HL) encompasses the skills that are decisive to make appropriate health decisions in this context. Given the paucity of evidence on the link between HL and adolescents' health behaviors, the present study examined overall HL and different components of HL and their associations with smoking and alcohol use among 13 to 17-year-old Austrian students. STUDY DESIGN Data were obtained from a national survey carried out in Austria (N = 4219; 56% females) as part of the Health Behaviour in School-aged Children: World Health Organization (WHO) collaborative cross-national study. METHODS We tested two structural equation models, one including the overall HL scale as the predictor and one with the three subscales of HL 'finding,' 'understanding and appraising,' and 'applying' health-related information as predictors of smoking and alcohol use. RESULTS Although overall HL was related to all indicators of adolescents' smoking and drinking, the three HL components had differential effects on these behaviors. The easier it was for the participants to 'understand and appraise' and 'apply' health-related information, the less frequently they had smoked and drunk alcohol and the less was the amount of alcohol they had consumed. Contrarily, the easier it was for the participants to 'find' information, the more they had smoked and drunk alcohol. CONCLUSIONS Our results indicate that availability of health-related information may be insufficient on its own to prevent or reduce risky substance use. This is of particular importance for the development and improvement of primary prevention programs targeting adolescent populations.
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Hofman P, Barlesi F. Companion diagnostic tests for treatment of lung cancer patients: what are the current and future challenges? Expert Rev Mol Diagn 2019; 19:429-438. [DOI: 10.1080/14737159.2019.1611426] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Paul Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, and Hospital-integrated Biobank, Côte d’Azur University, Nice, France
| | - Fabrice Barlesi
- CRCM, INSERM, CNRS, AP-HM, Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, Marseille, France
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Stead M, Angus K, Langley T, Katikireddi SV, Hinds K, Hilton S, Lewis S, Thomas J, Campbell M, Young B, Bauld L. Mass media to communicate public health messages in six health topic areas: a systematic review and other reviews of the evidence. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07080] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BackgroundMass media campaigns can be used to communicate public health messages at the population level. Although previous research has shown that they can influence health behaviours in some contexts, there have been few attempts to synthesise evidence across multiple health behaviours.ObjectivesTo (1) review evidence on the effective use of mass media in six health topic areas (alcohol, diet, illicit drugs, physical activity, sexual and reproductive health and tobacco), (2) examine whether or not effectiveness varies with different target populations, (3) identify characteristics of mass media campaigns associated with effectiveness and (4) identify key research gaps.DesignThe study comprised (1) a systematic review of reviews, (2) a review of primary studies examining alcohol mass media campaigns, (3) a review of cost-effectiveness evidence and (4) a review of recent primary studies of mass media campaigns conducted in the UK. A logic model was developed to inform the reviews. Public engagement activities were conducted with policy, practitioner and academic stakeholders and with young people.ResultsThe amount and strength of evidence varies across the six topics, and there was little evidence regarding diet campaigns. There was moderate evidence that mass media campaigns can reduce sedentary behaviour and influence sexual health-related behaviours and treatment-seeking behaviours (e.g. use of smoking quitlines and sexual health services). The impact on tobacco use and physical activity was mixed, there was limited evidence of impact on alcohol use and there was no impact on illicit drug behaviours. Mass media campaigns were found to increase knowledge and awareness across several topics, and to influence intentions regarding physical activity and smoking. Tobacco and illicit drug campaigns appeared to be more effective for young people and children but there was no or inconsistent evidence regarding effectiveness by sex, ethnicity or socioeconomic status. There was moderate evidence that tobacco mass media campaigns are cost-effective, but there was weak or limited evidence in other topic areas. Although there was limited evidence on characteristics associated with effectiveness, longer or greater intensity campaigns were found to be more effective, and messages were important, with positive and negative messages and social norms messages affecting smoking behaviour. The evidence suggested that targeting messages to target audiences can be effective. There was little evidence regarding the role that theory or media channels may play in campaign effectiveness, and also limited evidence on new media.LimitationsStatistical synthesis was not possible owing to considerable heterogeneity across reviews and studies. The focus on review-level evidence limited our ability to examine intervention characteristics in detail.ConclusionsOverall, the evidence is mixed but suggests that (1) campaigns can reduce sedentary behaviour, improve sexual health and contribute to smoking cessation, (2) tobacco control campaigns can be cost-effective, (3) longer and more intensive campaigns are likely to be more effective and (4) message design and targeting campaigns to particular population groups can be effective.Future workFuture work could fill evidence gaps regarding diet mass media campaigns and new-media campaigns, examine cost-effectiveness in areas other than tobacco and explore the specific contribution of mass media campaigns to multicomponent interventions and how local, regional and national campaigns can work together.Study registrationThis study is registered as PROSPERO CRD42015029205 and PROSPERO CRD42017054999.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Martine Stead
- Institute for Social Marketing, University of Stirling, Stirling, UK
- UK Centre for Tobacco and Alcohol Studies, UK
| | - Kathryn Angus
- Institute for Social Marketing, University of Stirling, Stirling, UK
- UK Centre for Tobacco and Alcohol Studies, UK
| | - Tessa Langley
- UK Centre for Tobacco and Alcohol Studies, UK
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Srinivasa Vittal Katikireddi
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Kate Hinds
- Institute of Education, University College London, London, UK
| | - Shona Hilton
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Sarah Lewis
- UK Centre for Tobacco and Alcohol Studies, UK
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - James Thomas
- Institute of Education, University College London, London, UK
| | - Mhairi Campbell
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Ben Young
- UK Centre for Tobacco and Alcohol Studies, UK
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Linda Bauld
- UK Centre for Tobacco and Alcohol Studies, UK
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
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Mannocci A, Backhaus I, D'Egidio V, Federici A, Villari P, La Torre G. What public health strategies work to reduce the tobacco demand among young people? An umbrella review of systematic reviews and meta-analyses. Health Policy 2019; 123:480-491. [PMID: 30922630 DOI: 10.1016/j.healthpol.2019.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 02/11/2019] [Accepted: 02/19/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To perform an umbrella review of systematic reviews and meta-analyses of health policy and health promotion strategies to reduce the tobacco demand in adolescents, youth and young adults. METHODS Reviewers independently performed an electronic database search, reviewed titles and abstracts, assessed articles' eligibility for inclusion and quality, and extracted relevant data. Only systematic reviews and meta-analyses reporting data on tobacco policies and interventions focusing on individuals aged <25 years were included. The Framework Convention on Tobacco Control was used to guide data synthesis. RESULTS 13 articles were included. Studies were of mixed quality with five studies ranked as critically low and seven as high quality. Overall, mixed results were found on the effectiveness for tobacco policies and interventions. Strategies such as increasing taxes on tobacco products were most promising. CONCLUSION Though data on a variety of measures to reduce smoking is available, conclusions concerning the effectiveness are inconclusive. Tobacco policies and interventions have the potential to reduce smoking, but conclusions are hampered due to both lack of high-quality trials and numerous biases in primary studies. Further high-quality research is required to examine the effectiveness of interventions and policies to reduce the tobacco demand in adolescents, youth and young adults.
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Affiliation(s)
- Alice Mannocci
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Insa Backhaus
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
| | - Valeria D'Egidio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | | | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
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Zhao X, Roditis ML, Alexander TN. Fear and Humor Appeals in "The Real Cost" Campaign: Evidence of Potential Effectiveness in Message Pretesting. Am J Prev Med 2019; 56:S31-S39. [PMID: 30661523 DOI: 10.1016/j.amepre.2018.07.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 05/05/2018] [Accepted: 07/25/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION In tobacco prevention campaigns, fear-appeal messages are widely used and generally shown to be effective, whereas the utility of humor appeals is less clear. This study compares the potential effectiveness of fear and humor ads developed for "The Real Cost" campaign. METHODS Adolescents (N=1,315) aged 13-17 years who were either experimenting with smoking or susceptible to smoking initiation were randomized to view either a single ad (of three fear and two humor ads in total) or nothing (control condition). Those in the ad viewing condition completed measures on fear, amusement, and perceived ad effectiveness. All participants completed measures on smoking attitudes and risk perceptions. Data were collected in 2014 and 2015. Analysis was performed in 2016. RESULTS Compared with control, both fear and humor ads produced greater risk perceptions (p<0.001). Fear ads also produced more negative smoking attitudes (p=0.001); humor ads had a similar effect on attitudes that approached significance (p=0.07). Fear ads scored higher on perceived ad effectiveness and fear, and lower on amusement than humor ads (p<0.001). In regression models, fear was a stronger predictor of perceived ad effectiveness, smoking attitudes, and risk perceptions than amusement for fear ads, whereas amusement was a stronger predictor of these outcomes than fear for humor ads. CONCLUSIONS Both fear and humor appeals have potential to be effective in "The Real Cost" campaign. Concurrent employment of these message strategies should help to diversify messaging and consistently recapture the target audience's attention. SUPPLEMENT INFORMATION This article is part of a supplement entitled Fifth Anniversary Retrospective of "The Real Cost," the Food and Drug Administration's Historic Youth Smoking Prevention Media Campaign, which is sponsored by the U.S. Food and Drug Administration.
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Affiliation(s)
- Xiaoquan Zhao
- Office of Health Communication and Education, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland; Department of Communication, George Mason University, Fairfax, Virginia.
| | - Maria L Roditis
- Office of Health Communication and Education, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Tesfa N Alexander
- Public Health Research and Translational Science, Battelle Memorial Institute, Baltimore, Maryland
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Kranzler EC, Schmälzle R, O’Donnell MB, Pei R, Falk EB. Adolescent neural responses to antismoking messages, perceived effectiveness, and sharing intention. MEDIA PSYCHOLOGY 2019; 22:323-349. [PMID: 30886543 PMCID: PMC6419746 DOI: 10.1080/15213269.2018.1476158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Health communication delivered via media channels can substantially influence adolescents' choices, and the effects of messages are amplified through interpersonal sharing. However, the underlying psychological and neurocognitive mechanisms that influence message effectiveness and likelihood of sharing are not well understood, especially among adolescents. Based on research in adults, we hypothesized and preregistered that message-induced neural activation in regions associated with self-reflection, social processing, and positive valuation would be related to greater perceived ad effectiveness and intentions to share messages. We focused on brain activity in meta-analytically defined regions associated with these three processes as 40 adolescent nonsmokers viewed advertisements from "The Real Cost" antismoking campaign. Perceived message effectiveness was positively associated with brain activity in the hypothesized social processing regions and marginally associated with brain activity in self-relevance regions, but not associated with brain activity in valuation regions. By contrast, intentions to share the messages were not associated with neural response in these 3 systems. In contrast to previous neuroimaging studies with adult subjects, our findings highlight the role of social cognition in adolescent processing of persuasive messages. We discuss the possibility that the mental processes responsive to effective and shareworthy messages may reflect developmental processes pertinent to media effects.
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Affiliation(s)
- Elissa C. Kranzler
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - Ralf Schmälzle
- College of Communication Arts and Sciences, Michigan State University, East Lansing, MI, USA
| | | | - Rui Pei
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - Emily B. Falk
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
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49
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Rath JM, Greenberg M, Ganz O, Pitzer L, Hair EC, Xiao H, Cantrell J, Vallone D. A multidisciplinary approach to health campaign effectiveness. J Public Health Res 2018; 7:1379. [PMID: 30581807 PMCID: PMC6278874 DOI: 10.4081/jphr.2018.1379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 09/18/2018] [Indexed: 11/22/2022] Open
Abstract
Campaign costs are rising, making ad execution testing more critical to determine effectiveness prior to media spending. Premarket testing occurs prior to messages' airing while in-market testing examines message attributes when messages are aired within a real-world setting, where context plays an important role in determining audience response. These types of ad testing provide critical feedback to help develop and deploy campaigns. Due to recent changes in media delivery platforms and audience tobacco use behavior, this study analyzes two nationally representative youth samples, aged 15-21, to examine if pre-market ad testing is an indicator of in-market ad performance for public health campaigns, which rely on persuasive messages to promote or reduce health behaviors rather than selling a product. Using data from the Truth® campaign, a national tobacco use prevention campaign targeted to youth and young adults, findings indicate strong associations between pre-market scores and in-market ad performance metrics.
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Affiliation(s)
- Jessica M Rath
- The Schroeder Institute, Truth Initiative, Washington DC.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Ollie Ganz
- The Schroeder Institute, Truth Initiative, Washington DC
| | - Lindsay Pitzer
- The Schroeder Institute, Truth Initiative, Washington DC
| | - Elizabeth C Hair
- The Schroeder Institute, Truth Initiative, Washington DC.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Haijun Xiao
- The Schroeder Institute, Truth Initiative, Washington DC
| | - Jennifer Cantrell
- The Schroeder Institute, Truth Initiative, Washington DC.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,College of Global Public Health, New York University, New York, NY, USA
| | - Donna Vallone
- The Schroeder Institute, Truth Initiative, Washington DC.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,College of Global Public Health, New York University, New York, NY, USA
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Jackson KM, Janssen T, Gabrielli J. Media/Marketing Influences on Adolescent and Young Adult Substance Abuse. CURRENT ADDICTION REPORTS 2018; 5:146-157. [PMID: 30393590 PMCID: PMC6208350 DOI: 10.1007/s40429-018-0199-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW We describe the state of research on substance use portrayals in marketing and media, considering exposure to tobacco, alcohol, e-cigarette, and marijuana content. Putative mechanisms are offered, and recommendations made for effective prevention strategies for mitigating the influence of these portrayals. RECENT FINDINGS There is consistent evidence that adolescents and young adults are highly exposed to substance use portrayals and that these portrayals are associated with subsequent substance use. Exposure via new media (social networking sites, brand websites) has risen rapidly. Social norms and cognitions appear to at least partially account for the effects of portrayals on youth substance use. SUMMARY Digital media has surpassed traditional marketing, which is concerning because youth have on-demand access to content and are active consumers of digital media. Developmentally appropriate media literacy interventions that include a parenting component and target multiple substances and media domains are recommended.
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Affiliation(s)
| | - Tim Janssen
- Center for Alcohol and Addiction Studies, Brown University
| | - Joy Gabrielli
- Department of Data Science, Geisel School of Medicine, Dartmouth College
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