1
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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.
| |
Collapse
|
2
|
Head KJ, Harrington NG, Schnur JB, Margolies L, Montgomery GH. Examining gain- and loss-framed messages in a novel breast cancer screening/cardiovascular context: Does framing matter? PEC Innov 2022; 1:100007. [PMID: 37364030 PMCID: PMC10194377 DOI: 10.1016/j.pecinn.2021.100007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/21/2021] [Accepted: 11/09/2021] [Indexed: 06/28/2023]
Abstract
Objective Digital mammography can reveal not only breast cancer but also breast arterial calcification (BAC), which can indicate potential coronary artery disease. To explore ways to inform women of their BAC status in the context of a standard mammography results letter, we conducted a preliminary study comparing gain- and loss-framed messages to encourage follow-up cardiovascular care. Methods U.S. women over age 40 with no heart disease history (N = 227) were randomly assigned to view a mammography letter including BAC information in one of seven ways (three gain-framed messages, three loss-framed messages, one comparison message). Results Post-test measures indicated no significant differences on BAC knowledge, recall of test results and recommendations, perceived message effectiveness, or behavioral intentions for follow-up. Conclusion Despite showing no significant differences between message conditions, results supported the messages' ability to clearly convey BAC information and encourage intention for follow-up cardiovascular care. Innovation This experimental study represents the first published report examining the inclusion of BAC screening results within the mammography letter. It also explored the use of message framing in a dual detection-prevention context and suggests that future work should test the effects of including both framing tactics in messages designed to target dual-focus contexts.
Collapse
Affiliation(s)
- Katharine J. Head
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, USA
| | | | - Julie B. Schnur
- Center for Behavioral Oncology, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, USA
| | - Laurie Margolies
- Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, USA
| | - Guy H. Montgomery
- Center for Behavioral Oncology, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, USA
| |
Collapse
|
3
|
Kim SJ, Minich M, Tveleneva A, Liu J, Padon AA, Silver LD, Yang S. Textual and pictorial enhancement of cannabis warning labels: An Online experiment among at-risk U.S. young adults. Drug Alcohol Depend 2022; 237:109520. [PMID: 35724518 DOI: 10.1016/j.drugalcdep.2022.109520] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 05/04/2022] [Accepted: 05/28/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND This study experimentally examines whether enhanced cannabis warning labels (CWLs) outperform those currently required in the U.S. in improving recall of health risks, emotional responses, and perceived message effectiveness among at-risk young adults. METHOD We conducted an online national survey-based experiment in October 2020. Young adults aged 18-26 years old and at-risk for cannabis use (N = 523) were randomly assigned in an online experiment, to view either currently required CWLs in California with small font and a composite health risk statement, or enhanced single-theme CWLs with varying textual and pictorial components. We performed linear regression analyses to compare the enhanced with existing CWLs on information recall, negative emotions, and perceived message effectiveness. Furthermore, information recall and negative emotions were examined as parallel mediators to better understand the mechanisms underlying effective textual and pictorial enhancement of CWLs. RESULTS Compared with currently required CWLs in California, both textually (b = 0.30, p = .011) and pictorially (b = 0.59, p < .001) enhanced CWLs increased recall accuracy. Pictorially enhanced CWLs outperformed their text-only counterparts (b = 0.28, p = .019) in improving information recall. Only pictorially enhanced CWLs improved perceived message effectiveness (b = 0.31, p = .008), which was mediated by negative emotions but not by information recall. CONCLUSIONS Given rapid expansion of the cannabis industry and declining perception of harm, currently required CWLs in the U.S. such as California's, would benefit from redesign to improve public understanding of health risks and to prevent youth use.
Collapse
Affiliation(s)
- Sang Jung Kim
- School of Journalism and Mass Communication, University of Wisconsin-Madison, 5115 Vilas Hall, 821 University Ave., Madison, WI 53706, USA.
| | - Matt Minich
- School of Journalism and Mass Communication, University of Wisconsin-Madison, 5115 Vilas Hall, 821 University Ave., Madison, WI 53706, USA.
| | - Arina Tveleneva
- Department of Marketing and International Business Michael G. Foster School of Business, University of Washington, PACCAR Hall, 4273 E Stevens Way NE, Seattle, WA 98195, USA.
| | - Jiaying Liu
- Department of Communication Studies, University of Georgia, 628 Caldwell Hall, Athens, GA 30602, USA.
| | - Alisa A Padon
- Public Health Institute, 555 12th, St Oakland, CA 94607, USA.
| | - Lynn D Silver
- Public Health Institute, 555 12th, St Oakland, CA 94607, USA.
| | - Sijia Yang
- School of Journalism and Mass Communication, University of Wisconsin-Madison, 5115 Vilas Hall, 821 University Ave., Madison, WI 53706, USA.
| |
Collapse
|
4
|
Sigala DM, Hall MG, Musicus AA, Roberto CA, Solar SE, Fan S, Sorscher S, Nara D, Falbe J. Perceived effectiveness of added-sugar warning label designs for U.S. restaurant menus: An online randomized controlled trial. Prev Med 2022; 160:107090. [PMID: 35594928 PMCID: PMC9236625 DOI: 10.1016/j.ypmed.2022.107090] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 12/01/2022]
Abstract
Added-sugar consumption in the U.S. exceeds recommended limits. Policymakers are considering requiring restaurants to use menu warning labels to indicate items high in added sugar. We sought to determine whether icon-only and icon-plus-text added-sugar menu labels were (1) perceived as more effective at potentially reducing consumption of items high in added sugar and (2) increased knowledge of menu items' added-sugar content relative to control labels, and if effects differed by label design. A national sample of U.S. adults (n = 1327) participated in an online randomized experiment. Participants viewed menu items with either a control label, 1 of 6 icon-only labels, or 1 of 18 icon-plus-text labels with 3 text variations. For their assigned label, participants provided ratings of perceived message effectiveness (a validated scale of a message's potential to change behavior). Participants were also asked to classify menu items by their added-sugar content. The icon-only and icon-plus-text labels were perceived as more effective than the control label (means: 3.7 and 3.7 vs. 3.1, respectively, on a 5-point scale; p < 0.001). The icon-only and icon-plus-text groups each correctly classified 71% of menu items by added-sugar content vs. 56% in the control group (p < 0.001). All icons and text variations were perceived as similarly effective. In conclusion, relative to a control label, icon-only and icon-plus-text added-sugar menu labels were perceived as effective and helped consumers identify items high in added sugar. Menu warning labels may be a promising strategy for reducing added-sugar consumption from restaurants, but research on behavioral effects in real-world settings is needed. Clinical Trials Identifier:NCT04637412.
Collapse
Affiliation(s)
- Desiree M Sigala
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California Davis, 1 Shields Ave, Davis, CA 95616, USA.
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health; Lineberger Comprehensive Cancer Center; and Carolina Population Center; University of North Carolina Chapel Hill, 170 Rosenau Hall, CB #7400, 135 Dauer Drive, Chapel Hill, NC 27599, USA.
| | - Aviva A Musicus
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
| | - Christina A Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Building 421, Philadelphia, PA 19104, USA.
| | - Sarah E Solar
- Human Development and Family Studies Program, Department of Human Ecology, University of California Davis, 1 Shields Ave, Davis, CA 95616, USA.
| | - Sili Fan
- Department of Statistics, University of California Davis, 1 Shields Ave, Davis, CA 95616, USA.
| | - Sarah Sorscher
- The Center for Science in the Public Interest, 1220 L St. N.W., Suite 300, Washington, D.C. 20005, USA.
| | - DeAnna Nara
- The Center for Science in the Public Interest, 1220 L St. N.W., Suite 300, Washington, D.C. 20005, USA.
| | - Jennifer Falbe
- Human Development and Family Studies Program, Department of Human Ecology, University of California Davis, 1 Shields Ave, Davis, CA 95616, USA.
| |
Collapse
|
5
|
Baig SA, Noar SM, Gottfredson NC, Lazard AJ, Ribisl KM, Brewer NT. Message perceptions and effects perceptions as proxies for behavioral impact in the context of anti-smoking messages. Prev Med Rep 2021; 23:101434. [PMID: 34194959 DOI: 10.1016/j.pmedr.2021.101434] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 04/26/2021] [Accepted: 05/07/2021] [Indexed: 11/20/2022] Open
Abstract
In the context of anti-smoking messages, effects perceptions (perceived behavioral impact) mediated message impact on quit intentions and six quitting and related behaviors while message perceptions (persuasive potential) did not. The sizes of indirect effects involving effects perceptions ranged from small to medium. These findings provide support for the diagnostic value of effects perceptions in testing messages for behavior change in the context of tobacco use and, possibly, other risky health behaviors. The use of effects perceptions in formative research may increase the efficiency with which behavior change interventions can be developed and optimized under resource constraints.
Researchers commonly use message perceptions (persuasive potential) or effects perceptions (perceived behavioral impact) in formative research to select tobacco risk messages. We sought to identify whether message perceptions or effects perceptions are more useful as proxies for the behavioral impact of tobacco risk messages. In a three-week trial, 703 U.S. adult smokers (ages ≥ 21) were randomly assigned to receive brief messages on their cigarette packs about toxic chemicals in cigarette smoke (chemical messages) or control messages about properly disposing of cigarette litter. The final follow-up survey assessed message perceptions, effects perceptions, quit intentions, and six behavioral outcomes. We conducted multiple mediation analysis in a structural equation modeling framework to test the indirect effects of messages by way of message perceptions and effects perceptions. Message perceptions did not independently mediate the impact of chemical messages on any of the outcomes (7 p-values ≥ 0.01). In contrast, effects perceptions mediated the impact of chemical messages on avoiding the messages, seeking chemical information, intentions to quit smoking, butting out a cigarette, forgoing a cigarette, and making a quit attempt (6 p-values ≤ 0.001). No mediation was present for social interactions about the message (p-value = 0.72). The effect sizes for these mediated effects were small to medium. Thus, effects perceptions, but not message perceptions, were a proxy for risk messages’ impact on quit intentions and six quitting and related behaviors. These findings point to the diagnostic value of effects perceptions in formative research on tobacco risk messages.
Collapse
|
6
|
Noar SM, Rohde JA, Prentice-Dunn H, Kresovich A, Hall MG, Brewer NT. Evaluating the actual and perceived effectiveness of E-cigarette prevention advertisements among adolescents. Addict Behav 2020; 109:106473. [PMID: 32521287 DOI: 10.1016/j.addbeh.2020.106473] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/18/2020] [Accepted: 05/14/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND The efficacy of e-cigarette prevention ads among adolescents has seldom been studied. We examined the impact of ads from the The Real Cost vaping prevention media campaign on what adolescents think and believe about vaping. We also sought to test whether perceived message effectiveness (PME) served as a proxy for ad impact. METHODS Participants were 543 U.S. adolescents ages 13-17. In an online experiment, we randomized participants to either: 1) persuasive e-cigarette prevention video ads from the Food and Drug Administration's The Real Cost campaign that was targeted to adolescents or 2) information-only e-cigarette harms control videos (control condition). Participants in each condition viewed 2 videos in a random order. After ad exposure, the survey assessed PME (message and effects perceptions), risk beliefs about vaping, attitudes toward vaping, and intentions to vape. RESULTS The FDA's The Real Cost ads led to higher beliefs about the harms of vaping (p < .001), more negative attitudes toward vaping (p < .001), and lower intentions to vape (p < .05) compared to the control videos. The Real Cost ads also scored higher on both message perceptions (p < .001) and effects perceptions (p < .001) compared to control videos. Effects perceptions were associated with all three outcomes (all ps < 0.001, adjusting for both types of PME and covariates), but message perceptions did not offer additional predictive value. CONCLUSIONS Exposure to The Real Cost vaping prevention ads gave adolescents a more negative view of vaping and lowered their intentions to vape compared to control videos. Effects perceptions may be superior to message perceptions as a proxy for e-cigarette prevention ad impact.
Collapse
Affiliation(s)
- Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA; Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA.
| | - Jacob A Rohde
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA
| | - Hannah Prentice-Dunn
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Alex Kresovich
- Hussman School of Journalism and Media, 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; Center for Health Promotion and Disease Prevention, 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
| |
Collapse
|
7
|
Baig SA, Noar SM, Gottfredson NC, Lazard AJ, Ribisl KM, Brewer NT. Incremental criterion validity of message perceptions and effects perceptions in the context of anti-smoking messages. J Behav Med 2021; 44:74-83. [PMID: 32519300 DOI: 10.1007/s10865-020-00163-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 05/21/2020] [Indexed: 10/24/2022]
Abstract
To select promising health messages, formative research has often relied on perceived message effectiveness (PME) scales assessing either of two related constructs, message perceptions (persuasive potential) and effects perceptions (potential for behavioral impact). We sought to examine their incremental criterion validity within a comparative framework. Participants were 703 U.S. adult smokers (ages [Formula: see text] 21) who received anti-smoking or comparable control (littering) messages on their cigarette packs for 3 weeks. Structural equation models examined both PME constructs as simultaneous correlates of outcomes from the UNC Tobacco Warnings Model. Message perceptions demonstrated incremental criterion validity with attention, an early behavioral antecedent ([Formula: see text] = 0.82, p < .001). Effects perceptions demonstrated incremental criterion validity with later behavioral antecedents (range [Formula: see text] = 0.74-0.87, all p < .01) and quitting behaviors ([Formula: see text] = 0.36-0.66, all p < .001). Formative research on anti-smoking messages may benefit from focusing on effects perceptions to characterize potential for behavior change.
Collapse
|