"Breaking the silence" suicide Prevention media campaign in Oregon: Evaluation of impact on help-seeking and suicide mortality

INTRODUCTION

Research has established that suicide-related media can impact suicide rates both positively and negatively, supporting efforts to engage the media in the service of suicide prevention. The goal of the current study is to evaluate the impact of a suicide prevention media campaign implemented April 7-14, 2019 in Oregon.

METHODS

Several indices of help-seeking behavior and suicide risk were employed: suicide-related Google Health API searches, National Suicide Prevention Lifeline (Lifeline) (currently known as the 988 Suicide and Crisis Lifeline) call volume, and state suicide mortality data from April 7, 2016-May 6, 2019. Eight states with similar 2016-2018 average suicide rates were compared with Oregon. Bayesian structural time-series modeling in R was used to test intervention effects.

RESULTS

During the 30 days following the start of the campaign, there was a significant increase in Lifeline calls from Oregon area codes (2488 observed vs. 2283 expected calls, p = 0.03). There were no significant changes in suicide mortality or suicide-related Google searches in Oregon.

CONCLUSIONS

The campaign appeared to increase help-seeking behavior in the form of Lifeline calls, without any indication of an iatrogenic suicide contagion effect. However, the campaign's potential to reduce suicide mortality was unmet.

"Breaking the Silence" Suicide Prevention Media Campaign in Oregon, April 7-14, 2019

Background: Between April 7 and 14, 2019, the "Breaking the Silence" media engagement campaign was launched in Oregon. Aims: We aimed to assess the consistency of media content related to the campaign with media guidelines and the quantitative footprint on Twitter (now X) over time. Method: Media items related to the campaign were analyzed regarding focus and consistency with media guidelines for suicide reporting and compared with other suicide-related reports published in the same time frame, as well as with reporting in Washington, the control region. Tweets related to the campaign were retrieved to assess the social media footprint. Results: There were n = 104 media items in the campaign month, mainly in the campaign week. Items typically used a narrative featuring suicide advocacy or policy/prevention programs. As compared to other items with a similar focus, they scored better on several protective characteristics listed in media recommendations. Stories of coping with adversity, however, were scarce. The social media footprint on Twitter was small. Limitations: Inability to make causal claims about campaign impact. Conclusion: Media items from the Breaking the Silence campaign appeared mainly consistent with media guidelines, but some aspects, such as stories of recovery, were under-represented.

An Evaluation of the Boys Do Cry Suicide Prevention Media Campaign on Twitter: Mixed Methods Approach

BACKGROUND

In most countries, men are more likely to die by suicide than women. Adherence to dominant masculine norms, such as being self-reliant, is linked to suicide in men in Western cultures. We created a suicide prevention media campaign, "Boys Do Cry," designed to challenge the "self-reliance" norm and encourage help-seeking in men. A music video was at the core of the campaign, which was an adapted version of the "Boys Don't Cry" song from "The Cure." There is evidence that suicide prevention media campaigns can encourage help-seeking for mental health difficulties.

OBJECTIVE

We aimed to explore the reach, engagement, and themes of discussion prompted by the Boys Do Cry campaign on Twitter.

METHODS

We used Twitter analytics data to investigate the reach and engagement of the Boys Do Cry campaign, including analyzing the characteristics of tweets posted by the campaign's hosts. Throughout the campaign and immediately after, we also used Twitter data derived from the Twitter Application Programming Interface to analyze the tweeting patterns of users related to the campaign. In addition, we qualitatively analyzed the content of Boys Do Cry-related tweets during the campaign period.

RESULTS

During the campaign, Twitter users saw the tweets posted by the hosts of the campaign a total of 140,650 times and engaged with its content a total of 4477 times. The 10 highest-performing tweets by the campaign hosts involved either a video or an image. Among the 10 highest-performing tweets, the first was one that included the campaign's core video; the second was a screenshot of the tweet posted by Robert Smith, the lead singer of The Cure, sharing the Boys Do Cry campaign's video and tagging the campaign's hosts. In addition, the pattern of Twitter activity for the campaign-related tweets was considerably higher during the campaign than in the immediate postcampaign period, with half of the activity occurring during the first week of the campaign when Robert Smith promoted the campaign. Some of the key topics of discussions prompted by the Boys Do Cry campaign on Twitter involved users supporting the campaign; referencing the original song, band, or lead singer; reiterating the campaign's messages; and having emotional responses to the campaign.

CONCLUSIONS

This study demonstrates that a brief media campaign such as Boys Do Cry can achieve good reach and engagement and can prompt discussions on Twitter about masculinity and suicide. Such discussions may lead to greater awareness about the importance of seeking help and providing support to those with mental health difficulties. However, this study suggests that longer, more intensive campaigns may be needed in order to amplify and sustain these results.

Effectiveness of a French mass-media campaign in raising knowledge of both long-term alcohol-related harms and low-risk drinking guidelines, and in lowering alcohol consumption

AIMS

To evaluate the effectiveness of a French mass-media campaign in raising knowledge of both long-term alcohol-related harms (LTH) and low-risk drinking guidelines (LRDG), as well as in lowering alcohol consumption.

DESIGN

An 8-month longitudinal survey from February to October 2019, with three waves of on-line data collection (T0 before the campaign, T1 just after it ended and T2 6 months after it ended).

SETTING

France.

PARTICIPANTS

A total of 2538 adult drinkers (aged 18-75 years).

MEASUREMENTS

The main outcomes' variables were LTH knowledge (cancer, hypertension, brain haemorrhage), LRDG knowledge (two guidelines: 'maximum of two drinks a day' and 'minimum of 2 days without alcohol per week'), intention to reduce alcohol consumption and self-declared consumption with respect to the French LRDG. At T1, exposure to the campaign was measured using self-reported campaign recall.

FINDINGS

In T1, we observed significant positive interactions between exposure group based on campaign recall and survey waves on knowledge of (i) the 'maximum two drinks a day' guideline [adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) = 1.08-1.62, P = 0.008], (ii) brain haemorrhage (aOR = 1.80, 95% CI = 1.44-2.25, P < 0.001) and (iii) hypertension (aOR = 1.41, 95% CI = 1.09-1.81, P = 0.008) risks. Campaign exposure was also associated with a significant decrease in at-risk drinking in women (aOR = 0.67, 95% CI = 0.50-0.88, P = 0.004). No significant interaction was observed at T1 for the knowledge of the 'minimum of 2 days without alcohol a week' guideline, or of cancer risk. At T2, no significant interaction was observed for the main outcomes' variables.

CONCLUSIONS

There appears to be an association between exposure to a 2019 French mass-media campaign to raise knowledge of long-term alcohol-related harms and low-risk drinking guidelines and reduce alcohol consumption and (i) improved knowledge of the 'maximum two drinks per day guideline', (ii) knowledge of the risks of hypertension and brain haemorrhage and (iii) a reduction in the proportion of people exceeding low-risk drinking guidelines (in the general population only). These associations were only observed over the short term and, in some cases, only for certain segments of the population.

Creating More Effective Vape Education Campaigns: Qualitative Feedback from Teens in Nine U.S. States

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.

Tobacco Control Measures' Role in Improving Employees' Health Under the Impact of Health Education and Media Campaign

The overarching purpose of this study was to investigate the impact of health education, media campaigns, and peer counselor training on employees' health. This study also attempted to evaluate the function of tobacco control as a mediator in the relationship between employees' health and health education, media campaigns, and peer counselor training. Data were collected from 440 tobacco industry workers in China using a questionnaire technique. Smart-PLS software and a structural equation modeling (SEM) technique were used to evaluate the data. Employees' health was found to be significantly improved by health education, media campaigns, and peer counselor training. Furthermore, tobacco control was discovered to moderate the association between employee health and health education, media campaigns, and peer counselor training. By analyzing the impact of health education, media campaigns, and peer counselor training on employees' health, this research provided an important theoretical contribution. In terms of practical applications, this study would help employees consuming tobacco to maintain a healthy and safe atmosphere that encourages them to be engaged and perform well. Furthermore, this study could prove effective in resolving difficulties linked to controlling employee tobacco addiction and improving their performance. The tiny sample size of this study, which included solely employees working in the Chinese tobacco sector, was one of its limitations. In addition, future studies can incorporate other constructs to acquire a deeper knowledge of the factors that influence employees' health.

Effect of a media intervention on hepatitis B screening among Vietnamese Americans

Objective: There is a lack of controlled studies of community-wide interventions to increase screening for hepatitis B (HBV) among Asian Americans, particularly Vietnamese Americans, who disproportionately suffer from HBV-related illnesses. The objective of our study was to develop, implement, and evaluate the effectiveness of a media campaign to promote HBV screening among Vietnamese Americans.Design: We designed and implemented a three-year media campaign promoting HBV screening among Vietnamese Americans. Evaluation consisted of cross-sectional pre- and post-intervention population-based telephone surveys of Vietnamese Americans adults age 18-64 who spoke English or Vietnamese and lived in the Northern California (intervention) or Greater Washington, D.C. (comparison) communities in 2007 or 2011. Statistical analysis was completed in 2012. The main outcome was self-report of HBV testing, defined as participants answering 'Yes' to the question: 'Have you ever had a blood test to check for hepatitis B?'Results: The sample sizes at pre- and post-intervention were 1,704 and 1,666, respectively. Both communities reported increased exposure to HBV-related booklets, radio and television advertisements, and websites. Only the intervention community reported increased exposure to newspaper elements. HBV screening increased in both communities (intervention: 65.3% to 73.1%, p < 0.01, comparison: 57.7% to 66.0%, p < 0.01). In multivariable analyses, there was no intervention effect. In both communities, exposure to media elements (Odds Ratio 1.26 [95% Confidence Interval: 1.21, 1.31] for each additional element) was significantly associated with screening.Conclusions: Among Vietnamese Americans in 2 large communities, HBV screening rates were sub-optimal. Screening increased in both the intensive media intervention and comparison communities, and exposure to HBV-related media messages was associated with increased screening. Efforts to address HBV screening among Vietnamese Americans should include mass media messaging.

Be under your own influence: Effectiveness of a Culturally-Adapted drug prevention campaign targeting Reservation-Dwelling American Indian youth

Be Under Your Own Influence (BUYOI) is a previously validated school-based intervention designed to delay adolescent substance use (SU) initiation. This study examined the effectiveness of a culturally-adapted version of BUYOI in delaying SU initiation among reservation-dwelling American Indian (AI) youth. Five reservation-based middle schools participated. Three schools were randomly assigned to receive BUYOI-AI (N = 321), and two schools served as controls (N = 176). Beginning in 7th grade, all participating students completed four assessments over the study period. Discrete time hazard models estimated the effects of BUYOI on students' risk of initiating alcohol, alcohol intoxication and marijuana before the end of 8th grade. AI students exposed to BUYOI had a lower risk of initiating alcohol use or intoxication, though sex moderated the effect on intoxication. These findings provide preliminary support for the effectiveness of a culturally-adapted version of BUYOI in delaying AI youth's first-time alcohol use and intoxication.

Exploring How Exposure to Truth and State-Sponsored Anti-Tobacco Media Campaigns Affect Smoking Disparities among Young Adults Using a National Longitudinal Dataset, 2002-2017

BACKGROUND

Little is known regarding long-term impacts of anti-tobacco media campaigns on youth smoking and related disparities in the United States.

METHODS

We examined longitudinal cohort data from Monitoring the Future (MTF) between 2000 and 2017 in modified Poisson regression models to understand the long-term impacts of televised Truth and state-sponsored ad campaign exposure at baseline (age 18) on first cigarette and daily smoking initiation 1 to 2 years later (at modal ages 19/20). We also used additive interactions to test for potential effect modification between campaign exposure and smoking outcomes by sex, race/ethnicity, and parental educational attainment.

RESULTS

We found no evidence for baseline media campaign exposure to be associated with first cigarette or daily smoking initiation at modal age 19/20. Further, results showed no evidence for effect modification between campaign exposure and first cigarette or daily smoking initiation.

CONCLUSIONS

We found no evidence that baseline Truth and state-sponsored ad exposure was associated with first cigarette or daily smoking initiation at follow up, nor did we find any evidence for effect modification by sex, race/ethnicity, or parental education. We hypothesize that anti-tobacco media campaigns might have had a short-term impact on smoking behaviors, though these effects were not sustained long term.

A Systematic Scoping Review of Media Campaigns to Develop a Typology to Evaluate Their Collective Impact on Promoting Healthy Hydration Behaviors and Reducing Sugary Beverage Health Risks

Interventions to discourage sugary beverages and encourage water consumption have produced modest and unsustainable behavioral changes to reduce obesity and noncommunicable disease risks. This systematic scoping review examined media campaigns to develop a typology to support healthy hydration nonalcoholic beverage behaviors. Our three-step methodology included the following: (1) review and summarize expert-recommended healthy beverage guidelines; (2) review six English-language electronic databases guided by PRISMA to describe existing campaign types by issue, goal and underlying theory; and (3) develop a media campaign typology to support policies, systems and environments to encourage healthy hydration behaviors. Results showed no international consensus for healthy beverage guidelines, though we describe expert-recommended healthy beverage guidelines for the United States. Of 909 records identified, we included 24 articles describing distinct media campaigns and nine sources that defined models, schemes or taxonomies. The final media campaign typology included: (1) corporate advertising, marketing or entertainment; (2) corporate social responsibility, public relations/cause marketing; (3) social marketing; (4) public information, awareness, education/ health promotion; (5) media advocacy/countermarketing; and (6) political or public policy. This proof-of-concept media campaign typology can be used to evaluate their collective impact and support for a social change movement to reduce sugary beverage health risks and to encourage healthy hydration behaviors.

Budgetary impact from multiple perspectives of sustained antitobacco national media campaigns to reduce the harms of cigarette smoking

BACKGROUND

High-intensity antitobacco media campaigns are a proven strategy to reduce the harms of cigarette smoking. While buy-in from multiple stakeholders is needed to launch meaningful health policy, the budgetary impact of sustained media campaigns from multiple payer perspectives is unknown.

METHODS

We estimated the budgetary impact and time to breakeven from societal, all-payer, Medicare, Medicaid and private insurer perspectives of national antitobacco media campaigns in the USA. Campaigns of 1, 5 and 10 years of durations were assessed in a microsimulation model to estimate the 10 and 20-year health and budgetary impact. Simulation model inputs were obtained from literature and both pubic use and proprietary data sets.

RESULTS

The microsimulation predicts that a 10-year national smoking cessation campaign would produce net savings of $10.4, $5.1, $1.4, $3.6 and $0.2 billion from the societal, all-payer, Medicare, Medicaid and private insurer perspectives, respectively. National antitobacco media campaigns of 1, 5 and 10-year durations could produce net savings for Medicaid and Medicare within 2 years, and for private insurers within 6-9 years. A 10-year campaign would reduce adult cigarette smoking prevalence by 1.2 percentage points, prevent 23 500 smoking-attributable deaths over the first 10 years. In sensitivity analysis, media campaign costs would be offset by reductions in medical care spending of smoking among all payers combined within 6 years in all tested scenarios.

CONCLUSIONS

1, 5 and 10-year antitobacco media campaigns all yield net savings within 10 years from all perspectives. Multiyear campaigns yield substantially higher savings than a 1-year campaign.

Does Exposure to the Choose Water Campaign Increase Parental Intentions to Promote More Water and Less Sugar-Sweetened Beverage Consumption?

PURPOSE

To assess if exposure to the Choose Water public health media campaign increased parents' intentions to promote healthier beverage consumption in their household.

DESIGN

A cross-sectional evaluation administered post-campaign.

SETTING

A 2017 internet panel survey in Los Angeles County, California.

PARTICIPANTS

The survey included 499 parents of young children.

INTERVENTION

The Choose Water media campaign included digital media and out-of-home advertisements (eg, transit shelters, interiors of buses) in both English and Spanish.

MEASURES

Dichotomous outcome variables were parental intentions to give child(ren) (1) more water and (2) less sugar-sweetened beverage consumption in their households. The independent variable was campaign exposure, categorized as no exposure, exposed but did not discuss visual, and exposed and discussed visual with someone.

ANALYSIS

Descriptive, bivariate, and multivariable logistic regressions.

RESULTS

Among those who were exposed and discussed a campaign visual, the adjusted odds of intending to promote water consumption were 2.82 times greater than for those who reported no exposure (95% confidence interval [CI]: 1.46-5.46). Similar odds to promote less sugar-sweetened beverage consumption were observed for those who were exposed and discussed a campaign visual (adjusted odds ratio: 3.27, 95% CI: 1.76-6.08). Those with the lowest educational attainment discussed the visual(s) less (10.5%).

CONCLUSION

Word of mouth may enhance health messaging by allowing time for intended audiences to process campaign content within their interpersonal network.

Communicating health risk in Southeast Nigeria: The case of media campaign against viral hepatitis and its implication for health communication

The purpose of this study is to investigate the media coverage of viral hepatitis in Southeast Nigeria and the implication it has on health communication. This study was conducted with the aim of determining the level of awareness of viral hepatitis disease in Southeast Nigeria; and the extent of media coverage of hepatitis disease.Cross-sectional survey study was carried out in the 5 states of Southeast Nigeria while structured questionnaire was used to generate data. A representative sample of 500 respondents was selected from the capital cities of the 5 states in the Southeast zone of Nigeria. The data generated were analyzed using mean, percentage (%), and analysis of variance tests of between-subjects effects in SPSS, version 20. Results were considered significant at P ≤ .05.Even though majority of the people are consumers of media products, only a few of the respondents were aware of viral hepatitis, its symptoms, mode of transmission, and curative measures. Inappropriate timing and scanty or limited scheduling of media health programs were significant hindrances to media campaign against viral hepatitis in Southeast Nigeria.Regular media campaign programs against the disease are required to build more awareness as well as appropriate timing of media programs such as Sunday evenings and news hours, and media interactive forum with phone-in programs. Further research on the nature and impact of funding, support, and policy on media campaigns on this health risk are also recommended.

Cultural Adaptation of the Be under Your Own Influence Media Campaign for Middle-School American Indian Youth

American Indian (AI) adolescents living on reservations report much higher substance use rates compared to other youth yet there are few effective prevention interventions developed for them. This paper presents findings from formative research undertaken to guide adaptation for AI youth of a prevention intervention, Be Under Your Own Influence (BUYOI), previously found to be effective in reducing substance use among middle-school youth. We conducted focus groups with 7th graders, the primary target audience, and photovoice with 11th graders, the role models who would help deliver the campaign, to inform surface and deep structure adaptation. Both age groups noted the pervasiveness of substance use on the reservation and indicated that this posed a major challenge to being drug and alcohol free. Students also described aspects of their community that tied to signs of social disorganization. However, these youth have much in common with other youth, including high future aspirations, involvement in activities and hobbies, and influence from family and friends. At the same time, there were important differences in the experiences, environment, and values of these AI youth, including emphasis on different types of activities, a more collectivist cultural orientation, tribal identity and pride, and the importance of extended families.

Cost benefit study of a safety campaign's impact on road safety

The aim of this paper is to identify a break in the development trend of the time series of the number of fatal, light and heavy injuries in traffic accidents and compare the progress caused by the media campaign named "Think or you'll pay! "in the Czech Republic over the period 2000-2015. The campaign focuses on the age group of drivers under the age of 25 and the most common cause of their traffic accidents as the drivers in this age category are the most vulnerable group in road traffic. The campaign uses a method in which it tries to influence behaviour by negative action, or by causing negative emotions. The authors concentrate on the effects of mass media campaigns in the long-term development of accidents in the Czech Republic and a financial evaluation of the road safety campaign "Think or you'll pay! "by comparing the campaign costs, the cost of road fatalities, and the cost savings from the perspective of government expenditures. The secondary source data for the chart analysis and interpolation according to the criteria of analytical and mechanical balancing time series, the Chow test and Quandt Likelihood Ratio test, choosing the appropriate model trend of accidents and consequences of traffic accidents were obtained from the Czech Ministry of Transport, the database of The Losses due to Traffic Accident Rates (CZRSO) and the Czech Association of Victims of Traffic Accidents (CSODN, 2015) from period of 1990 till 2016. The impact of the media campaign "Think or you'll pay!", measured by enumerating the costs was compared with the number of fatalities in the years immediately after the campaign and the impact of the media campaign was evaluated and recognised. The conclusion and the highlights summarize the findings of research and the limits of media campaign evaluation approach.

Exposure to a national multimedia Alzheimer's disease awareness campaign: Assessing stigmatic beliefs towards persons with the disease

OBJECTIVE

The purpose of this study was to examine the impact of being exposed to a multimedia campaign on stigmatic beliefs towards a person with Alzheimer's disease (AD).

METHODS

A cross-sectional posttest online survey was conducted immediately after the campaign among 510 Jewish participants aged 40 and above.

RESULTS

Most the participants reported being exposed to the campaign. The campaign elicited significantly higher positive than negative emotions. Exposure to the campaign was not significantly associated with any of the stigmatic beliefs as a direct or moderating variable. Worry about developing AD was associated with increased stigmatic beliefs.

CONCLUSIONS

More research is needed to better understand which types of media campaigns work best to increase awareness and reduce stigma associated with AD.

[Effects on female healthcare workers of the ministry of health campaign against tobacco smoking.]

OBJECTIVES

Smoking prevalence among health care workers is higher in comparison with general population and the prevalence of women who smoke is higher than among men. In the prevention strategies the multimedia campaign may be a positive impact on the fight against tobacco. Objective. The aim of the study was to assess the impact of the last Italian campaign against smoking (Il fumo fammale) in the health care women workers.

METHODS

A cross-sectional study was conducted in Latium and Sicily (Italy) in 2015, through an interview on memories and impressions about the spots and after a new vision of the spot and eventually other comments.

RESULTS

357 individuals entered the study, 204 female health care workers and 153 from the general population. The female health care workers were more skeptical than the general population. The impressions aroused in the healthcare workers versus the general population were: sadness (OR=2.96;IC95%:1.17-7.49), indifference (OR=5.57;IC95%:2.43-12.77); while a cue to reflect was more considered from general population than health care workers (OR=0.13;IC95%:0.07-0.23). The female professionals health referred the main characteristics of the spot as no original, no impactful, no persuasive and boring too.

CONCLUSIONS

In conclusion the multimedia campaign to fight against the smoking should be useful, but the psico-behavioural factors have applied and considered when it is implemented; to reduce the tobacco consumption in the healthcare workers can make them an example for the people of healthy life styles and they are a start up of prevention mechanism too. Furthermore it is important to consider the healthcare professional's opinions for future healthy communications and multimedia campaign on tobacco harm.

Do You Know What Your Kids Are Drinking? Evaluation of a Media Campaign to Reduce Consumption of Sugar-Sweetened Beverages

OBJECTIVE

This study evaluates a citywide media campaign that targeted reducing sugar-sweetened beverage (SSB) consumption as a strategy for addressing obesity.

DESIGN

Rolling cross-sectional survey data, collected before and during the media campaign, with 1367 parents to assess exposure to and effect of a televised public service advertisement (TV PSA) developed using a reasoned action approach.

SETTING

Televised public service advertisement campaign created by the Philadelphia Department of Public Health and disseminated on cable television channels within the Philadelphia market.

PARTICIPANTS

Philadelphia parents/primary caregivers with a child between the ages of 3 and 16.

RESULTS

Linear regression analysis shows that exposure to the TV PSA was significantly associated with intention to substitute nonsugary drinks for SSBs for the parent ( P = .04) and the child ( P = .02). The effect of exposure on intention to reduce child's SSB consumption increased the longer the campaign was in the field. Exposure was also significantly associated with the belief that reducing SSB consumption decreases the risk of diabetes ( P = .04) and was significantly negatively related to the belief that reducing SSB consumption would make mealtimes less enjoyable ( P = .04).

CONCLUSION

These findings suggest that a theory-based mass media campaign can achieve positive changes in intention related to SSB consumption by changing relevant and salient underlying beliefs.

Measuring the impact of a public awareness campaign to increase Welfare Power of Attorney registrations in Scotland

Objective

to measure the impact of the 'My Power of Attorney' media campaign on the number of new power of attorney (POA) registrations in Scotland.

Setting

POA registrations in Scotland processed by the Office of the Public Guardian during January 2010 to June 2015.

Methods

multilevel Poisson models for POA registrations nested by council and annual quarter were run using Markov chain Monte Carlo methods, adjusting for time, campaign (variable ranging between 0 and 5 dependent on intensity of campaign measured by the number of media platforms received) and offset term mid-year population estimate for those aged 25 years+/65 years+.

Results

POA registrations saw a reduction between 2010 and 2011 but overall, increased between 2010 and 2015. POA registrations rose by 33.3% in Glasgow City between 2013 and 2014, when the campaign began, while the rest of Scotland saw a rise of 17.3%. When the data were modelled, Relative Risk (RR) of a POA registration increased with increasing intensity of campaign, so that in an area in receipt of the full campaign was RR = 1.31 (1.28, 1.34) that of an area with no campaign. Between council variation persisted after adjustment for campaign (Variance = 0.041 (0.011)).

Conclusions

during the period of the campaign, area-level increases in POA registrations were observed associated with the 'My Power of Attorney' timing and location, in an approximate dose-response relationship with campaign intensity, suggesting that this is likely to be due to the campaign that began in Glasgow City.

A Multiyear Assessment of Public Response to a Statewide Drug Take-Back and Disposal Campaign, 2010 to 2012

This study is the first to analyze public response to a drug take-back program, the American Medicine Chest Challenge, in a single state over a period of 3 years (2010-2012). The study utilized a three-wave repeated cross-sectional design and an annual phone survey conducted with a representative sample of adults ( N = 906 in 2010, N = 907 in 2011, and N = 906 in 2012), which assessed exposure to the campaign, drug disposal behaviors, possible mediators of campaign effects (risk appraisal, personal agency, normative influence, and interpersonal talk), and potential confounders. Logistic regression and causal mediation analysis were employed to estimate confounder-adjusted direct and mediated effects of the campaign. Results showed that the campaign reached a sizable portion (50% to 60%) of state adults and that campaign exposure was associated with increased likelihood of having conversations with others about this topic. About 55% of all adults in the state reported taking at least one of the actions recommended by the campaign, and campaign exposure was associated with increased likelihood of disposing of prescription drugs at a drug collection day event (adjusted odds ratio = 4) and of talking to a child about the risks associated with prescription drug abuse (adjusted odds ratio = 2). The causal mediation analysis demonstrated that the campaign influenced audiences by reinforcing their efficacy to safely dispose of prescription drugs, but also potentially by stimulating conversations among community members about this topic. Drug take-back campaigns can be an effective mechanism to decrease the availability of prescription drugs in communities.

Linking mass media campaigns to pictorial warning labels on cigarette packages: a cross-sectional study to evaluate effects among Mexican smokers

OBJECTIVE

This study assessed the effects of pictorial health warning labels (HWLs) and a linked media campaign in Mexico.

METHODS

Cross-sectional data were collected from a population-based sample of 1756 adult smokers, aged 18-55 years, during the initial implementation of pictorial HWLs, which some smokers had seen on cigarette packages while others had seen only the text-based HWLs. Exposure to the campaign and pictorial HWLs was assessed with aided recall methods, and other questions addressed attention and cognitive impact of HWLs, knowledge related to HWL and campaign content, and quit-related thoughts and behaviours. Logistic and linear regression models were estimated to determine associations between key outcomes and intervention exposure.

RESULTS

In bivariate and multivariate adjusted models, recall of pictorial HWLs and of the campaign were positively associated with greater attention to and cognitive impact of HWLs, whereas only pictorial HWL exposure was associated with having refrained from smoking due to HWLs. Both recall of pictorial HWLs and of the campaign were independently associated with greater knowledge of secondhand smoke harms and toxic tobacco constituents. Smokers who recalled only the pictorial HWLs were more likely to try to quit than smokers who recalled neither the pictorial HWLs nor the campaign (17% vs 6%, p<0.001).

CONCLUSIONS

Consistent with other studies, adult smokers' exposure to new pictorial HWLs in Mexico was associated with psychosocial and behavioural responses related to quit behaviour. Exposure to the complementary media campaign was associated with independent additive effects on campaign-related knowledge, and it enhanced psychosocial responses to pictorial HWLs.

Prevention of alcohol misuse among children, youths and young adults

BACKGROUND

Despite many activities to prevent risky alcohol consumption among adolescents and young adults there is an increase of alcohol intoxications in the group of ten to twenty year old juveniles.

OBJECTIVES

This report gives an overview about the recent literature as well as the German federal prevention system regarding activities concerning behavioral and policy prevention of risky alcohol consumption among children, adolescents and young adults. Furthermore, effective components of prevention activities are identified and the efficiency and efficacy of ongoing prevention programs is evaluated.

METHODS

A systematic literature review is done in 34 databases using Bool'sche combinations of the key words alcohol, prevention, treatment, children, adolescents and young adults.

RESULTS

401 studies were found and 59 studies were selected for the health technology assessment (HTA). Most of the studies are done in USA, nine in Germany. A family strengthening program, personalized computer based intervention at schools, colleges and universities, brief motivational interventions and policy elements like increase of prices and taxes proved effective.

DISCUSSION

Among the 59 studies there are three meta-analyses, 15 reviews, 17 randomized controlled trials (RCT) and 18 cohort studies. Despite the overall high quality of the study design, many of them have methodological weaknesses (missing randomization, missing or too short follow-ups, not clearly defined measurement parameters). The transferability of US-results to the German context is problematic. Only a few prevention activities reach a sustainable reduction of frequency and/or amount of alcohol consumption.

CONCLUSION

The HTA-report shows the need to develop specific and target group focused prevention activities for the German situation. Essential for that is the definition of target goals (reduction of consumption, change of behaviour) as well as the definition and empirical validation of risky alcohol consumption. The efficacy of prevention activities should be proven before they are launched. At present activities for the reduction or prevention of risky alcohol consumption are not sufficiently evaluated in Germany concerning their sustainable efficacy.

Tobacco marketing in California and implications for the future

BACKGROUND

Tobacco marketing influences tobacco use initiation, maintenance of use, and it undermines comprehensive tobacco control programmes. Policies to ban the impact of tobacco marketing are most likely to be more effective if they are comprehensive, as partial bans shift marketing to non-banned forms of media. A comprehensive approach to reducing tobacco marketing includes documentation through monitoring, media and policy interventions and aggressive enforcement of existing laws.

METHODS

This paper summarises California tobacco industry monitoring of events and retail outlets, and findings about exposure to and beliefs about tobacco industry marketing among youths and adults conducted during the period 2000 through 2008.

RESULTS

There was no overall change in the average number of cigarette materials per store, and an increase in the percentage of stores with advertisements promoting price discounts for cigarettes. Stores with cigarette advertisements near candy displays declined from 12.5% (95% CI 9.8% to 15.2%) to 1% (95% CI 0.2% to 1.9%) of stores, and advertisements at or below the eye-level of children declined from 78.6% (95% CI 75.2% to 82.0%) to 31% (95% CI 27.1% to 34.9%) of stores. Overall, the number of public events with tobacco sponsorship declined from 77.3% to 48.1%. This trend was consistent with a significant decline noted among high school students and adults who reported seeing tobacco advertisements at events or attending a tobacco company-sponsored event.

CONCLUSIONS

Tobacco industry monitoring, media, policy and enforcement interventions may have contributed to observed changes in tobacco marketing and to declines in reported exposure to tobacco marketing.

Assessing the relationship between ad volume and awareness of a tobacco education media campaign

BACKGROUND

The relation between aided ad recall and level of television ad placement in a public health setting is not well established. We examine this association by looking back at 8 years of the California's Tobacco Control Program's (CTCP) media campaign.

METHODS

Starting in July 2001, California's campaign was continuously monitored using five telephone series of surveys and six web-based series of surveys immediately following a media flight. We used population-based statewide surveys to measure aided recall for advertisements that were placed in each of these media flights. Targeted rating points (TRPs) were used to measure ad placement intensity throughout the state.

RESULTS

Cumulative TRPs exhibited a stronger relation with aided ad recall than flight TRPs or TRP density. This association increased after log-transforming cumulative TRP values. We found that a one-unit increase in log-cumulative TRPs led to a 13.6% increase in aided ad recall using web-based survey data, compared to a 5.3% increase in aided ad recall using telephone survey data.

CONCLUSIONS

In California, the relation between aided ad recall and cumulative TRPs showed a diminishing return after a large volume of ad placements These findings may be useful in planning future ad placement for CTCP's media campaign.

Healthcare provider back pain beliefs unaffected by a media campaign

OBJECTIVE

Healthcare providers play a key role in transmitting knowledge and beliefs about LBP to their patients. There are differences in back pain beliefs between the various professionals groups treating LBP patients. This study examined whether LBP beliefs changed among the healthcare providers exposed to a media campaign.

DESIGN

A quasi-experimental postal before-and-after survey of health professional beliefs following a campaign aimed at improving beliefs about LBP in the general public, and which included specific interventions also towards the healthcare providers.

SETTING

Two Norwegian counties, with a neighbouring county serving as control.

SUBJECTS

A total of 243 doctors, physiotherapists, and chiropractors in primary care.

MAIN OUTCOME MEASURES

Beliefs about LBP before and after exposure to the campaign.

RESULTS

A total of 243 doctors, physiotherapists, and chiropractors answered the questionnaire in 2002 and 2005. A general tendency was observed for all providers to have beliefs more in line with guidelines in 2005 compared with 2002, irrespective of exposure status. Some baseline differences in beliefs between the professional groups were not only sustained but in fact seemed to increase from 2002 to 2005. This was particularly as regards LBP as a self-limiting condition.

CONCLUSION

An LBP mass media campaign with educational initiatives aimed at healthcare providers did not result in important improvement in LBP beliefs of providers exposed to the campaign. Important differences were observed between beliefs of the different healthcare provider groups in their view of LBP.