Evaluation of smoking prevention television messages based on the elaboration likelihood model.

Progress in reducing youth smoking may depend on developing improved methods to communicate with higher risk youth. This study explored the potential of smoking prevention messages based on the Elaboration Likelihood Model (ELM) to address these needs. Structured evaluations of 12 smoking prevention messages based on three strategies derived from the ELM were conducted in classroom settings among a diverse sample of non-smoking middle school students in three states (n = 1771). Students categorized as likely to have higher involvement in a decision to initiate cigarette smoking reported relatively high ratings on a cognitive processing indicator for messages focused on factual arguments about negative consequences of smoking than for messages with fewer or no direct arguments. Message appeal ratings did not show greater preference for this message type among higher involved versus lower involved students. Ratings from students reporting lower academic achievement suggested difficulty processing factual information presented in these messages. The ELM may provide a useful strategy for reaching adolescents at risk for smoking initiation, but particular attention should be focused on lower academic achievers to ensure that messages are appropriate for them. This approach should be explored further before similar strategies could be recommended for large-scale implementation.

Increasing patient/physician communications about colorectal cancer screening in rural primary care practices.

BACKGROUND: Rural populations as well as less educated people in the United States are less likely to receive colorectal cancer (CRC) screening than people living in urban areas and more educated people. METHODS: We tested a computer tablet, Patient/Provider Communication Assistant (PPCA), which collected data, educated patients, and printed personalized notes to patients and providers encouraging conversation about CRC screening. Mixed model analyses using a prepost quasi-experimental design compared patient results during the comparison and intervention periods in 5 rural primary care practices on provider discussion about CRC screening, provider recommendation, and patient intention to be screened. Models including age, education, and literacy measures as covariates were examined. RESULTS: Providers talked with patients about CRC screening in general, and colonoscopy specifically more frequently after the PPCA than with the comparison group (P values = 0.04 and 0.01, respectively). Providers recommended CRC screening more often to patients in the intervention group than to the comparison group (P = 0.02). Patients planned to be screened, specifically with colonoscopy, more frequently after the intervention than in the comparison group (P = 0.003). There were no interactions between group and any of the covariates. Ninety-five percent of the patients, regardless of age or education, found the PPCA easy to use. CONCLUSIONS: Results indicated increased provider discussion and recommendation, and patients' intentions to obtain CRC screening, and in particular colonoscopy, for patients exposed to the intervention, regardless of the patients' age or literacy levels. The PPCA is a promising intervention method that is acceptable to rural patients.

Youth audience segmentation strategies for smoking-prevention mass media campaigns based on message appeal.

Mass media interventions are among the strategies recommended for youth cigarette smoking prevention, but little is known about optimal methods for reaching diverse youth audiences. Grades 4 through 12 samples of youth from four states (n = 1,230) rated smoking-prevention messages in classroom settings. Similar proportions of African American, Hispanic, and White youth participated. Impact of audience characteristics on message appeal ratings was assessed to provide guidance for audience segmentation strategies. Age had a strong effect on individual message appeal. The effect of gender also was significant. Message ratings were similar among the younger racial/ethnic groups, but differences were found for older African American youth. Lower academic achievement was associated with lower appeal scores for some messages. Age should be a primary consideration in developing and delivering smoking-prevention messages to youth audiences. The unique needs of boys and girls and older African American adolescents should also be considered.

Mass media and community interventions to reduce alcohol use by early adolescents.

OBJECTIVE: Although early use of alcohol is an immediate and long-term risk for young people, proven prevention strategies are limited. Mass media interventions have been shown to be effective in reducing use of other substances by adolescents. This study tested the impact of a 4-year media campaign designed to reduce alcohol use by early adolescents. METHOD: Theory-based television and radio messages promoting avoidance of alcohol were developed and delivered to an audience of young people as they matured from Grades 4-5 to Grades 7-8. A set of eight school districts was identified as the Media Area; eight matching districts served as the Comparison Area. Independent Grade 7-8 surveys were conducted in all districts at baseline (N= 2897) and after the interventions (N=2419). Unanticipated community coalitions working to reduce youth substance use were introduced into 10 of these 16 communities during the same time period. RESULTS: Exposure of the target audience to the media messages was lower than expected, and the unplanned community coalition interventions may have favored the Comparison Area. The main analyses indicated that the media interventions did not significantly affect alcohol use or its mediators. Supplementary analyses suggested a substantial impact of community coalitions on alcohol use and several key mediators. CONCLUSIONS: The mass media interventions provided by this study had no effect on adolescent alcohol use or its psychosocial mediators. Factors external to the study reduced chances of detecting media effects. Further work is needed to develop and test mass media strategies for alcohol use prevention among early adolescents.