Evans William Douglas, Bingenheimer Jeffrey, Cantrell Jennifer, Kreslake Jennifer, Tulsiani Shreya, Ichimiya Megumi, D'Esterre Alexander P, Gerard Raquel, Martin Madeline, Hair Elizabeth C
Milken Institute School of Public Health, The George Washington University, Washington, DC, United States.
New York University School of Global Public Health, New York, NY, United States.
J Med Internet Res. 2024 Mar 12;26:e50741. doi: 10.2196/50741.
e-Cigarette use, especially by young adults, is at unacceptably high levels and represents a public health risk factor. Digital media are increasingly being used to deliver antivaping campaigns, but little is known about their effectiveness or the dose-response effects of content delivery.
The objectives of this study were to evaluate (1) the effectiveness of a 60-day antivaping social media intervention in changing vaping use intentions and beliefs related to the stimulus content and (2) the dose-response effects of varying levels of exposure to the intervention on vaping outcomes, including anti-industry beliefs, vaping intentions, and other attitudes and beliefs related to vaping.
Participants were adults aged 18 to 24 years in the United States. They were recruited into the study through Facebook (Meta Platforms) and Instagram (Meta Platforms), completed a baseline survey, and then randomized to 1 of the 5 conditions: 0 (control), 4, 8, 16, and 32 exposures over a 15-day period between each survey wave. Follow-up data were collected 30 and 60 days after randomization. We conducted stratified analyses of the full sample and in subsamples defined by the baseline vaping status (never, former, and current). Stimulus was delivered through Facebook and Instagram in four 15-second social media videos focused on anti-industry beliefs about vaping. The main outcome measures reported in this study were self-reported exposure to social media intervention content, attitudes and beliefs about vaping, and vaping intentions. We estimated a series of multivariate linear regressions in Stata 17 (StataCorp). To capture the dose-response effect, we assigned each study arm a numerical value corresponding to the number of advertisements (exposures) delivered to participants in each arm and used this number as our focal independent variable. In each model, the predictor was the treatment arm to which each participant was assigned.
The baseline sample consisted of 1491 participants, and the final analysis sample consisted of 57.28% (854/1491) of the participants retained at the 60-day follow-up. We compared the retained participants with those lost to follow-up and found no statistically significant differences across demographic variables. We found a significant effect of the social media treatment on vaping intentions (β=-0.138, 95% CI -0.266 to -0.010; P=.04) and anti-industry beliefs (β=-0.122, 95% CI 0.008-0.237; P=.04) targeted by the intervention content among current vapers but not among the full sample or other strata. We found no significant effects of self-reported exposure to the stimulus.
Social media interventions are a promising approach to preventing vaping among young adults. More research is needed on how to optimize the dosage of such interventions and the extent to which long-term exposure may affect vaping use over time.
ClinicalTrials.gov NCT04867668; https://clinicaltrials.gov/study/NCT04867668.
电子烟的使用，尤其是在年轻人中，处于令人无法接受的高水平，是一种公共卫生风险因素。数字媒体越来越多地被用于开展反电子烟运动，但对于其效果或内容传播的剂量反应效应知之甚少。
本研究的目的是评估（1）为期60天的反电子烟社交媒体干预在改变与刺激内容相关的电子烟使用意图和信念方面的效果，以及（2）不同程度暴露于该干预对电子烟结果的剂量反应效应，包括反行业信念、电子烟意图以及与电子烟相关的其他态度和信念。
参与者为美国18至24岁的成年人。他们通过脸书（Meta平台）和照片墙（Meta平台）招募进入研究，完成基线调查，然后随机分为5种情况中的一种：0次（对照组）、4次、8次、16次和32次暴露，在每次调查波次之间的15天内进行。随机分组后30天和60天收集随访数据。我们对全样本以及根据基线电子烟使用状况（从不使用、曾经使用和当前使用）定义的子样本进行分层分析。刺激通过脸书和照片墙以四个15秒的社交媒体视频呈现，重点是关于电子烟的反行业信念。本研究报告的主要结局指标是自我报告的对社交媒体干预内容的暴露、对电子烟的态度和信念以及电子烟意图。我们在Stata 17（StataCorp）中估计了一系列多元线性回归。为了捕捉剂量反应效应，我们为每个研究组分配一个与该组参与者收到的广告（暴露）数量相对应的数值，并将此数字用作我们的主要自变量。在每个模型中，预测变量是每个参与者被分配的治疗组。
基线样本包括1491名参与者，最终分析样本包括在60天随访中保留的57.28%（854/1491）的参与者。我们将保留的参与者与失访者进行比较，发现各人口统计学变量之间无统计学显著差异。我们发现社交媒体治疗对当前电子烟使用者中干预内容所针对的电子烟意图（β=-0.138，95%CI -0.266至-0.010；P=0.04）和反行业信念（β=-0.122，95%CI 0.008 - 0.237；P=0.04）有显著影响，但在全样本或其他分层中没有。我们发现自我报告的对刺激的暴露没有显著影响。
社交媒体干预是预防年轻人使用电子烟的一种有前景的方法。需要更多研究来探讨如何优化此类干预的剂量以及长期暴露随时间推移可能影响电子烟使用的程度。
ClinicalTrials.gov NCT04867668；https://clinicaltrials.gov/study/NCT04867668
