FRAMING MESSAGES FOR TEEN SMOKING PREVENTION IN PRIMARY CARE

青少年吸烟的一级预防是国家公共卫生的优先事项，是全面烟草控制的核心。有效的健康宣传是这一努力的一部分，包括针对年轻人的有说服力的反吸烟信息，说明避免吸烟的健康益处和吸烟的危害。反吸烟信息通常是强调避免吸烟的好处（收益框架）或吸烟对健康的代价（损失框架）。事实上，FDA最近承认了框架信息的重要性，要求在香烟标签上出现图形损失框架健康警告。基于前景理论，信息框架表明，在预防青少年吸烟方面，收益框架信息上级损失框架信息，但这方面的研究仍然很少。了解框架信息的效果和影响信息效果的因素对于优化其作为预防青少年吸烟的公共卫生工具的影响至关重要。初级保健提供者在向青少年提供预防吸烟信息方面处于非常有利的地位，但提供此类信息的程度仍然很低。作为克服办公室干预障碍的一种手段，青少年可以与以证据为基础的在线预防吸烟资源联系起来，以辅助儿科初级保健。简短的增益和/或损失框架的消息可能是一个有效的策略，激励青少年使用循证网上预防资源在这种情况下提供的，但鲜为人知的是，关于使用框架的反吸烟信息，为此目的。我们的研究旨在开发和评估有说服力的框架信息对青少年利用循证在线预防吸烟资源的影响，该资源是初级保健的辅助资源，称为“预防吸烟互动体验”（ASPIRE）。使用三组实验设计，通过大型HMO招募的12 - 17岁的青少年将收到一个增益或损失帧的消息，或一个通用的消息，将介绍青少年ASPIRE。在查看消息后，青少年将可以选择立即在线访问ASPIRE，并持续访问30天。青少年还将通过邮件和电子邮件收到每周的助推器信息，并将完成ASPIRE使用和吸烟相关结果的1个月随访评估。我们将研究框架信息对ASPIRE利用率的影响，并探讨社会和心理因素的调节作用。我们还将对框架信息和ASPIRE使用对吸烟易感性的影响进行初步分析，以告知该研究领域未来研究的规划。这项研究准备提供关键的见解，关于使用框架信息，以防止青少年吸烟。这将是第一批调查框架信息是否能有效激励青少年使用儿科初级保健辅助提供的在线预防资源的研究之一，了解框架信息是否有效以及对谁有效。这一系列研究的结果也可用于为新出现的国家预防工作提供信息，这些工作利用框架信息作为预防青年吸烟的战略，例如在香烟包装上使用丢失框架的健康警告标签。 预防青少年吸烟是国家公共卫生优先事项，对全面烟草控制至关重要。本研究旨在开发和评估简短的框架信息的效果，以激励12 - 17岁的青少年使用以证据为基础的预防吸烟网站提供辅助儿科初级保健。简短的框架信息可能是一种高效和有效的方法，可以让青少年在这种临床背景下使用经过验证的在线预防吸烟资源，并可以作为预防青少年吸烟的策略。

DESCRIPTION (provided by applicant): Primary prevention of teen smoking is a national public health priority and is central to comprehensive tobacco control. Effective health communication is part of this effort, including persuasive anti-smoking messages targeting young people about the health benefits of avoiding cigarette smoking and the harms of use. Anti- smoking messages are typically framed to emphasize either the benefits of smoking avoidance (gain-framed) or the costs of smoking to health (loss-framed). Indeed, the FDA recently acknowledged the importance of framed messages by requiring that graphic loss-framed health warnings appear on cigarette labels. Grounded in Prospect Theory, message framing suggests that gain-framed messages are superior to loss-framed messages for preventing teen smoking, but research in this area remains scarce. Understanding the effects of framed messages and the factors that influence message effects is critical to optimize their impact as a public health tool to prevent teen smoking. Primary care providers are in an excellent position to deliver smoking prevention information to teens, but provision of such information remains low. As a means to overcome barriers to office-based interventions, teens can be linked with evidence-based, online smoking prevention resources adjunct to pediatric primary care. Brief gain- and/or loss-framed messages may be an effective strategy to motivate teens to use evidence-based online prevention resources offered in this context, but little is known regarding the use of framed anti-smoking messages for this purpose. Our study seeks to develop and evaluate the effects of persuasive, framed messages on teens' utilization of an evidence-based online smoking prevention resource offered adjunct to primary care called "A Smoking Prevention Interactive Experience" (ASPIRE). Using a three-group experimental design, teens age 12 - 17 recruited via a large HMO will receive either a gain- or loss-framed message, or a generic message that will introduce teens to ASPIRE. After viewing messages, teens will have the option to access ASPIRE online immediately with continued access for 30-days. Teens will also receive weekly booster messages via mail and email, and will complete a 1-month follow-up assessment of ASPIRE use and smoking-related outcomes. We will examine the impact of framed messages on ASPIRE utilization and explore the moderating effects of social and psychological factors. We will also conduct preliminary analyses on the impact of framed messages and ASPIRE use on smoking susceptibility to inform planning of future studies in this area of research. This study is poised to provide critical insights regarding the ue of framed messages to prevent teen smoking. It will be among the first studies to investigate whether framed messages are effective for motivating teens to use online prevention resources offered adjunct to pediatric primary care, learning if framed messages work and for whom. Findings from this line of research may also be used to inform emerging national prevention efforts leveraging framed messages as a strategy to prevent youth smoking, such as the use of loss-framed health warning labels on cigarette packages. PUBLIC HEALTH RELEVANCE: Preventing teen smoking is a national public health priority and is critical to comprehensive tobacco control. This study seeks to develop and evaluate the effects of brief, framed messages for motivating teens age 12 - 17 to use an evidence-based smoking prevention web site offered adjunct to pediatric primary care. Brief, framed messages may be a highly efficient and effective approach to engage teens with proven online smoking prevention resources within this clinical context and could be adopted as a strategy to prevent teen smoking.