FRAMING MESSAGES FOR TEEN SMOKING PREVENTION IN PRIMARY CARE

描述(由申请人提供)：青少年吸烟的初级预防是国家公共卫生优先事项，是全面烟草控制的核心。有效的健康沟通是这一努力的一部分，包括针对年轻人的说服性反吸烟信息，宣传避免吸烟的健康益处和使用香烟的危害。反吸烟信息通常被框定为强调戒烟的好处(框定的收益)或吸烟对健康的成本(框定的损失)。事实上，FDA最近承认了装框信息的重要性，要求卷烟标签上出现带有装框的健康警告。以展望理论为基础的信息框架表明，在防止青少年吸烟方面，收益框架信息比丢失框架信息更好，但这方面的研究仍然很少。了解框式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有利地位，但此类信息的提供仍然很少。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吸烟预防资源联系起来，这些资源是儿科初级保健的补充。简短的得失框架信息可能是激励青少年使用在这种背景下提供的基于证据的在线预防资源的有效策略，但关于为此目的使用框架反吸烟信息的情况知之甚少。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使用循证在线吸烟预防资源的影响，该资源是初级保健的辅助工具，名为“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岁青少年将收到一条以得或失为框架的信息，或一条介绍青少年渴望的一般信息。青少年在查看邮件后，可以选择立即在线访问ASPIRE，并可在30天内继续访问。青少年还将通过邮件和电子邮件每周收到助推器信息，并将完成为期1个月的ASPIRE使用和吸烟相关结果的后续评估。我们将考察框架信息对ASPIRE使用的影响，并探索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，以规划这一研究领域的未来研究。这项研究准备提供关于框定信息以防止青少年吸烟的关键见解。这将是首批调查框架信息是否有效的研究之一，目的是鼓励青少年使用儿科初级保健辅助提供的在线预防资源，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能被用来为新兴的国家预防工作提供信息，利用框架信息作为防止青少年吸烟的战略，例如在香烟包装上使用丢失框架的健康警告标签。 公共卫生相关性：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。这项研究旨在开发和评估简短的框架信息的效果，以激励12-17岁的青少年使用提供儿科初级保健辅助的循证预防吸烟网站。简短、框定的信息可能是一种高效和有效的方法，可以在这种临床背景下利用经过验证的在线吸烟预防资源来吸引青少年，并可以作为防止青少年吸烟的一种战略。

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.