Targeted Advertising for Cancer Prevention

我的目标是从根本上改变我们的预防方法。我想利用在线广告、社交媒体和 智能手机技术，为有针对性的预防信息创建快速、有效和可扩展的平台 实际上改变了健康行为。我计划从皮肤癌预防开始，用日光浴床和黑色素瘤作为 证明原则的例子。然而，这项工作将广泛推广到许多其他公共卫生领域 行为在疾病过程中发挥关键作用的挑战。 超过一半的癌症是可以通过行为改变、疫苗或药物来预防的。 从科学证据到实施的过程缓慢得令人痛苦。新近成立的医学研究所 兰德报告估计，只有50%的推荐医疗保健做法得到了实施，而这 需要几十年的时间。预防性卫生保健的情况更糟。 与此同时，黑色素瘤和非黑色素瘤皮肤癌(NMSC)的发病率都在继续上升。 事实上，皮肤癌的发病率比所有其他癌症的总和还要高。室内晒黑是I类致癌物质 以及一个主要的、可修改的危险因素，导致超过450,000个新的NMSC和超过10,000个黑色素瘤 每年。5这相当于每年近50万有可能预防的皮肤癌。然而，日光浴床的使用 在过去的一年中，五分之一的青少年和超过40%的大学生使用日光浴床仍然很常见 5尽管在预防工作上投入了大量资金，包括基金会精心设计的宣传活动 专注于皮肤癌预防，我们影响皮肤癌发病率的努力遇到了障碍。 针对健康信息的技术可以在正确的时间将正确的信息传递给正确的人。 社交媒体和在线搜索引擎给了我们前所未有的能力来定位我们的健康信息 直接给那些风险最高的人。这些平台为我们提供了一种方式，在青少年处于- 例如，搜索日光浴沙龙。7，8超过90%的青少年和年轻人每天上网，92% 同时使用两台或更多设备-包括智能手机、平板电脑、PC和电视9、10最多 接触最多年轻人的有效方法是通过他们正在使用的技术，包括： 社交媒体、在线搜索引擎和智能手机。 在线广告有助于改变人们对消费品牌的态度，改变购买行为。 因此，这种方法可以用来改变室内晒黑的态度和行为。的优势 利用社交网络和搜索网站上的广告包括：1)覆盖范围空前，2)相对较低 成本，以及3)瞄准特定受众的机会。首先，我们将使用混合方法来学习 哪些信息最吸引人。然后我们将测试哪些消息在转换时最有效 知识和自我报告的晒黑行为使用两个在线随机试验设计。最后，我们将运行一个 大型全国性试验，以测试这些信息是否会改变日光浴床的实际使用情况和黑色素瘤的发病率。

My goal is to radically shift our approach to prevention. I want to leverage online advertising, social media and smartphone technology to create a rapid, effective and scalable platform for targeted prevention messages that actually shift health behaviors. I plan to start with skin cancer prevention, using tanning beds and melanoma as the proof-of-principle example. However, this work will be broadly generalizable to many other public health challenges where behaviors play a key role in the disease process. Over half of cancers are preventable through behavioral changes, vaccines, or medications.1,2 However the process of moving from scientific evidence to implementation is painfully slow. Recent Institute of Medicine and RAND reports estimate that only 50% of recommended health care practices are implemented, and this takes decades. The situation is even worse for preventive health care. Meanwhile, both melanoma and non-melanoma skin cancer (NMSC) rates continue to increase.3 4 In fact, incidence of skin cancer is higher than all other cancers combined. Indoor tanning is a class I carcinogen and a major, modifiable risk factor that accounts for over 450,000 new NMSC and over 10,000 melanomas each year.5 This is close to half a million potentially preventable skin cancers each year. Yet, tanning bed use remains common with 1 in 5 adolescents and over 40% of college students using tanning beds in the last year.5 Despite significant investment in prevention efforts, including well-designed campaigns by foundations focused on skin cancer prevention, our efforts to impact incidence of skin cancer have hit a brick wall. Technology to target health messages can get the right message to the right person at the right time. Social media and online search engines give us an unprecedented ability to target our health messages directly to those at highest risk. These platforms give us a way to direct a message precisely when teens are – for example – searching for a tanning salon.7,8 Over 90% of teens and young adults are online daily, and 92% engage with two or more devices simultaneously-including smartphones, tablets, PC and TV.9, 10 The most efficient way to reach the largest number of young adults is through the technology they are using, including: social media, online search engines and smartphones. Online advertising works to shift attitudes towards consumer brands, and shift purchasing behaviors. Therefore, this approach could be used to shift indoor tanning attitudes and behaviors. The advantages of leveraging advertising on social networking and search sites include: 1) unprecedented reach, 2) relatively low cost, and 3) the opportunity to target specific audiences. First, we will use a mixed-methods approach to learn which messages are most engaging. Then we will test which messages are most effective at shifting knowledge and self-reported tanning behaviors using two online randomized trial designs. Finally, we will run a large national trial to test whether these messages shift actual tanning bed use and melanoma incidence.