|1R01CA253013-01 Interpret this number
|George Washington University
|Digital Media for Cancer Control: Randomized Controlled Trial and Dose Response Effects
Tobacco remains the single leading preventable cause of death in the US and annual tobacco-related
health care costs are estimated at $170 billion. In 2016, 20% of high school students (3.05 million
youth) reported recent use of tobacco products and estimated 5.6 million youth under the age of 18
will die early due to smoking-related illness demonstrating a need for prevention interventions.
According to the CDC, some 13.1% of adults aged 18-24 were smokers, and over 5 million of these
young adults will die early due to smoking-related illness. Moreover, the significant declines in youth
cigarette smoking may be eclipsed by other tobacco products and use of JUUL, a highly-effective
nicotine delivery product. Given their widespread use, there is a need to leverage digital media to
influence health outcomes and public education campaigns are increasingly using them. Recent
studies show that social media can be effective in countering tobacco industry product promotion
online and as a tobacco control campaign platform. However, there is little published data on
exposure to and evaluations of large-scale, online tobacco control campaigns. The proposed R01
project addresses this gap and builds on over 16 years of collaboration among the research team in
evaluating the national Truth campaign. This application is significant for several reasons. First,
tobacco use prevention and other health behavior change campaigns are increasingly delivered
through digital channels, yet few studies have focused on rigorous measurement of digital message
exposure and response. Exposure measures are a critical component since analyses either compare
those exposed to the unexposed, or examine a dose-response curve among varying levels of campaign
exposure. This research will use pixel tracking (HTML codes embedded in digital ads) to measure
campaign dose-response effects. While the predictive value of self-report and exogenous mass media
measures of exposure (e.g., GRPs) has been well studied, there is little evidence on the effects of
digital exposure. Finally, little is known about the independent effects of varying levels of digital
message exposure to promote anti-tobacco attitudes, beliefs, or behaviors among youth and young
adults. In aim 1, we will conduct a 6-month controlled, online, randomized study to compare the
effects of varying levels of digital media exposure, measured by pixel tracking, on campaign-targeted
tobacco-related knowledge, attitudes, beliefs and behavioral outcomes. In aim 2, we will conduct a
field-based randomized trial to evaluate a truth digital campaign to confirm the relationship between
digital media exposure, message awareness, and tobacco-related outcomes over 36 months. The result
of these studies will be benchmark methods and measures of digital ad exposure that have wide
application to future digital health campaigns.
Assessing the Feasibility of Studying Awareness of a Digital Health Campaign on Facebook: Pilot Study Comparing Young Adult Subsamples.
, Ichimiya M.
, Gerard R.
, Mills S.
, Bingenheimer J.B.
, Hair E.C.
, Vallone D.
, Evans W.D.
JMIR formative research, 2022-08-29; 6(8), p. e37856.
The Measurement of Dose and Response for Smoking Behavior Change Interventions in the Digital Age: Systematic Review.
, Gerard R.
, Mills S.
, Brodsky A.
, Cantrell J.
, Evans W.D.
Journal of medical Internet research, 2022-08-25; 24(8), p. e38470.