Prevention Messages Research Articles

Efficacy of digital interventions for smoking prevention among children: a systematic review

Abstract Background Smoking remains a leading preventable cause of morbidity and mortality globally, with initiation often occurring in childhood. Early smoking onset is linked to increased difficulty in quitting and higher risk of long-term health complications. Traditional prevention strategies have not fully succeeded in curbing youth smoking rates, highlighting the need for innovative approaches. Digital interventions (DI), such as gamified education, social media campaigns, and virtual reality, offer a novel avenue for engagement and education. This systematic review aims to assess the efficacy of DI in preventing smoking, and improving knowledge and awareness about smoking damages, among children. This review is part of the PRIN project, whose goal is to evaluate the effectiveness of a DI aimed at school-aged children, intended to increase knowledge about the negative effects of smoking and prevent its use. Methods On the 18th of March 2024, PubMed, Scopus, and PsycINFO were surfed for trials and observational studies evaluating DI for smoking prevention among children aged 6-12 years. Study quality will be evaluated using the Cochrane Risk of Bias Tool and New Castle-Ottawa scale. The protocol has been registered in PROSPERO. Results From 3,081 initially identified articles, 328 papers were removed because duplicate. The screening process is ongoing. Conclusions DI are a promising tool for engaging young populations through platforms they are familiar with and receptive to. By leveraging the high penetration of digital technology in the daily lives of children, these interventions have the potential to deliver smoking prevention messages in a compelling and interactive manner. Understanding the effectiveness of DI in smoking prevention can significantly contribute to public health by providing viable alternatives to traditional methods and potentially reducing future smoking-related health burdens. Key messages • Evaluating digital strategies for smoking prevention among children could offer vital alternatives to traditional methods, potentially reducing long-term health risks. • Digital interventions (DI) offer promising new ways to engage young audiences on smoking prevention using familiar platforms, potentially reshaping public health approaches.

Disseminating fraud awareness and prevention advice to older adults: perspectives on the most effective means of delivery

AbstractRaising awareness to combat scams has become a central strategy of fraud/scam prevention. Using data from a wider evaluation of a targeted campaign to improve fraud prevention and awareness for older adults predominantly over 75, this paper offers findings on the most effective means of dissemination of anti-scam communications to this group. The paper draws upon almost 1000 questionnaire responses and qualitative data from older adults, as well as volunteers and workers involved in the project. The research finds many older adults have not received any fraud prevention or awareness communications in the prior six months, illustrating a gap in fraud prevention messaging reaching this group. The paper also shows that the preferred method of dissemination is one-to-one through friends and family and that is also the case for the most isolated. The paper offers some potential solutions to address these gaps, particularly for lonely older adults.

Evaluating young people's listening practices: a public health issue

Listening to music through headphones or earphones has become commonplace with the development of new technologies. If this listening is prolonged over long periods and at high noise levels, it exposes young people to risks to their hearing systems. The WHO (2021) indicates that one person in four is expected to have hearing problems by 2050, and 1.1 billion young people worldwide could be at risk of hearing loss due to dangerous listening habits. Three French organizations (Le RIF, Bruitparif and CidB) have joined forces, with the support of the regional health agency of Ile de France, to coordinate their hearing risk prevention campaign and carry out a study ahead of the campaign to find out about listening practices using headphones or earphones, concert attendance and the precautions taken by teenagers to protect themselves from hearing risks. The results, based on a sample of 2,685 teenagers (secondary school), will provide a snapshot of practices so that prevention messages can be adapted during awareness campaigns.

Categorizing E-cigarette-related tweets using BERT topic modeling

BackgroundSocial media platforms are critical channels for promoting e-cigarettes, particularly among youth, making analysis of their vast and diverse content essential for public health interventions. Prevalence rates of e-cigarette use are high and evidence suggests that social media are popular forums that promote e-cigarette use through direct and indirect marketing techniques. The volume and diverse nature of e-cigarette-related information on social media is challenging and may obfuscate public health prevention messaging. Traditional hand-coding methods are labor-intensive and limit scalability. In contrast, unsupervised machine learning approaches, such as topic modeling, allow for efficient analysis of large datasets, uncovering patterns and trends that manual methods cannot achieve at scale. The present study focused on ascertaining the extent to which themes and topics in tweets related to e-cigarettes can be successfully rendered into useful homogenous units using machine learning. A better understanding of current depictions and discussions around e-cigarette products and use on social media can inform public health counter messaging and policy interventions. MethodsWe used topic modeling (BERTopic) to iteratively derive vape-related tweet clusters and calculate the importance of particular words to these groupings. We conducted a qualitative content analysis to study clustered tweets. We also sought to determine the geographic locations of e-cigarette conversations using automated geoparsing methods, which translate toponyms in textual data into geographic identifiers, to attempt to infer the location of tweets. ResultsWe were able to successfully identify >100,000 tweets in broad thematic categories in English and Spanish. Our correlation and inter-topic map analysis of the machine-derived topics, which examines the relationships between topics, indicated that most of the topics were unique (correlation value < 0.5) and did not overlap with each other. We identified six topics: Flavors and Disposable Vapes, Cannabis, Vape Shops and Refillable Vapes, Vape Culture, Anti-vaping and Quitting, and Spanish Tweets and Vaping Nicotine. Further analysis of these topics using qualitative methods identified themes within each topic. For example, Category 6 (Spanish Tweets and Vaping Nicotine) included four topics focused on the health risks of vaping, personal motivations for vaping, and the regulation of vaping products. Using geoparsing, which automatically detects location information, we found that the United States had the highest number of tweets related to vaping. Discussion/conclusionResults underscore the possibility of leveraging BERTopic modeling to reduce large quantities of data to comprehensively describe and categorize myriad e-cigarette related messages to which social media users are exposed. This data reduction approach can be applied to various social media platforms to describe and categorize e-cigarette posts and thereby triangulate and validate findings. Thematic content analysis of the topics identified through this technique requires supervision and human inputs. Our approach provides a comprehensive understanding of the evolving e-cigarette discourse, informing public health counter-messaging and policy interventions. Moreover, findings support the need for regulation, such as reducing appealing flavors and suggest that social media can be used effectively to support public health messaging (i.e., quitting messages).

Understanding Potential Mechanisms of Vaping Prevention Messages: A Mediation Analysis of the Real Cost Campaign Advertisements.

The U.S. Food and Drug Administration (FDA) developed a public education campaign, The Real Cost, that reduced youth susceptibility to tobacco product use. We sought to identify the mechanisms that may underlie the impact of The Real Cost ads on susceptibility to vaping to inform youth tobacco prevention campaigns. Our online randomized controlled trial (clinicaltrials.gov, identifier NCT04836455) examined a large sample of U.S. adolescents (n = 1,348) who had multiple exposures to Real Cost ads or control videos over a 3-week period in 2021. To examine potential mediating pathways between The Real Cost ads and susceptibility to vaping, we examined theory-based psychosocial and message-related variables. The largest impact of The Real Cost ads on susceptibility was via more negative attitudes toward vaping (βa*βb = -0.16; 95% confidence interval [CI] = [-0.25, -0.06]). Other mediation paths were via improved health harm risk beliefs (βa*βb = -0.08; 95% CI = [-0.13, -0.04]), addiction risk beliefs (βa*βb = -0.04; 95% CI = [-0.06, -0.01]), injunctive norms against vaping (βa*βb = -0.05; 95% CI = [-0.09, -0.02]), negative affect (βa*βb = -0.05; 95% CI = [-0.08, -0.02]), and cognitive elaboration (βa*βb = -0.03; 95% CI = [-0.05, -0.003]). Our findings suggest that ads that target negative attitudes may decrease susceptibility to vaping among youth. Our findings also introduce normative pressure as a novel factor that may be important for vaping prevention messages.

Age differences in cannabis-related perceptions, knowledge, and sources of information among adults in the post-legalization era in Quebec, Canada.

Individuals access and perceive information about cannabis differently according to age groups. This study compared differences in beliefs and knowledge regarding cannabis, and exposure to information, advertisement, and prevention messages among emerging (18-24 years old), prime-age (25-44), middle-age (45-64), and old-age adults (65 and over). Participants (n=2,001) completed online questionnaires regarding their sociodemographic characteristics, mental health perception, cannabis use, sources of cannabis information, and exposure to advertisement and prevention messages. Bivariate analyses allowed the detection of differences among the age groups. Emerging adults exhibited more positive attitudes regarding cannabis and were more knowledgeable regarding cannabis facts than their older counterparts. Online media constituted the principal source of information for the overall sample. Health resources were the most trusted information source for all age groups, but only one-fifth of the sample consulted them. A higher proportion of emerging adults were exposed to cannabis advertisements and prevention messages. Old-age adults were more likely to be reached through traditional media. As perceptions and beliefs about cannabis, information access, and exposure to advertisement or prevention messages vary across age groups, effective prevention and education should be tailored accordingly. Health resources and scientific literature about cannabis should become more accessible and understandable to the general population.

Abstract B027: Adapting communication resources for clinic staff in a multisite FQHC to improve HPV vaccination encounters with Spanish-speaking parents of adolescents

Abstract Introduction: Adopting evidenced-based strategies (EBS) targeting clinic staff in safety-net settings can improve adolescent HPV vaccination rates. Still, adaptations of EBS are needed to reach racial/ethnic minority patients and families effectively. As part of a larger implementation study on HPV vaccination, we examined and addressed adaptation needs for HPV vaccine communication resources to support clinic staff serving Hispanic adolescent FQHC patients. Methods: In October 2022-January 2023, we partnered with a large multi-site FQHC in Los Angeles, CA to deliver two clinic staff trainings designed to i) improve HPV knowledge and communication strategies; and ii) discuss HPV vaccine workflow. Informed by the Practice Change Model, we completed baseline qualitative interviews with clinic team members (providers, clinic staff, and leadership) and provider and clinic staff surveys to inform the development, implementation, and adaptation of clinic staff training on HPV vaccine knowledge and communication strategies. We then conducted site visits and key-informant interviews with clinic staff immediately post-training. Notes from site visits and key-informant interviews were transcribed to identify potential barriers to adoption and opportunities for adaptation. Results: Baseline data indicated 95% of clinic staff identified as Hispanic and 94% reported speaking a language other than English. Notes from site visits and key-informant interviews with clinic staff indicated clinic staff identified the need for Spanish language messaging to communicate HPV and cancer prevention messages to monolingual Spanish families. As a result, we adapted Spanish-language messages from the 2023 Health Resources and Services Administration toolkit and American Cancer Society to develop a handout with scripts that address top concerns about HPV vaccination with monolingual Spanish-speaking parents of adolescents to that were identified from baseline data collection. Bilingual-bicultural staff then validated messages and confirmed cultural relevance. Developed materials were then presented to clinic leadership to review and suggest further refinement before delivering them to clinic staff. Discussion: Key-informant interviews and post-training site visits played an important role in identifying opportunities to adapt EBS designed to improve HPV vaccination among culturally diverse patients. To better serve diverse communities disproportionately impacted by HPV-associated cancers, clinic staff need resources with HPV vaccine communication messages available in languages that reflect the needs of their patient population. Citation Format: Samantha Garcia, Adrienne Martinez-Hollingsworth, Sheila Salinas Navarro, Sharon Hudson, Zehui He, Emily Dang, Lawrence Palinkas, Lourdes Baezconde-Garbanati, Jennifer Tsui. Adapting communication resources for clinic staff in a multisite FQHC to improve HPV vaccination encounters with Spanish-speaking parents of adolescents [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B027.

The Relative Reinforcing Value of Menthol Among Young Adult Cigarette Smokers: Results From a Behavioral Choice Task.

Menthol cigarettes are associated with experimentation and progression to regular use. Although reinforcement processes likely underlie menthol's appeal, the reinforcing value of menthol cigarettes remains unknown. This study examined the relative reinforcing value (RRV) of menthol versus nonmenthol cigarettes in young adult menthol (n = 54) and nonmenthol (n = 53) smokers, and differences in menthol's RRV by race, ethnicity, and sexual orientation. Overnight abstinent participants completed a choice task assessing willingness to "work" to click targets on a computer screen to earn menthol or nonmenthol cigarette puffs. A progressive ratio schedule was used where the menthol target had to be clicked progressively more times, over 10 trials, to earn a menthol cigarette puff, while clicks for the nonmenthol target were fixed across trials. RRV for menthol was defined by the breakpoint, or the highest trial (out of to 10) completed for a menthol cigarette puff. Number of clicks for menthol and nonmenthol puffs were also examined. Menthol smokers worked harder for menthol versus nonmenthol cigarette puffs (breakpoint = 9.17; ~1236 clicks vs. 24 clicks). Breakpoint was higher among Hispanic (6.49) versus NH White (4.83) and NH non-White smokers (4.43). In exploratory analyses of interactions of menthol preference with race and ethnicity, nonmenthol Hispanic smokers worked harder for menthol cigarette puffs versus NH non-White and NH White nonmenthol smokers. Menthol cigarettes are highly reinforcing for young adult menthol and Hispanic smokers. A menthol ban may reduce addiction risk among younger individuals and some minoritized groups of smokers. This study provides evidence of the greater relative reinforcing value of menthol compared to nonmenthol cigarettes among young adults who had a cigarette flavor preference, suggesting increased addiction risk of menthol cigarettes. Young adult menthol smokers and Hispanic (vs. non-Hispanic) smokers worked harder to earn menthol (vs. nonmenthol) cigarette puffs. Findings add to the evidence base supporting the U.S. Food and Drug Administration's (FDA) intent to ban menthol in cigarettes. Further, prevention messaging campaigns and cessation programs should take into account the reinforcing value of menthol in cigarettes, especially in vulnerable and at-risk populations.

"If I Stay Silent, It Doesn't Help Anyone": Understanding How People Use TikTok to Talk About Sexual Violence.

TikTok is the second most popular social media platform among American teenagers, suggesting it may be a way to reach young people with sexual violence-related messages. This qualitative content analysis focused on what TikTok users share about sexual violence. The content of the videos fell into two primary types of information, people sharing experiences of sexual violence (i.e., what happened, how they responded, impacts of experiences) and people sharing other information related to sexual violence (i.e., education, raising awareness). The study results demonstrate that people use TikTok as a platform to share their messages about sexual violence-related topics, underscoring the potential of this platform for prevention and recovery messages targeted toward individuals who directly or indirectly experience sexual violence.

Public health measures related to the transmissibility of suicide.

Transmission is an important concept in suicide prevention. It can occur when exposure to another person's death by suicide (or to suicide-related information more generally) draws attention to suicide or highlights specific suicide methods. In this paper, the fourth in a Series on a public health approach to suicide prevention, we contend that the transmissibility of suicide must be considered when determining optimal ways to address it. We draw on five examples of how transmission might occur and be prevented. The first two examples relate to transmission initiated by representations of suicide in traditional and new media. The third concerns transmission that leads to suicide clusters, and the fourth considers a specific setting in which transmission occurs, namely secondary schools. Finally, we discuss how suicide risk might be countered by the transmission of suicide prevention messages in media campaigns.

Applying Communication Science to Substance Use Prevention Messaging.

Despite a wealth of evidence-based messaging on youth alcohol and drug prevention, there remains a dearth of research on how to construct and deliver these messages effectively. Communication science is useful for increasing the efficacy of these messages in reducing substance use risk among youth. This study explores the perspectives of youth and youth-serving providers to identify theory-informed substance use prevention messages and strategies and how the content and delivery of prevention messages evolved during the COVID-19 pandemic. This is a secondary analysis of qualitative data derived from focus groups with 53 youth ages 13 to 18 years and 18 youth-serving providers conducted in the USA between 2021 and 2022. The results describe theory-informed strategies that are important to consider when constructing effective substance use prevention messaging for youth, including preferences around key communication framework constructs, including sources, content, channels, and context. An element that emerged across the communication constructs was the saliency of "connection" in youth substance use prevention messaging content. Findings point to the need to further explore connection related to having shared experiences and the extent to which these dimensions are critical ingredients to effective substance use prevention.

Impact of mass media campaigns on knowledge of malaria prevention measures among pregnant mothers in Uganda: a propensity score-matched analysis

BackgroundUganda grapples with a considerable malaria burden, reporting prevalence rates of over 33% in some regions. To address this, the Uganda Ministry of Health employs audiovisual platforms for disseminating malaria prevention messages. However, the impact of these messages on pregnant women’s knowledge of malaria prevention remains insufficiently explored. This paper therefore emphasizes the influence of audiovisual messages on the knowledge of malaria prevention measures among pregnant women in Uganda.MethodsSecondary data obtained from the Uganda Malaria Indicator Survey (MIS) 2018–2019 was used for this analysis. Women aged 15–49 were included in the study. A total of 8868 women were selected using a two-stage sample design. The two stages of selection included clusters and households. Women who were currently pregnant were included in the study, resulting in a weighted sample of 721 women. Propensity score-matched analysis was used to evaluate the impact of access to malaria messages on knowledge of prevention measures.ResultsThe study revealed that 39% [95% CI 34.0–44.2] of pregnant women were exposed to malaria messages before the survey. Those exposed had a 17.2% higher knowledge [ATT = 0.172; 95% CI 0.035–0.310] of using mosquito nets for prevention compared to those unexposed. Among women exposed, radios accounted for most form of access to mass media campaigns [64.8, 95% CI 57.0–71.8] followed by interpersonal communication [45.0, 95% CI 37.6–52.6], community health workers [38.8, 95% CI 29.6–48.8], community events [21.4, 95% CI 15.8–28.3], and social mobilization [18.3, 95% CI 12.7–25.8].ConclusionResults highlight the importance of radios in spreading important malaria prevention messages to pregnant women. Being exposed to these messages is linked to increased awareness and knowledge about the proper use of insecticide-treated bed nets (ITNs) for preventing malaria. This finding underscores the importance of evaluating different channels for mass media campaigns to ensure the effective delivery of information about malaria prevention to the intended audiences.

Animations to communicate public health prevention messages: a realist review protocol

IntroductionWith digital and social media advances, animated health communications (health animations) are highly prevalent globally, yet the evidence base underpinning them remains unclear and limited. While individual studies have attempted...

How materialities and space–time travellings in class can breathe new life into Swedish secondary school Natural Science sexuality education

In this study, we investigate the phenomenon of Swedish Natural Science sexuality education. These classes tend to provide factual knowledge, focus on the negative outcomes of sexuality, be heteronormative and include little time for discussion—like much school sexuality education across the world—and this study aims to contribute ideas about new becomings of Natural Science sexuality education. Baradian theorising was used to explore how materialities and space and time travels within the classroom can challenge often-dominant perspectives. Data were produced in a secondary school and consist of teacher-researcher discussions and participatory observations in class. A futuristic case introduced students to spaces, times and materialities that not only helped the group move beyond a medical focus but also made the sexuality education more student centred. The participating teachers suggested imaginary lust-oriented scenarios for the 15–16-year-old students as an entrance to more preventive messages in teaching. A taken-for-granted heterosexual premise was also challenged with gender-neutral words and pronouns, an exercise on how to use both condoms and dental dams, and a time travel into future possibilities for reproduction and parenting. The acknowledgement of spacetimematter intra-activity in teaching thereby enabled new becomings of Swedish Natural Science sexuality education. However, although this study suggests how dominant medical and heterosexual perspectives can be challenged, it also made visible the absence of cultural, religious, asexuality and disability perspectives in Swedish sexuality education.

Prevalence and perception of pre-morbid lifestyle-related risk factors among covid-19 survivors in Lagos state and Abuja capital city of Nigeria

IntroductionThis study investigated the prevalence and perception of premorbid lifestyle-related risk factors among Covid-19 Survivors in Abuja and Lagos, Nigeria.MethodologyA cross-sectional descriptive survey design was used to collect data from 522 consenting adult Covid-19 survivors in Abuja (274) and Lagos (248), Nigeria, using a self-developed, close-ended and validated questionnaire called the Lifestyle-related Factors in Covid-19 Questionnaire (LFC-19 Questionnaire) through a multistage sampling technique. Descriptive and inferential statistical analysis was done using the Statistical Package for Social Science (SPSS) with P value set at ≤ 0.05. Ethical approval was obtained for the study.ResultsA significant number of Covid-19 Survivors were overweight/obese (67.8%) and had a history of physical inactivity (73.8%). A small proportion had premorbid chronic diseases (23.8%) as well as pre-existing lifestyle-related risk factors such as inadequate consumption of fruits (67.2%) and vegetables (60.0%) and physical inactivity (73.8%).ConclusionThis study revealed that most Covid-19 survivors residing in Lagos State and in Abuja capital city of Nigeria were either overweight or obese. This was due to physical inactivity, an unhealthy diet consisting of low fruit and vegetable consumption and poor sleep. Additionally, the study showed that patients’ perceptions of their risk factors were often inaccurate as it differed from what was measured. The findings from this study will assist public health professionals and clinicians in designing and implementing more effective Covid-19 management strategies that incorporate healthy lifestyle practices and lifestyle modifications and assist public health promotion and communication specialists in designing appropriate and evidence-based preventive messages.

The Influence of Billboard-Based Tobacco Prevention Posters on Memorization, Attitudes, and Craving: Immersive Virtual Reality Study.

Health prevention campaigns often face challenges in reaching their target audience and achieving the desired impact on health behaviors. These campaigns, particularly those aimed at reducing tobacco use, require rigorous evaluation methods to assess their effectiveness. This study aims to use immersive virtual reality (iVR) to systematically evaluate recall, attitudinal, and craving responses to antitobacco prevention messages when presented in a realistic virtual environment, thereby exploring the potential of iVR as a novel tool to improve the effectiveness of public health campaigns. A total of 121 undergraduate students (mean age 19.6, SD 3.7 years), mostly female (n=99, 82.5%), were invited to take a guided walk in the virtual environment, where they were randomly exposed to a different ratio of prevention and general advertising posters (80/20 or 20/80) depending on the experimental condition. Participants' gaze was tracked throughout the procedure, and outcomes were assessed after the iVR exposure. Incidental exposure to antitobacco prevention and general advertising posters did not significantly alter attitudes toward tobacco. Memorization of prevention posters was unexpectedly better in the condition where advertising was more frequent (β=-6.15; P<.001), and high contrast between poster types led to a better memorization of the less frequent type. Despite a nonsignificant trend, directing attention to prevention posters slightly improved their memorization (β=.02; P=.07). In addition, the duration of exposure to prevention posters relative to advertisements negatively affected memorization of advertising posters (β=-2.30; P=.01). Although this study did not find significant changes in attitudes toward tobacco after exposure to prevention campaigns using iVR, the technology does show promise as an evaluation tool. To fully evaluate the use of iVR in public health prevention strategies, future research should examine different types of content, longer exposure durations, and different contexts. Open Science Framework E3YK7; https://osf.io/e3yk7.

Preventive behavior intention for a viral outbreak among college students: The case of Mpox

Objective Examine college students’ behavior intention to reduce viral outbreak transmission in the context of Mpox, and what preventive messaging strategies would be most effective in future transmissible disease outbreaks based on the Reasoned Action Approach (RAA). Participants Undergraduates at a mid-Atlantic U.S. University. Methods An online survey (n = 266) conducted at the height of the recent Mpox outbreak in the U.S., asked about five target behaviors to reduce Mpox transmission, including RAA determinants for each behavior. Results Highest intention was safe sex practices, lowest were vaccination and sexual abstinence, and sharing dishes and fabrics were in between. RAA determinants differed by target behavior, although attitudes were significantly positively associated with intention for all five behaviors. Conclusions College students are potentially open to preventative behaviors to reduce viral transmission during an outbreak. However, specific target behavior matters and messaging should focus on differing RAA determinants depending on target behavior.

P-476 Barriers and facilitators to nationwide implementation of fertility screening interventions: a qualitative study

Abstract Study question What are the barriers and facilitators to the potential nationwide implementation of Fertility Health Screening (FHS) and/or Fertility Awareness and Education (FAE) in Singapore? Summary answer The study reveals implementation factors that shed light on how advanced societies can adopt evidence-based interventions to deliver fertility education together with behavioural change nudges. What is known already Fertility awareness surveys have consistently shown low public awareness of age-related fertility decline and the limitations of fertility treatments. Furthermore, preventive public health messages to increase fertility awareness are known to produce limited sustained effects. While there is evidence that tailored interventions are more effective than generic ones at increasing fertility awareness, interventional studies targeted at those of reproductive age are scarce. An effectiveness-implementation hybrid type I 3-arm open-label randomized clinical trial (RCT) is underway to evaluate the effects of two theory-based interventions on knowledge, attitudes and practices around childbearing among young married couples in Singapore. Study design, size, duration The present qualitative study was conducted to explore experiences and perspectives on the interventions and their potential implementation among healthcare professionals (HCPs) involved in implementing the interventions and a sub-sample of couples randomized into either treatment group. Recruitment used purposive sampling. Individual semi-structured interviews were conducted from June 2021 to December 2023. The Consolidated Framework for Implementation Research (CFIR) was used to develop the interview guide. Sample size was determined by data saturation. Participants/materials, setting, methods Couples in either treatment group were recruited after completing their final follow-up visit, while HCPs were recruited at their convenience. After taking written informed consent, the interviews were conducted in person or over Zoom and audio recorded. The interviews were transcribed verbatim and inductive thematic analysis was used to evaluate the data. Themes were then mapped to CFIR constructs. The results were reported according to O’Brien et al.’s (2014) Standards for Reporting Qualitative Research. Main results and the role of chance Twenty HCPs (10 doctors, 8 embryologists, 1 nurse and 1 manager) and 29 heterosexual couples (FHS n = 16; FAE n = 13) participated in the interviews. Median age was 30 (women) and 32 (men) years with most participants having post-secondary education. In FHS, couples underwent an Anti-Mullerian Hormone (AMH) test and semen analysis (SA), doctor’s consultation, and standardized counselling by a trained nurse. In FAE, couples watched a video of other couples’ pre-pregnancy experiences, completed an adapted fertility status awareness tool (FertiSTAT), and received an educational brochure. FHS barriers (CFIR constructs n = 6) included the discomfort when producing SA samples, male partners’ reluctance to share personal information with embryologists for SA, stigma associated with undergoing fertility-related tests, lack of time for appointments, limited cost effectiveness, and shortage of human resources due to potential increase in service demand. FHS facilitators (constructs n = 4) included evidence-based testing, increased knowledge of reproductive potential, advice from trained HCPs and comprehensible brochures. Perceived facilitators for FAE (constructs n = 2) included compelling video messages and clearly designed questionnaires. No major barrier was reported for FAE. Overall, insights gained from the interviews can inform strategies to address barriers and leverage facilitators for each intervention. Limitations, reasons for caution Barrers and facilitators may differ between countries. There may also be selection bias in the recruitment strategy, as participants were likely those who wished to have children. Moreover, the lack of diversity in educational qualifications and ethnicity may exclude the influence of class and cultural factors on parenthood intentions. Wider implications of the findings The findings contribute to an understanding of personalised fertility interventions coupled with behavioural change influences by showing how qualitative process indicators could complement research on interventions’ effectiveness. This has implications for other developed countries that are seeking to explore how implementation factors can expedite clinical best practice after research discovery. Trial registration number NCT04647136

Impacts of Fear Appeal Type and Source Similarity in Horse-Racing Addiction Prevention Messages on Anticipated Regret and Discontinuance Intent between Horse-Racing Participant Types

PURPOSE This study aimed to verify the differences in anticipated regret and gambling discontinuance intent based on the fear appeal type and source similarity in different types of horse-racing gamblers. METHODS Using convenience sampling, 172 responses were collected from horse-racing participants who bought horseracing tickets within the last 6 months. After eliminating 30 insincere responses, descriptive, correlation, reliability, and two-way multivariate covariance analyses were conducted using SPSS Ver. 26.0. RESULTS Anticipated regret and discontinuance intent were higher under fear appeal using social compared with financial risk. Compared to recreational gamblers, problem gamblers had higher anticipated regret and discontinuance intent under fear appeal using social compared with financial risk. There were no differential impacts of source similarity on anticipated regret and discontinuance intent in both types of gambler. CONCLUSIONS Practitioners in charge of conducting messaging campaign to prevent addiction to horse-racing gambling may cause problem gamblers to expect regret and quit gambling by delivering preventive messages with relatively unfamiliar risks such as social risks, rather than familiar risks such as financial ones.

An Almost Empty Scoping Review: State of the Research on Tobacco Prevention and Cessation Messaging Strategies for Black and/or Latine LGBTQ+ Youth and Young Adults

ABSTRACT Research has yet to offer strong recommendations for effective tobacco prevention and cessation messaging that can reduce tobacco-related health disparities among Black and/or Latine LGBTQ+ youth and young adults. As a result of predatory marketing strategies and community stressors, among other factors, LGBTQ+ youth and young adults use tobacco products at higher rates than their non-LGBTQ+ peers. These disparities are uniquely complex among Black and/or Latine youth and young adults within the LGBTQ+ community, but there has been little research addressing the communication strategies that can promote tobacco prevention and cessation for these groups. Given the promise and history of successful health communication campaigns for tobacco control, this research is crucial. We thus conducted a scoping review to identify trends and gaps in the empirical research published from 2002–2022 that analyzed tobacco prevention and cessation communication strategies for Black and/or Latine LGBTQ+ youth and young adults (ages 12–30) living in the United States. Despite an initial search query of 3,182 articles after deleting duplicates, only five articles were eligible for inclusion, three of which evaluated the This Free Life campaign. Accordingly, we view our scoping review as an almost empty review. Although our results offer preliminary insight into messaging strategies used in these campaigns, our larger contribution is to expose the scarcity of tobacco-related communication research being conducted among Black and/or Latine LGBTQ+ communities. Given the marginalization these communities face, we issue a call to action for researchers and campaign designers and offer a series of suggestions for future research.