Media Literacy to Prevent Adolescent Smoking
Condition: Smoking Status
Study type: Interventional

Summary: 
      The purpose of this project is to determine if a 3-session anti-smoking media literacy based
      intervention is more effective that a standard 3-session anti-smoking media literacy
      intervention at changing students' intention to smoke, actual smoking behavior, attitudes and
      norms regarding smoking, and level of media literacy.
    

Detailed description: 
      Cigarette smoking is the top cause of preventable death and disease in the U.S., and about
      90% of those who die from smoking begin as adolescents. Because smoking-related mass media
      messages (such as episodes of smoking in films and advertisements) significantly increase
      adolescent smoking, media literacy, defined as analysis and evaluation of mass media
      messages, presents a promising new framework for development of innovative school-based
      tobacco control programs. Media literacy may be more effective than standard tobacco
      education among the populations that are at greatest risk for smoking, such as
      African-Americans and the socio-economically disadvantaged, and national organizations have
      called for use of media literacy to reduce smoking. However, anti-smoking media literacy
      programs have been neither widely implemented nor well-evaluated.

      The aims of this project are to determine if a theory-driven, school-based, 3-session
      anti-smoking media literacy curriculum delivered to 9th grade students can affect clinically
      relevant factors mediating adolescent smoking according to the widely accepted Theory of
      Reasoned Action: intention to smoke, smoking behavior, attitude toward smoking, and norms
      involving smoking. It is hypothesized that, compared with those exposed to a currently
      accepted school-based smoking prevention program, students exposed to the media literacy
      program will develop more negative attitudes toward smoking, a more negative sense of smoking
      norms, less intention to smoke, and less smoking. We also expect that the curriculum will
      improve smoking media literacy scores as measured by a reliable, valid scale.

      Over two years, eight high schools will be recruited to randomize all 9th grade health
      classrooms to receive either the 3-session media literacy anti-smoking curriculum or a
      currently accepted anti-smoking program of equivalent length. This recruitment will occur via
      two prominent community organizations responsible for anti-tobacco programming in 50 local
      school districts. Experienced health educators will be trained in implementation of both
      experimental and control curricula. Outcome measures, demographic data, and other important
      covariates will be collected by a questionnaire given three times: at baseline, immediately
      post-intervention, and after one year. Questionnaire items are reliable, valid, and
      pilot-tested. Process evaluation will be conducted to assess implementation fidelity, to
      confirm or refute the findings of the quantitative assessment, to help explain outcome data,
      to refine the intervention, and to inform future replications of the curriculum.

      Given the substantial nationwide morbidity and mortality due to tobacco use, the role of mass
      media messages in adolescent initiation of smoking, and the potential power of media literacy
      as an agent for health behavior change, it is essential to study the utility of media
      literacy in altering smoking behaviors and antecedents in this age group. If media literacy
      programs are successful in buffering the impact of mass media on adolescent smoking, similar
      interventions can be developed to prevent other harmful behaviors related to mass media
      messages.
    

Intervention name(s): Control; Media Literacy
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Standard anti-tobacco programming; Anti-smoking media literacy curriculum intervention
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: Smoking; Tobacco use disorder