title: The effects of framed messages for engaging adolescents with online smoking prevention interventions.
abstract: Messages emphasizing the harms of smoking (loss-framed) or the benefits of not smoking (gain-framed) may be effective for engaging adolescents with tobacco prevention resources. This novel approach could help to close a gap in tobacco prevention intervention delivery in the pediatric primary care setting. To examine the effects of framed messages for engaging adolescents with an evidence-based smoking prevention website, adolescents ages 12 to 17 presenting for primary care well-visits were recruited for a three-arm experiment. Participants completed baseline measures including demographics, smoking behavior, and smoking susceptibility and were randomized to view 1 of 3 messages introducing an evidence-based smoking prevention website: (1) gain-framed communicating the benefits of avoiding smoking, (2) loss-framed communicating the harms of smoking, or (3) neutral. Self-reported website engagement was assessed at 1-month follow-up. Participants (279) (87% of those enrolled) completed a follow-up (M age 14.9 years, 66% female, 32% non-white race, 47% non-susceptible never smokers, 53% susceptible never smokers/ever smokers). Overall, 26% of participants reported website engagement. After adjusting for baseline intentions to visit the website, engagement was significantly greater in response to the loss-framed message than the gain-framed (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.51, 6.15) and neutral (OR 2.31, 95% CI 1.15, 4.63) messages. The message framing effects did not differ by baseline smoking risk. Loss-framed messages emphasizing the harms of smoking may be effective for engaging adolescents with smoking prevention resources.
authors.affiliation: Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven St., NW, Suite 4100, Washington, DC, 20007, USA. dmm239@georgetown.edu.
authors.forename: Darren
authors.initials: D
authors.lastname: Mays
authors.affiliation: Department of Pediatrics, MedStar Georgetown University Hospital, Washington, DC, USA.
authors.forename: Kirsten B
authors.initials: KB
authors.lastname: Hawkins
authors.affiliation: The Lewin Group, Falls Church, VA, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Bredfeldt
authors.affiliation: Department of Pediatrics, MedStar Georgetown University Hospital, Washington, DC, USA.
authors.forename: Hilary
authors.initials: H
authors.lastname: Wolf
authors.affiliation: Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven St., NW, Suite 4100, Washington, DC, 20007, USA.
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Tercyak
mesh_terms: D000293:Adolescent; D002648:Child; D004198:Disease Susceptibility; D005260:Female; D005500:Follow-Up Studies; D058015:Health Communication / Q000379:methods; D006293:Health Promotion / Q000379:methods; D006801:Humans; D020407:Internet; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010358:Patient Participation; D011678:Punishment; D012201:Reward; D057566:Self Report; D000074285:Smokers / Q000523:psychology; D000074606:Smoking Prevention / Q000379:methods
keywords: Adolescents; Message framing; Primary care; Smoking prevention