June A. Flora

Seventh graders' self-reported exposure to cigarette marketing and its relationship to their smoking behavior.

OBJECTIVES This study examined among youth the extent of their perceived exposure to cigarette marketing and the relationship of their perceptions to their smoking behavior. METHODS Surveys measuring exposure to cigarette advertisements and promotions were completed by 571 seventh graders in San Jose, Calif. RESULTS Eighty-eight percent of these 13-year-olds reported exposure to cigarette marketing: the majority often saw ads in magazines, on billboards, and at stores and events, and one quarter owned cigarette promotional items. After social influences to smoke were controlled for, exposure to cigarette marketing was related to self-reported smoking behavior. Likelihood of experimenting with smoking was 2.2 times greater among those who owned promotional items and 2.8 times greater among those who had received mail from a tobacco company. Seeing cigarette advertisements in magazines increased this likelihood by 21%, and seeing tobacco marketing in stores increased it by 38%. CONCLUSIONS Youth are daily and widely exposed to tobacco industry marketing efforts; this exposure is related to smoking behavior. More effective regulation is needed.

HIV/AIDS communication campaigns: progress and prospects.

The mass media have been the primary method for disseminating human immuno deficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) prevention messages worldwide. In this article, we update previous reviews by systematically examining published articles (n = 41) of empirical evaluations of international HIV/AIDS prevention campaigns. Of the 41 studies identified, 17 countries are represented. In this review, we examine six components related to media campaign design and evaluation: target audience, communication channel(s), message content, campaign theme, exposure, and outcomes. Of the studies included in this sample, each one described the target audience; 93% reported on channel selection; 75% described message content; 63% mentioned a campaign theme; and 62% documented campaign exposure. We investigate also the extent to which HIV/AIDS prevention efforts have moved beyond media campaigns to comprehensive communitywide programs. We conclude that HIV/AIDS prevention efforts would benefit from: (1) better reporting of media campaign components and outcomes, (2) more systematic evaluation, (3) greater integration of theory, and (4) increased attention to communitywide intervention strategies.The mass media have been the primary method for disseminating human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) prevention messages worldwide. In this article, we update previous reviews by systematically examining published articles (n = 41) of empirical evaluations of international HIV/AIDS prevention campaigns. Of the 41 studies identified, 17 countries are represented. In this review, we examine six components related to media campaign design and evaluation: target audience, communication channel(s), message content, campaign theme, exposure, and outcomes. Of the studies included in this sample, each one described the target audience; 93% reported on channel selection; 75% described message content; 63% mentioned a campaign theme; and 62% documented campaign exposure. We investigate also the extent to which HIV/AIDS prevention efforts have moved beyond media campaigns to comprehensive communitywide programs. We conclude that HIV/AIDS prevention efforts would benefit from: (1) better reporting of media campaign components and outcomes, (2) more systematic evaluation, (3) greater integration of theory, and (4) increased attention to communitywide intervention strategies.

Seeing, wanting, owning: the relationship between receptivity to tobacco marketing and smoking susceptibility in young people

OBJECTIVE To assess the effect of the tobacco industry’s marketing practices on adolescents by examining the relationship between their receptivity to these practices and their susceptibility to start smoking. DESIGN Paper-and-pencil surveys measuring association with other smokers, exposure to tobacco industry marketing strategies, experience with smoking, and resolve not to smoke in the future. SETTING 25 randomly selected classrooms in five middle schools in San Jose, California. SUBJECTS 571 seventh graders with an average age of 13 years and 8 months; 57% were female. Forty-five per cent of the students were Asian, 38% were Hispanic, 12% were white, and 5% were black. MAIN OUTCOME MEASURES Exposure to social influences, receptivity to marketing strategies, susceptibility to start smoking. RESULTS About 70% of the participants indicated at least moderate receptivity to tobacco marketing materials. Children who are more receptive are also more susceptible to start smoking. In addition to demographics and social influences, receptivity to tobacco marketing materials was found to be strongly associated with susceptibility. CONCLUSIONS Tobacco companies conduct marketing campaigns that effectively capture teenage attention and stimulate desire for their promotional items. These marketing strategies may function to move young teenagers from non-smoking status toward regular use of tobacco. Our results demonstrate that there is a clear association between tobacco marketing practices and youngsters’ susceptibility to smoke. The findings, along with other research, provide compelling support for regulating the manner in which tobacco products are marketed, to protect young people from the tobacco industry’s strategies to reach them.

Household Energy Consumption Segmentation Using Hourly Data

The increasing US deployment of residential advanced metering infrastructure (AMI) has made hourly energy consumption data widely available. Using CA smart meter data, we investigate a household electricity segmentation methodology that uses an encoding system with a pre-processed load shape dictionary. Structured approaches using features derived from the encoded data drive five sample program and policy relevant energy lifestyle segmentation strategies. We also ensure that the methodologies developed scale to large data sets.

Third-Person Perception and Children Perceived Impact of Pro- and Anti-Smoking Ads

Results of two studies provide the first evidence of third-person effect among children. In Study 1 (a survey of 571 seventh-grade students), children believed that cigarette advertisements influenced others more than themselves (third-person perception). Moreover, when children compared themselves with peers, the discrepancy between self and others was larger than when children compared themselves with their best friends (social distance corollary). In Study 2, children from Grades 4, 6, and 8 (n = 666) watched a 10-minute video portraying either cigarette or anti-smoking advertisements. Regardless of which video they watched, children believed that cigarette ads have greater influence on others than on themselves. The opposite was true for anti-smoking advertisements, however. Children believed that anti-smoking ads have greater influence on themselves than others (a reverse third-person perception). Children did not perceive uniformly greater impact of persuasive messages on people other than themselves. Instead, childrens judgments of media influence were consistently self-serving. These findings corroborate a theory that third-person perception is the product of a superiority bias—the tendency to see ourselves as better, or better off, than others.

The cost-effectiveness of three smoking cessation programs.

This study analyzed the cost-effectiveness and distribution of costs by program stage of three smoking cessation programs: a smoking cessation class; an incentive-based quit smoking contest; and a self-help quit smoking kit. The self-help program had the lowest total cost, lowest per cent quit rate, lowest time requirement for participants, and was the most cost-effective. The most effective program, the smoking cessation class, required the most time from participants, had the highest total cost, and was the least cost-effective. The smoking contest was in-between the other two programs in total costs, per cent quit rate, and cost-effectiveness; it required the same time commitment from participants as the self-help program. These findings are interpreted within the context of community-based intervention in which the argument is made that cost-effectiveness is only one of several factors that should determine the selection of smoking cessation programs.

A community-based heart disease intervention: predictors of change.

OBJECTIVES This paper presents a prospective examination of sociodemographic, psychosocial, and physiologic characteristics associated with positive change in cardiovascular disease risk factors during a 6-year multiple risk factor intervention study. METHODS Data are presented on 221 women and 190 men (aged 25 through 74 years) who participated in four cohort surveys (1979 through 1985). A signal detection model was used to identify baseline variables that best divide the sample into subgroups on the basis of the probability of positive change in a composite risk factor score. RESULTS Sixty-nine percent of the respondents showed a positive change in risk factor score during the intervention. The subgroup with the highest proportion of positive changers (83%) was composed of older adults (> 55 years) with the highest perceived risk, highest health media use, and highest blood pressure and cholesterol levels. The subgroup with the lowest proportion of positive changers (42%) was the least educated, was the most likely to be Hispanic, and had the lowest health knowledge and self-efficacy scores. CONCLUSIONS The differing composition of subgroups who respond or do not respond to community cardiovascular disease interventions illustrates the need to develop specific interventions that target different age, socioeconomic, and cultural subgroups.

Violence-Prevention Programs in Schools: State of the Science and Implications for Future Research

Abstract This article reviews school-based violence-prevention interventions published from 1993 through 1997. All of the interventions fitting the inclusion criteria involved classroom-based curricula; about one third included efforts to change the broader school environment or other settings where youth spend their time. Modest intervention effects in knowledge, attitudes, and aggressive, violent and prosocial behavior were reported. Elementary school interventions and programs focusing on the broader school environment appeared more successful in changing violence-related behavior. School-based health-promotion programs that integrated the community and home in other health areas were used to illustrate the potential success of more comprehensive interventions. A proposed framework for future comprehensive violence-prevention intervention research composed of three physical settings (school, home, and community) and three types of environments (information, social, and physical) is presented and discussed.

Health Lifestyles: Audience Segmentation Analysis for Public Health Interventions:

This article is concerned with the application of market segmentation techniques in order to improve the planning and implementation of public health education programs. Seven distinctive patterns of health attitudes, social influences, and behaviors are identified using cluster analytic techniques in a sample drawn from four central California cities, and are subjected to construct and predictive validation: The lifestyle clusters predict behaviors including seatbelt use, vitamin C use, and attention to health information. The clusters also predict self-reported improvements in health behavior as measured in a two-year follow-up survey, e.g., eating less salt and losing weight, and self-reported new moderate and new vigorous exercise. Implications of these lifestyle clusters for public health education and intervention planning, and the larger potential of lifestyle clustering techniques in public health efforts, are discussed.

Achieving Improvements in Overall Health Orientation Effects of Campaign Exposure, Information Seeking, and Health Media Use

Public health campaign success is conceptualized in terms of improvements in three cardiovascular disease-related behaviors (diet, exercise, and smoking) and their precursors, including knowledge and self-efficacy. Two cross-sectional data waves (baseline and sixth year, N = 4,214) from the Stanford Five-City Project (FCP) are analyzed to test a model of campaign influences. Exposure to FCP campaign messages is correlated with health information seeking and interpersonal communication, which in turn are correlated with health behaviors. The central premise of the model is then tested on a longitudinal sample (N = 1,225) over a 3-year period with similar results. An overall health orientation index is introduced and recommendations are made for enhancing public health campaign effectiveness.