Lindsay Pitzer

Child Outcome Measures in the Study of Child Care Quality

This article assesses whether there are methodological problems with child outcome measures that may contribute to the small associations between child care quality and child outcomes found in the literature. Outcome measures used in 65 studies of child care quality published between 1979 and December 2005 were examined, taking the previous review by Vandell and Wolfe (2000) as the starting point. Serious methodological problems were not pervasive for child outcome measures. However, methodological concerns were most prevalent among measures of socioemotional development. Furthermore, psychometric information on outcome measures was often missing from published reports, and health outcomes and approaches to learning were infrequently studied. Future research should address alignment issues between aspects of quality and the specific child outcomes chosen for study.

Harnessing Youth and Young Adult Culture: Improving the Reach and Engagement of the truth® Campaign

The national youth and young adult tobacco prevention mass media campaign, truth®, relaunched in 2014 with the goal of creating “the generation that ends smoking.” The objective of this study was to assess whether the strategy of airing truth ads during popular, culturally relevant televised events was associated with higher ad and brand awareness and increases in social media engagement. Awareness of six truth advertisements that aired during popular television events and self-reported social media engagement were assessed via cross-sectional online surveys of youth and young adults aged 15–21 years. Social engagement was also measured using separate Twitter and YouTube metrics. Logistic regression models predicted self-reported social engagement and any ad awareness, and a negative binomial regression predicted the total social media engagement across digital platforms. The study found that viewing a popular televised event was associated with higher odds of ad awareness and social engagement. The results also indicate that levels of social media engagement for an event period are greater than for a nonevent period. The findings demonstrate that premiering advertisements during a popular, culturally relevant televised event is associated with higher awareness of truth ads and increased social engagement related to the campaign, controlling for variables that might also influence the response to campaign messages.

Longitudinal Tobacco Use Transitions Among Adolescents and Young Adults: 2014–2016

INTRODUCTION Among youth, the frequency and prevalence of using more than one tobacco (small cigar, cigarette, and hookah) or nicotine-containing product (e-cigarettes-ENDS) are changing. These shifts pose challenges for regulation, intervention, and prevention campaigns because of scant longitudinal data on the stability of use patterns in this changing product landscape. METHODS A nationally representative longitudinal survey of 15- to 21-year olds (n = 15,275) was used to describe transitions between never use, noncurrent use, and past 30-day use of combustible tobacco, e-cigarettes (ENDS), and dual use of both kinds of products. A multistate model was fit to observations collected every 6 months across 2.5 years to estimate the probability of transitions between states (TPs), the average time in state (sojourn time), and the effect of age on transitions. RESULTS Current state strongly predicted future state over time intervals of 1 year or less, but only weakly predicted future state at longer intervals: TP to noncurrent use was higher for ENDS-only than combustible-only users over a 6-month interval but was similar for both groups over a 2-year interval. Sojourn time was significantly longer for combustible-only (0.52 years) and dual use (0.55 years) than ENDS-only use (0.27 years); older youth were more likely than younger youth to stay combustible tobacco users or noncurrent users. CONCLUSIONS The dynamics of transitions between combustible tobacco products and ENDS in a population of youth and young adults suggest that policy and prevention efforts must consider the frequent changes and instability over a 1-year or less time period in use patterns among young people. IMPLICATIONS The study addresses an urgent need in public health for timely information on how youth and young adults use tobacco and nicotine products. We found that youth, particularly adolescents, moved frequently between using ENDS and combustible tobacco products either alone or together. Importantly, the utility of current-use states for predicting future use states declined for time horizons longer than 1 year. Our results demonstrate a need for caution in interpreting product transitions. Longitudinal data with frequent observations and coverage of a wide range of possible product types is required to fully characterize usage patterns in youth.

The Association Between Menthol Perceptions and Support for a Policy Ban among US Smokers

Objective To examine the relationship between menthol perceptions and support for a national menthol ban. Participants Data were collected from a nationally representative probability-based panel of adults aged ≥18 years during June 21, 2016 through July 18, 2016. A total of 1,303 respondents, including an oversample of 300 African Americans, completed the survey. Main Outcome Measures Weighted logistic regression models examined the relationship between menthol perceptions, specifically related to health and addiction, and the outcome measure: support for a menthol ban, by menthol smoking status. All models controlled for age, sex, education level, and race/ethnicity. Results The association between reporting accurate menthol health perceptions differed by menthol preference. Among non-menthol smokers, there was no association between accurate menthol health perceptions and support of a menthol ban while more accurate menthol perceptions of addiction were associated with greater support of a menthol ban (aOR=2.83, CI=1.19-6.72). Among menthol smokers, more accurate health-related menthol perceptions were associated with increased odds of supporting a menthol ban (aOR=3.90, CI=1.02-14.79) while more accurate menthol addiction perceptions were not. Conclusions Fewer current menthol smokers support a menthol ban than current non-menthol smokers given its effect on their preferred product. Given the large proportions of smokers who have misperceptions of the health consequences and addictive properties of menthol, there is a moral imperative to inform those who use these products. Findings suggest the need for tailored messaging strategies targeted to reach menthol smokers who will be most impacted by a ban, but also have the most to gain from such a policy change.