Development of a social media-based intervention targeting tobacco use and heavy episodic drinking in young adults

Danielle E Ramo, Meredith C Meacham, Manpreet Kaur, Ella S Corpuz, Judith J Prochaska, Derek D Satre, Danielle E Ramo, Meredith C Meacham, Manpreet Kaur, Ella S Corpuz, Judith J Prochaska, Derek D Satre

Abstract

Background: Tobacco use and heavy episodic drinking (HED) commonly co-occur in young adults. We developed and tested usability of the Smoking Tobacco and Drinking (STAND) intervention for young adults delivered on Facebook.

Methods: To inform the intervention, focus groups were held with 25 young adults age 18 to 25 (12% female; Mean age = 20.4) who smoked cigarettes and reported at least one HED episode in the past month. Facebook intervention posts (N = 180) were tailored to readiness to quit smoking, and tested in two private Facebook behavioral change groups (Ready, Not Ready) with N = 29 young adults (10% female; Mean age = 20.8). Participants flagged posts in need of change, and we assessed engagement (comment frequency).

Results: Focus groups revealed preference for changing one substance at a time and greater receptivity to quitting smoking than reducing drinking. Mean comments per post were 5.3 (SD = 1.1) in Ready groups and 11.7 (SD = 5.1) in Not Ready groups; 94/180 (52.2%) posts were flagged for change. The level of engagement and the flagging of posts for change did not differ by group or by whether the post targeted tobacco, alcohol, or both substances combined (all p > .10). Overall, STAND was rated as easy to understand, providing sound advice, worthy of recommendation, and helpful (all agreement 100% among Ready; 50-70% among Not Ready).

Conclusions: The current findings informed development of a social media-based intervention targeting tobacco and alcohol use in young adults. Although there was greater interest in making changes in smoking than drinking behavior, receptivity and acceptability of the Facebook post messages in the STAND intervention was high overall. The intervention is being further refined for evaluation in a larger trial. Trial registration Name of the registry Smoking Tobacco and Drinking Study (STAND); Trial registration number NCT03163303; Date of registration 5/23/17; URL of trial registry record https://ichgcp.net/clinical-trials-registry/NCT03163303 .

Keywords: Alcohol; Drinking; Facebook; Focus groups; Smoking; Social media; Young adults.

Conflict of interest statement

Dr. Ramo has consulted for Carrot, Inc., which makes a tobacco cessation device. Dr. Prochaska has provided consultation to pharmaceutical and technology companies that make medications and other treatments for quitting smoking and has served as an expert witness in lawsuits against the tobacco companies. Other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Most common codes pertaining to alcohol and tobacco use patterns, b most common codes pertaining to social media use and social media to quit tobacco or change alcohol use. Size of word represents frequency of code use
Fig. 2
Fig. 2
Sample of post feedback adaptation based on usability feedback
Fig. 3
Fig. 3
Intervention usability ratings by participant level of readiness to quit

References

    1. Weitzman ER, Chen YY. The co-occurrence of smoking and drinking among young adults in college: national survey results from the United States. Drug Alcohol Depend. 2005;80(3):377–386.
    1. Gubner NR, Delucchi KL, Ramo DE. Associations between binge drinking frequency and tobacco use among young adults. Addict Behav. 2016;60:191–196.
    1. Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration: NSDUH Series H-52; 2017.
    1. Falk DE, Yi HY, Hiller-Sturmhofel S. An epidemiologic analysis of co-occurring alcohol and tobacco use and disorders: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Alcohol Res Health. 2006;29(3):162–171.
    1. Harrison EL, McKee SA. Non-daily smoking predicts hazardous drinking and alcohol use disorders in young adults in a longitudinal U.S. sample. Drug Alcohol Depend. 2011;118(1):78–82.
    1. Murray RP, Istvan JA, Voelker HT, Rigdon MA, Wallace MD. Level of involvement with alcohol and success at smoking cessation in the lung health study. J Stud Alcohol. 1995;56(1):74–82.
    1. Hymowitz N, Cummings KM, Hyland A, Lynn WR, Pechacek TF, Hartwell TD. Predictors of smoking cessation in a cohort of adult smokers followed for five years. Tob Control. 1997;6(Suppl 2):S57–S62.
    1. Duffy SA, Ronis DL, Valenstein M, Lambert MT, Fowler KE, Gregory L, et al. A tailored smoking, alcohol, and depression intervention for head and neck cancer patients. Cancer Epidemiol Biomark Prev. 2006;15(11):2203–2208.
    1. Jaszyna-Gasior M, Schroeder JR, Moolchan ET. Alcohol use and tobacco abstinence among adolescents in cessation treatment: preliminary findings. Addict Behav. 2007;32(3):617–621.
    1. U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion. Healthy People 2020 Washington, DC; 2019 [cited 2019 January 22]. .
    1. Ames SC, Werch CE, Ames GE, Lange LJ, Schroeder DR, Hanson AC, et al. Integrated smoking cessation and binge drinking intervention for young adults: a pilot investigation. Ann Behav Med. 2010;40(3):343–349.
    1. Ames SC, Pokorny SB, Schroeder DR, Tan W, Werch CE. Integrated smoking cessation and binge drinking intervention for young adults: a pilot efficacy trial. Addict Behav. 2014;39(5):848–853.
    1. Witkiewitz K, Desai SA, Bowen S, Leigh BC, Kirouac M, Larimer ME. Development and evaluation of a mobile intervention for heavy drinking and smoking among college students. Psychol Addict Behav. 2014;28(3):639–650.
    1. Haug S, Castro RP, Kowatsch T, Filler A, Schaub MP. Efficacy of a technology-based, integrated smoking cessation and alcohol intervention for smoking cessation in adolescents: results of a cluster-randomised controlled trial. J Subst Abuse Treat. 2017;82:55–66.
    1. Cao B, Gupta S, Wang J, Hightow-Weidman LB, Muessig KE, Tang W, et al. Social media interventions to promote HIV testing, linkage, adherence, and retention: systematic review and meta-analysis. J Med Internet Res. 2017;19(11):e394.
    1. Pagoto S, Waring ME, May CN, Ding EY, Kunz WH, Hayes R, et al. Adapting behavioral interventions for social media delivery. J Med Internet Res. 2016;18(1):e24.
    1. Elaheebocus S, Weal M, Morrison L, Yardley L. Peer-based social media features in behavior change interventions: systematic review. J Med Internet Res. 2018;20(2):e20.
    1. Bull SS, Levine DK, Black SR, Schmiege SJ, Santelli J. Social media-delivered sexual health intervention: a cluster randomized controlled trial. Am J Prev Med. 2012;43(5):467–474.
    1. Patrick K, Marshall SJ, Davila EP, Kolodziejczyk JK, Fowler JH, Calfas KJ, et al. Design and implementation of a randomized controlled social and mobile weight loss trial for young adults (project SMART) Contemp Clin Trials. 2014;37(1):10–18.
    1. Young SD. Social media technologies for HIV prevention study retention among minority men who have sex with men (MSM) AIDS Behav. 2013;18(9):1625–1629.
    1. Kernot J, Olds T, Lewis LK, Maher C. Effectiveness of a facebook-delivered physical activity intervention for post-partum women: a randomized controlled trial protocol. BMC Public Health. 2013;13:518.
    1. Cavallo DN, Tate DF, Ries AV, Brown JD, DeVellis RF, Ammerman AS. A social media-based physical activity intervention: a randomized controlled trial. Am J Prev Med. 2012;43(5):527–532.
    1. Napolitano MA, Hayes S, Bennett GG, Ives AK, Foster GD. Using facebook and text messaging to deliver a weight loss program to college students. Obesity. 2013;21(1):25–31.
    1. Pedrana A, Hellard M, Gold J, Ata N, Chang S, Howard S, et al. Queer as F**k: reaching and engaging gay men in sexual health promotion through social networking sites. J Med Internet Res. 2013;15(2):e25.
    1. Williams G, Hamm MP, Shulhan J, Vandermeer B, Hartling L. Social media interventions for diet and exercise behaviours: a systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2014;4(2):e003926.
    1. Jones K, Baldwin KA, Lewis PR. The potential influence of a social media intervention on risky sexual behavior and Chlamydia incidence. J Community Health Nurs. 2012;29(2):106–120.
    1. Baskerville NB, Azagba S, Norman C, McKeown K, Brown KS. Effect of a digital social media campaign on young adult smoking cessation. Nicotine Tob Res. 2015;18:351–360.
    1. Naslund JA, Kim SJ, Aschbrenner KA, McCulloch LJ, Brunette MF, Dallery J, et al. Systematic review of social media interventions for smoking cessation. Addict Behav. 2017;73:81–93.
    1. Moreno MA, Whitehill JM. Influence of social media on alcohol use in adolescents and young adults. Alcohol Res Curr Rev. 2014;36(1):91–100.
    1. Hendriks H, Van den Putte B, Gebhardt WA, Moreno MA. Social drinking on social media: content analysis of the social aspects of alcohol-related posts on facebook and instagram. J Med Internet Res. 2018;20(6):e226-e.
    1. Boyle SC, LaBrie JW, Froidevaux NM, Witkovic YD. Different digital paths to the keg? How exposure to peers’ alcohol-related social media content influences drinking among male and female first-year college students. Addict Behav. 2016;57:21–29.
    1. Bertholet N, Daeppen JB, McNeely J, Kushnir V, Cunningham JA. Smartphone application for unhealthy alcohol use: a pilot study. Subst Abuse. 2017;38(3):285–291.
    1. Bertholet N, Godinho A, Cunningham JA. Smartphone application for unhealthy alcohol use: pilot randomized controlled trial in the general population. Drug Alcohol Depend. 2018;195:101–105.
    1. Bhochhibhoya A, Hayes L, Branscum P, Taylor L. The use of the internet for prevention of binge drinking among the college population: a systematic review of evidence. Alcohol Alcohol. 2015;50(5):526–535.
    1. Greenwood S, Perrin A, Duggan M. Social Media Update 2016: Pew Research Center: Internet, Science, and Technology; 2016 [cited 2016 November 29]. Archived by Webcitation at .
    1. Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51(3):390–395.
    1. Ramo DE, Thrul J, Chavez K, Delucchi KL, Prochaska JJ. Feasibility and quit rates of the tobacco status project: a facebook smoking cessation intervention for young adults. J Med Internet Res. 2015;17(12):e291.
    1. Ramo DE, Thrul J, Delucchi KL, Ling PM, Hall SM, Prochaska JJ. The Tobacco Status Project (TSP): study protocol for a randomized controlled trial of a Facebook smoking cessation intervention for young adults. BMC Public Health. 2015;15(1):897.
    1. Ramo D, Thrul J, Delucchi KL, Hall SM, Ling PM, Belohlavek A, Prochaska JJ. A randomized controlled evaluation of the tobacco status project, a facebook intervention for young adults. Addiction. 2018;113:1683–1695.
    1. Thrul J, Belohlavek A, Hambrick DA, Kaur M, Ramo DE. Conducting online focus groups on Facebook to inform health behavior change interventions: two case studies and lessons learned. Internet Interv. 2017;9((Supplement C)):106–111.
    1. Klassen AC, Creswell J, Plano Clark VL, Smith KC, Meissner HI. Best practices in mixed methods for quality of life research. Qual Life Res. 2012;21(3):377–380.
    1. Zhang W, Creswell J. The use of “mixing” procedure of mixed methods in health services research. Med Care. 2013;51(8):e51–e57.
    1. Yardley L, Morrison L, Bradbury K, Muller I. The person-based approach to intervention development: application to digital health-related behavior change interventions. J Med Internet Res. 2015;17(1):e30.
    1. Ramo DE, Liu H, Prochaska JJ. A mixed-methods study of young adults’ receptivity to using facebook for smoking cessation: if you build it, will they come? Am J Health Promot. 2014;29(4):e126–e135.
    1. Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The fagerström test for nicotine dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991;86:1119–1127.
    1. Prochaska JO, DiClemente CC. Stages and processes of self-change for smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51(3):390–395.
    1. Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. . Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998;158(16):1789–1795.
    1. Dedoose Version 4.5, web application for managing, analyzing, and presenting qualitative and mixed method research data. Los Angeles, CA: SocioCultural Research Consultants, LLC (); 2013.
    1. Fiore MC, Jaén CR, Baker TB, et al. Treating tobacco use and dependence: 2008 update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service; 2008.
    1. National Institute on Alcohol Abuse and Alcoholism, editor. Rethinking drinking: alcohol use and your health. Rockville, MD: US Department of Health and Human Services; 2010.
    1. National Institute on Alcohol Abuse and Alcoholism. Alcohol screening and brief intervention for youth: a practitioner’s guide. US Department of Health and Human Services, editor. Rockville, MD: National Institute on Alcohol Abuse and Alcoholism; 2011.
    1. Standard I. Ergonomic requirements for office work with visual display terminals (vdts)–part 11: guidance on usability. ISO Standard 9241-11: 1998. International Organization for Standardization; 1998.
    1. Radovic A, Gmelin T, Hua J, Long C, Stein BD, Miller E. Supporting Our Valued Adolescents (SOVA), a social media website for adolescents with depression and/or anxiety: technological feasibility, usability, and acceptability study. JMIR Mental Health. 2018;5(1):e17.
    1. Valdés BA, Hilderman CG, Hung C-T, Shirzad N, Van der Loos HM, editors. Usability testing of gaming and social media applications for stroke and cerebral palsy upper limb rehabilitation. In: Engineering in Medicine and Biology Society (EMBC), 2014 36th annual international conference of the IEEE. IEEE; 2014.
    1. Park BK, Nahm E-S, Rogers VE, Choi M, Friedmann E, Wilson M, et al. A facebook-based obesity prevention program for Korean American adolescents: usability evaluation. J Pediatr Health Care. 2017;31(1):57–66.
    1. Thrul J, Klein AB, Ramo DE. Smoking cessation intervention on facebook: which content generates the best engagement? J Med Internet Res. 2015;17(11):e244.
    1. Sambunjak D, Straus SE, Marusic A. A systematic review of qualitative research on the meaning and characteristics of mentoring in academic medicine. J Gen Intern Med. 2010;25(1):72–78.
    1. Kim DJ, Choo EK, Ranney ML. Impact of gender on patient preferences for technology-based behavioral interventions. West J Emerg Med. 2014;15(3):593.
    1. Ramo DE, Kaur M, Corpuz ES, Satre DD, Delucchi K, Brown SA, et al. Using Facebook to address smoking and heavy drinking in young adults: protocol for a randomized, controlled trial. Contemp Clin Trials. 2018;68:52–60.
    1. Granville K. Facebook and Cambridge Analytica: what you need to know as fallout widens. New York Times; 2018.
    1. Pew Internet & American Life Project. Internet User Demographics; 2018 [cited 2015 May 8]. .

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner