Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): Medicaid Reform, Provider Training/Education, Media Campaign (Print Materials, Public Address System, Social Media),

Intervention Description: We estimate the association of the Delaware Contraceptive Access Now (DelCAN) initiative with use of postpartum Long-Acting Reversible Contraception (LARC). DelCAN included Medicaid payment reform for immediate postpartum LARC use, provider training and technical assistance in LARC provision, and a public awareness campaign.

Intervention Results: Relative to the comparison states, postpartum LARC use in Delaware increased by 5.26 percentage points (95% CI 2.90-7.61, P < 0.001) during the 2015-2017 DelCAN implementation period. This increase was the largest among Medicaid-covered women, and grew over the first three implementation years. By the third year of the DelCAN initiative (2017), the relative increase in postpartum LARC use for Medicaid women exceeded that for non-Medicaid women by 7.24 percentage points (95% CI 0.12-14.37, P = 0.046).

Conclusion: The DelCAN initiative was associated with increased LARC use among postpartum women in Delaware. During the first 3 years of the initiative, LARC use increased progressively and to a greater extent among Medicaid-enrolled women. Comprehensive initiatives that combine Medicaid payment reforms, provider training, free contraceptive services, and public awareness efforts may reduce unmet demand for highly effective contraceptives in the postpartum months.

Study Design: Difference in differences design

Setting: Delaware (statewide compared to 15 other states)

Sample Size: 4815 women in Delaware; 88470 women in 15 comparison states

Age Range: 15-50

Intervention Components (click on component to see a list of all articles that use that intervention): Engagement with Payers, Educational Material, Media Campaign (Print Materials, Public Address System, Social Media),

Intervention Description: - The interventions include developing a jurisdiction-wide collaborative initiative with stakeholders, implementing education and skill-building strategies targeting providers, conducting AFIX enhanced with individualized clinician-to-clinician feedback, and conducting a comprehensive communication campaign targeting the public.

Intervention Results: - The results include increased HPV vaccine coverage rates among adolescents, with specific details on the number of clinics showing increases in vaccine coverage after AFIX peer-to-peer feedback sessions and the estimated reach and effectiveness of the public information campaign.

Conclusion: - The conclusion of the study is not explicitly mentioned in the provided excerpts.

Study Design: - The study design involves a combination of interventions including developing a jurisdiction-wide collaborative initiative, implementing education and skill-building strategies targeting providers, conducting AFIX enhanced with individualized clinician-to-clinician feedback, and conducting a comprehensive communication campaign targeting the public.

Setting: - The setting of the study is Chicago, Illinois, from 2013 to 2015.

Population of Focus: - The target audience includes adolescents aged 11 to 17 years, their parents or guardians, and healthcare providers in Chicago.

Sample Size: - The sample size is not explicitly mentioned in the provided excerpts.

Age Range: - The age range of the target audience is 11 to 17 years for adolescents and older than 18 years for accompanying adults.

Intervention Components (click on component to see a list of all articles that use that intervention): Media Campaign (Print Materials, Public Address System, Social Media),

Intervention Description: The study focused on analyzing the impact of Truth and state-sponsored anti-tobacco media campaigns on youth smoking in the United States, as well as their potential to reduce tobacco-related health disparities.

Intervention Results: Greater campaign exposure (80th vs. 20th GRP percentile) was associated with lower probabilities of smoking intentions among 8th graders, smoking participation among 8th and 12th graders, and initiation among 8th graders. Greater exposure was associated with a greater reduction in the likelihood of smoking participation among 10th and 12th grade males than females; 10th and 12th graders with parents of lower education versus those with a college degree; and 12th graders who did not definitely plan to go to college relative to those who did.

Conclusion: Media campaign exposure was associated with a lower likelihood of youth smoking behaviors. Associations were more pronounced for groups disproportionately affected by smoking, including youth of lower socioeconomic status. Media campaigns may be useful in reducing smoking disparities and improving health equity.

Study Design: Cross-sectional survey analysis

Setting: USA (Nationwide)

Population of Focus: Researchers, public health professionals, policymakers

Sample Size: 736235 students from 8th-12th grade

Age Range: ages 13-18

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Peer-led Mentoring/Support Counseling, SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: This study examines the impact of a peer support service as an intervention to counteract bullying in a school with a serious problem. The impact of the intervention was assessed by a survey and by qualitative interviews with staff, peer supporters, users and potential users of the service.

Intervention Results: The survey indicated that the intervention had no overall effect on levels of bullying in the school as a whole or on the likelihood that peers would intervene to help. However, the interviews indicated that peer helpers and some victims were helped by the initiative, and some potential users of the service perceived it in a positive light.

Conclusion: Some explanations of the findings and implications for implementation of such interventions are discussed.

Intervention Components (click on component to see a list of all articles that use that intervention): Social Media, Educational Material, Media Campaign (Print Materials, Public Address System, Social Media),

Intervention Description: Enrolling a community pharmacy as a Vaccines for Children (VFC) provider to provide free HPV vaccines to eligible adolescents. The intervention included a multi-faceted campaign to promote vaccination, including printed mailers, posters, informational pamphlets, social media strategy, and follow-up cards for adolescents who were vaccinated to remind them when to come back for their next dose. The pharmacy also held a community back-to-school vaccine clinic and block party to distribute school supplies, educational information regarding HPV and HPV vaccination, and vaccines were offered.

Intervention Results: Over the 8-month study, 166 total vaccines were administered to 89 adolescents. The county-level HPV vaccination uptake and completion rates increased from 20.5% to 33.3% and from 12.8% to 22.2%, respectively.

Conclusion: Enrolling a community pharmacy as a VFC provider to provide free HPV vaccines to eligible adolescents is a feasible strategy to increase HPV vaccination rates in rural, medically underserved areas.

Study Design: Feasibility study

Setting: Rural, medically underserved Alabama county

Population of Focus: Adolescents aged 10-18 years old

Sample Size: 89 adolescents

Age Range: 10-18 years old

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Training (Parent/Family), CLASSROOM, Adult-led Curricular Activities/Training, SCHOOL, Teacher/Staff Training, Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: This article presents results from an evaluation of the ConRed cyberbullying intervention program.

Intervention Results: Repeated measures MANOVA showed that cyber victims, cyber aggressors and cyberbully/victims reduced their involvement in cyberbullying. Moreover, cyber-victims and bystanders adjusted their perceptions about their control of personal information on the Internet, and cyber aggressors and bystanders reduced their Internet dependence.

Conclusion: The ConRed program had stronger effects on male participants, especially in heightening their affective empathy.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Spain

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (N=875) Intervention (n=586); Control (n=289)

Age Range: 11/19/2022

Intervention Components (click on component to see a list of all articles that use that intervention): Media Campaign (Print Materials, Public Address System, Social Media), Distribution of Promotional Items (Community),

Intervention Description: The first intervention involved an FASD informational poster affixed to a pregnancy test dispenser, while the second intervention involved an FASD informational poster alone. Both interventions were posted in women's restrooms at establishments serving alcohol in eight study communities in Alaska and the Yukon Territory.

Intervention Results: The study found that both intervention groups showed improvement in knowledge of FASD, with the dispenser group scoring higher than the poster group on the FASD Health Belief questions at both baseline and follow-up. Additionally, alcohol consumption among pregnant women was lower at follow-up than at baseline, and a smaller proportion of pregnant participants reported drinking alcohol within the past 30 days at follow-up, indicating that the interventions may have influenced pregnant participants to stop drinking. The study also reported generally positive comments from patrons and no requests from establishments to remove the messages prior to the end of the study

Conclusion: Both interventions were posted in women's restrooms at establishments serving alcohol in eight study communities in Alaska and the Yukon Territory.

Study Design: Formative Evaluation

Setting: Alaska & Yukon regions

Population of Focus: women of childbearing age, particularly those who consume alcohol and may be pregnant or become pregnant

Sample Size: 2132

Age Range: 21-40

Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, Media Campaign (Print Materials, Public Address System, Social Media), Social Supports

Intervention Description: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health behaviors among youth and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors related to unintended pregnancy and sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of obesity and asthma and other priority health behaviors. YRBSS includes a national school-based Youth Risk Behavior Survey (YRBS) conducted by CDC and state and large urban school district school-based YRBSs conducted by state and local education and health agencies. This report summarizes results for 118 health behaviors plus obesity, overweight, and asthma from the 2015 national survey, 37 state surveys, and 19 large urban schoo l district surveys conducted among students in grades 9–12.

Intervention Results: Results from the 2015 national YRBS indicated that many high school students are engaged in priority health-risk behaviors associated with the leading causes of death among persons aged 10–24 years in the United States. During the 30 days before the survey, 41.5% of high school students nationwide among the 61.3% who drove a car or other vehicle during the 30 days before the survey had texted or e-mailed while driving, 32.8% had drunk alcohol, and 21.7% had used marijuana. During the 12 months before the survey, 15.5% had been electronically bullied, 20.2% had been bullied on school property, and 8.6% had attempted suicide. Many high school students are engaged in sexual risk behaviors that relate to unintended pregnancies and STIs, including HIV infection. Nationwide, 41.2% of students had ever had sexual intercourse, 30.1% had had sexual intercourse during the 3 months before the survey (i.e., currently sexually active), and 11.5% had ha d sexual intercourse with four or more persons during their life. Among currently sexually active students, 56.9% had used a condom during their last sexual intercourse. Results from the 2015 national YRBS also indicated many high school students are engaged in behaviors associated with chronic diseases, such as cardiovascular disease, cancer, and diabetes. During the 30 days before the survey, 10.8% of high school students had smoked cigarettes and 7.3% had used smokeless tobacco. During the 7 days before the survey, 5.2% of high school students had not eaten fruit or drunk 100% fruit juices and 6.7% had not eaten vegetables. More than one third (41.7%) had played video or computer games or used a computer for something that was not school work for 3 or more hours per day on an average school day and 14.3% had not participated in at least 60 minutes of any kind of physical activity that increased their heart rate and made them breathe hard on at least 1 day during the 7 day s before the survey. Further, 13.9% had obesity and 16.0% were overweight.

Conclusion: Many high school students engage in behaviors that place them at risk for the leading causes of morbidity and mortality. The prevalence of most health behaviors varies by sex, race/ethnicity, and grade and across states and large urban school districts. Long-term temporal changes also have occurred. Since the earliest year of data collection, the prevalence of most health-risk behaviors has decreased (e.g., riding with a driver who had been drinking alcohol, physical fighting, current cigarette use, current alcohol use, and current sexual activity), but the prevalence of other behaviors and health outcomes has not changed (e.g., suicide attempts treated by a doctor or nurse, smokeless tobacco use, having ever used marijuana, and attending physical education classes) or has increased (e.g., having not gone to school because of safety concerns, obesity, overweight, not eating vegetables, and not drinking milk). Monitoring emerging risk behav iors (e.g., texting and driving, bullying, and electronic vapor product use) is important to understand how they might vary over time.

Study Design: N/A

Setting: N/A

Data Source: N/A

Sample Size: N/A

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, Peer-led Mentoring/Support Counseling, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Presentation/Meeting/Information Session/Event, CLASSROOM, Adult-led Curricular Activities/Training, SCHOOL, Reporting & Response System, Teacher/Staff Training, Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: This study investigated the effectiveness of the KiVa Antibullying Program in two samples of students, one from Grades 1-3 (7-9 years old, N = 6,927) and the other from Grades 7-9 (13-15 years old, N = 16, 503).

Intervention Results: Multilevel regression analyses revealed that after 9 months of implementation, the intervention had beneficial effects in Grades 1-3 on self-reported victimization and bullying (odds ratios approximately equal to 1.5), with some differential effects by gender. In Grades 7-9, statistically significant positive results were obtained on 5 of 7 criterion variables, but results often depended on gender and sometimes age. The effects were largest for boys' peer reports: bullying, assisting the bully, and reinforcing the bully (Cohen's ds 0.11-0.19).

Conclusion: Overall, the findings from the present study and from a previous study for Grades 4-6 (Karna, Voeten, Little, Poskiparta, Kaljonen, et al., 2011) indicate that the KiVa program is effective in reducing bullying and victimization in Grades 1-6, but the results are more mixed in Grades 7-9. (Contains 1 figure, 7 tables, and 1 footnote.)

Study Design: Cluster RCT: pretest-posttest

Setting: Finland

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=16503)

Age Range: 13-15

Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: The toolkit comprised of a) continuing medical education (CME) presentation on strategies to improve HPV vaccination, b) campus-wide visual messaging regarding HPV prevalence, genital warts, cancer, and vaccine availability, and c) an electronic medical record (EMR) form prompting discussion about the HPV vaccine during visits.

Intervention Results: HPV vaccination rates at JHU SHWC improved from historical baseline 290/2,372 students/year (12.2%) to 515/2,479 students/year (20.8%), [risk ratio (RR) 1.70 (95% CI, 1.47–1.96), p < 0.001]. Additional changes included significant increases in vaccination rate per visit and vaccination rate by gender, especially among male students.

Conclusion: Methods and resources from this toolkit could be successfully adapted and deployed by college health centers.

Setting: Johns Hopkins Health and Wellness Center

Population of Focus: Students (male and female) ages 18-26

Intervention Components (click on component to see a list of all articles that use that intervention): Notification/Information Materials (Online Resources, Information Guide), Media Campaign (Print Materials, Public Address System, Social Media), Online Material/Education/Blogging,

Intervention Description: Community tools for CHIMC-TCI! dissemination plan with parent toolkit, multimedia campaign, elearning cafe, and reminder emails

Intervention Results: A convenience sample was obtained that yielded n = 1857 children, 404 adolescents and n = 1335 parents/caregivers for the CHIMC parent-study. After using the inclusion criteria of 13–17 years old, enrolled in CHIMC-TCI! a minimum of 9 months, and AA, a final sample of n = 118 adolescents was obtained. A diagram of inclusion criteria can be seen in Fig. 1. CHIMC-TCI! parents/caregivers (n = 118) were all AA (100%); female (92%); low-income, earning < $30,000 a year (83%); had an education level of high school graduate/GED or less (54%); and were unemployed (56%). Demo-graphics of parents/caregivers can be seen in Table 2. Comparison groups obtained from Wisconsin Department of Health Services consisted only of AA adolescents 13–17 years old. There was an overall similar percent of female and male adolescents in each group. Proportion of female adolescents for each group was: 57% among CHIMC-TCI!; 50% among the City of Milwaukee; and 49% for the State of Wisconsin. At the time of enrollment, parents/caregivers were asked whether their adolescent was UTD on immunizations. Parents/caregivers perceived that 92% of adolescents were HPV-UTD, while only 24% of adolescents had a WIR-verified HPV-UTD status, [p ≤ 0.001]. Baseline UTD status was significantly associated with favorable parental immunization attitudes/beliefs. Those that were UTD pre/post intervention were more confident with safety of childhood immunizations (97%), compared with those that were not UTD pre/post-intervention (79%) [p = 0.032]. Those that were UTD pre/post intervention agreed more that unvaccinated children may get a disease such as measles (93%), compared with those that were not UTD pre/post intervention (57%) [p = 0.001]. State of Wisconsin.

Conclusion: A culturally-tailored CBPR approach targeting parents/caregivers of younger AA children can have significant ancillary benefit to increase HPV immunization rates in adolescent siblings.

Study Design: pre and post quasi-experimental design

Setting: Two dependent proportions testing compared the proportion of adolescents that became UTD in the study cohort, City of Milwaukee, and State of Wisconsin.

Population of Focus: Public Health officials

Sample Size: Data from a community-based participatory research (CBPR) study addressing immunization disparities among 19–35 month old children was analyzed to identify ancillary benefits in HPV immunization rates for adolescent siblings. Sub-study analysis inclusion criteria: AA (N = 118), 13–17 years old, younger sibling enrolled in parent study, and enrolled ≥ 9 months.

Age Range: 19-35 month old children

Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material (Provider), Educational Material, Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: HBWW is a multi-dimensional, community-based approach to preventing preventable preterm births. In HBWW sites, community health leaders, including hospitals, health departments and local March of Dimes staff partner to work together to implement multiple (bundled) interventions known to impact preterm birth; to improve systems of care in their community so that these interventions reach the patients who need them; and to promote awareness of preterm birth across all the community, including providers, patients and the public. The pilot/demonstration project was built on an innovative, ecological model designed to work in real world settings, where a multitude of factors—not a single intervention— influence outcomes. Like other public health problems, prematurity must be addressed in communities with broader approaches than just medical care. Working with providers, the goal of the project was to move research to practice quickly and effectively. With patients, the teams worked to improve networks of support services that addressed patient needs. For the public, the goal was that everyone, whether grandmothers, friends or business leaders, understood the impact of prematurity on families and the community.

Intervention Results: (In the pilot study in Kentucky) Real world implementation of HBWW in Kentucky provided potential for “contamination” due to a high likelihood that comparison sites were exposed to HBWW and other prematurity prevention messages due to overall state and national publicity regarding the HBWW program. Such contamination is an important consideration when interpreting HBWW evaluation results. Additionally, comparison site knowledge that its performance was being scrutinized (the Hawthorne Effect [Landsberger, 1958]) may have influenced its activities and outcomes. Population Objective Patients Create positive changes in knowledge, attitudes and behavior regarding preterm birth circumstances and modifiable risk factors, with a focus on late preterm birth. Perinatal providers Bring the latest research to everyday practice, particularly regarding late preterm infants; create positive changes in knowledge, attitudes and behaviors regarding adherence to professional guidelines on preterm birth prevention (especially late preterm birth) and elective inductions and cesareans. Public (community) Increase awareness of the importance of preventing preterm birth and the risks associated with late preterm birth. Chapter 3: The HBWW Initiative marchofdimes.com 21 The HBWW evaluation used an ecological design. This design means that the unit of analysis was the aggregated results of the intervention and comparison groups rather than individual hospitals, patients or providers. The HBWW Evaluation Team (including an independent program evaluator hired for the project and March of Dimes and Kentucky Department for Public Health staff) used data collected from the state vital records system prior to project implementation and at follow-up. They compared data over time and between intervention and comparison sites. March of Dimes staff tracked process data, and the program evaluator gathered additional data via surveys and interviews. Outcome data was collected through two methods: 1) consumer and perinatal provider surveys on knowledge, attitudes and behaviors related to preterm birth, and 2) analyses of extant vital records and birth certificate data (on preterm birth rates and other outcomes) provided by the Kentucky Department for Public Health. The HBWW logic model in Figure 3.4 has more information on inputs (resources), principle strategies, outputs, and intended behavioral, policy, health status and cost outcomes of the project. Before the HBWW initiative, Kentucky had increasing preterm birth rates. A year after HBWW implementation, Kentucky had the largest drop in preterm birth rates of any of its contiguous states. There were no other major, new initiatives addressing preterm birth in the state during this time. Both survey and birth outcome data provide exciting evidence about the success of the HBWW Kentucky pilot. Some of the most compelling outcomes are anecdotes from women and perinatal providers. HBWW successfully built relationships, partnerships and collaborations that resulted in enhancement of services and patient care. Many of these anecdotes are shared throughout this manual.

Conclusion: A lesson learned through the HBWW Kentucky pilot is that data has the power to influence behavior and, therefore, directly affect program success. For example, KDMC staff recognized a problem—a substantial number of pregnant women had substance abuse problems, illustrated by the number of newborns with positive toxicology screens. To address this issue, KDMC staff developed a “plan” to appoint a perinatal social worker to address prenatal substance abuse. The site applied for a March of Dimes community chapter grant and received funding for the perinatal social worker position. The social worker’s objectives (the “do” step) included screening women for tobacco, alcohol and drug use during pregnancy; providing appropriate referrals; and providing continuity of care for high-risk prenatal patients by improving communication between the social services department and private physician practices at the hospital. Staff examined toxicology screens at a woman’s entry into prenatal care and at delivery. Once the social worker was established at the site, women with positive toxicology screens at prenatal care enrollment were less likely to deliver infants with positive toxicology screens than prior to the social worker being available. These findings (“study”) and supporting anecdotal evidence encouraged the hospital system to continue funding the social work position beyond the grant funding period. In addition, the social worker was validated and felt empowered to continue work to reduce substance use during pregnancy. Both of these results are part of the “act” stage in PDSA. As new HBWW programs move forward, program staff should share stories and data with partners to celebrate program success. Outcome measurement and process tracking provide program staff with information on accomplishments. Defining measurable objectives for each HBWW core component in a project’s implementation workplan offers opportunities to track success. Although barriers and roadblocks may exist, small and large wins along the way provide reasons to acknowledge and celebrate project successes. Program staff can share these successes with partners, collaborators and the community and thank them for their support through media efforts and during community outreach activities. Each person working on prematurity prevention makes life better for children, their families and the communities in which they live.

Study Design: Ecological Design Study

Setting: Pilot Study based in Kentucky.

Data Source: data collected from the state vital records system prior to project implementation and at follow-up

Sample Size: N/A

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Peer-led Mentoring/Support Counseling, CLASSROOM, Presentation/meeting/information Session (Classroom), SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media), POPULATION-BASED SYSTEMS, COMMUNITY, Event, Outreach

Intervention Description: An investigation of whether and to what extent a peer-led model is able to counteract mechanisms underlying bullying in peer groups, seeking clarification of divergence in reported results on the efficacy of peer-led models.

Intervention Results: Two studies were carried out in Italy within a project tackling bullying and cyberbullying in secondary schools. In the first study (n= 386), concerning the first phase of the project, a significant decrease was found only for cyberbullying, most of all for male peer educators. For the second study (n= 375) the model was improved and significant effects were found for several participating groups (peer educators and the experimental classes), who exhibited a decrease in bullying, victimization, and cybervictimization.

Conclusion: Results suggest that peer educators can act as agents of change in the broader context.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Italy

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Study 1: Intervention 1 (n=126); Intervention 2 (n=63); Control (n=47) Study 2: Intervention (n=231); Control (n=144)

Age Range: 14-20

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Peer-led Curricular Activities/Training, SCHOOL, Teacher/Staff Training, School Rules, Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: This study examined the effectiveness of a comprehensive, school-based intervention program, Creating A Safe School (CASS; The Ophelia Project) designed to reduce relational aggression (RA) and relational victimization (RV).

Intervention Results: Results revealed significant reductions in RA and RV among students who reported initially high levels of involvement. Findings also showed that decreasing approval of RA accounted for a significant amount of variance in changes in RA between pre- and posttest.

Conclusion: These results provide initial evidence of the effectiveness of the CASS intervention model in reducing RA among early adolescents.

Study Design: Quasi-experiment study: pretestposttest

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: N=405

Age Range: Mean: 11.4

Intervention Components (click on component to see a list of all articles that use that intervention): Media Campaign (Print Materials, Public Address System, Social Media),

Intervention Description: The study evaluated the impact of vaping prevention advertisements from the US Food and Drug Administration (FDA) Real Cost national vaping prevention campaign among a national convenience sample of US adolescents

Intervention Results: Participants were 1514 adolescents (1140 [75.3%] boys; mean [SD] age, 15.22 [1.18] years), including 504 randomized to the Real Cost health harms group, 506 randomized to the Real Cost addiction group, and 504 randomized to the control group. Adolescents in the Real Cost groups (combined) had lower susceptibility to vaping at visit 4 than those in the control group (b = -0.21; 95% CI, -0.32 to -0.10). The Real Cost groups did not differ from one another on susceptibility to vaping (visit 4: b = -0.05; 95% CI, -0.17 to 0.07). Adolescents in the Real Cost groups (combined) also had lower susceptibility to smoking cigarettes than those in the control group (b = -0.21; 95% CI, -0.32 to -0.10). For both vaping and smoking, Real Cost groups had less positive attitudes (vaping: b = -0.27; 95% CI, -0.40 to -0.14; smoking: b = -0.23; 95% CI, -0.39 to -0.08) compared with the control group.

Conclusion: These findings suggest that vaping prevention advertisements from the FDA Real Cost campaign led to lower adolescent susceptibility to vaping and had beneficial spillover effects on cigarette smoking outcomes. Tobacco prevention campaigns can help reduce youth tobacco use.

Study Design: Randomized controlled trial

Setting: USA (Nationwide)

Population of Focus: Researchers, public health professionals, policymakers

Sample Size: 1500 youth

Age Range: ages 13-17

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Training (Parent/Family), CLASSROOM, Adult-led Curricular Activities/Training, SCHOOL, Teacher/Staff Meeting, Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: An evaluation of the success of the evidence-based ConRed program, which addresses cyberbullying and other emerging problems linked with the use of the internet and seeks to promote a positive use of this new environment.

Intervention Results: The results of the mixed repeated measures ANOVAs demonstrate that ConRed contributes to reducing cyberbullying and cyber-dependence, to adjusting the perception of information control, and to increasing the perception of safety at school.

Conclusion: The results of the mixed repeated measures ANOVAs demonstrate that ConRed contributes to reducing cyberbullying and cyber-dependence, to adjusting the perception of information control, and to increasing the perception of safety at school.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Spain

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=893) Intervention (n=595); Control (n=296)

Age Range: 11- 19

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Peer-led Mentoring/Support Counseling, CLASSROOM, Presentation/meeting/information Session (Classroom), Peer-led Curricular Activities/Training, SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media), POPULATION-BASED SYSTEMS, COMMUNITY, Event, Presentation

Intervention Description: The NoTrap! (Noncadiamointrappola!) program is a school-based intervention, which utilizes a peer-led approach to prevent and combat both traditional bullying and cyberbullying. The aim of the present study was to evaluate the efficacy of the third Edition of the program in accordance with the recent criteria for evidence-based interventions.

Intervention Results: Towards this aim, two quasi-experimental trials involving adolescents (age M = 14.91, SD = .98) attending their first year at different high schools were conducted. In Trial 1 (control group, n = 171; experimental group, n = 451), latent growth curve models for data from pre-, middle- and post-tests showed that intervention significantly predicted change over time in all the target variables (victimization, bullying, cybervictimization, and cyberbullying). Specifically, target variables were stable for the control group but decreased significantly over time for the experimental group. Long-term effects at the follow up 6 months later were also found. In Trial 2 (control group, n = 227; experimental group, n = 234), the moderating effect of gender was examined and there was a reported decrease in bullying and cyberbullying over time (pre- and post-test) in the experimental group but not the control group, and this decrease was similar for boys and girls.

Conclusion: The significant improvement in target variables in trials of the third edition, compared to the non-significant improvements found for the first and second editions, suggests that the new/modified components may have improved the efficacy of the program.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Italy

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=375) Intervention (n=231); Control (n=144)

Age Range: 14-18

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Peer-led Mentoring/Support Counseling, CLASSROOM, Presentation/meeting/information Session (Classroom), SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media), POPULATION-BASED SYSTEMS, COMMUNITY, Event, Presentation

Intervention Description: The aim of the present study is to describe and evaluate an ongoing peer-led model against bullying and cyberbullying carried out with Italian adolescents.

Intervention Results: Results showed a significant decrease in the experimental group as compared to the control group for all the variables except for cyberbullying. Besides, in the experimental group we found a significant increase in adaptive coping strategies like problem solving and a significant decrease in maladaptive coping strategies like avoidance: these changes mediate the changes in the behavioural variables. In particular, the decrease in avoidance predicts the decrease in victimization and cybervictimization for peer educators and for the other students in the experimental classes whereas the increase in problem solving predicts the decrease in cyberbullying only in the peer educators group.

Conclusion: Results are discussed following recent reviews on evidence based efficacy of peer led models.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Italy

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Trial 1: Intervention (n=451); Control (n=171) Trial 2: Intervention (n=234); Control (n=227)

Age Range: Mean: ~16.23

Intervention Components (click on component to see a list of all articles that use that intervention): SCHOOL, Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: Bullying attitudes and behaviors and perceptions of peers were assessed in a case study experiment employing a social norms intervention in five diverse public middle schools in the State of New Jersey (Grades 6 to 8).

Intervention Results: A pre-/postintervention comparison of results revealed significant reductions overall in perceptions of peer bullying and probullying attitudes while personal bullying of others and victimization were also reduced and support for reporting bullying to adults at school and in one’s family increased. The extent of reductions across school sites was associated with the prevalence and extent of recall of seeing poster messages reporting actual peer norms drawn from the initial survey data. Rates of change in bullying measures were highest (from around 17% to 35%) for the school with the highest message recall by students after a one-and-a-half-year intervention.

Conclusion: Results suggest that a social norms intervention may be a promising strategy to help reduce bullying in secondary school populations.

Study Design: QE: pretest-posttest

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total: Pretest (n=2589); Posttest (n=3024) School A: Pretest (n=180); Posttest (n=225) School B: Pretest (n=759); Posttest (n=681) School C: Pretest (n=578); Posttest (n=799) School D: Pretest (n=484); Posttest (n=592) School E: Pretest (n=588); Posttest (n=727)

Age Range: 11/14/2022

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, Peer-led Mentoring/Support Counseling, CLASSROOM, Peer-led Curricular Activities/Training, SCHOOL, Assembly, Reporting & Response System, Teacher/Staff Training, School Rules, Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: To counter bullying at an Australian coeducational secondary school, staff and students co-operated in developing and implementing appropriate policies and procedures.

Intervention Results: Questionnaires assessing the incidence of bullying and related attitudes were completed by students in Years 7, 9, 10 and 11 in 1995 and again in 1997. Significant reductions in levels of victimization were recorded for Year 7 students only. Significantly increased support for anti-bullying initiatives was found among senior students (Years 10 and 11)

Conclusion: Anti-bullying activities directed and undertaken by students themselves received most approval from peers.

Study Design: QE: pretest-posttest

Setting: Australia

Population of Focus: Not specified

Data Source: Not specified

Sample Size: NR (The school has a total of ~1200 students; 4 of the 5 grades included in the study)

Age Range: NR

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Peer-led Curricular Activities/Training, SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: Effects of a peer-led intervention campaign against school bullying, carried out by eight peer counsellors, were studied in an upper-level comprehensive school in southern Finland.

Intervention Results: The results showed that the campaign was especially effective among girls. This was most clearly shown by decreases in both self- and peer-reported bullying, as well as an increase in 'power attitudes', i.e. attitude items reflecting the students' self-perceived potential and willingness to influence bullying problems in their class. Among boys, on the other hand, there was a slight decrease in self-reported bullying, not confirmed by peer reports and, unfortunately, there was an increase in pro-bullying attitudes, such as 'bullying might be fun sometimes'. Evaluating the campaign, girls also perceived it as more beneficial and more effective than boys did.

Conclusion: Most students who reported being bullied before the intervention were satisfied with the campaign and thought it was helpful.

Study Design: QE: pretest-posttest

Setting: Finland

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=196) Analysis (n=144)

Age Range: ~13-15

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Peer-led Curricular Activities/Training, SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media), POPULATION-BASED SYSTEMS, COMMUNITY, Training, Event, Media Campaign (Print Materials, Radio, TV), Distribution of Promotional Items (Classroom/School), Distribution of Promotional Items (Community)

Intervention Description: In a community randomized controlled trial, intervention middle school students from small towns were exposed to a community and school-based anti-violence intervention ("Resolve It, Solve It").

Intervention Results: Students in the intervention group reported a significantly higher rate of decline in verbal victimization compared to control students. The difference was only significant among males. For physical victimization, the decline in the intervention group compared to the control group was in the expected direction but did not reach statistical significance (p=0.069). This near significant difference was accounted for by males.

Conclusion: These results suggest that a media and reinforcing community intervention led by older peers can alter rates of growth for some measures of violence and associated factors among small-town youth. Further research is indicated to determine how different campaign messages influence students by sex.

Study Design: Cluster RCT: pretest-posttest

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=1492) Intervention (n=712); Control (n=780)

Age Range: NR

Intervention Components (click on component to see a list of all articles that use that intervention): Media Campaign (Print Materials, Public Address System, Social Media),

Intervention Description: The current study explores the utility of Down and Dirty, a Social Branding tobacco education campaign, in changing Virginia Country teens' chewing tobacco-related attitudes and behavior. The relationship between chew use and Country peer crowd identification was also explored.

Intervention Results: Compared with Wave 1, Waves 2 and 3 Country teens who engaged with Down and Dirty had greater odds of holding strong attitudes against chew. Among campaign-engaged Country teens, odds of chew use were lower at Waves 2 and 3, and lower odds were associated with liking the campaign. Related to chew prevalence, Country teens demonstrated greater odds of past 30-day chew use compared to non-Country teens, and higher Country identification was associated with greater odds of chew use.

Conclusion: Down and Dirty is a promising intervention associated with positive attitudinal and behavioral outcomes for high-risk Country teens. Additionally, this study helps document tobacco-related behavioral patterns of the Country peer crowd, a priority for ongoing tobacco education, especially around chew.

Study Design: Cross-sectional survey

Setting: Virginia, USA

Population of Focus: Researchers, public health professionals, educators, policymakers

Sample Size: 1264 youth

Age Range: ages 13-18