Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Reminder/Recall Systems, Education/Training (caregiver), Social Media,

Intervention Description: Based on the concerns parents expressed through the survey, a program was designed and implemented that included reminder calls, parent education, proactive appointment scheduling, and social media reminders.

Intervention Results: After implementing a parent-driven quality-improvement program for 6 months during influenza season, the health center's pediatric influenza immunization rates rose to 57% compared with 44% during the year before.

Conclusion: Childhood immunization is a critical priority to protect the health and wellness of children. Increasing parent engagement in discussions about increasing immunization rates not only promotes awareness surrounding vaccines but also allows primary care providers to learn from parents to create a patient-centered immunization program. Programs that specifically target immunization efforts toward parental concerns have the potential for increased vaccine acceptance and improved health outcomes.

Study Design: The study utilized a randomized sampling method and conducted open-ended telephone surveys with parents of young children to identify key barriers to influenza immunization

Setting: a diverse, urban family health center

Population of Focus: The target audience for the study is parents of children aged 6 through 24 months at the urban family health center

Sample Size: The sample size is not explicitly mentioned in the provided text

Age Range: The age range of the children involved in the study is 6 through 24 months

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: This study investigates the experiences of women using a social media Facebook group for breastfeeding support and attempts to explore whether it has aided in extended breastfeeding success. In addition, it aims to explore the value of social cognitive theory (SCT) in explaining these experiences. Qualitativ, audio-recorded, semi-structured interviews were conducted from eight women who were members of a private Facebook group.

Intervention Results: A number of themes were identified from the women's experiences, with analysis uncovering the superordinate theme 'increased self-efficacy' which provided an understanding of how the group impacted women's experiences and aided them in breastfeeding success. The sub-themes of education, accessibility, online community, normalization, and extended goals provided a more detailed understanding of how self-efficacy was increased through group membership.

Conclusion: The symbiotic relationship between members of a social media group facilitates greater breastfeeding success and a longer duration of breastfeeding through the central concept of the SCT: reciprocal determinism. Therefore, it is posited that the SCT is a suitable theory of behaviour change which can potentially be used to develop interventions aiming to increase breastfeeding rates and duration.

Study Design: Qualitative study (exploratory, deductive approach)

Setting: Social media platform: Private Facebook group

Population of Focus: Women who were members of a private Facebook group

Sample Size: 8 women

Intervention Components (click on component to see a list of all articles that use that intervention): Social Media, Other Media, Mass Media, NATIONAL, COMMUNITY

Intervention Description: To examine whether exposure to safe sleep recommendations using a blog format changed infant sleep practices.

Intervention Results: The average infant age (n = 1500) was 6.6 months (Standard Deviation 3.3). Most participants (74%) were female; 77% were married; 65% identified as white Non-Hispanic, 12% were black and 17% were Hispanic. 47% (n = 711) completed both surveys. We identified no differences in the odds of any of the four safe sleep practices after exposure to safe sleep recommendations in blog post format.

Conclusion: Although in-person advice has been associated with improved safe sleep practices, we did not identify changes in infant sleep practices after exposure to safe sleep advice using blog posts.

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): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: The support offered to mothers after hospital discharge can be decisive in maintaining exclusive breastfeeding during the first 6 months post-partum. The objective of this study was to assess the impact on the duration of exclusive breastfeeding of a participatory intervention using an online social network--Facebook. A randomized clinical trial was performed involving 251 mother–child pairings in a university hospital in the Northeast of Brazil, 123 of which assigned to the intervention group and 128 to the control group. After hospital discharge, the intervention group was followed through a closed group of an online social network, where weekly posters were published on topics related to breastfeeding and an active communication was established with the mothers. The groups were interviewed monthly over the phone until the child reached 6 months of age.

Intervention Results: The exclusive breastfeeding frequencies were higher in the intervention group in all follow-up months, reaching 33.3% in the sixth month versus 8.3% in the control group. The median exclusive breastfeeding duration was 149 days (95% CI [129.6, 168.4]) in the intervention group and 86 days (95% CI [64.9, 107.1]) in the control group (P < 0.0001). The proportional risk of early interruption of exclusive breastfeeding was 0.38 (95% CI [0.28, 0.51], P < 0.0001).

Conclusion: This intervention had a positive impact on the duration and frequency of exclusive breastfeeding.

Study Design: Single-blind, RCT

Setting: Social media platform: Facebook

Population of Focus: Mother-child pairings assisted in the maternity ward of a Baby-Friendly Hospital who used Facebook

Sample Size: 251 mother-child pairings

Intervention Components (click on component to see a list of all articles that use that intervention): Social Media,

Intervention Description: Examine the regional associations between social media messages and vaccine attitudes and vaccination, as well as the influence of discussions with family and friends on the relation of social media content and vaccination.

Intervention Results: The study used Bayesian correlations to assess the relations between topics in the tweets and vaccine attitudes and actual vaccination longitudinally. The results showed moderate evidence of a prospective correlation with vaccine attitudes.

Conclusion: The study aimed to contribute to the understanding of the regional effects of social media messages on vaccine attitudes and vaccination, incorporating individual-level data to minimize the threat of the ecological fallacy and examining the role of discussions with others as a factor that may strengthen or weaken the influences of social media.

Study Design: The study utilized a longitudinal assessment of the regional effects of social media messages on vaccine attitudes and vaccination. It combined individual-level survey data with county-level tweets about vaccines and involved a five-wave panel conducted between September 2018 and May 2019.

Setting: The study was conducted in the United States during the 2018–2019 influenza season.

Population of Focus: The target audience consisted of American adults, as the study utilized a probability-based, nationally representative sample of American adults.

Sample Size: The sample sizes of the multiple-wave survey ranged from 1591 to 3005 participants.

Age Range: The mean age of the participants was 48.4 years old, with a wide range of ages represented in the sample.

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,

Intervention Description: Study participants were randomized to the following: a study website with vaccine information and social media components (VSM arm); a website with vaccine information only (VI); or usual care.

Intervention Results: Among 1,093 study participants, 945 (86.5%) completed all three surveys. Comparing baseline with Timepoint 1 among vaccine-hesitant parents, the VSM and VI arms were associated with significant improvements in attitudes regarding vaccination benefits compared to usual care (VSM mean change 0.23 on a 5-point scale, 95% CI=0.05, 0.40, VI mean change 0.22, 95% CI=0.04, 0.40). Comparing baseline with Timepoint 2 among hesitant parents, the VSM and VI arms were also associated with significant reductions in parental concerns about vaccination risks compared to usual care (VSM mean change –0.37, 95% CI= –0.60, –0.14, VI mean change –0.31, 95% CI= –0.55, –0.07). Self-efficacy around vaccine decision making also improved among vaccine-hesitant parents. No intervention effect was observed among parents not vaccine-hesitant at baseline.

Conclusion: Among vaccine-hesitant parents, an Internet-based intervention improved parents' attitudes about vaccines.

Study Design: A three-arm RCT.

Setting: The study was conducted in a large Colorado integrated healthcare organization.

Population of Focus: Printed in American Journal of Preventative Medicine

Sample Size: 1,093 study participants

Age Range: Parents, recruited during pregnancy, were given a survey about vaccine-related attitudes at enrollment (i.e., baseline) and when their child was aged 3–5 months and 12–15 months (Timepoints 1 and 2, respectively).

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): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Supports, Social Media

Intervention Description: In the United States, there are lower rates of breastfeeding among African American mothers, particularly those who are younger women. Recent epidemiological studies have shown a strong association of more aggressive types of breast cancer (estrogen receptor negative) among African American women, with a higher risk in African American women who did not breastfeed their children. This study aims to describe the process evaluation of recruitment and educational strategies to engage pregnant African American participants for a pilot study designed to determine whether social media messaging about breast cancer risk reduction through breastfeeding may positively influence breastfeeding rates.

Intervention Results: More than 3000 text messages were sent and received through WIC e-blasts and keyword responses from flyers. A total of 472 women were recruited through WIC e-blast, and 161 responded to flyers and contacts through the local health care network, community-based organizations, Facebook, and friend referrals. A total of 633 women were assessed for eligibility to participate in the study. A total of 288 pregnant African American women were enrolled, consented, and completed presurvey assessments (102.8% of the goal), and 22 participants attended focus groups or interviews reporting on their experiences with Facebook and the educational messages.

Conclusion: This process evaluation suggests that using electronic, smartphone apps with social media holds promise for both recruitment and conduct of health education intervention studies for pregnant African American women. Providing messaging and resources through social media to reinforce and educate women about breastfeeding and potentially provide lactation support is intriguing. Convenience (for researchers and participants) is an attribute of social media for this demographic of women and worthy of further research as an educational tool.

Study Design: Process evaluation

Setting: Social media platform: Facebook

Population of Focus: Pregnant African American women recruited through WIC

Sample Size: 472 women

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): Hospital Policies, Social Media,

Intervention Description: The intervention included in-hospital vaccinations for stable preterm infants, vaccination counseling for outpatient follow-up, and online dissemination of vaccine scientific data through social media.

Intervention Results: The study found that the intervention was associated with higher coverage and timeliness of routine immunizations in preterm infants.

Conclusion: Increasing vaccine confidence through web-based interventions could have a positive impact on vaccination acceptance of parents of preterm infants, although timeliness results still delayed. There is a strong need to develop different and effective vaccination strategies to protect this very vulnerable population.

Study Design: The study used a historical cohort design, comparing the interventional 2016-2017 cohort with a preterm cohort from 2013-2014 and a regional pediatric population cohort from 2016-2017.

Setting: The study was conducted in a single NICU in Italy with a specific protocol for vaccination of preterm infants

Population of Focus: The target audience was families of preterm infants.

Sample Size: The study evaluated a cohort of preterm infants born from 2016 to 2017, regularly followed in the outpatient clinic up to 2 years of life.

Age Range: The study focused on preterm infants, but the age range was not specified.

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): Media Campaign (Print Materials, Radio, TV), Social Media,

Intervention Description: The Real Cost is a national public education campaign designed to prevent and reduce smoking among U.S. teenagers. The campaign utilized multimedia channels, including TV, radio, the Internet, out-of-home displays, magazines, and movie theaters, to convey the theme "every cigarette costs you something" and highlight the health effects, toxicity, and loss of control associated with smoking

Intervention Results: The odds of reporting smoking initiation at follow-up was lower among youths in media markets with higher levels of campaign advertisements than among those with less. Both between-wave and cumulative target rating points were associated with decreased risk of smoking initiation (AOR=0.69 [p<0.01] and AOR=0.89 [p<0.05], respectively); for every 3,500 between-wave target rating points on air, there was an associated 30% reduction in the hazard of smoking initiation among youths. Results from self-reported recall of the campaign advertisements found similar dose-response effects. The campaign is associated with an estimated 380,000-587,000 youths aged 11-19 years being prevented from initiating smoking nationwide.

Conclusion: Sustained national tobacco public education campaigns like The Real Cost can change population-level smoking initiation among youths, preventing future generations from tobacco-related harms.

Study Design: Longitudinal observational design

Setting: USA (National)

Population of Focus: Public health professionals, researchres, policymakers

Sample Size: 5103 adolescents

Age Range: ages 11-19

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, HOSPITAL, Quality Improvement, Policy/Guideline (Hospital), Crib Card, Sleep Environment Modification, Promotional Event, POPULATION-BASED SYSTEMS, COMMUNITY, Social Media, CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Visual Display (Community)

Intervention Description: To improve sleep environment safety for inpatient infants.

Intervention Results: The proportion of infant cribs without loose objects in them increased (32-72%, p = .025), and safe sleep positioning remained stable (82% vs. 95%, p = .183).

Conclusion: Staff education, swaddle sleep sacks, and bedside storage containers were associated with improved sleep safety among pediatric inpatients at our institution and may help at other institutions.

Study Design: QE: pretest-posttest

Setting: University of Iowa Children’s Hospital

Population of Focus: Infants less than 1 year of age developmentally ready for a crib and asleep

Data Source: Crib audit/infant observation

Sample Size: Baseline (n=22) Follow-up 1 (not reported) Follow-up 2 (n=37) Follow-up 3 (n=18)

Age Range: Not specified

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): Social Media, Notification/Information Materials (Online Resources, Information Guide), , PARENT_FAMILY, COMMUNITY

Intervention Description: We compared the impact of safe sleep or breastfeeding mHealth messaging on bedsharing and breastfeeding at 2 to 5 months.

Intervention Results: Overall, exposure to breastfeeding versus safe sleep messaging was not associated with a difference in any breastfeeding at 2 to 5 months (69.3% vs 65.5%, respectively; adjusted odds ratio [aOR] = 1.33 [95% confidence interval, 0.91, 1.94]). Women with shorter planned duration of breastfeeding who received breastfeeding messaging had increased odds of breastfeeding at 2 to 5 months (50% vs 31%; aOR 3.13 [95% CI, 1.47, 6.65]). Mothers who received safe sleep messaging had lower rates of bedsharing overall when compared to breastfeeding messaging (24.8% vs 35.2%; aOR = 0.58 [95% CI, 0.44, 0.78]).

Conclusion: In this large multi-ethnic US sample, receipt of safe sleep mHealth messaging was associated with lower rates of bedsharing without negatively impacting breastfeeding rates. Future research should focus on continued development of interventions to improve adherence to both safe sleep and breastfeeding recommendations.

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): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: Alongside increasing social media use worldwide, there is an expanding research focus on how social media use affects health behaviours, decisions and perceptions. The objective of this study was to systematically determine if and how breastfeeding is promoted and supported on the popular social media platform Instagram, which currently has over 700 million active users worldwide. To assess how Instagram is used to depict and portray breastfeeding, and how users share perspectives and information about this topic, we analysed 4,089 images and 8,331 corresponding comments posted with popular breastfeeding-related hashtags (#breastfeeding, #breastmilk, #breastisbest, and #normalizebreastfeeding).

Intervention Results: We found that Instagram is being mobilized by users to publicly display and share diverse breastfeeding-related content and to create supportive networks that allow new mothers to share experiences, build confidence, and address challenges related to breastfeeding. Discussions were overwhelmingly positive and often highly personal, with virtually no antagonistic content. Very little educational content was found, contrasted by frequent depiction and discussion of commercial products.

Conclusion: Instagram is currently used by breastfeeding mothers to create supportive networks and could potentially offer new avenues and opportunities to "normalize," protect, promote, and support breastfeeding more broadly across its large and diverse global online community.

Study Design: Qualitative study

Setting: Social media platform: Instgram

Population of Focus: Active Instagram users who shared perspectives and information about breastfeeding with popular breastfeeding-related hashtags

Sample Size: 4,089 images and 8,331 corresponding comments

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): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: The importance of support to breastfeeding success is well established, as are the difficulties many mothers face in accessing the support they need. With the majority of UK mothers now accessing social media for support, Breastfeeding Support Facebook (BSF) groups have increased exponentially. BSF groups vary in type (local or national/international) and in moderation—overseen by breastfeeding mothers and by midwives or trained lactation specialists. Some groups aimed at supporting mothers in a specific geographical area also have associated face-to-face groups, facilitated as either professional or peer support. Little is currently known about these specific local groups, their prevalence, impact or value to mothers. This paper examines mothers' experiences of using local BSF groups and why they value them as part of a larger study exploring the impact of midwife moderation on these groups. An online survey consisting of open and closed questions was completed by 2028 mothers.

Intervention Results: Findings identified that local BSF groups are widely used and highly valued for their connection with local face-to-face services and other mothers. They offer access to expertise and shared experience in a format mothers find convenient and timely, improving confidence and self-efficacy. Local BSF groups enable the formation of support networks and development of breastfeeding knowledge that mothers credit with increased well-being, motivation and breastfeeding duration. As such, they have the potential to add value to local face-to-face services and improve breastfeeding experiences and knowledge in communities.

Conclusion: The findings have important implications to support the development of integrated online interventions to improve public health.

Study Design: Qualitative study

Setting: Social media platform: Breastfeeding Support Facebook groups

Population of Focus: Mothers in the UK using local Breastfeeding Support Facebook groups

Sample Size: 2028 mothers

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: To date, most breastfeeding research on social media only focuses on content analysis, and there remains limited knowledge about the social networks of online communities (who interacts with whom), influencers in the breastfeeding space and the diffusion of evidence-based knowledge. This study, grounded in social network theory, aims to better understand the breastfeeding communication landscape on Twitter including determining the presence of a breastfeeding network, communities and key influencers. Further, we characterize influencer interactions, roles and the content being shared.

Intervention Results: The study revealed an overall breastfeeding social network of 3,798 unique individuals (users) and 3,972 tweets with commonly used hashtags (e.g., #breastfeeding and #normalizebreastfeeding). Around one third of users (n = 1,324, 34%) exchanged pornographic content (PC) that sexualized breastfeeding. The non-PC network (n = 2,474 users) formed 144 unique communities, and content flowing within the network was disproportionately influenced by 59 key influencers. However, these influencers had mostly inward-oriented interaction (% composition, E-I index: 47% professionals, -0.18; 41% interested citizens, -0.67; 12% companies, -0.18), limiting opportunities for evidence-based dissemination to the lay public.

Conclusion: Although more tweets about peer-reviewed research findings were sent compared with tweets about nonevidence-based lay recommendations, our findings suggest that it is the lay public who often communicated findings, which may be overcome through a targeted social network-based intervention.

Study Design: Outcome evaluation

Setting: Social media platform: Twitter

Population of Focus: Influencers in the breastfeeding space on Twitter

Sample Size: 3,798 unique individuals (users), 3,962 tweets

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: As recently highlighted by the National Academy of Sciences, there is a need for the scientific community (SC) to diffuse its findings to the public more effectively online, as means to counteract the spread of misinformation. In response to this call, we gathered data from Twitter for one month from major breastfeeding hashtags resulting in an interconnected social network (n = 3,798 users). We then identified 59 influencers who disproportionately influenced information flow using social network analysis. These influencers were from the SC (e.g. academics, researchers, health care practitioners), as well as interested citizens (IC) and companies. We then conducted an ego-network analysis of influencer networks, developed ego maps, and compared diffusion metrics across the SC, IC and company influencers. We also qualitatively analyzed their tweets (n = 711) to understand the type of information being diffused.

Intervention Results: Content analysis of tweets suggest IC are more active than the SC in diffusing evidence-based breastfeeding knowledge, with 35% of their tweets around recent research findings compared to only 12% by the SC. Nonetheless, in terms of outreach to the general public, the two-step networks of SC influences were more heterogenous than ICs (55.7 ± 5.07, 50.9 ± 12.0, respectively, P<0.001).

Conclusion: Collectively, these findings suggest SC influencers may possess latent potential to diffuse research and evidence- based practices. However, the research suggests specific ways to enhance diffusion.

Study Design: Outcome evaluation

Setting: Social media platform: Twitter

Population of Focus: Influencers from the scientific community using major breastfeeding hashtags on Twitter for a month

Sample Size: 59 influencers, 711 tweets

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): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: Social media crosses socioeconomic and geographic lines and can inform and empower people, increase communication speed, and mobilize partnerships. Through the dissemination of standardized messages and graphics, social media can be optimized for the delivery of evidence-based nutrition information. In 2014, the USDA launched a mobile-responsive Web site to assist WIC staff in engaging participants and community partners. Resources included posters, brochures, videos, widgets, graphics, and BF peer counseling training. Recognizing the opportunity for spreading messages via social media, the Web site was enhanced with the addition of a social media toolkit for World Breastfeeding Week/National Breastfeeding Month (August, 2016). The goal of the project was to create sample graphics and messages based on the campaign that could be used by WIC agencies and partners to reach participants, eligible participants, and the public. Messages were developed using content from the Loving Support campaign materials and Loving Support Peer Counseling Training. Agencies were encouraged to link to the Loving Support Web site and use the hashtag #WICLovingSupport in their posts. Agencies could also customize the messages and graphics as needed to promote their own activities and events. The toolkit included Facebook covers and posts, Twitter headers and posts, a Twibbon, an Instagram post, and an e-card. A guide to using the toolkit with sample messages was created as well. The Figure shows sample images and messages.

Intervention Results: The toolkit was launched on July 12, 2016 and received 4,319 page views by the end of August. Overall there were 9,432 downloads of all Loving Support materials and 29,745 page views to the Loving Support Web site. This was a 50% increase in page views and a 17% increase in downloads over the previous month, before the launch of the toolkit. Use of the toolkit continued since August with 1,507 page views between August, 2016 and February, 2017. The number of users for that same period was 5,007 (new and returning users). There were 2,342 downloads of social media graphics, with Facebook covers and posts, the e-card, and Instagram posts as the most downloaded items. The Twibbon campaign had 36 supporters. A TweetReach snapshot report from August 2 to August 6 (during World Breastfeeding Week) showed that the hashtag #WICLovingSupport had 60 tweets from 40 contributors, 287,820 accounts reached (the number of people who likely saw content), and 362,607 impressions (the number of times people likely reached).

Conclusion: Translating policy and guidance into action-oriented messages that WIC agencies can easily use and disseminate can increase the exposure of evidence-based nutrition messages. Although it is a relatively low-cost communication strategy, social media involves a high cost in time and attention needed to maintain an active presence.8 By providing a ready-to-go social media toolkit, the Food and Nutrition Service was able to offer consistent messaging, but it also reduced WIC staff workload and reached many people with information about BF promotion and support.

Study Design: Program evaluation

Setting: Social media platforms: Facebook, Twitter, and Instagram

Population of Focus: WIC staff

Sample Size: 5,007 new and returning users

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): Social Media, Policy/Guideline (State),

Intervention Description: The interventions include the suspension of mandatory vaccination in the Veneto Region, strengthened political commitment leading to the release of an updated National Immunization Prevention Plan, and the influence of social media influencers like Professor Roberto Burioni in promoting vaccination.

Intervention Results: The results highlight the impact of different interventions on vaccine coverage rates, changes in public attitudes towards immunization, and the success of social media influencers in promoting vaccination.

Conclusion: The study provides insights into the effectiveness of various vaccination strategies and offers a basis for discussion within the European public health community to evaluate similar policies implemented in different settings.

Study Design: The study employs a real-life case study approach to evaluate the impact of different vaccination strategies implemented in Italy. It critically appraises the strategies and quantitatively assesses their impact on coverage rates and other selected indicators.

Setting: The setting of the study is Italy, focusing on the implementation and impact of vaccination strategies within the country.

Population of Focus: The target audience includes the general population, public health practitioners, decision makers, and the broader European public health community.

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

Age Range: The age range of the study participants is not explicitly specified in the provided excerpts.

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

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: Many women do not have adequate and consistent social support to help them deal with breastfeeding difficulties at home after childbirth. Millennial women (those born between 1980 and 1999) have a significant presence online, making internet-based sources of breastfeeding support a potentially far-reaching, cost-effective, and convenient innovation. Social media platforms (e.g., Facebook, YouTube, Twitter, LinkedIn, Pinterest, GooglePlus+, Tumblr, and Instagram) are internet-based applications that enable the creation and exchange of user-generated content that may provide an avenue of social support. Social media breastfeeding support groups (SMBSGs) provide a cost-efficient, immediate approach to gaining social support and education from vast populations with various sociodemographics. Using 17 SMBSGs, the study team explored the variables that lead to sustained, exclusive breastfeeding to 6 months for breastfeeding millennial women who follow SMBSGs.

Intervention Results: Using structural equation modeling, I examined relationships among personal factors; competing situational demands; social support; and confidence in, knowledge of, attitude toward, and sustainability of breastfeeding. Age, education, and competing work and family demands were all predictive of social support. Breastfeeding social support had a direct effect on participants’ breastfeeding confidence, knowledge, and attitudes (F = 4.96, R2 = .07, p < .002). Furthermore, within SMBSGs, exclusive breastfeeding to 6 months was reported to be three times (66%) greater than the U.S. national average (22%).

Conclusion: Interventions aimed at providing women with resources to gain breastfeeding social support, such as SMBSGs, may be vehicles to improve women’s confidence, knowledge, and attitudes and, therefore, increase the potential for exclusive breastfeeding to 6 months.

Study Design: Repeated measures, longitudinal, mixed-methods

Setting: Online social media support groups across 21 countries

Population of Focus: Convenience sample of exclusively breastfeeding millenial women who followed at least one of 17 social media breastfeeding support groups

Sample Size: 241 women

Age Range: Women 18 years and older