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The magnitude and impact of tobacco marketing exposure in adolescents' day-to-day lives: An ecological momentary assessment (EMA) study.

ABSTRACT: PURPOSE:Research indicates that tobacco marketing contributes to higher pro-tobacco attitudes and behaviors among adolescents, but no studies have been able to assess the impact of real-world tobacco marketing exposures in real-time. The purpose of this study was to examine the magnitude and impact of tobacco marketing exposure on adolescents using ecological momentary assessment (EMA). Our primary hypotheses were that (1) youth would most frequently report tobacco marketing at the retail points-of-sale and (2) greater exposures to tobacco marketing would be associated with more favorable tobacco-related attitudes, use, and expectancies. METHODS:Participants were adolescent males from rural and urban Ohio (N?=?176, ages 11-16). For ten days, these adolescents were prompted at two-three random times/day to complete a brief smartphone-based survey about their exposures and responses to tobacco-related advertising. RESULTS:Adolescents reported exposures to tobacco marketing an average of 1.9 times over the 10-day EMA period, with over 10% seeing a tobacco advertisement 5 or more times. Reports of marketing exposures occurred most frequently at the point-of-sale; exposures were higher among tobacco users and rural adolescents. Consistent with hypotheses, marketing exposure was related to more positive attitudes to the tobacco advertisements, more tobacco use, and higher expectancies to use in the future. CONCLUSIONS:Overall, these findings signal the magnitude of tobacco marketing exposures and their pernicious impact on youth. Findings underscore the importance of federal, state, and local-level tobacco regulatory policies to protect youth from the marketing that puts them at risk for a lifetime of nicotine addiction and tobacco-related diseases.

SUBMITTER: Roberts ME

PROVIDER: S-EPMC6957907 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Project description:Digital interventions often suffer from low usage, which may reflect insufficient attention to user experience. Moreover, the existing evaluation methods have limited applicability in the remote study of user experience of complex interventions that have expansive content and that are used over an extensive period of time. To alleviate these challenges, we describe here a novel qualitative Ecological Momentary Assessment (EMA) method: the CORTO method (Contextual, One-item, Repeated, Timely, Open-ended). We used it to gather digital intervention user experience data from Finnish adults (n = 184) who lived with interview-confirmed major depressive disorder (MDD) and took part in a randomized controlled trial (RCT) that studied the efficacy of a novel 12-week game-based digital intervention for depression. A second dataset on user experience was gathered with retrospective interviews (n = 22). We inductively coded the CORTO method and retrospective interview data, which led to four user experience categories: (1) contextual use, (2) interaction-elicited emotional experience, (3) usability, and (4) technical issues. Then, we used the created user experience categories and Template Analysis to analyze both datasets together, and reported the results qualitatively. Finally, we compared the two datasets with each other. We found that the data generated with the CORTO method offered more insights into usability and technical categories than the interview data that particularly illustrated the contextual use. The emotional valence of the interview data was more positive compared with the CORTO data. Both the CORTO and interview data detected 55 % of the micro-level categories; 20 % of micro-level categories were only detected by the CORTO data and 25 % only by the interview data. We found that the during-intervention user experience measurement with the CORTO method can provide intervention-specific insights, and thereby further the iterative user-centered intervention development. Overall, these findings highlight the impact of evaluation methods on the categories and qualities of insights acquired in intervention research.

Project description:BackgroundEcological momentary assessment (EMA) is an in situ method of gathering self-report on behaviors using mobile devices. In typical phone-based EMAs, participants are prompted repeatedly with multiple-choice questions, often causing participation burden. Alternatively, microinteraction EMA (micro-EMA or μEMA) is a type of EMA where all the self-report prompts are single-question surveys that can be answered using a 1-tap glanceable microinteraction conveniently on a smartwatch. Prior work suggests that μEMA may permit a substantially higher prompting rate than EMA, yielding higher response rates and lower participation burden. This is achieved by ensuring μEMA prompt questions are quick and cognitively simple to answer. However, the validity of participant responses from μEMA self-report has not yet been formally assessed.ObjectiveIn this pilot study, we explored the criterion validity of μEMA self-report on a smartwatch, using physical activity (PA) assessment as an example behavior of interest.MethodsA total of 17 participants answered 72 μEMA prompts each day for 1 week using a custom-built μEMA smartwatch app. At each prompt, they self-reported whether they were doing sedentary, light/standing, moderate/walking, or vigorous activities by tapping on the smartwatch screen. Responses were compared with a research-grade activity monitor worn on the dominant ankle simultaneously (and continuously) measuring PA.ResultsParticipants had an 87.01% (5226/6006) μEMA completion rate and a 74.00% (5226/7062) compliance rate taking an average of only 5.4 (SD 1.5) seconds to answer a prompt. When comparing μEMA responses with the activity monitor, we observed significantly higher (P<.001) momentary PA levels on the activity monitor when participants self-reported engaging in moderate+vigorous activities compared with sedentary or light/standing activities. The same comparison did not yield any significant differences in momentary PA levels as recorded by the activity monitor when the μEMA responses were randomly generated (ie, simulating careless taps on the smartwatch).ConclusionsFor PA measurement, high-frequency μEMA self-report could be used to capture information that appears consistent with that of a research-grade continuous sensor for sedentary, light, and moderate+vigorous activity, suggesting criterion validity. The preliminary results show that participants were not carelessly answering μEMA prompts by randomly tapping on the smartwatch but were reporting their true behavior at that moment. However, more research is needed to examine the criterion validity of μEMA when measuring vigorous activities.

Project description:BackgroundFew adolescents achieve sufficient levels of physical activity, and many are spending most of their time in sedentary behavior. Affective response following sedentary time may influence motivation to remain sedentary. Ecological Momentary Assessment (EMA) is a real-time data capture methodology that can be used to identify factors influencing sedentary time, such as the context of the home setting, and resulting affective state within a free-living setting. The purpose of this study was to evaluate the relationship between context at home and adolescent sedentary time, and the relationship of sedentary time and subsequent affect.MethodsAdolescents (n = 284; 10-16 y) participated in an EMA study that used random, interval-based sampling methods. Adolescents each received 22 unannounced surveys over 7-days through a smartphone application. One survey was randomly sent within each 2-h time-period. These time-periods occurred between 4:00 pm-8:00 pm on weekdays and 8:00 am-8:00 pm on the weekend. This 15-question survey included a series of questions on context (indoors/outdoors, alone/not alone) and positive affect. Adolescents concurrently wore an accelerometer at the hip, and the 30-min bout of accelerometry data prior to each survey was used in analyses. Mixed-effect location scale models were used to examine the association between context at home and sedentary time (stage 1) and the adjusted sedentary time and positive affect (stage 2), with each model adjusted for covariates.ResultsAdolescents were 12.6 ± 1.9 y of age on average, about half were White (58%), and engaged in high levels of sedentary behavior during the 30 min prior to the survey (21.4 ± 6.8 min). Most surveys occurred when adolescents were with others (59%) and indoors (88%). In Stage 1, both being alone and being indoors at home were positively associated with sedentary time (p < 0.001 for both). In Stage 2, adjusted sedentary time was not related to positive affect. Age was negatively related to positive affect (p < 0.001).ConclusionsBoth contextual factors, being alone and indoors at home, were related to additional time spent sedentary compared to being with someone or outdoors. After adjustment, sedentary time was not related to subsequent positive affect, indicating other factors may be related to adolescent's positive affect in home settings.

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The magnitude and impact of tobacco marketing exposure in adolescents' day-to-day lives: An ecological momentary assessment (EMA) study.

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