Social media has dramatically changed the Internet landscape. Users gather information and actively disseminate it, influencing information spread and credibility. Our team is evaluating the effectiveness of employing social media in a public health campaign directed to mothers of adolescent daughters with the goal of decreasing indoor tanning (IT) by adolescent girls. This research is significant because many health agencies and organizations rely on social media yet there is a paucity of research on their potential effectiveness. Project specific aims are to: 1) develop and implement a social media campaign for mothers on health and wellness of adolescent daughters that includes theory-based messaging advocating adolescent girls avoid IT and 2) evaluate the effectiveness of the IT messages at a) decreasing mothers' permissiveness for daughters to indoor tan and daughters' perceptions of their permissiveness, b) reducing the prevalence of IT by mothers and daughters, and c) increasing the number of mothers who support strengthening bans on IT by minors. Mother (n=869) were recruited in 34 U.S. states without a full ban on IT by minors and enrolled in a randomized controlled design. The 12-month campaign, named Health Chat, contained over 700 posts addressing mother- daughter communication and other adolescent health and lifestyle topics. It was delivered to mothers through Facebook private groups, each receiving 180 experimental posts on either IT prevention (intervention; n=435 mothers) or prescription drug abuse prevention (control; n=434 mothers). Mothers and daughters were assessed at baseline and 12- and 18-months post-randomization. The goal of this competitive revision is to examine the potential impact of social media messages on the COVID-19 response. Many Americans are receiving COVID-19 information over social media but are exposed to substantial misinformation. Effective risk communication relies on using highly credible information sources to ensure that consumers engage in practices that will reduce risk such as social distancing behavior and COVID-19 vaccine intentions, if available. We will enroll mothers (n=300) from the original trial sample in a new experiment that aims to: 1) test a social media feed impact on COVID-19 mitigation behaviors (i.e., social distancing) and vaccination intentions and 2) evaluate whether source of social media messages modifies the change in mothers' COVID-19 mitigation and vaccination intentions. Based on the principles of risk communication, pandemic response, and the Extended Parallel Process Model, the 9-week social media feed will cover mother-daughter communication on COVID- 19, media literacy skills to counter COVID-19 misinformation, and COVID-19 mitigation (i.e., social distancing behaviors) and vaccination (if available). Analyses will test the hypothesis that mothers will report increased COVID-19 social distancing behaviors and explore whether rate of change in social distancing, vaccine intentions, and secondary outcomes differ across type of source. Qualitative research using focus groups and interviews will assess preferences for message sources, topics, and formats.

Public Health Relevance

Indoor tanning (IT) increases the risk of melanoma and many states, but not all, have responded by passing bans on access to IT facilities by minors to reduce the rates of melanoma. A social media campaign was delivered to mothers with adolescent daughters designed to convince them not to allow their daughters to indoor tan. We now propose to conduct a new experiment with the original sample of mothers to test the impact of social media messaging on COVID-19 mitigation (i.e., social distancing behaviors) and vaccination intentions to examine the impact of various types of sources frequently providing this information online.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Chou, Wen-Ying
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Klein Buendel, Inc.
United States
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Linos, Eleni; Pagoto, Sherry (2018) USPSTF Recommendations for Behavioral Counseling for Skin Cancer Prevention: Throwing Shade on UV Radiation. JAMA Intern Med 178:609-611
Pagoto, Sherry L; Baker, Katie; Griffith, Julia et al. (2016) Engaging Moms on Teen Indoor Tanning Through Social Media: Protocol of a Randomized Controlled Trial. JMIR Res Protoc 5:e228