THIS FREE LIFE FDA S PUBLIC EDUCATION CAMPAIGN AMONG LGBT YOUNG ADULTS MDQUIT 11 TH BEST PRACTICES CONFERENCE Presented by Janine Delahanty, PhD Leah Hoffman, MPH Health Scientist (Communications) Office of Health Communications and Education, CTP, FDA Disclaimer: This is not a formal dissemination of information by FDA and does not represent Agency position or policy. January 26, 2017
Why LGBT young adults? Introduction to This Free Life Formative Research Findings Campaign & Evaluation Design 1
PUBLIC EDUCATION CAMPAIGNS Multiple efforts over several years targeting discrete, at-risk audiences: General market youth who are experimenting with cigarettes The Real Cost Rural male youth at risk of smokeless tobacco initiation The Real Cost Smokeless Multicultural (African American, Hispanic, and Asian/Pacific Islander) youth Fresh Empire Young adults who identify as Lesbian, Gay, Bisexual, or Transgender This Free Life American Indian / Alaska Native youth 2
THIS FREE LIFE The FIRST-EVER national public education campaign designed to prevent or reduce tobacco use among LGBT young adults. This Free Life aims to prevent and reduce tobacco use among at-risk lesbian, gay, bisexual, and transgender (LGBT) young adults, ages 18-24, who smoke occasionally, by employing authentic and credible messages to encourage LGBT young adults to live tobacco-free. 3 3
WHY LGBT YOUNG ADULTS? 4
ADDRESSING TOBACCO USE DISPARITIES The Challenge: Disproportionately high prevalence of tobacco use compared to non-lgbt young adults Of the more than 2 million LGBT young adults, ages 18-24, more than 800,000 are occasional smokers meaning that they have smoked at least one cigarette in their lifetime, but have not smoked every day during the past 30 days They do not identify as smokers, terms such as social smoker, casual smoker, occasional smoker are used to refer to their non-daily use of tobacco Increased risk of nicotine dependence Disparity begins in adolescence Historically targeted by tobacco industry The Solution: First public education campaign specifically focused on LGBT young adults to prevent further escalation to daily smoking 5
LGBT COMMUNITY HISTORICALLY TARGETED BY TOBACCO INDUSTRY San Francisco Weekly (2000) Gay & Lesbian Film Festival (2000) OUT Magazine (2001) Jane Magazine (2003) The Advocate Magazine (2005) (2008) OUT Magazine (2010) Lavender Magazine (2011) 6
THIS FREE LIFE CAMPAIGN 7
THIS FREE LIFE CAMPAIGN This Free Life campaign aims to prevent and reduce tobacco use among at-risk lesbian, gay, bisexual, and transgender (LGBT) young adults, ages 18-24, who smoke occasionally. We are employing authentic and credible messages, including some messages directly from members of the LGBT community, to encourage LGBT young adults to live tobacco-free. 8
KEY INSIGHTS FROM RESEARCH TARGET POPULATION LGBT YOUNG ADULTS 18-24 NON-DAILY SMOKERS INSIGHT 1 INSIGHT 2 INSIGHT 3 INSIGHT 4 EXPERIENCED DIFFICULTY PROUD IDENTITY CARE ABOUT APPEARANCE HIGHLY SOCIAL Have experienced difficulties because of their sexuality and/or gender identity. Are proud of who they are including their sexuality and gender identity. Care about their appearance and about what others think of them. Are highly social and often see their friends as family. THESE 4 KEY INSIGHTS APPLY TO THE ENTIRE TARGET POPULATION 9
AUDIENCE SEGMENTATION LGBT TARGET AUDIENCE SCENE 1 FEMALE CENTRIC NON-DAILY SMOKERS SCENE 2 MALE CENTRIC NON-DAILY SMOKERS 10
CAMPAIGN @ LAUNCH 11
FORMATIVE RESEARCH FINDINGS 12
CAMPAIGN GOALS AND OBJECTIVES Change Beliefs Increase perceived risks of tobacco use Align tobacco-free benefits with LGBT peer crowd values Increase the importance of living tobacco-free Change Perceived Norms Increase perceived pride for tobacco-free lifestyles in the LGBT peer crowd Increase perceived rejection of tobacco in the LGBT peer crowd Change Intentions to Not Smoke Increase intention to not smoke, even socially Increase intention to stop smoking 13
CAMPAIGN DEVELOPMENT PROCESS Message Development Concept Development Copy Testing Perform extensive literature review Consult subject matter experts with expertise in tobacco public health education and LGBT culture 14 Use focus groups to identify promising brand and creative concepts Consulted subject matter experts with expertise in tobacco public health education and LGBT culture Conduct copy testing of final rough cut ads to measure perceived effectiveness, level of engagement, and message comprehension
COPY TESTING OVERVIEW Quantitative copy testing of ads was conducted to assess: Overall level of ad performance Includes perceived effectiveness, level of engagement and message comprehension Potential for any unintended consequences Assessed from responses to health, behavioral, and attitudinal statements Perceived effectiveness (PE) is a primary component for assessing overall level of ad performance Validated measure that is predictive of potential for positive attitude & behavior change Comprised of six items: (1) This ad is worth remembering, (2) This ad grabbed my attention, (3) This ad is powerful, (4) This ad is informative, (5) This ad is meaningful, (6) This ad is convincing Scores have been used as an indicator for assessing the effectiveness of ads from other FDA campaigns and the CDC s Tips campaign 15
METHODOLOGY Data were collected in 5 weeks from Oct to Nov 2015, utilizing one of three methods: At or near LGBT social venues in 3 large markets Targeted social media advertisements on Facebook Online research panel specializing in LGBT populations Recruited, screened, and surveyed LGBT young adults 18-24 years old in 24 DMAs. Eligible respondents were either shown two of four rough cut television advertisements (n = 733) or placed into control groups that were not exposed to any ads (n = 328). Ad-viewing or control group placement was random. Ads selected for participants in the ad group were also randomized to control for order effects. 16
Lesbian/ gay female Gay male Bisexual Gender minority Other sexual minority SAMPLE DEMOGRAPHICS Age LGBT Status Race/Ethnicity 65% 44% 35% 30% 30% 21% 19% 20% 10% 3% 10% 13% 18-20 21-24 API AA Hispanic White Other 17
COPY TESTED ADS OUR STORY FLAWLESS TIP THE SCALE : MALE & FEMALE 18
SUMMARY OF COPY TESTING RESULTS 5 4 3 4.1 All ads exceeded the midpoint (3), which indicates they are promising. 3.9 3.8 3.2 2 1 19 0 Our Story Flawless TTS Female TTS Male
KEY FINDINGS Authenticity Concepts that featured realistic and relatable scenes and settings, and sensitive portrayals of gender non-conforming characters were wellreceived Participants frequently commented on the importance of featuring diversity and non-traditional standards of beauty but were sensitive to the idea of stereotypes of the community Importance of the authentic messenger Using social smoker, casual smoker, or occasional smoker terms to refer to their own characterization of non-daily tobacco use Key Themes in Recommended Concepts Tobacco messaging was understood and not overshadowed Hopeful messages that focus on short-term consequences were favored; emotional appeals should be balanced carefully with positive outcomes 20
CAMPAIGN & EVALUATION DESIGN 21
THIS FREE LIFE DMAs GEOGRAPHIC FOCUS AREAS This Free Life is in 12 designated market areas (DMA) across the US. The DMAs were selected based on the concentration of the target audience, smoking prevalence, and media availability. 22
EVALUATION STUDY DESIGN Design & Methods Cross-sectional pre-test/post-test design (baseline survey before campaign launch followed by 3 follow up surveys). Data are collected in 12 campaigntargeted cities and 12 comparison cities. A total of 12,600 baseline and follow up surveys will be completed. Timeline Follow-ups at approximately 6 month intervals following campaign launch: o Baseline Collection: February 2016 o Follow-up 1: September 2016 o Follow-up 2: April 2017 o Follow-up 3: September 2017 Evaluation Measures Primary outcomes of interest among young adults will be awareness of the campaign as well as tobacco-related knowledge, beliefs, attitudes, and intentions. 23
THANK YOU Janine.Delahanty@fda.hhs.gov Leah.Hoffman@fda.hhs.gov 24