Youth, Cannabis, & Media: Understanding Appeals and Effects and Implications for Prevention

David Merriman Author

08/10/2023 Added

20 Plays

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2023 NECPA Statewide Convening

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[00:00:04.350]Okay, great, thank you.
[00:00:05.880]So my first question is,
[00:00:07.050]I wanna make sure that everybody in the room can hear us.
[00:00:10.170]Could someone raise their hand to say yes?
[00:00:12.240]A-okay.
[00:00:13.080]Awesome, thank you.
[00:00:15.210]Hopefully you can see our slides as well.
[00:00:18.180]I'm gonna stay on camera, but feel free,
[00:00:20.850]it seems like I might have a little bit of spotty internet
[00:00:23.130]where I'm actually traveling,
[00:00:25.650]so if I am distracting,
[00:00:28.200]please raise your hand and feel free to interrupt
[00:00:30.450]and I'll just go off camera
[00:00:31.500]and talk without you seeing my face.
[00:00:34.830]So Jessica and I are excited to be here today.
[00:00:37.830]We've been studying cannabis, media, and young people
[00:00:41.370]for almost a decade, to be honest, together,
[00:00:45.510]we founded the Washington State University's
[00:00:48.810]Media, Adolescents, and Cannabis Lab.
[00:00:52.980]I'm a professor, as they mentioned,
[00:00:54.600]Jessica is an associate professor,
[00:00:56.820]and I focus my research on substance misuse prevention
[00:01:00.690]and sexual violence reduction
[00:01:02.400]among adolescents, young adults.
[00:01:04.950]And Jessica focuses on the use of technology
[00:01:07.260]for health risk reduction
[00:01:08.640]among adolescents and young adults.
[00:01:10.980]And both of us have been working with
[00:01:14.760]and or creating our own interventions for a number of years.
[00:01:18.720]We've also advice to others
[00:01:21.210]about how to craft effective messaging
[00:01:23.280]to reduce cannabis misuse.
[00:01:26.580]So our MAC Lab has a number of funded projects.
[00:01:29.700]These include funding
[00:01:30.960]from the dedicated marijuana accounts grant,
[00:01:33.780]the Washington State Department of Health,
[00:01:36.150]Washington State Liquor and Cannabis Control Board.
[00:01:39.390]We have a Miller Coors Great Plays grant program.
[00:01:42.540]We are adept and conduct
[00:01:44.430]both qualitative and quantitative methods,
[00:01:47.280]both in-depth interviews and focus groups,
[00:01:48.930]as well as surveys and experiments.
[00:01:51.150]And then we have a pretty large research team.
[00:01:52.920]We have found in recent years
[00:01:54.510]that our research has attracted quite a few students
[00:01:57.510]from across the country who wanna study this work,
[00:02:00.180]includes both of us,
[00:02:01.350]two doctoral candidates,
[00:02:02.880]four doctoral students, and one master's students
[00:02:05.520]with a couple of others
[00:02:06.690]on their way to joining us this next fall.
[00:02:09.570]Today we're gonna cover four main topics.
[00:02:13.800]We're gonna first talk about product packaging and appeals.
[00:02:16.800]I understand that in your state,
[00:02:18.660]cannabis is still illegal,
[00:02:21.390]but in our state it is legal
[00:02:23.010]and we're finding that adolescents and young adults
[00:02:25.500]have quite a bit of experience with cannabis products.
[00:02:28.410]And so some of our research is focused on that.
[00:02:30.570]We thought you might be able
[00:02:32.070]to gain some information from that
[00:02:33.540]despite our state differences.
[00:02:35.460]We're also gonna cover cannabis marketing and effects,
[00:02:37.860]cannabis messaging on social media
[00:02:39.646]and the effects of that messaging,
[00:02:41.610]and then some tips and tricks and theoretical foundations
[00:02:45.000]for designing effective prevention messaging.
[00:02:48.420]Jessica?
[00:02:50.130]Thank you Stacey.
[00:02:51.390]So one of the first things we wanted to do
[00:02:52.740]to kind of prompt some discussion
[00:02:54.510]is have you look at this image and decide
[00:02:56.790]if you think this is a picture of cannabis or candy.
[00:03:01.200]So if you think this is candy,
[00:03:03.840]go ahead and raise your hand for me.
[00:03:06.450]And if you think this is cannabis,
[00:03:07.920]go ahead and raise your hand for me.
[00:03:11.370]Any thoughts there?
[00:03:12.870]So it's actually very difficult to tell,
[00:03:15.390]and that is one of the main takeaways
[00:03:16.800]that we wanted to give here with this.
[00:03:18.570]This is an example of a package in Washington State.
[00:03:21.900]This is an edible
[00:03:22.733]that can be purchased down at our retailers
[00:03:24.870]that we have cannabis dispensaries throughout the state.
[00:03:28.230]And what you're seeing here is a product
[00:03:29.970]that has gone through a review process in Washington State.
[00:03:33.360]Our Washington State Liquor and Cannabis Board
[00:03:36.030]has a process through which
[00:03:37.230]they actually look at product packaging
[00:03:39.000]prior to it being released in stores.
[00:03:41.880]But what you're seeing here is one of the products
[00:03:43.560]that's out on the market currently in Washington State.
[00:03:46.290]And if you'll notice this little image at the very bottom,
[00:03:48.900]it's actually very similar in looks
[00:03:50.970]to Starburst candies, for example.
[00:03:53.550]So this is a package of fruit chew.
[00:03:55.440]And some of the other things
[00:03:56.400]that I wanted to call your attention to on this package
[00:03:58.740]would be some of the labels,
[00:04:00.360]specifically in that upper left-hand corner,
[00:04:02.940]you see a little red hand,
[00:04:04.710]it's a tiny bit grainy on here,
[00:04:06.060]but it actually says not for kids.
[00:04:07.920]And then it has a phone number
[00:04:09.330]for the Washington State poison control line.
[00:04:11.820]And then the yellow one with the cannabis leaf on it
[00:04:15.120]actually is what's called the Washington Universal symbol
[00:04:18.030]that lets people know that it's a packaging
[00:04:20.010]that has cannabis,
[00:04:22.170]has THC in the product essentially.
[00:04:25.320]And so as Stacey mentioned,
[00:04:26.610]we know that you don't currently have cannabis
[00:04:29.340]legal to be purchased in your state,
[00:04:31.140]but I saw earlier this year there was also a bill
[00:04:33.120]where that was being talked about and discussed.
[00:04:35.220]And we know that in 20 states now,
[00:04:36.870]cannabis has been made legal for recreational purchase.
[00:04:40.410]And so it's just an interesting kind of market
[00:04:42.390]because all of these different states
[00:04:43.980]actually have different requirements
[00:04:45.840]about what packages can do
[00:04:47.220]or what those packages should look like.
[00:04:49.410]And so it's a really interesting kind of area
[00:04:51.540]in terms of some of those pieces.
[00:04:55.320]And so there's that image again,
[00:04:56.153]so you can see how it looks very similar to products
[00:04:58.350]that young people might've encountered.
[00:05:02.520]And so with this,
[00:05:03.353]we were really interested
[00:05:04.770]in finding out some more information
[00:05:06.030]about how young people perceived cannabis packaging.
[00:05:09.300]There are certain requirements that I mentioned
[00:05:11.040]that the Washington State Liquor and Cannabis Board
[00:05:13.830]oversees,
[00:05:14.850]and that's that products
[00:05:15.750]can't be especially appealing to people under the age of 21.
[00:05:19.110]And there are specifics about what that means
[00:05:21.090]in terms of the regulation.
[00:05:22.350]So this can't include cartoons, for example,
[00:05:25.140]or bubble lettering on the packaging,
[00:05:27.660]but there's also some ambiguity with that.
[00:05:29.640]And so while cartoons aren't allowed,
[00:05:31.770]you can actually have an image of a mascot or a character
[00:05:35.430]as part of your brand logo, for example.
[00:05:37.830]And while bubble letters aren't allowed,
[00:05:39.420]you can have other font types
[00:05:40.860]that might be seen as interesting.
[00:05:42.840]And so there's some interest in terms of us,
[00:05:44.880]in terms of what,
[00:05:46.020]what do youth in particular
[00:05:47.700]see about these packages or find appealing
[00:05:50.190]and are these guidelines kind of related to those pieces?
[00:05:52.920]And so Stacey's going to share with us
[00:05:54.300]some other information here.
[00:05:57.120]Yeah, so because of this interest,
[00:05:58.830]we conducted focus groups with young people
[00:06:01.110]across Washington State
[00:06:02.940]to find out how they perceived these products.
[00:06:06.630]We gathered them together via Zoom.
[00:06:09.210]We showed them pictures of the cannabis product packaging
[00:06:12.240]and we asked them what they found appealing
[00:06:14.850]and what they thought about the products.
[00:06:16.800]We have since followed that up with a statewide survey
[00:06:19.830]and those results are under review.
[00:06:22.260]We're getting ready to prepare those
[00:06:24.090]to present to our funders.
[00:06:25.980]Go ahead, next slide, Jessica.
[00:06:28.650]So what we found
[00:06:30.570]was that young people had a lot of difficulty
[00:06:33.120]making sense of the warning labels.
[00:06:35.460]They correctly identified that these were warnings
[00:06:38.490]and that they could use this phone number,
[00:06:42.150]but they primarily thought
[00:06:43.440]that they would use this phone number
[00:06:44.760]for someone who was much, much younger than they are.
[00:06:48.060]And so even if Washington State
[00:06:50.280]was identifying this phone number could be used by teens,
[00:06:53.190]they're not seeing it for themselves.
[00:06:55.260]Instead, they figured
[00:06:56.340]that if they had a toddler that was around them
[00:06:59.880]that was maybe choking on an edible,
[00:07:01.830]or if they had a toddler that was,
[00:07:04.740]had used a large amount of edibles
[00:07:06.630]and they were concerned about that toddler's welfare,
[00:07:08.610]they would maybe use the phone number
[00:07:10.800]to call for help in that regard.
[00:07:13.200]However, when we asked them what they would do
[00:07:15.420]if they felt they had overconsumed cannabis,
[00:07:17.820]or if they felt that they used cannabis
[00:07:20.790]and then felt sick afterward,
[00:07:22.380]they just said they would write it out
[00:07:25.140]or they would call their friends
[00:07:27.240]or their friends' parents or their parents.
[00:07:29.880]They did not see the need to call the emergency number.
[00:07:34.488]The Washington State universal symbol,
[00:07:36.210]which is that cannabis leaf,
[00:07:38.700]also was a little bit tricky.
[00:07:40.380]Some of our focus group participants
[00:07:42.510]felt that that was an advertisement
[00:07:45.210]and they viewed it as such
[00:07:46.740]rather than a warning label,
[00:07:47.910]they thought it advertised
[00:07:49.020]that the product included cannabis.
[00:07:51.360]And then we had some participants
[00:07:52.920]who were not knowledgeable about cannabis at all,
[00:07:54.780]who actually were unaware that it was a cannabis leaf.
[00:07:57.510]One of our participants thought it was an oak leaf,
[00:07:59.580]for example.
[00:08:01.050]So we really found that cannabis knowledge
[00:08:03.780]and familiarity with cannabis
[00:08:05.040]influenced how adolescents viewed these products.
[00:08:09.330]We also found that the serving sizes
[00:08:13.260]are quite different across products
[00:08:15.390]and that young people are very unaware
[00:08:18.180]of the serving sizes of cannabis products.
[00:08:20.640]This is perhaps, in my opinion,
[00:08:22.010]one of the most startling findings from our work.
[00:08:25.590]This is a Blaze cannabis soda.
[00:08:28.050]It's cannabis-infused soda
[00:08:29.880]and it's actually includes 10 servings.
[00:08:33.630]So the way a person is supposed to use this product
[00:08:36.480]that's pictured here
[00:08:37.590]is you open it up,
[00:08:39.330]you actually use the lid to measure the serving.
[00:08:42.360]You pour out one serving,
[00:08:43.800]you have it,
[00:08:44.820]and then you put it away,
[00:08:46.530]and you have to wait,
[00:08:47.520]and according to the bottle,
[00:08:48.600]it takes up to two hours
[00:08:49.830]for you to potentially feel that effect.
[00:08:52.170]When we asked adolescents
[00:08:53.520]how many servings they felt was in this bottle,
[00:08:56.250]they said that it was like a soda bottle
[00:08:58.350]and they would likely drink it in its entirety.
[00:09:01.170]Now we understand that cannabis products
[00:09:04.230]are not easily accessible to most adolescents,
[00:09:07.440]in Washington State, for example,
[00:09:08.820]they'd have to go to a retailer,
[00:09:10.410]IDs are checked,
[00:09:12.480]but our adolescents also told us
[00:09:14.610]that they see these products,
[00:09:16.260]they often see these products at a party.
[00:09:18.570]And so I think one of the important takeaways
[00:09:20.970]from this part of the research
[00:09:22.470]is that parents and health practitioners
[00:09:24.870]need to be keenly aware
[00:09:25.980]what products are available in and around their state
[00:09:28.890]because at least youth in our state
[00:09:31.110]are seeing these products at parties.
[00:09:32.820]And if they're not aware
[00:09:34.830]that it's a cannabis-infused product
[00:09:36.510]or if they don't know
[00:09:37.343]how to properly use a cannabis-infused product,
[00:09:40.320]they could definitely overindulge and misuse the cannabis.
[00:09:45.930]We also looked at what they thought about these products
[00:09:49.440]outside of the fact that they were selling cannabis.
[00:09:51.960]And I've been doing research with adolescents
[00:09:54.570]for close to 20 years now,
[00:09:56.820]and one of the projects that's near and dear to my heart
[00:09:59.250]is I went and interviewed young teens
[00:10:02.280]and early college students in their personal spaces
[00:10:05.730]and looked to see how they were using media
[00:10:07.490]in their bedrooms
[00:10:08.550]and on social media
[00:10:10.110]in kind of a way to create their identity.
[00:10:12.600]So one of the things that we found in our focus groups
[00:10:15.300]was that adolescents were very interested, at least some,
[00:10:18.570]were interested in using these products
[00:10:20.760]to connect themselves to the cannabis imagery.
[00:10:24.240]So we had one group, one focus group
[00:10:26.190]in which a young woman said
[00:10:27.810]that Blaze bottle was just so cute,
[00:10:29.940]she wanted to take a photo shoot with it,
[00:10:32.550]which I thought was really telling
[00:10:33.900]because it didn't bother her
[00:10:35.370]that the product was illegal for her to use.
[00:10:37.800]She wasn't concerned about identifying herself
[00:10:40.260]with something that was illegal or that was a substance
[00:10:43.050]instead of that was what made it attractive.
[00:10:45.240]They also talked about using some of the packages
[00:10:47.550]as designs, design elements in their bedrooms.
[00:10:51.090]So we see here that these young adults and adolescents
[00:10:54.000]are using cannabis in much the same way
[00:10:55.620]that they use advertisements for other products
[00:10:59.250]in ways that they can use to kind of showcase who they are
[00:11:03.030]and identify what they find as attractive and appealing
[00:11:05.970]with products outside of their own,
[00:11:08.580]you know, their own homes or their own self.
[00:11:11.940]Go ahead, Jessica.
[00:11:13.762]So we wanted to take a second
[00:11:14.970]and contextualize some of it too
[00:11:16.647]and kind of why does this matter.
[00:11:18.570]And what we really know and understand
[00:11:20.730]is that based on theories and on research,
[00:11:23.520]having them see these products
[00:11:24.960]and be interested in these products
[00:11:26.280]can really make a difference
[00:11:27.570]in their intentions to use a product
[00:11:29.220]and then also potentially their behaviors down the line.
[00:11:32.550]So what you're seeing here is kind of a brief version
[00:11:34.500]of the integrated model of behavioral prediction.
[00:11:37.440]But we like to highlight
[00:11:38.430]how this covers a number of different factors, right,
[00:11:40.620]that influence individual's behavior.
[00:11:42.720]And so background factors such as demographic variables,
[00:11:46.170]the culture that one's in,
[00:11:47.430]the media that they're exposed to,
[00:11:49.530]community, all of these different elements
[00:11:51.420]can impact the beliefs that someone might have.
[00:11:54.150]So our attitudes toward whether using cannabis
[00:11:56.640]is an okay idea
[00:11:58.020]or the perceived norms
[00:11:59.310]on whether or not others are using cannabis
[00:12:01.470]and what others around us might think of our cannabis use,
[00:12:04.320]for example.
[00:12:05.550]Similarly, they can also impact self-efficacy.
[00:12:07.770]So your ability to feel
[00:12:08.940]like you could turn down cannabis
[00:12:10.560]if you were offered it at a party, for example,
[00:12:13.200]or engaged with a product if you wanted to.
[00:12:15.900]And then all of those features
[00:12:17.130]can impact our behavioral intentions,
[00:12:19.110]which may have an impact later on on behavior.
[00:12:21.630]We recognize there are a number of places here
[00:12:23.430]where that behavior might not happen,
[00:12:25.110]but it's important to kind of note that this bigger picture
[00:12:27.210]that all of this packaging discussion is happening in
[00:12:30.210]can have that impact on these attitudes,
[00:12:32.280]the norms and self-efficacy,
[00:12:33.780]which can then impact behavioral intentions and behaviors.
[00:12:37.350]And so seeing, for example,
[00:12:38.790]products that people think might look appealing,
[00:12:41.100]seeing that they have others,
[00:12:42.420]that they know that they're are using them
[00:12:44.310]or that they're familiar with,
[00:12:45.810]all of those things can lead towards
[00:12:47.730]less perceptions of risk of using the product,
[00:12:49.740]for example,
[00:12:50.573]or increased attitudes toward
[00:12:52.500]that the product is going to be tasty or flavorful,
[00:12:54.630]which were some of the things
[00:12:55.463]that we also found in those focus groups.
[00:12:57.750]In quantitative results that we also received,
[00:13:00.270]similarly, where we had people looking at product packaging,
[00:13:03.090]a lot of their perceptions of appeal
[00:13:05.250]were then associated with their intentions
[00:13:06.930]to potentially use a product.
[00:13:08.610]So we asked teens and 18 to 20 year olds,
[00:13:12.270]for example, how they felt about these product packages
[00:13:14.760]and those that found them more appealing
[00:13:16.200]had these greater intentions
[00:13:17.400]to potentially use those products.
[00:13:18.870]So all of this kind of comes together
[00:13:20.340]to talk a little bit about how behaviors and intentions
[00:13:23.100]can be impacted by those features.
[00:13:31.560]Okay, so one of the studies
[00:13:32.820]that Jessica and I did early on
[00:13:34.680]was we looked at whether or not
[00:13:37.470]youth's intentions to use cannabis
[00:13:39.750]was associated with advertising
[00:13:41.940]and with their access to a retailer.
[00:13:45.090]We really thought that being close to a retailer
[00:13:48.150]would have an impact.
[00:13:49.830]So we did a survey of 350 teens in Washington State.
[00:13:53.970]We used the Washington State's list of retailers
[00:13:56.190]to create a list representing the number of retailers
[00:13:59.280]in a participant zip code.
[00:14:01.200]But we didn't find that the zip code,
[00:14:03.690]that the number of retailers in a young person's zip code
[00:14:07.470]was associated with their intentions at all.
[00:14:11.040]Research conducted by others since then
[00:14:13.890]have found that there is an association,
[00:14:15.990]but they have looked at greater precision
[00:14:18.120]with the density of retailers
[00:14:20.550]in a particular neighborhood or in a particular city.
[00:14:23.100]Jessica and I, after the fact,
[00:14:24.750]felt that the zip code was probably just too large
[00:14:27.570]of an area to measure the density
[00:14:30.960]or the presence of retailers.
[00:14:33.210]What we did find in our study, however,
[00:14:35.640]was that perceived proximity to retailers.
[00:14:38.310]So this was a self-reported measure.
[00:14:40.560]If a young person felt that they lived close to a retailer,
[00:14:44.580]then they were more likely to perceive that they,
[00:14:47.130]that they interacted with cannabis advertisements,
[00:14:50.430]and then if they interacted with cannabis advertisements,
[00:14:53.340]they were more likely to intend to use.
[00:14:56.070]Adolescents who lived far away from a retailer
[00:14:59.070]who perceived they saw
[00:15:00.030]a large amount of cannabis advertising
[00:15:02.760]were more likely to report intentions to use
[00:15:05.220]than those who said they saw fewer advertisements.
[00:15:09.060]So what does this mean?
[00:15:10.260]What this really means is that
[00:15:12.420]if you have a young person
[00:15:13.920]who's paying attention to these cannabis advertisements
[00:15:17.220]who perceives that they're seeing
[00:15:18.510]a lot of these cannabis advertisements,
[00:15:21.150]then that perception in and of itself
[00:15:23.850]may have an impact on their intentions to use.
[00:15:26.730]And Jessica and I's most recent work,
[00:15:29.160]this came up again
[00:15:30.270]because in Washington State
[00:15:32.010]there are laws for whether or not
[00:15:33.600]a cannabis retailer can be close to a school, for example.
[00:15:37.200]But we had teens reporting
[00:15:38.730]that they are seeing cannabis advertisements
[00:15:40.950]and cannabis retailers on their way to school
[00:15:43.980]and on their way home from school.
[00:15:45.780]And so it may be that the states like ours have to consider
[00:15:49.800]whether or not the retailers or the retail lane, right,
[00:15:53.610]the number of cannabis retailers
[00:15:55.710]to kind of conglomerate together,
[00:15:57.450]whether or not that is on a main thoroughfare
[00:15:59.550]to a school or school district
[00:16:01.140]should be considered
[00:16:02.670]as opposed to just being a certain distance
[00:16:04.830]from the school.
[00:16:09.240]We also found that youth's intentions were associated
[00:16:12.570]with viewing cannabis social media content.
[00:16:15.240]So those who viewed social media content
[00:16:17.850]and those who saw that pro-cannabis content online
[00:16:21.300]were more likely to intend to use cannabis.
[00:16:24.390]Interestingly, for those of you in the room who are like us
[00:16:27.240]who are working to reduce cannabis misuse,
[00:16:30.300]if youth saw negative messaging online about cannabis,
[00:16:34.290]so messaging that said it was harmful
[00:16:36.390]or that would have a negative effect,
[00:16:38.730]they were less likely to intend to use.
[00:16:41.157]And so I think it's an important takeaway to note
[00:16:43.950]that it's not just about seeing the positive content,
[00:16:46.890]it's about also seeing the negative.
[00:16:49.020]However, as the next slide will indicate,
[00:16:51.900]teens actually don't often see
[00:16:54.030]a whole lot of negative cannabis messaging.
[00:16:58.320]They often see positive messaging.
[00:17:00.330]So here we have a picture of a billboard.
[00:17:03.330]The nice grass advertisement is actually an advertisement
[00:17:06.150]that's been used on social media.
[00:17:08.460]It's a branded message,
[00:17:09.690]it's created by an organization that sells cannabis.
[00:17:12.660]And then there's also content that teens will create
[00:17:15.300]or that their peers will create.
[00:17:17.520]So there's whole Twitter community called weed tweets,
[00:17:22.140]and here you have, you know,
[00:17:23.340]my first bong rip was better than my first kiss.
[00:17:26.790]Right, and so there's a lot of content
[00:17:29.370]that young people are gonna be exposed to,
[00:17:31.800]even content that is not age-restricted.
[00:17:35.280]Of course, if you were to go to a retailer's website,
[00:17:38.010]at least in Washington State,
[00:17:39.630]you do have to enter in a birthdate.
[00:17:41.610]And that birthdate does have to be over the age of 21.
[00:17:44.100]We all know that that can be tricked, however.
[00:17:47.190]I know my 11 year old can certainly identify
[00:17:49.770]what year she has to be born in order to be 21.
[00:17:53.070]But even if,
[00:17:55.410]even on those particular retailer sites,
[00:17:58.830]kids can get access.
[00:18:00.240]But then in addition,
[00:18:01.620]when you have sites like Twitter or Facebook or Instagram,
[00:18:05.820]there are no age restrictions there.
[00:18:07.530]That content can just be generated
[00:18:09.330]and is accessible by both young people and young adults.
[00:18:14.940]So I wanna open this up
[00:18:16.680]and I understand in this hybrid environment,
[00:18:18.690]this is gonna be potentially a little bit difficult,
[00:18:22.170]but I'd like to just do a show of hands in the room,
[00:18:25.290]and then refer attendees online.
[00:18:27.000]You can post in the chat.
[00:18:28.860]Which type of cannabis-related social media
[00:18:31.260]do you think youth are gonna see most often?
[00:18:34.740]So I'll give you a second to read through the slide here.
[00:18:38.340]With posts about using cannabis or being high,
[00:18:41.610]posts about celebrities or songs
[00:18:43.320]that are linked positively to cannabis,
[00:18:45.480]posts about how cannabis can relieve stress,
[00:18:47.940]post about how cannabis is harmless,
[00:18:50.070]posts about how cannabis is harmful,
[00:18:52.110]how it's unattractive or gross,
[00:18:54.180]or about a celebrity or song
[00:18:55.470]that's linked to negative cannabis use.
[00:18:58.560]So if I could just get a show of hands,
[00:19:00.270]and I'm not gonna,
[00:19:01.103]I'm gonna try to count,
[00:19:02.160]but I'm not really gonna be able to count.
[00:19:03.930]So maybe I'll just see a slew of hands
[00:19:06.600]on one particular piece here.
[00:19:08.640]But those of you
[00:19:09.473]who think that the one they're gonna see the most often
[00:19:11.580]is using cannabis or being high,
[00:19:13.470]feel free to raise your hand.
[00:19:16.440]Okay, so we have a few people there.
[00:19:18.360]Excellent.
[00:19:19.410]How about a celebrity or song
[00:19:21.090]that links positive to cannabis use?
[00:19:25.170]Okay, some hands there.
[00:19:26.370]Great.
[00:19:27.203]How about cannabis relieving stress?
[00:19:31.839]Okay, not as much.
[00:19:33.180]How about the fact that cannabis is harmless?
[00:19:36.180]Do you think they're gonna see ads that say that?
[00:19:39.990]Not as many there, a couple.
[00:19:41.940]Okay, and then how about that cannabis is harmful
[00:19:45.030]or unattractive or gross or that it's negative?
[00:19:48.660]I'll throw all those in together.
[00:19:49.980]So not as many,
[00:19:51.000]not as many there.
[00:19:52.710]Okay, so the room is right.
[00:19:55.170]So Jessica, if you can show the next slide,
[00:19:58.380]what we found is that teens and young adults,
[00:20:00.630]so the teens are the burgundy bar.
[00:20:02.550]The young adults are the gray bar here.
[00:20:06.000]They are much more likely to see
[00:20:07.830]posts about being high
[00:20:09.480]or a celebrity that promotes cannabis use.
[00:20:13.110]They are, though contrary to what you thought,
[00:20:15.900]likely to see things about it relieving stress,
[00:20:19.380]and they are also likely to see things
[00:20:21.240]about it being harmless.
[00:20:22.920]As an aside,
[00:20:23.753]Jessica and I did some interviews with cannabis users
[00:20:26.760]and in those interviews
[00:20:28.500]one of the most common reasons
[00:20:29.730]why young women were reporting using cannabis
[00:20:31.830]was to reduce anxiety or to relieve stress.
[00:20:34.620]I'm sure some of you are seeing that
[00:20:35.970]in your practicing as well.
[00:20:38.250]Adolescents are seeing,
[00:20:40.274]and young adults are both reporting
[00:20:41.580]that they see negative information about cannabis
[00:20:44.430]at a lower rate
[00:20:46.170]than they see positive,
[00:20:47.220]but they are still seeing it.
[00:20:48.630]So they are still seeing that it's harmful and gross
[00:20:51.240]and they are still seeing a celebrity that was negatively,
[00:20:54.600]but it's at a much lower rate than those that are positive.
[00:21:00.360]Okay, Jessica. So in addition to that,
[00:21:02.130]we also are seeing that teens in particular and young adults
[00:21:05.580]are actually posting a lot of content related to cannabis
[00:21:08.730]on social media.
[00:21:10.050]So what you're seeing here is a survey that was done,
[00:21:13.050]this is just teen data from 350 Washington State residents,
[00:21:18.060]and they reported that about 30% of them
[00:21:20.580]had posted cannabis-related content on social media.
[00:21:24.000]And out of that content they're posting,
[00:21:25.980]see that memes are really popular,
[00:21:27.600]they were sharing a lot of memes related to this.
[00:21:30.330]Some were actually sharing pictures
[00:21:32.460]of someone smoking cannabis or videos of that occurring.
[00:21:36.330]And this actually, the study was done a few years ago,
[00:21:38.910]and we would assume that actually since then,
[00:21:40.560]this might have even increased further.
[00:21:42.420]And some of the work that we've done,
[00:21:43.770]we've found that it tends to be fairly common
[00:21:45.600]for people to share and amplify media messages,
[00:21:48.690]even if it's not specific
[00:21:49.860]to something they might be doing in their own life.
[00:21:51.810]But it's a way that they feel like
[00:21:53.370]they're engaging in a discussion about this broader culture.
[00:21:56.250]And so they might share that information and content.
[00:21:58.560]And we really highlight this also
[00:21:59.790]to illustrate that a large portion
[00:22:01.800]of what people are seeing related to some of this
[00:22:04.020]isn't necessarily brand-generated messaging
[00:22:06.750]or things that have been approved
[00:22:09.030]like packaging in advance to go out in front of individuals.
[00:22:12.600]So this is content that anyone can be creating,
[00:22:15.180]anyone can be sharing,
[00:22:16.680]and even teens themselves are making some of this content
[00:22:20.040]and distributing it on social media channels.
[00:22:24.240]And so somewhat related to the point
[00:22:25.650]that Stacey had made earlier
[00:22:26.760]in this section of our presentation,
[00:22:28.290]we did wanna talk about how some of this mapped back on
[00:22:31.140]to the integrative model of behavioral intention
[00:22:33.750]in terms of the messaging that people see
[00:22:35.580]related to cannabis.
[00:22:36.720]So what you're seeing here is a model
[00:22:38.700]that basically is trying to tell us
[00:22:40.860]that if people are viewing pro-cannabis messages
[00:22:43.260]and anti-cannabis messages,
[00:22:44.820]it can have an impact on their actual cannabis use.
[00:22:49.140]And so we had two different samples for this study.
[00:22:52.680]We had those teens that were 13 to 17 years of age,
[00:22:57.090]they answered a number of survey questions.
[00:22:58.920]And then we also had college students
[00:23:00.840]who were part of a sample, a separate sample
[00:23:03.540]that we asked similar survey questions with
[00:23:05.430]because we wanted to also see what their responses were.
[00:23:09.210]And with both sets of data,
[00:23:10.920]so with anybody from 13 up to about 25 in our sample,
[00:23:15.450]we noted that if they were seeing pro-cannabis messages,
[00:23:18.660]which could be described as any of those messages
[00:23:20.940]from kind of that long list of the positive things, right,
[00:23:23.520]seeing things that
[00:23:25.230]they thought were promoting the use of cannabis,
[00:23:27.150]showed people using it and having a good time,
[00:23:29.820]all of those things were associated
[00:23:31.590]with their intentions to use cannabis.
[00:23:33.990]And then in our young adult sample,
[00:23:35.670]we actually had use data.
[00:23:37.170]So we asked them about their frequency of use.
[00:23:39.720]And so with the young adults,
[00:23:40.860]we were able to see too
[00:23:41.760]that if you were exposed to those pro-cannabis messages,
[00:23:44.850]you were more likely to use cannabis more frequently
[00:23:48.570]than someone who was seeing less of that messaging.
[00:23:51.330]On the flip side and helpful for prevention efforts,
[00:23:54.420]anti-cannabis messaging can also make a difference.
[00:23:57.330]But one thing to note here
[00:23:58.590]is there's not actually a direct line
[00:24:00.660]from anti-cannabis messages
[00:24:02.250]to cannabis use or even intentions.
[00:24:05.070]And so this was a little bit trickier
[00:24:06.420]because basically it means
[00:24:07.650]that if people are seeing more anti-cannabis messages,
[00:24:11.040]those impact their outcome beliefs,
[00:24:13.110]which are essentially their attitudes
[00:24:14.550]towards using cannabis,
[00:24:16.170]and those also impact their perceived norms.
[00:24:18.510]So whether or not they think others are using cannabis.
[00:24:21.600]And then because of that
[00:24:22.740]it also then impacts intentions to use
[00:24:25.320]and then later cannabis use in that young adult sample.
[00:24:28.890]So it's a,
[00:24:30.030]it's a helpful way to kind of think about
[00:24:31.350]how those prevention efforts can make a difference.
[00:24:33.630]But they do seem to have to work through
[00:24:35.130]some of these internalized beliefs
[00:24:37.110]that people have to potentially impact use.
[00:24:40.320]And we also do like to highlight with this research
[00:24:43.140]that this was actually a cross-sectional study.
[00:24:45.180]So we can't be sure
[00:24:46.680]that people who intend to use cannabis and use cannabis
[00:24:50.010]aren't just looking, you know,
[00:24:51.150]for more of those positive messages, right,
[00:24:52.950]or following more positive accounts, for example.
[00:24:55.470]Although some research that we have not done
[00:24:57.210]that was longitudinal in nature
[00:24:58.950]has shown that the exposure to pro-cannabis messages
[00:25:02.280]and cannabis messages in particular on social media
[00:25:05.040]have an impact on cannabis use later on.
[00:25:07.170]So we feel pretty confident in the direction
[00:25:09.120]even though we recognize that with this specific data,
[00:25:11.700]we can't always make those claims.
[00:25:16.050]And then from there,
[00:25:16.883]we also did some work looking at
[00:25:18.900]what are called sex-related cannabis expectancies.
[00:25:21.270]And this is essentially whether or not
[00:25:23.520]people think that using cannabis prior to sex
[00:25:26.850]can be beneficial.
[00:25:28.170]And we were interested in this in particular
[00:25:30.270]because alcohol has often used sexualized appeals
[00:25:34.050]in their promotional messages.
[00:25:35.910]Cannabis is a little bit different
[00:25:37.320]because some people are against that.
[00:25:39.030]If you actually look at some of the literature
[00:25:40.620]where they're talking about marketing cannabis,
[00:25:42.960]some claim that they don't wanna be using sex
[00:25:45.000]to try to sell cannabis,
[00:25:46.050]whereas others have done so
[00:25:47.820]as you saw with that nice grass ad
[00:25:49.950]that was shown there.
[00:25:51.180]And so in that case,
[00:25:52.140]we were really interested too in
[00:25:53.670]if these things were having an impact
[00:25:55.470]on sex-related cannabis expectancies
[00:25:57.630]or whether or not one would think
[00:25:59.010]that using cannabis prior to sex was beneficial.
[00:26:02.340]And so in this data where we also looked again
[00:26:04.560]at teens and young adults,
[00:26:05.700]we found that more exposure to positive portrayals
[00:26:08.790]was again associated with increased intentions to use.
[00:26:12.360]But it also had these kind of impacts
[00:26:13.950]on sex-related cannabis expectancies.
[00:26:16.890]They were a bit trickier to parse out
[00:26:19.140]when you had positive content,
[00:26:20.700]they tended to have higher expectancies.
[00:26:22.500]So if they saw more of that positive content,
[00:26:24.990]and especially if they saw it in relation to,
[00:26:27.480]relationships or portrayals related to sex,
[00:26:31.350]then they tended to have those higher expectancies.
[00:26:33.960]And in particular for boys,
[00:26:35.700]so for teenage boys,
[00:26:36.900]higher expectancies in this case
[00:26:38.520]was associated with higher intentions to use.
[00:26:41.460]And so it's an interesting thing to think about too
[00:26:45.030]this broader discussion around cannabis
[00:26:47.460]and the way that it's being promoted
[00:26:48.960]can also impact certain contexts
[00:26:50.820]in which people might be considering it
[00:26:52.680]and ways that they might be thinking through use.
[00:26:56.730]So we wanted to talk next in this next section
[00:26:58.710]about designing effective prevention messages.
[00:27:01.680]But before we did that,
[00:27:02.513]we did wanna give a moment
[00:27:03.450]just to have anybody ask questions
[00:27:05.160]if they had them at this point.
[00:27:06.420]So I don't know if we have someone in the room
[00:27:07.620]who can unmute
[00:27:08.580]or if there's a way to lead those questions,
[00:27:10.050]but if anybody did have questions up for anything this far
[00:27:12.270]or any of our viewers in the chat wanted to post something,
[00:27:15.780]please feel free to do that now.
[00:27:19.710]We do have a question.
[00:27:22.380]Excellent.
[00:27:25.020]Thanks.
[00:27:25.980]I was just curious on the last slide,
[00:27:28.080]if any of that,
[00:27:29.850]if there's like a moderating factor or anything
[00:27:31.950]in terms of sexuality in the sex-related expectations.
[00:27:36.000]Are these people who are identifying
[00:27:39.090]what type of partner, I guess, or...
[00:27:40.383]Yeah, that is an excellent question.
[00:27:43.080]So in that specific study,
[00:27:44.550]we actually didn't look at that as a moderating factor,
[00:27:47.850]but we would think that's possible.
[00:27:49.320]And so in some other work that we've done
[00:27:50.970]where we haven't analyzed the data yet, unfortunately,
[00:27:53.670]we have a more diverse sample of young adults
[00:27:56.310]and it's specific to cannabis and sex
[00:27:58.980]and looks at their actual behaviors
[00:28:00.660]or self-reported behaviors
[00:28:02.430]as well as their engagement there.
[00:28:04.230]And so the thought for some of that
[00:28:06.540]would be that it also depends on what you're seeing
[00:28:08.340]in terms of how those portrayals are happening.
[00:28:10.200]What we tend to see with alcohol content
[00:28:12.090]and some of that cannabis
[00:28:13.410]is essentially sexual objectification
[00:28:15.630]and more discussion related to heteronormative beliefs.
[00:28:18.660]Then you actually see some of the others,
[00:28:20.160]although cannabis products often
[00:28:22.590]target vulnerable communities.
[00:28:24.027]And so we've seen some individuals
[00:28:26.670]who might be seeing those product advertisements more.
[00:28:30.000]And so it's kind of this interesting piece
[00:28:31.320]that we don't actually know yet if that moderates it,
[00:28:33.690]but it's quite possible that it would.
[00:28:35.800]And I just don't have that information for you right now.
[00:28:40.740]Any more questions?
[00:28:43.920]Okay, no more questions.
[00:28:45.270]Okay, awesome.
[00:28:46.170]Thank you so much.
[00:28:47.550]So in this section we did wanna talk about
[00:28:49.410]designing effective prevention messages.
[00:28:55.200]Wonderful, so hope everybody can hear me still.
[00:28:58.260]Okay, sorry that I have to jump back on.
[00:29:01.980]So Jessica and I have spent, as I mentioned earlier,
[00:29:05.130]a lot of time
[00:29:06.690]learning how to craft really effective messaging
[00:29:09.930]to reduce cannabis misuse.
[00:29:12.240]One of the things that I like to talk to people
[00:29:14.760]about doing first
[00:29:15.900]is understanding where their audience is.
[00:29:18.810]So to do that,
[00:29:19.740]we need to first consider the hierarchy of effects.
[00:29:23.610]And so the hierarchy of effects is this really neat theory
[00:29:27.540]that helps us kind of understand where our audience is
[00:29:31.470]and we have to meet our audience, right?
[00:29:33.480]So in our particular state,
[00:29:35.550]there's a lot of awareness
[00:29:36.600]about cannabis among college students,
[00:29:39.120]but not as much awareness among adults
[00:29:41.460]and or health practitioners, right?
[00:29:45.690]And so if we were going to do a campaign
[00:29:49.110]to health practitioners,
[00:29:50.100]because it's such a new thing for health practitioners
[00:29:53.220]who are dealing with it in our state,
[00:29:54.870]we would maybe do an awareness campaign
[00:29:56.580]or we maybe do a knowledge campaign.
[00:29:59.070]But as you move up in the hierarchy of effects,
[00:30:01.440]you move from telling people
[00:30:04.200]and helping them think about the situation
[00:30:06.630]or think about the problem
[00:30:08.100]to trying to change how they feel
[00:30:09.870]or what they actually do about the problem.
[00:30:12.480]And so in this particular situation,
[00:30:14.610]if you had people who were very aware
[00:30:17.550]and they had a lot of knowledge about cannabis,
[00:30:19.740]then you might be able to move them
[00:30:21.660]or to think about trying to affect
[00:30:24.000]their preference for using cannabis
[00:30:26.010]or how much they like cannabis, for example.
[00:30:28.770]And then ultimately you would maybe wanna affect
[00:30:31.590]whether or not they're actually gonna use cannabis,
[00:30:33.600]which in this particular theory
[00:30:36.030]is referred to as purchase,
[00:30:37.380]but we would refer to it as use.
[00:30:39.360]Right?
[00:30:40.740]Go ahead.
[00:30:43.860]We also have another theory that I like to talk about
[00:30:47.160]because this is a fun theory to utilize.
[00:30:50.430]So social cognitive theory tells us
[00:30:53.130]that what we see in the media affects what we do.
[00:30:57.360]And so really very basically
[00:31:00.540]what social cognitive theory tells us
[00:31:01.973]is that we can't learn everything from direct experiences.
[00:31:07.440]So I could guarantee that not everybody in the room
[00:31:11.100]has been through a house fire, for example.
[00:31:14.280]But hopefully all of us know
[00:31:17.310]that if we're involved in a fire,
[00:31:19.650]the thing we have to do is to test the door
[00:31:21.750]to make sure the doorknob isn't too hot,
[00:31:24.330]we maybe know that we have to get low to the ground
[00:31:27.180]to avoid the smoke,
[00:31:28.650]and we also know that we have to break through windows
[00:31:31.890]and or get an exit that doesn't take us through the fire.
[00:31:35.580]We don't have to do that
[00:31:37.020]or learn that from a direct experience
[00:31:39.570]because we've seen videos
[00:31:41.010]to teach us how to behave in a fire.
[00:31:43.500]And we've seen maybe portrayals on television and or movies
[00:31:48.300]about people who are dealing with a house fire experience.
[00:31:51.570]So all that this theory tells us
[00:31:53.160]is that's true for everything in life, right?
[00:31:55.980]So I pretend sometimes to be a really fantastic baker
[00:32:01.140]because I really love
[00:32:02.070]watching the Great British Baking show, right?
[00:32:04.560]Maybe some of you are feeling that way with me,
[00:32:07.380]but I didn't have to actually go and study how to bake.
[00:32:10.440]I could instead just watch people do it on television
[00:32:13.470]and try to muddle my way through doing it in my own kitchen.
[00:32:17.220]So the idea behind social cognitive theory
[00:32:20.040]is that media has an effect on us
[00:32:21.630]when we pay attention to it,
[00:32:23.730]when the message is easily retained,
[00:32:26.280]when we see what actions need to be produced
[00:32:29.370]and when we are motivated to produce those actions.
[00:32:33.210]So if we know that,
[00:32:34.350]we can then design messages with that in mind.
[00:32:37.350]So to design a message using social cognitive theory,
[00:32:40.650]you would create a message that has characters
[00:32:43.980]that are relevant to the audience,
[00:32:45.960]you would perhaps use a realistic setting,
[00:32:48.780]maybe a setting that's familiar.
[00:32:50.940]So I often tell people to use a setting on your campus
[00:32:54.273]that students are gonna be familiar with
[00:32:56.040]because then that they're are all of a sudden
[00:32:57.960]gonna pay more attention to that setting.
[00:33:00.960]We're gonna repeat the message,
[00:33:02.460]we're gonna have multiple sources, use the message,
[00:33:05.160]and then we may actually use
[00:33:06.480]something called a transitional character.
[00:33:08.760]So if we're really truly trying
[00:33:10.410]to get people to change their behavior,
[00:33:12.390]we may show someone modeling that change.
[00:33:15.510]So in this case,
[00:33:16.470]we would maybe show somebody going from using cannabis
[00:33:19.380]to not using cannabis,
[00:33:21.240]or we would show somebody who's faced with a decision
[00:33:24.960]to use a cannabis edible at a party
[00:33:26.880]who chooses not to use a cannabis edible at a party.
[00:33:29.640]So they're modeling that behavior
[00:33:30.990]that you're wanting them to model.
[00:33:32.700]And then of course,
[00:33:33.533]once they've modeled that behavior,
[00:33:34.770]it's really important that they're rewarded for it
[00:33:37.920]because we tend not to do things
[00:33:40.020]if we don't think that we're gonna be rewarded.
[00:33:42.360]And that reward has to be consistent with our audience.
[00:33:45.630]So for a young adult,
[00:33:46.920]you might have that reward
[00:33:48.180]be that they are seen as spoon cool
[00:33:50.250]or exciting by their peers.
[00:33:52.800]You certainly wouldn't want them to be shown
[00:33:54.360]they're being shunned by their peers.
[00:33:56.010]You wouldn't want their behavior
[00:33:57.060]to be stigmatizing in any way.
[00:33:59.220]And so you have to have that reward or that punishment
[00:34:01.980]be consistent.
[00:34:03.630]One of the other key factors of social cognitive theory
[00:34:06.150]is our efficacy to make the change.
[00:34:08.850]So like I said at the beginning,
[00:34:10.800]we understand how to deal with a house fire.
[00:34:14.070]If we were in an actual house fire,
[00:34:15.840]if our efficacy for dealing with that situation was high,
[00:34:20.010]we would know what to do and we would enact that change.
[00:34:22.410]If it was low,
[00:34:23.640]even if we knew what to do,
[00:34:25.770]we may not actually do that behavior.
[00:34:28.440]In the same way,
[00:34:29.850]I can bake a one-layer cake
[00:34:32.100]that I see on the Great British Baking Show,
[00:34:34.110]but those showcase pieces I'm not even gonna attempt, right?
[00:34:37.440]Because my efficacy for doing something grandiose or larger
[00:34:41.220]is lower than my efficacy to do something more basic.
[00:34:48.840]And so another one that we wanted to briefly talk about
[00:34:50.610]is this idea of stages of change
[00:34:52.920]and the transtheoretical model.
[00:34:55.170]Essentially stages of change tells us
[00:34:57.120]that people are at a specific moment in time
[00:35:00.810]in a certain stage
[00:35:02.100]that may or may not lend them to engaging in a behavior.
[00:35:06.030]So the transtheoretical model lays out this idea
[00:35:08.880]that people start out in precontemplation,
[00:35:11.610]and I'll talk about what each of these are a bit,
[00:35:12.930]but it's essentially that you're not thinking about this,
[00:35:14.850]they move to contemplation.
[00:35:16.200]I'm thinking about engaging in a behavior,
[00:35:18.750]they move to preparation.
[00:35:20.040]So getting ready to engage in that behavior,
[00:35:22.170]they move to action,
[00:35:24.180]then they go on to maintenance or termination.
[00:35:26.040]And it tries to be very linear in this thinking,
[00:35:28.920]but it's not always quite as linear as this might seem.
[00:35:32.100]So we're gonna talk about this a little bit here briefly.
[00:35:35.100]So in that first stage that I mentioned, precontemplation,
[00:35:37.680]and I use the example here of smoking
[00:35:39.180]because a lot of the earlier stages of change in work,
[00:35:42.150]earlier stages of change work
[00:35:44.550]came out of this idea of trying to help people quit smoking.
[00:35:48.120]So with precontemplation,
[00:35:49.710]you might see someone who's still smoking,
[00:35:51.570]they have no intention to take action to quit,
[00:35:54.000]and they use this timeframe of within the next six months
[00:35:56.700]because stages of change
[00:35:57.780]tries to quantify this a little bit.
[00:35:59.190]So the idea here is that
[00:36:00.600]when you're in the precontemplation stage,
[00:36:02.700]you have no intention to change your behavior
[00:36:05.010]in the foreseeable future.
[00:36:06.600]Essentially you're still engaging in
[00:36:07.950]whatever that behavior is.
[00:36:10.200]Contemplation would be the next stage here,
[00:36:12.180]and that one tells us instead
[00:36:13.650]that people intend to act within about the next six months.
[00:36:16.860]So we're really saying here that
[00:36:18.600]if you're in contemplation,
[00:36:19.800]you're starting to think about this.
[00:36:21.870]It might not be that you've actually done anything yet,
[00:36:24.420]you don't really have a plan for how you're going to do it,
[00:36:26.820]but in terms of smoking cessation, for example,
[00:36:29.190]this just means that someone's been thinking,
[00:36:30.900]maybe I should, I should think about quitting smoking.
[00:36:33.060]Maybe that's something of interest to me.
[00:36:35.493]And so they're kind of pondering that
[00:36:36.690]and they might have a date, they might not,
[00:36:38.280]but they're kind of within this foreseeable future,
[00:36:40.440]I could see that changing.
[00:36:43.020]Preparation, on the other hand,
[00:36:44.280]is really this idea that there's an intention to act.
[00:36:47.040]And so stages of change quantifies this
[00:36:48.840]with this like 30-day timeframe.
[00:36:50.610]But really we would just talk about this more
[00:36:52.590]as it's a more immediate intention to act here
[00:36:54.480]and you're actually trying to get ready
[00:36:55.830]for what that action is.
[00:36:57.210]So instead of this idea that maybe with quitting smoking,
[00:36:59.280]you're just kind of thinking about it
[00:37:00.810]and debating your options.
[00:37:03.120]In this case, you might be looking up ways
[00:37:04.830]that you can quit or things that can help you.
[00:37:06.600]You might be purchasing nicotine patches, for example,
[00:37:09.780]if you think that's going to be something
[00:37:11.010]that would be useful in your process of quitting.
[00:37:13.350]And so in preparation
[00:37:14.490]you're really thinking through
[00:37:15.510]how do I do that in the near future
[00:37:17.520]and what do I need to have to make that change happen.
[00:37:21.330]Action, on the other hand,
[00:37:22.590]is this idea that you've changed that behavior,
[00:37:24.840]but it's been for a smaller amount of time.
[00:37:27.120]So in the smoking cessation literature,
[00:37:28.830]this would be something like you've changed that behavior,
[00:37:30.720]but it's been less than six months.
[00:37:32.610]What that length of time is
[00:37:33.810]could vary depending on what the behavior is.
[00:37:36.690]But it's essentially the idea that you're engaged in
[00:37:39.240]actually stopping that behavior or starting a behavior
[00:37:42.089]if you're using stages of change that way.
[00:37:43.440]So you can also use all of this kind of in the reverse,
[00:37:45.960]or somebody who's in precontemplation
[00:37:47.850]isn't thinking about starting a physical activity program,
[00:37:50.070]for example,
[00:37:50.970]once they're in contemplation,
[00:37:52.170]they're looking at different options
[00:37:53.340]for that physical activity program.
[00:37:55.110]And then once they're actually in preparation,
[00:37:57.120]they're maybe getting new walking shoes.
[00:37:59.190]And then by that action point,
[00:38:00.540]what we're actually doing is seeing them engage in that.
[00:38:03.150]So that's one of the things that we're thinking through here
[00:38:05.190]is like those stages of change can work both
[00:38:07.080]for terminating a behavior
[00:38:08.430]and also potential uptake of a behavior.
[00:38:10.530]But action essentially for us is
[00:38:12.630]we're engaged in that behavior
[00:38:13.920]for at least a shortish amount of time.
[00:38:16.980]And then the idea is that in stages of change,
[00:38:18.630]you get to this end goal,
[00:38:20.100]either maintenance or termination
[00:38:21.690]depending on what that behavior is.
[00:38:23.230]So in the example right of physical activity
[00:38:25.200]that I just gave,
[00:38:26.190]that would be you've changed your behavior
[00:38:27.900]for more than six months, right?
[00:38:29.310]You've been going on walks every couple of days
[00:38:31.260]or something like that.
[00:38:32.640]And on the flip side of that termination
[00:38:34.320]is one that would apply, for example, to smoking cessation.
[00:38:36.600]So you've actually given up smoking,
[00:38:38.850]you're not really tempted to relapse
[00:38:40.230]and you're feeling really confident in your ability
[00:38:41.940]to stay free of cigarettes or these other smoking products.
[00:38:46.770]So stages of change is one
[00:38:47.850]that can kind of give us also some guidance
[00:38:49.350]in terms of the information that people might need.
[00:38:51.450]Similar to hierarchy of effects
[00:38:52.890]in that if we understand where someone is at
[00:38:55.080]in terms of their stage,
[00:38:56.070]they might have very different information needs
[00:38:58.800]than somebody who's in a different stage.
[00:39:00.930]So for example, if you've got someone
[00:39:02.160]who's not even thinking
[00:39:03.540]about changing their behavior related to substances,
[00:39:06.720]then you probably need a very different message
[00:39:08.580]than if you've got someone who's been actively looking into
[00:39:10.710]how they can reduce their use of alcohol
[00:39:12.690]and is trying to make a plan, right?
[00:39:14.520]Those individuals need different resources.
[00:39:16.620]And so this can just be a useful model for us to think about
[00:39:19.410]which areas media messaging may or may not impact
[00:39:22.680]depending on who you're trying to reach, right?
[00:39:24.780]So those messages that we share
[00:39:26.310]and show on social media,
[00:39:28.080]depending on the place that people are
[00:39:29.730]in terms of their stages,
[00:39:31.230]they may have more or less of an impact
[00:39:33.060]as long as those lined up with the areas
[00:39:34.830]of their life as well.
[00:39:38.280]And so, again, as I said, it looks very linear,
[00:39:40.140]but it's always not as quite as linear as it would seem
[00:39:43.740]because sometimes people can bounce back and forth
[00:39:45.660]between stages.
[00:39:46.800]So they can start out, you know,
[00:39:47.850]not thinking about this at all,
[00:39:49.110]but the messaging brings it up
[00:39:50.310]and they start to consider it.
[00:39:51.840]And then we might end up back in precontemplation, again,
[00:39:54.630]for example.
[00:39:58.110]So another theory is the use of fear appeals.
[00:40:01.410]And fear appeals are just one of the emotions
[00:40:03.780]that can be used
[00:40:05.160]in order to convey a message.
[00:40:07.020]We talked specifically about fear appeals
[00:40:09.660]because fear appeals use successfully
[00:40:12.240]in other substance use prevention campaigns.
[00:40:14.760]So for example, here is a fear appeal
[00:40:17.100]that's produced by the CDC
[00:40:19.590]to convince people to stop smoking
[00:40:22.020]and it is effective.
[00:40:24.300]But I wanna talk about why it's effective
[00:40:26.460]in this particular instance
[00:40:27.540]and why it may not be effective with cannabis.
[00:40:30.630]So negative information can be more memorable
[00:40:33.510]and it can be more persuasive than positive information.
[00:40:36.570]However, it is difficult to use it effectively
[00:40:38.880]and it's critical to understand your audience.
[00:40:41.700]The efficacy component is really important here.
[00:40:46.320]So in this particular ad that you see before you,
[00:40:49.920]the CDC, not only did the scare tactic of, you know,
[00:40:53.580]if you're gonna continue smoking,
[00:40:55.410]you might end up like this young man no longer has legs
[00:40:58.650]because you lost them
[00:40:59.730]due to something related to smoking.
[00:41:02.910]But they also provide you with a quit helpline.
[00:41:06.270]So if you see this and you're scared
[00:41:09.150]and you're spurned into action,
[00:41:11.670]then you could call the 1-800-QUIT-NOW number.
[00:41:15.210]If this message did not include
[00:41:17.430]that 1-800-QUIT-NOW number,
[00:41:20.400]it would more likely just scare people
[00:41:23.010]into just smoking more
[00:41:25.410]because there's nothing for them to change,
[00:41:28.080]there's nothing for them to do.
[00:41:29.850]Now there have been some fear campaigns
[00:41:31.830]that have been used for cannabis.
[00:41:34.500]There was one recently that talked about
[00:41:37.020]being, you know, using cannabis to such a degree
[00:41:39.150]that you could not get off your couch.
[00:41:41.520]And a lot of individuals
[00:41:43.260]reacted negatively to that advertisement, to that message
[00:41:46.200]because they felt it was unrealistic
[00:41:48.480]and they felt it was unnecessarily fearful.
[00:41:51.750]We do know based on Jessica and I's research
[00:41:55.200]that people do get what they call couch-locked
[00:41:57.870]after using cannabis
[00:41:58.980]and they will use cannabis sometimes so much
[00:42:01.890]that they purposefully
[00:42:03.030]so that they can get couch-locked,
[00:42:04.950]but they don't view it as something negative.
[00:42:07.530]And so again, that's where it's really important
[00:42:09.450]to understand the effects of the drug
[00:42:12.030]on the individuals who are using it,
[00:42:13.500]it's important to understand the level of fear,
[00:42:16.350]and it's also important to understand
[00:42:17.910]how your audience is gonna respond to such a message.
[00:42:23.040]Jessica.
[00:42:26.460]Thanks Stacey.
[00:42:27.750]The other one that we wanted to talk a little bit about
[00:42:29.520]was elaboration likelihood model.
[00:42:31.890]And so the elaboration likelihood model
[00:42:34.110]is this idea that people process information
[00:42:37.440]in two different routes or two different ways.
[00:42:40.350]And these two routes of persuasion
[00:42:41.760]include the central route and the peripheral route.
[00:42:44.520]And I use this image of the arrow on either side
[00:42:47.370]because it's actually kind of more of a spectrum
[00:42:49.590]and people don't process one way or the other all the time.
[00:42:53.340]But the central route would tell us
[00:42:54.840]that you are going to think hard
[00:42:56.880]about the information that's presented before you
[00:42:58.740]before you make that decision.
[00:43:00.780]So typically we end up using the central route
[00:43:03.210]if we have high motivation for something
[00:43:05.670]and we have the ability to do so.
[00:43:07.650]So I often use the example of purchasing a car.
[00:43:10.470]It tends to be, right, a larger investment
[00:43:12.870]in terms of money,
[00:43:13.703]you need to maybe get a loan, something like that.
[00:43:16.080]And so you might be centrally processing this decision,
[00:43:18.870]you're thinking, I need to get a car,
[00:43:20.190]but what does that car need to include, right?
[00:43:22.860]Does it...
[00:43:23.693]I live in Pullman, Washington,
[00:43:24.750]we get snow in the winter,
[00:43:26.760]I need something that can get over,
[00:43:28.980]you know, those snow drifts
[00:43:29.910]when they haven't had a chance yet
[00:43:31.050]to plow the roads early in the morning.
[00:43:33.690]I also need to be thinking through like,
[00:43:35.550]does it have the safety features that I want?
[00:43:37.500]Does it have the look that I want?
[00:43:39.090]All of these things.
[00:43:39.930]And if you're in the central route
[00:43:41.100]and you're processing that,
[00:43:42.420]you're thinking through all of these elements.
[00:43:45.060]On the other side of that is the peripheral route.
[00:43:47.100]And the peripheral route is one
[00:43:48.570]in which people can be influenced more by cues in a message.
[00:43:52.650]So for example,
[00:43:53.880]it might be something like source liking,
[00:43:56.040]source attractiveness when giving a message,
[00:43:58.080]kind of the overall appeal of a message,
[00:44:00.630]if you're using the peripheral route to process something,
[00:44:02.820]those cues matter more
[00:44:04.650]because you're really being kind of making that decision
[00:44:08.430]based on the things that you're seeing.
[00:44:10.320]But not so much this really cognitive,
[00:44:12.870]you know, process
[00:44:14.280]of thinking through your different options here.
[00:44:16.710]So with that peripheral route,
[00:44:17.790]this might be something like
[00:44:18.623]when you're making a decision about toothpaste,
[00:44:20.220]something that you feel like
[00:44:21.330]overall your motivation isn't super high,
[00:44:23.790]you don't need to read the ingredient list
[00:44:25.620]on every single toothpaste,
[00:44:26.820]you would go with the one that you tend to like,
[00:44:28.620]or you know, look at the model on that box had shiny teeth,
[00:44:31.410]that seems like a good idea and go with that.
[00:44:33.120]I like that flavor.
[00:44:34.020]Whatever that is.
[00:44:35.700]So this actually makes a difference in terms of messaging
[00:44:37.890]that we can use for prevention efforts as well.
[00:44:40.230]Because if we think
[00:44:41.063]that people are going to have high motivation
[00:44:42.990]to process a message as well as that ability,
[00:44:45.750]we wanna make sure that we're kind of countering
[00:44:47.400]some of the things that they might come back,
[00:44:50.520]come at us with in terms of criticisms of that message.
[00:44:53.850]If instead it's something
[00:44:55.020]where people maybe aren't paying a lot of attention,
[00:44:57.000]they haven't really worried about this
[00:44:58.860]and it's not a huge investment for them
[00:45:00.750]in terms of time, money, resources,
[00:45:02.520]whatever that would be,
[00:45:03.900]a message that's kind of jazzed up,
[00:45:05.430]looks really fancy,
[00:45:07.230]even if it doesn't have a lot of substance,
[00:45:08.700]can still be useful.
[00:45:10.260]But again, often people
[00:45:11.310]end up falling kind of on this middle ground.
[00:45:12.870]And so we have to make messages
[00:45:14.070]that can do a little bit of both
[00:45:15.720]and reach out to those different groups differently.
[00:45:17.700]So they need to look good,
[00:45:18.690]they need to have those good features,
[00:45:20.100]but also they need to have some of that substance
[00:45:22.230]and that information that might be convincing,
[00:45:24.570]especially if someone's going to process that information
[00:45:26.880]in a way that might be more central.
[00:45:29.760]I did wanna mention too some research that we've done
[00:45:31.690]where we've looked at how elaboration is impacted
[00:45:34.710]in terms of health messaging.
[00:45:36.720]So one thing that came up for me in particular
[00:45:38.400]was I was doing some work with a text message intervention,
[00:45:41.070]and in this work
[00:45:42.930]we were sending text messages to college students
[00:45:45.510]that promoted health behaviors.
[00:45:47.430]And in some feedback that I got when we were piloting,
[00:45:49.860]some of the students were like,
[00:45:50.820]you really need to include emoji with those messages.
[00:45:53.490]And so in traditional research fashion,
[00:45:55.320]instead of just putting emoji in,
[00:45:57.270]we started going like, what would that actually do?
[00:45:59.070]Right?
[00:45:59.903]How would that impact people?
[00:46:00.736]Because emoji, and that seems kind of,
[00:46:03.360]you know, younger and fun, sure,
[00:46:05.610]but is that still gonna be credible?
[00:46:07.410]We wanna be an authority in terms of the health information
[00:46:09.780]that we're putting out there.
[00:46:11.220]So is that going to have an impact here?
[00:46:13.350]And so we did a research study
[00:46:14.580]where we looked at this with college students
[00:46:16.350]and then a separate study
[00:46:17.340]where I looked at this with adolescents.
[00:46:18.960]And in both studies, what we essentially found
[00:46:20.610]was that using emoji in your health messaging
[00:46:23.640]does increase attention.
[00:46:25.170]So people are more likely to see your message
[00:46:27.300]and pay attention to it if it includes emoji.
[00:46:30.090]However, it did actually bring down
[00:46:32.160]the credibility of the message, a small amount.
[00:46:35.220]So I say that it was a small amount
[00:46:36.510]because you didn't go from like we're a credible source
[00:46:38.580]to we're now not credible.
[00:46:39.810]That wasn't the problem.
[00:46:41.160]But it decreased the credibility a tiny bit.
[00:46:43.320]So you were a little bit less credible
[00:46:44.730]than you were in the beginning.
[00:46:46.410]And I mentioned this because it shows kind of the nuance
[00:46:48.600]that this can have with our messaging decisions, right?
[00:46:51.150]Like this was something that was small,
[00:46:52.620]maybe we wouldn't always give it a lot of thought.
[00:46:54.630]We wanna relate to the students,
[00:46:56.100]students use emoji in their texts,
[00:46:58.080]we're gonna go ahead and do that.
[00:46:59.850]And in some cases,
[00:47:00.780]that could absolutely be the right decision
[00:47:02.640]because you're gaining attention.
[00:47:04.110]And that is really powerful
[00:47:05.400]in this over-media-saturated environment
[00:47:07.650]where people are seeing a lot of messaging
[00:47:09.720]a lot of the time.
[00:47:11.280]However, especially if you're an organization
[00:47:13.080]that's maybe not as well-known,
[00:47:14.550]doesn't already have credibility behind you,
[00:47:16.620]that's small hit to credibility
[00:47:18.660]might actually be really problematic for you.
[00:47:20.667]And so in that case,
[00:47:21.660]if you're concerned about credibility,
[00:47:23.160]you know, maybe it's something
[00:47:24.120]that you've been working for for a while
[00:47:25.800]and students still aren't really seeing your messages
[00:47:28.020]as resonating and credible,
[00:47:29.700]then including something like this
[00:47:30.720]might not be the ideal in that case.
[00:47:32.850]And even though it can draw that attention
[00:47:34.680]and they'll see it and it's kind of a peripheral cue,
[00:47:36.870]it might not necessarily lead to
[00:47:38.340]establishing that credibility
[00:47:39.420]in the way that you would hope.
[00:47:43.590]Okay, so I know those of you
[00:47:45.690]who attended earlier sessions today
[00:47:48.060]likely have already heard a little bit about social norms
[00:47:51.450]and many of you have probably ran a social norms campaign
[00:47:54.870]on your campus.
[00:47:55.860]In fact, can I get a show of hands?
[00:47:58.080]Those in the room and those of you who are virtual
[00:47:59.940]can include in the chat.
[00:48:01.020]How many of you have ran a social norms campaign
[00:48:03.930]on your campus already?
[00:48:06.600]Anybody?
[00:48:08.160]Okay, a couple of you.
[00:48:09.210]Excellent, great, I'm glad to see that.
[00:48:11.640]So social norms campaigns are really popular
[00:48:14.550]among campus health practitioners.
[00:48:16.980]They are an an easier way
[00:48:18.750]for us to reach our target audience.
[00:48:21.900]And I'm gonna talk a little bit about the way
[00:48:24.240]in which Jessica and I have ran social norms different
[00:48:26.970]and I'm gonna talk about this new way
[00:48:28.620]that she and I have been doing it
[00:48:30.000]and that I've been doing it for a few years
[00:48:32.010]and why I came up with a slightly
[00:48:34.530]adapted way of doing social norms interventions.
[00:48:37.860]So first, it's important
[00:48:39.000]that you collect the personal behaviors via the survey.
[00:48:42.990]So for example,
[00:48:43.890]we've collected data that says,
[00:48:45.330]that indicates as a result of drinking alcohol,
[00:48:48.150]I've had unprotected sex.
[00:48:49.590]And the mean is higher among the personal behaviors,
[00:48:53.550]but they estimate very high what their peers are doing.
[00:48:57.810]So this first norm is for young women,
[00:48:59.790]their actual personal behaviors on our campus,
[00:49:02.370]the second, perceived collective norms
[00:49:04.380]collected via survey.
[00:49:05.280]So these are the estimations of what their peers are doing.
[00:49:08.400]And in this regard,
[00:49:09.660]it's really important to understand the referent group.
[00:49:12.570]So when I first started doing research
[00:49:15.420]with college students,
[00:49:16.650]I did not segregate things by gender.
[00:49:19.590]Found very quickly that I had to segregate things by gender
[00:49:22.500]because alcohol,
[00:49:24.060]and especially the things that I study,
[00:49:26.100]substance use and sexual behaviors,
[00:49:28.620]differ significantly among men and women.
[00:49:31.920]But there's also different estimations
[00:49:33.390]of their peers' behavior.
[00:49:35.370]And then I started studying
[00:49:38.280]Greek life and fraternity and sorority members
[00:49:41.340]and I found that the referent group with those populations
[00:49:43.950]had to be very specifically
[00:49:45.660]their fraternity and or sorority peers.
[00:49:48.270]I could not use a referent group
[00:49:49.710]that was even just the general college student population
[00:49:53.310]because they did not identify with that referent group.
[00:49:55.920]So it's really important to understand
[00:49:57.390]what referent group you're gonna use.
[00:49:59.676]In this particular survey, we asked college women
[00:50:03.540]to report both themselves and their estimations of peers.
[00:50:06.210]And you can see the mean here is very different,
[00:50:08.130]a 4.72 as compared to 3.37.
[00:50:12.180]You do wanna make sure that that is significant difference.
[00:50:15.150]However, it's possible that it's not.
[00:50:16.920]So you run a t-test or a percent difference test
[00:50:20.580]to find out if there's a significant difference
[00:50:22.620]between the personal norm and the collective norm.
[00:50:25.770]But I encourage you not to to stop there.
[00:50:27.600]That's actually where quite a few people stop.
[00:50:29.460]And I encourage you not to stop there
[00:50:31.740]because I've done research with sexual consent and alcohol
[00:50:36.000]in which the perceived norm,
[00:50:38.610]the perceived collective norm
[00:50:39.810]is actually not significantly associated
[00:50:42.660]or correlated with the personal behavior,
[00:50:45.900]which means that it doesn't matter
[00:50:47.220]what our peers think or say,
[00:50:48.750]or what we think our peers think and say.
[00:50:51.150]The behavior is such a personal one
[00:50:52.980]that the norm is not,
[00:50:54.180]a norm corrective message is not going to change it.
[00:50:57.030]So in order to make sure that the norm corrective messaging
[00:50:59.790]is actually gonna have an effect,
[00:51:01.230]you wanna run a correlation
[00:51:03.000]between the collective norm and the personal behavior.
[00:51:05.340]And in this particular instance,
[00:51:06.750]the correlation is significant
[00:51:09.780]and it's a moderate correlation,
[00:51:11.330]which means that college women
[00:51:14.070]making a choice to drink alcohol and have unprotected sex
[00:51:18.480]is in some way impacted by
[00:51:20.220]what they estimate their peers are doing.
[00:51:22.680]So if we were to run a social norms campaign,
[00:51:26.220]to do this, we would use the percentage of individuals
[00:51:29.880]who say that they have not had unprotective sex
[00:51:34.050]as a result of drinking alcohol
[00:51:35.700]in order to try to change the misperception
[00:51:38.580]of that overestimation.
[00:51:40.650]Right, does that make sense to everybody?
[00:51:44.490]Looks like I'm getting a couple of nods.
[00:51:46.260]Okay, great.
[00:51:47.093]We'll go ahead and go through the next slide.
[00:51:49.719]The way we typically see social norms
[00:51:52.980]be distributed on campuses
[00:51:54.600]is through posters like this,
[00:51:55.920]or I've seen 'em on coasters,
[00:51:57.630]I've seen 'em on email,
[00:51:58.710]I've seen 'em on screensavers, on computers.
[00:52:01.440]It typically emphasizes the positive behavior.
[00:52:03.870]As I mentioned earlier,
[00:52:04.830]the referent group is important.
[00:52:06.840]I encourage people to make sure the message is simple.
[00:52:09.930]I actually think this message
[00:52:11.070]is almost a little too complicated.
[00:52:13.410]There's a lot going on on this poster.
[00:52:15.270]You really want the message itself to stand out.
[00:52:18.570]There are two different types of norms.
[00:52:20.280]Of course, there's the descriptive norm,
[00:52:22.050]which is the actual behavior,
[00:52:23.850]and the injunctive norm,
[00:52:25.020]which is the beliefs associated with the behavior.
[00:52:27.990]And so you might wanna use an injunctive norm
[00:52:31.110]if you're saying
[00:52:32.280]people think it's important to consider
[00:52:34.080]the serving sizes of cannabis, for example, before using,
[00:52:37.800]or an injunctive norm might be
[00:52:40.350]that people think it's okay to say no
[00:52:42.810]to a drink or to refuse a drink
[00:52:44.940]if you choose not to consume alcohol.
[00:52:47.670]It is important to consider graphics.
[00:52:50.580]I always love going to conferences
[00:52:52.140]and looking at social norms posters,
[00:52:54.300]and talking with message designers
[00:52:56.490]who maybe didn't consider their graphics
[00:52:58.920]prior to the poster.
[00:52:59.850]I've done this myself,
[00:53:02.190]you know, sometimes you'll have a message
[00:53:03.720]that's contradictory.
[00:53:04.890]So it's a message
[00:53:05.723]that's actually about partying atmosphere
[00:53:08.640]when you're trying to tell people not to drink.
[00:53:10.680]Or my favorite one was a social norms message used years ago
[00:53:15.780]in which they showed college students getting sick
[00:53:18.450]in a toilet.
[00:53:20.340]And their whole message was about moderation.
[00:53:22.890]And a bunch of us got together and pointed out,
[00:53:25.800]if you're drinking in moderation,
[00:53:26.910]you're not gonna be vomiting.
[00:53:28.020]So that image is inconsistent
[00:53:30.420]with what you're asking people to do.
[00:53:32.400]And in part, this hearkens back
[00:53:33.990]to the elaboration likelihood model
[00:53:35.820]that Jessica talked about,
[00:53:37.350]because if the message is so,
[00:53:39.870]if the visual, rather,
[00:53:41.640]is so important and so eye eye-catching,
[00:53:43.830]like perhaps seeing somebody get sick,
[00:53:46.410]you're gonna see the mess, the visual
[00:53:48.570]more than you are the text cue.
[00:53:51.660]And so you're gonna process that visual
[00:53:53.550]more in the periphery,
[00:53:55.170]but it doesn't mean it's not gonna stick, right?
[00:53:57.390]And so what people may take away from your message
[00:54:00.390]is that it's okay to get drunk enough to get sick,
[00:54:03.150]which is counter to
[00:54:04.281]what the message designers wanted.
[00:54:07.357]Now, like I mentioned before,
[00:54:09.060]I've been working with college students
[00:54:10.950]and trying to correct norms
[00:54:12.330]for almost a decade at this point
[00:54:15.240]with our fraternity and sorority members.
[00:54:17.640]And this is all sponsored by our Great Place Grant.
[00:54:21.120]And what I have found is fraternity and sorority members,
[00:54:24.720]because they see so many messages,
[00:54:26.670]they're really not too keen
[00:54:28.140]on getting more social norms content.
[00:54:30.720]They kind of know what we're doing.
[00:54:33.180]So what I started doing was embedding it
[00:54:36.300]in content that would be otherwise entertaining to them.
[00:54:39.270]And so I developed what's called
[00:54:41.430]a narrative-based social norms message.
[00:54:45.090]We create these little (indistinct)
[00:54:47.910]or these little emails
[00:54:49.200]in which we talk about fraternity and sorority life.
[00:54:52.530]When we do this and we're well funded,
[00:54:54.540]we actually create a newsletter
[00:54:56.400]that includes some prevention content
[00:54:58.170]and some non-prevention content,
[00:55:00.960]because college students love to read about themselves.
[00:55:03.960]And so they love reading and seeing stories
[00:55:06.240]about their philanthropic events
[00:55:07.770]or about their, you know, Greek life and what's coming up
[00:55:11.760]in addition to reading about the prevention content.
[00:55:14.850]Here this is sort of a combo
[00:55:16.860]of using social cognitive theory with social norms
[00:55:20.100]in that we include the social norms content
[00:55:22.650]as a pullout quote.
[00:55:23.797]"So 89% of WSU fraternity members
[00:55:26.107]"have not gotten into a fight at a party
[00:55:28.597]"as a result of drinking too much alcohol."
[00:55:31.290]But we also embed it in a narrative story.
[00:55:34.530]And so these stories are created
[00:55:36.330]based on a lot of in-depth interviews
[00:55:39.990]in which we've collected testimonials from individuals.
[00:55:42.900]We actually usually have a steering committee
[00:55:44.940]in which we involve members of a target audience
[00:55:47.117]to help us write the stories.
[00:55:48.870]And then the stories are fictionalized,
[00:55:50.670]although they are based on reality.
[00:55:52.890]And in this particular story,
[00:55:54.270]we had a scenario in which a guy
[00:55:57.300]was maybe gonna get into a physical fight
[00:55:59.160]and he decided not to.
[00:56:00.990]And so again, we're modeling the behavior
[00:56:04.440]of not getting into a fight.
[00:56:06.390]And then we are reminding the reader
[00:56:09.180]that others are just like this character,
[00:56:12.060]they also don't get into fights.
[00:56:14.520]And so that's one way
[00:56:15.420]that we've been using social norms quite successfully.
[00:56:19.290]So before we go on to discuss additional messaging
[00:56:23.250]that Jessica and I have found to be strong,
[00:56:26.190]what I'd like to do
[00:56:27.240]is to ask those of you in the audience
[00:56:30.210]to take a moment to do an activity.
[00:56:32.730]And this is gonna be a little bit hard
[00:56:34.230]in a hybrid environment,
[00:56:35.640]but I am committed to making this work.
[00:56:38.760]So what I would like to do
[00:56:41.100]is to have you get into groups of two or three,
[00:56:44.550]and I would like you to pick one of the theories
[00:56:47.220]that we discussed today,
[00:56:48.510]so social cognitive theory,
[00:56:50.580]elaboration likelihood model,
[00:56:52.080]stages of change theory,
[00:56:54.540]or social norms theory,
[00:56:56.010]so one of those four theories,
[00:56:58.980]and create a message that you think will be,
[00:57:04.230]that you think would work with your,
[00:57:07.410]in your campus, on your campus.
[00:57:09.960]And it can be on cannabis,
[00:57:11.400]it can be on alcohol,
[00:57:13.230]it could be on tobacco, if you prefer.
[00:57:15.450]But I just want you to take a stab at creating a message.
[00:57:17.700]The message doesn't,
[00:57:18.561]you don't have to think about the visuals or anything,
[00:57:20.580]think about the message itself,
[00:57:22.230]and think about the theoretical foundation of that message.
[00:57:25.710]So if you could take maybe say five,
[00:57:28.470]five to 10 minutes,
[00:57:29.520]and then I'll ask you to report back
[00:57:32.610]what you found in that message creation.
[00:57:35.100]And Jessica and I'll take a moment to discuss it
[00:57:37.590]with those of you who choose to share.
[00:57:40.440]Okay, so we'll take five or 10 minutes.
[00:57:41.880]Please do that.
[01:02:25.030]We're just gonna take about two more minutes,
[01:02:27.180]so go ahead and keep going for about two more minutes
[01:02:29.040]and then we'll pop back and have a discussion.
[01:03:18.090]Okay, so I'd love to hear
[01:03:19.560]what some of you came up with in the room.
[01:03:22.050]So are there a couple of groups
[01:03:23.700]that are interested in sharing?
[01:03:28.410]Yeah, we've been having some great conversations.
[01:03:30.930]It looks like some groups are wrapping up.
[01:03:33.540]Do we wanna do like maybe one more minute to wrap up?
[01:03:36.660]Absolutely.
[01:03:38.880]Okay, great. Thank you.
[01:03:47.220]Okay, it looks like we all wrapped up.
[01:03:51.330]Okay, great.
[01:03:52.830]Did I have a couple of people from the room
[01:03:55.110]share the messages that they came up with
[01:03:57.390]and why they felt it would work
[01:03:59.130]at their particular university?
[01:04:12.720]I think this is harder than expected to begin.
[01:04:16.980]And I may add,
[01:04:18.330]is social norming kind of a new concept for some of you,
[01:04:22.010]or at least, you know, even if your campus does it,
[01:04:24.900]maybe you are like behind it?
[01:04:27.570]So that seems to be like
[01:04:28.950]maybe why this was a little bit of a harder...
[01:04:35.991]I'll take a stab.
[01:04:37.319]Okay. Do it. Yes.
[01:04:41.113]I don't know what my score will be on the assignment,
[01:04:43.470]but I'll take a stab.
[01:04:45.930]I don't,
[01:04:46.763]I guess when you mentioned that,
[01:04:48.750]I was thinking about social norming for us,
[01:04:51.750]we were at UNO, we work in caps,
[01:04:54.090]a couple of us grouped together,
[01:04:55.680]we went for four instead of two.
[01:04:57.150]So sorry, we also cheated.
[01:04:59.700]You used our resources.
[01:05:02.130]So social norms around finals week
[01:05:05.280]and the first week of school
[01:05:06.510]like we have a lot of events
[01:05:08.040]around the stress of finals week,
[01:05:09.810]so we have de-stress fest
[01:05:11.370]and that is marketed very largely across campus
[01:05:15.660]and different departments and stuff.
[01:05:16.950]So we didn't necessarily come up with a quote per se,
[01:05:23.070]but we were talking a little bit about
[01:05:25.440]the kind of reward and punishment
[01:05:27.240]of social rewards and punishments.
[01:05:30.990]So if I said I started picturing an image
[01:05:33.840]when we were talking about social cognitive theory setting
[01:05:37.950]and relevance that like the library,
[01:05:39.870]everybody's going to the library to study for finals,
[01:05:43.050]so can we show an image of someone like doing a meditation
[01:05:47.673]or a calming technique that's like, that's okay,
[01:05:50.550]and a good stress reduction,
[01:05:53.490]and that if someone's trying to like sneak a vape,
[01:05:55.117]you know, and like calm down by getting high
[01:05:58.620]and looking really guilty and nervous, like,
[01:06:00.420]oh I hope I don't get caught in the library doing this.
[01:06:03.510]That maybe that would be kind of a social punishment,
[01:06:06.090]like if you got caught or someone saw you doing that.
[01:06:08.820]Both are trying to reduce stress,
[01:06:11.160]but one is like rewarded
[01:06:12.630]and one is shamed or punished, I guess.
[01:06:15.270]So what did we say?
[01:06:18.300]Calming down without getting called out,
[01:06:20.670]something like that.
[01:06:21.503]Oh, I love that.
[01:06:23.490]I love that.
[01:06:24.323]So, you know, I actually,
[01:06:26.700]I would give you an A plus for a variety of reasons.
[01:06:31.260]But first I really love that you thought about the setting
[01:06:34.980]and where your audience in particular
[01:06:38.310]may see your message and have it resonate with them.
[01:06:41.070]That's really important.
[01:06:42.960]I also like that you're focusing on the positive behavior
[01:06:46.380]and emphasizing the positive behavior.
[01:06:48.750]My only caution and this is true
[01:06:50.460]of any time that you're dealing with substances
[01:06:52.800]is we wanna be careful not to stigmatize users, right?
[01:06:58.140]Because number one,
[01:06:59.130]well, in our state, it's legal
[01:07:00.390]for many of our students to use,
[01:07:02.640]but we also, even if it were illegal for them to use,
[01:07:05.370]even if we think it's the worst idea for them,
[01:07:08.310]we don't want 'em to feel bad about using,
[01:07:10.560]because, again, that can be kind of borderline
[01:07:12.690]onto that fear appeal.
[01:07:14.550]And so I think I love where you're going with it
[01:07:17.130]and this is a challenging task
[01:07:19.080]and it's not meant to be perfect.
[01:07:21.660]It's hard to do over Zoom,
[01:07:22.740]but it's also hard to do with such a short period of time.
[01:07:25.740]But I love what you were thinking.
[01:07:27.120]So kudos, excellent job.
[01:07:29.520]Anybody else in the room willing to share what they have?
[01:07:37.142]I have a question. Okay.
[01:07:41.040]So mine's more kind of question focused.
[01:07:45.330]Is there, I guess, experience or advice that you can give
[01:07:48.390]like on using current trends and reshaping that message?
[01:07:52.710]So we kind of discussed like the Borg thing,
[01:07:56.340]which is like the blackout rage gallon,
[01:07:58.320]and how you can kind of spin that message
[01:08:00.450]instead of blacking out,
[01:08:01.860]you can fill your gallon with water
[01:08:03.360]and drink 100 ounces of water instead.
[01:08:06.510]So kind of using current trends
[01:08:08.040]and changing those a little bit
[01:08:10.320]or does that kind of fall into a
[01:08:12.450]like shameful type of approach?
[01:08:15.780]I don't think it necessarily has to fall into
[01:08:17.790]the shameful approach,
[01:08:18.900]but what I would tell you is that in my experience,
[01:08:21.450]sometimes relying on the trends
[01:08:24.450]or using something that's trendy
[01:08:27.120]has sometimes backfired for me.
[01:08:28.860]So I'm gonna use a very concrete example
[01:08:31.860]of something that was popular.
[01:08:33.660]Oh, at this point, it's probably been close to 10 years ago.
[01:08:37.530]So I was heavily involved in a campus campaign
[01:08:40.290]against sexual assault.
[01:08:41.700]I was funded by the U.S. Department of Education.
[01:08:44.340]We were creating messages
[01:08:46.680]to get people to not only ask for (indistinct)
[01:08:50.040]and adhere to people's decision-making,
[01:08:51.990]but also to refuse consent behavior.
[01:08:55.260]And so we had a steering committee,
[01:08:56.760]which I often encourage health practitioners to do.
[01:09:00.230]We had a steering committee
[01:09:01.500]in which we had people from our campus,
[01:09:04.290]college students, undergraduates, Greek members
[01:09:07.410]who were helping us come up with ideas.
[01:09:09.750]And our steering committee was like,
[01:09:11.220]have you guys heard of these stoplight parties?
[01:09:14.340]These are such a hot topic right now
[01:09:17.040]and everybody's doing them.
[01:09:19.110]You should do a messaging around stoplight parties.
[01:09:22.290]So for those of you who don't know,
[01:09:23.940]stoplight parties were parties
[01:09:25.680]in which people dressed in a certain color
[01:09:28.950]to indicate their sexual availability.
[01:09:31.950]There was actually a "Law & Order SVU" episode
[01:09:34.680]highlighting stoplight parties
[01:09:36.120]around the time that it was popular on college campuses.
[01:09:39.330]So if you were green,
[01:09:40.560]you were communicating
[01:09:41.610]that you were sexually available and interested.
[01:09:44.130]If you were yellow,
[01:09:45.270]you were cautious.
[01:09:46.770]So maybe you could approach me,
[01:09:48.270]but I'm not sure I'm gonna say yes.
[01:09:50.580]And red was hands off,
[01:09:51.930]I'm not interested at all.
[01:09:54.300]And I loved this idea.
[01:09:55.870]I was like, oh my gosh,
[01:09:56.970]we're gonna be so topical,
[01:09:58.320]we're gonna be so trendy
[01:09:59.490]and they're just gonna love us.
[01:10:01.170]So we created a number of messaging
[01:10:03.270]around stoplight parties.
[01:10:05.040]And when we went to market test,
[01:10:07.380]which is taking it to other members
[01:10:09.330]outside of our steering committee
[01:10:10.560]to see what people thought of it,
[01:10:12.450]it fell completely and utterly flat.
[01:10:15.360]And the reason why it fell flat
[01:10:17.370]is because the college students were angry
[01:10:19.080]that we knew about this party,
[01:10:21.390]these types of parties.
[01:10:23.280]They felt offended that we were trying to be like them.
[01:10:28.380]And the message that we received was quite clearly,
[01:10:31.410]you're not like us,
[01:10:32.520]you're not one of us.
[01:10:33.480]So don't try to be like one of us.
[01:10:35.580]And so for our particular population,
[01:10:37.320]it didn't work.
[01:10:39.090]Now it could be that we just had a really poor message,
[01:10:41.490]but I don't, I don't think so.
[01:10:42.840]I think in part with college students in particular,
[01:10:46.530]sometimes their trends are things
[01:10:48.930]that they want to have for themselves
[01:10:52.350]that comes in
[01:10:53.610]that message can fall flat
[01:10:55.170]if it's too much like their,
[01:10:58.500]like their daily lives.
[01:10:59.880]So what I would encourage you to do
[01:11:01.920]is if you come up with something like,
[01:11:04.860]I like your idea,
[01:11:06.510]but I would run it by a few college students on your campus
[01:11:10.020]to see how they would respond
[01:11:12.510]so that you could avoid the situation that we had
[01:11:14.400]where we created a number of messages
[01:11:15.840]around the topic that (indistinct).
[01:11:17.610]Jessica, do you have other guidance or thoughts about that?
[01:11:21.390]It's just kind of related but different.
[01:11:23.160]So I'm gonna be that person.
[01:11:24.240]But I was gonna say, too,
[01:11:25.620]I had some students,
[01:11:26.550]graduate students who were really interested in that topic
[01:11:28.590]in my class most recently.
[01:11:30.540]We were talking about methods and some things
[01:11:32.910]and one wanted to create a campaign
[01:11:35.070]where you would promote taking your gallon jug
[01:11:38.640]and instead of putting alcohol in it,
[01:11:40.260]just not spiking it, right?
[01:11:41.640]Just have a gallon jug
[01:11:42.600]that includes crystal light or whatever.
[01:11:44.910]And then people could feel like they're participating
[01:11:47.010]but not actually participate.
[01:11:48.420]And so she was really interested
[01:11:49.860]in doing this type of a campaign
[01:11:51.030]that would help people feel like,
[01:11:53.460]you know, kind of that idea like
[01:11:54.360]you drink club soda at a party and nobody really knows
[01:11:56.610]that if you're having alcohol or not.
[01:11:58.410]And I was really, really cautious in saying like,
[01:12:00.810]I actually think you should be really careful
[01:12:02.850]and consider if that's actually a good strategy
[01:12:04.770]because it might be challenging in that
[01:12:06.720]if you actually have more people
[01:12:07.920]who are carrying around the jugs
[01:12:09.030]and pretending that they're getting,
[01:12:10.470]you know, engaging in this behavior,
[01:12:12.690]it actually might increase norms around it, right?
[01:12:15.060]And make people think that it's a more common behavior
[01:12:16.950]than it really is.
[01:12:18.240]And so this is one of the tricky things
[01:12:19.650]that we see with health communication interventions, too,
[01:12:21.720]is sometimes what you're seeing
[01:12:23.490]doesn't always align with the messaging.
[01:12:24.930]And so this is also something like
[01:12:26.310]in food products, for example,
[01:12:28.320]when people are saying like, oh, you know,
[01:12:29.610]maybe you don't eat as many greasy cheeseburgers
[01:12:31.980]and they put a greasy cheeseburger picture on the image,
[01:12:34.830]people then want the cheeseburger.
[01:12:36.330]They're like, it looks delicious and I want that.
[01:12:38.850]And so sometimes we also have to be cautious.
[01:12:40.710]So I know that wasn't your exact example,
[01:12:42.240]I'm not saying it was,
[01:12:43.440]but I just think it leads to this bigger discussion too
[01:12:45.540]about unintended effects.
[01:12:47.100]And so I'm sure a lot of you
[01:12:48.150]are thinking about those things in your efforts,
[01:12:50.220]but sometimes it's something
[01:12:51.150]we don't necessarily think about right away.
[01:12:53.280]And that's where that steering committee
[01:12:54.630]or advisory committee can also be helpful.
[01:12:56.430]Like, how would you take this message?
[01:12:58.260]You know, what's the good, what's the bad,
[01:13:00.150]what are the things we need to think about?
[01:13:01.830]And that's just one example from that, too.
[01:13:06.210]And I think your question
[01:13:08.370]really highlights the importance of that market testing.
[01:13:12.480]So I once gathered a social norm survey
[01:13:15.360]in which a large majority of
[01:13:18.630]fraternity and sorority men and women
[01:13:21.120]were saying that they help their peers
[01:13:23.700]if their peers have over-consumed alcohol.
[01:13:26.670]So I was really excited.
[01:13:28.260]I was like, yes, we're having a change,
[01:13:29.700]you know, we're affecting change here.
[01:13:31.050]This is really great.
[01:13:33.289]So I was getting ready to design a messaging
[01:13:35.400]around this great number of people
[01:13:37.320]that were helping their friends
[01:13:38.520]who were too drunk to help themselves.
[01:13:41.490]And I did some market testing around the message and I said,
[01:13:44.970]well, what does this mean to you?
[01:13:46.200]What does helping a peer mean?
[01:13:48.360]And to my utter complete dismay,
[01:13:51.840]what it meant to our members of our target audience
[01:13:54.210]was that they took the shoes off,
[01:13:56.010]they took their friends' shoes off at a party
[01:13:59.520]because on our campus for a while,
[01:14:01.320]if you passed out drunk with your shoes on,
[01:14:05.040]that meant nobody was taking care of you.
[01:14:06.810]And it was free,
[01:14:07.950]you were free to be marked on by people.
[01:14:10.320]You could have people draw on your face with Sharpie,
[01:14:12.840]you could have people put fake tattoos on you,
[01:14:15.570]anything was game.
[01:14:17.100]But if your shoes were taken off,
[01:14:18.750]that meant that people were looking out for you
[01:14:20.610]and you were off limits.
[01:14:22.350]But this seems ridiculous to me
[01:14:24.210]as I'm sure it might seem to some of you in the room,
[01:14:26.820]but I realized pretty quickly
[01:14:30.090]that I couldn't use the statistic,
[01:14:31.560]I couldn't use the social norms
[01:14:33.030]because I couldn't be sure
[01:14:35.190]that the way I was interpreting helping a friend,
[01:14:37.290]which would be things like making sure they got home safe
[01:14:39.930]and making sure that, you know,
[01:14:41.910]that they were not vomiting or potentially,
[01:14:44.220]you know, getting sick from having too much alcohol,
[01:14:47.137](indistinct) were safe.
[01:14:49.170]The way I was interpreting that
[01:14:50.610]was not necessarily the way
[01:14:51.960]my respondents were interpreting that.
[01:14:55.260]And so after that,
[01:14:56.880]when I did another social norm survey,
[01:14:58.470]I was really clear,
[01:14:59.760]have you helped a friend by
[01:15:01.560]walking them home
[01:15:03.210]or making sure that they have not drinking so much alcohol
[01:15:07.083]that they're going to get sick?
[01:15:09.000]Because I couldn't just use kind of that generic statement.
[01:15:12.510]So I think it's really important
[01:15:14.340]to market test your messages
[01:15:15.600]and to see how members of your target audience
[01:15:17.820]are gonna respond and interpret those messages.
[01:15:20.430]And I know that can sometimes be costly
[01:15:22.410]and it sometimes takes a lot of time,
[01:15:24.900]but in the end, your message will be more effective.
[01:15:28.380]Well, I really appreciate those of you who shared,
[01:15:30.660]wish we could get through all of you.
[01:15:32.250]I wanna go through a couple of of sample messages here
[01:15:35.610]that Jessica and I have done,
[01:15:37.710]that have been effective
[01:15:40.080]at reducing at least intentions to use products.
[01:15:44.040]And then we wanna make sure that we have time
[01:15:45.750]for some additional questions at the end.
[01:15:47.850]So this message that I think has been up on the room
[01:15:50.400]for a number of minutes while you worked,
[01:15:53.370]this is a message that Jessica and I created together
[01:15:56.610]in which we use social cognitive theory
[01:15:58.980]with a mobile media kind of approach.
[01:16:01.290]So we kind of created a texting messaging here
[01:16:04.950]and Jessica did this
[01:16:06.240]where she actually texted information out to individuals
[01:16:09.780]and I've done it where I've created it
[01:16:11.670]in a print version or an electronic version
[01:16:14.250]where it just looks like a text message.
[01:16:16.350]So here the idea is that someone, you know,
[01:16:20.070]is kind of questioning their own intentions
[01:16:23.220]and they're talking to a friend
[01:16:25.260]and then they do the behavior that we're wanting them to do.
[01:16:27.930]So this is a narrative-based social norms message,
[01:16:30.600]although we don't include the social norms here
[01:16:34.140]in this particular slide.
[01:16:35.940]Go ahead, Jessica.
[01:16:36.773]This is our most recent work.
[01:16:39.540]Jessica and I are trying to figure out
[01:16:41.340]how we can create more cost-effective
[01:16:44.670]and time-efficient messaging
[01:16:47.736]around topics that typically required a gendered response,
[01:16:52.770]in our particular population,
[01:16:54.210]we have a number of non-binary individuals
[01:16:57.420]who do not respond to either male or female,
[01:16:59.880]which means we would need to segregate by gender
[01:17:03.120]using multiple types of messaging.
[01:17:05.670]And so we were trying to see
[01:17:07.320]if we used just the neutral they them
[01:17:11.310]as opposed to male or female,
[01:17:12.930]would that work?
[01:17:14.130]And what we found was,
[01:17:15.900]so what we did, just to back up,
[01:17:17.280]is we used this kind of modeling, narrative modeling
[01:17:21.420]where we had a text messaging going back and forth,
[01:17:24.750]and then embedded in the text message was our norm, right?
[01:17:29.220]So it was kind of an adaptation of a narrative norm.
[01:17:32.400]And what we found was that
[01:17:34.617]the they them message worked
[01:17:38.431]and our audience members identified with it
[01:17:42.120]and it seemed to be effective.
[01:17:43.770]However,
[01:17:45.390]gender is so ingrained
[01:17:48.060]that even in the they them condition,
[01:17:50.970]we had students who perceived that the character was female
[01:17:55.110]based solely on the character's actions.
[01:17:59.010]So in this particular scenario,
[01:18:01.470]the individual consumes too much alcohol,
[01:18:04.770]has sex worries that they have contracted an SCI.
[01:18:08.520]So goes and gets tested.
[01:18:10.410]And our respondents felt
[01:18:12.240]that the fact that the person went and got tested
[01:18:14.250]meant that they were a woman
[01:18:15.900]as opposed to a guy.
[01:18:16.920]'Cause apparently in their minds,
[01:18:18.480]a guy would be less likely to do that.
[01:18:21.030]So we have to play around with this a little bit more
[01:18:23.280]and figure out what we can do differently
[01:18:25.710]in order to make these messages more effective.
[01:18:28.470]But that's kind of one area of work
[01:18:30.510]that we're trying to work on
[01:18:31.980]to see if we can make it more gender-neutral
[01:18:34.830]so that it can relate to all of our participants
[01:18:37.320]as opposed to just those who choose a binary gender.
[01:18:41.040]Go ahead, Jessica.
[01:18:43.050]Thanks Stacey.
[01:18:44.520]And then another example that we wanted to talk about
[01:18:46.290]was a series of messages that we created
[01:18:48.720]that were either narrative or non-narrative.
[01:18:51.120]And they were aimed at harm reduction
[01:18:53.910]related to cannabis use during pregnancy.
[01:18:56.520]So research has found that use of cannabis during pregnancy
[01:18:59.940]has also been increasing.
[01:19:01.800]And we worked with some individuals
[01:19:03.780]in the college of nursing
[01:19:05.160]who've been looking at this
[01:19:06.240]also to talk about
[01:19:07.950]how could we make messaging
[01:19:09.210]that might help combat some of that
[01:19:10.920]and reduce these behaviors.
[01:19:13.380]And so we created a series of messages.
[01:19:15.210]There was a narrative version,
[01:19:17.010]so it had a story format,
[01:19:18.150]and there was a version that had no story,
[01:19:19.710]but just the factual information for some of it.
[01:19:22.350]So what you're seeing here
[01:19:23.310]is one of the non-narrative versions,
[01:19:25.800]and these were about science messages
[01:19:28.170]and the relationship between THC and the placenta.
[01:19:30.660]And basically that THC can cross a placenta
[01:19:33.420]and then impact the developing fetus.
[01:19:35.790]And so you see messages here,
[01:19:37.500]like when you're pregnant,
[01:19:38.490]the things you consume, like caffeine,
[01:19:40.050]can travel from your blood to the baby through the placenta.
[01:19:42.450]THC, the substance that makes you feel high
[01:19:44.610]when you use marijuana,
[01:19:45.600]also crosses the placenta and can reach the baby.
[01:19:48.060]Giving up marijuana when pregnant
[01:19:49.350]can keep THC away from your developing baby.
[01:19:51.840]This was one sample of messages
[01:19:53.460]and we put this one here to also highlight
[01:19:55.080]this was kind of what the information behind it looks like.
[01:19:57.540]But then we also did a version that had a storyline to it
[01:20:01.140]where characters were talking to each other
[01:20:03.420]and engaging in discussion.
[01:20:05.370]And when making these messages,
[01:20:06.690]it was actually really important to us
[01:20:08.280]not to stigmatize the behavior
[01:20:10.380]because we wanted people to be able to reach out for help
[01:20:12.630]if they needed it,
[01:20:13.463]we wanted them to feel comfortable
[01:20:14.370]talking to their physicians.
[01:20:15.570]And actually that's not the case right now.
[01:20:18.330]The research shows that pregnant women,
[01:20:20.430]if they have used or are considering using cannabis,
[01:20:22.680]are actually not very likely
[01:20:23.910]to talk to their physicians about it.
[01:20:25.650]Even if they're thinking that they wanna quit
[01:20:27.240]or reduce their use,
[01:20:28.770]they don't feel comfortable having those discussions.
[01:20:30.570]And so we definitely didn't wanna stigmatize that behavior.
[01:20:33.420]And there's a lot of things
[01:20:34.253]that go into making your message.
[01:20:35.490]We also considered a lot of things
[01:20:36.690]like what the images should look like.
[01:20:38.730]This particular campaign included a lot of pre-testing.
[01:20:42.690]So we ended up doing things where we asked
[01:20:45.210]individuals who had used cannabis previously
[01:20:48.510]and been pregnant,
[01:20:49.343]some had used during pregnancy and some had not,
[01:20:51.600]and we were asking them specifically,
[01:20:53.340]you know, what types of messages would be appealing to you?
[01:20:55.920]Here's the storyline that we have.
[01:20:57.900]What were your own experiences related to these things
[01:21:00.480]so they're similar or different?
[01:21:02.070]So we were trying to use settings that were very similar,
[01:21:04.110]for example.
[01:21:05.010]So the one you're seeing here was a friend set up,
[01:21:07.110]but another set of our messages
[01:21:08.850]included romantic partners
[01:21:10.680]in a more heterosexual relationship
[01:21:12.420]because a number of our participants
[01:21:13.770]said that was kind of where they talked about
[01:21:15.270]their cannabis use with a partner.
[01:21:17.550]And so all of these things
[01:21:18.540]kind of featured into our decisions
[01:21:20.250]about how to create these messages
[01:21:21.660]in a way that would hopefully be impactful.
[01:21:23.700]And again, it shows how you can use those theories
[01:21:25.440]to kind of guide some of your message development
[01:21:27.270]and some of the decisions that you're making around those.
[01:21:34.890]Yeah, and so our final example
[01:21:37.230]is something that we've been creating
[01:21:39.593]and that Jessica and I have been working on,
[01:21:42.450]which is about trying to educate individuals
[01:21:45.660]about cannabis use.
[01:21:47.130]And in particular,
[01:21:48.180]it goes all the way back to the first part
[01:21:49.620]of our presentation about cannabis products.
[01:21:52.740]So as we told you,
[01:21:54.450]in Washington State,
[01:21:55.560]a number of adolescents and young adults
[01:21:57.330]are familiar with cannabis products.
[01:21:58.890]It's legal in our state for people to use the products
[01:22:01.116]after age 21.
[01:22:02.910]But what we're finding is that
[01:22:04.830]not only are they not aware of the products,
[01:22:06.900]but there's a lot of myths around the products, right?
[01:22:10.200]So for example,
[01:22:11.430]they're not aware of the potency level of products,
[01:22:13.980]they don't understand the serving sizes
[01:22:16.800]and they don't even understand
[01:22:18.300]the wide variety of products
[01:22:19.830]that are available on the market.
[01:22:21.930]And so what we've done is to create an intervention
[01:22:26.820]that is around product literacy
[01:22:28.410]where we teach people about the products,
[01:22:30.450]we help them understand
[01:22:31.980]the different types of products that are available.
[01:22:34.320]The intervention does have an abstinence message,
[01:22:36.900]but it also acknowledges
[01:22:38.610]that a high percentage of individuals in our state
[01:22:41.640]who over the age of 21
[01:22:42.750]are gonna choose to use.
[01:22:44.400]And those who are under age 21
[01:22:46.170]are likely going to at least be exposed to these products
[01:22:49.260]if not use themselves.
[01:22:51.420]And so it also talks about
[01:22:54.210]if you choose to use the products,
[01:22:55.710]here's what you should be thinking about when you do.
[01:22:58.470]And what we have found is that
[01:23:00.720]the intervention in its very initial test
[01:23:03.720]was positively associated
[01:23:05.790]with greater knowledge about cannabis.
[01:23:07.410]And for those individuals who had not used cannabis,
[01:23:10.560]it encouraged them not to use cannabis.
[01:23:12.870]For those of them had been using it,
[01:23:15.150]it helped them understand a little bit better
[01:23:16.950]the serving sizes and the warning labels
[01:23:19.620]and that sort of thing.
[01:23:21.300]So we actually just written a large NIH grant proposal
[01:23:26.040]in hopes that we'll get some additional funding
[01:23:28.590]to further test this intervention
[01:23:30.480]to see if it can be useful.
[01:23:32.430]One of the things that Jessica and I think
[01:23:35.730]as far as researchers go in relation to cannabis
[01:23:38.580]is it's not gonna go away.
[01:23:40.620]There is this perception
[01:23:41.580]and we've run into it a little bit
[01:23:43.020]with people thinking that
[01:23:44.580]abstinence is the only message we can give
[01:23:47.340]around cannabis to young people.
[01:23:49.440]And while I firmly believe that young people,
[01:23:52.020]especially those under the age of 27,
[01:23:54.390]should avoid cannabis.
[01:23:56.400]It's just not the reality.
[01:23:57.630]Especially in a state like ours,
[01:23:59.220]which has had legal cannabis for over a decade.
[01:24:03.000]And so because it's not the reality,
[01:24:04.740]we have to now figure out
[01:24:06.030]how to help people think about using cannabis
[01:24:08.580]in a way that is gonna prevent misuse
[01:24:11.700]and in the most educated way possible.
[01:24:14.070]And so that's what we've been working on most recently.
[01:24:18.390]So we're open to any kind of questions
[01:24:21.720]related to the work that we're doing.
[01:24:24.360]You have access to our emails as well.
[01:24:27.360]Feel free to reach out to us.
[01:24:29.370]Jessica and I are really committed to helping
[01:24:32.520]individuals across the country
[01:24:34.050]create messaging around cannabis use in particular
[01:24:38.160]that can be helpful for their communities.
[01:24:40.260]So feel free to reach out to us
[01:24:41.370]specifically if you have additional questions.
[01:24:43.110]But we'd open the floor today.
[01:24:44.850]I think we have about five minutes left for questions.
[01:24:49.950]Any questions?
[01:24:55.200]Okay, well thank you both so much for all the information
[01:24:58.650]and for being here today.
[01:25:00.780]We all greatly appreciate it.

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Youth, Cannabis, & Media: Understanding Appeals and Effects and Implications for Prevention

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