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LETTER |
Steven H. Kelder is with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston. Cornelia Pechmann is with the Graduate School of Management, University of California, Irvine. Michael D. Slater is with the Department of Journalism and Technical Communication and the Department of Psychology, Colorado State University, Ft Collins. John K. Worden is with the Office of Health Promotion Research, University of Vermont, Burlington. Drs Kelder, Pechmann, and Slater are members of the Behavior Change Expert Panel, of which Dr Worden is chairman. Alan Levitt is director of the National Youth Anti-Drug Media Campaign, Office of National Drug Control Policy, Washington, DC.
Correspondence: Requests for reprints should be sent to John K. Worden, PhD, Office of Health Promotion Research, University of Vermont, One South Prospect St, Burlington, VT 05401 (e-mail: jworden{at}zoo.uvm.edu).
We wish to correct misunderstandings about the National Youth Anti-Drug Media Campaign, sponsored by the Office of National Drug Control Policy, that might result from reading the article by Fishbein et al. in the February 2002 issue of the Journal.1 The article is critical of some televised antidrug advertisements broadcast from 1996 through 1998, while acknowledging evidence for the possible effectiveness of other ads studied. The authors conclude by recommending experimental tests of such messages before release to the public.
We heartily concur with this recommendation. Virtually all of the antidrug ads tested in the Fishbein et al. study were older ads used at the beginning of the campaign, when lawmakers had authorized initiation of the campaign but before new ads had been developed and rigorously pretested. Readers should be aware that the study’s findings should not be extrapolated to these more recent ads.
The Office of National Drug Control Policy has from the outset emphasized the importance of a research foundation for the campaign and the use of extensive testing of messages to ensure, so far as is possible, that the messages are effective and that taxpayers’ dollars are efficiently used. The National Youth Anti-Drug Media Campaign uses communication strategies based on extensive social science research on adolescent substance abuse.2 As the campaign developed, draft versions (storyboards) of all ads created for this campaign received increasingly extensive focus group testing across target audiences. They are also reviewed by behavioral scientists to ensure that they are consistent with an approved behavioral influence strategy based in the research literature.
Subsequently, ad execution strategies that are implemented are tested by means of experimental and quasi-experimental designs that evaluate liking of the ad, perceived message communicated by the ad, and, following a Theory of Reasoned Action framework,3 effects on a variety of relevant beliefs as well as on behavioral intention. As of early 2002, 1 ad from each execution strategy directed at youths has been tested with 500 youths (aged 12 to 17 years) in the treatment condition and 500 youths in the control condition. For ads directed at adults, regarding parenting behavior, the sample size is 200 in each condition. The sample is stratified by age, sex, and ethnicity. Current plans are to expand testing to all television ads, from all strategies.
Any ad for which we find solid evidence of boomerang effects for any ethnic/sexual subgroup is pulled, even if the effects on other subgroups are positive. In other words, not only is this campaign now following many of the procedural recommendations of Fishbein et al., it goes considerably further in terms of measurement and criteria used. We should also note that our continuing efforts to refine this pretesting process owe a considerable debt to work done by Fishbein and his colleagues at the University of Pennsylvania, drawing on both their previous work and their work on the independent campaign evaluation.
Finally, we should comment on the finding by Fishbein et al. that ads directed at marijuana use are often perceived by teenagers to be less effective than ads targeted at harder drugs. We agree that marijuana is a more challenging topic for antidrug ads, as negative consequences of marijuana use are not as easily communicated in a 30-second ad as are the negative consequences of heroin or methamphetamine use. However, existing evidence indicates that use of marijuana by young teenagers is a substantial risk factor for more severe substance use4,5 and that marijuana use dwarfs use of hard drugs among America’s adolescents.6 Therefore, reducing marijuana use, especially among younger teenagers, remains a public health and public policy priority and has been designated a principal objective of the campaign.
Refining effective communication strategies to help reduce marijuana use among young teenagers on the basis of the campaign’s extensive qualitative and quantitative research efforts is an ongoing task and may prove to be one of the primary scientific and creative contributions of the National Youth Anti-Drug Media Campaign.
References
1. Fishbein M, Hall-Jamieson K, Zimmer E, von Haeften I, Nabi R. Avoiding the boomerang: testing the relative effectiveness of antidrug public service announcements before a national campaign. Am J Public Health.2002;92:238–245.
2. Kelder SH, Maibach E, Worden JK, Biglan A, Levitt A. Planning and initiation of the ONCDP National Youth AntiDrug Media Campaign. J Public Health Manage Pract. 2000;6(3):14–26.[Medline]
3. Fishbein M, Ajzen I. Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research. Menlo Park, Calif: AddisonWesley; 1975.
4. Kandel D, Yamaguchi K, Chen K. Stage of progression in drug involvement from adolescence to adulthood: further evidence for the gateway theory. J Stud Alcohol. 1992;53:447–457.[Medline]
5. Newcomb M, Bentler P. Substance use and abuse among children and teenagers. Am Psychol. 1989;44:242–248.[Medline]
6. Johnston L, O’Malley P, Bachman J. Monitoring the Future National Survey Results on Drug Use, 1975–2000. Vol 1. Secondary School Students. Rockville, Md: National Institute on Drug Abuse; 2001. NIH publication 01-4924.
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