Cost-Effective Online Engagement In Youth Tobacco Prevention Program

Background:  Ninety percent of youth who start smoking before age 18 will likely become smokers for life. In Massachusetts, about 3,700 teenagers under 18 become regular smokers each year. Studies show that youth who engage in tobacco prevention activities are less likely to smoke. The Massachusetts Tobacco Cessation and Prevention Program contracted with Health Resources in Action (HRiA) to develop a program to mobilize Massachusetts youth to help change tobacco policies, educate peers and adults about tobacco issues, and promote healthy lifestyles.

Program background:  HRiA developed The 84 Movement in 2007 to nurture a sense of affiliation among the 84% of youth who choose not to smoke. The 84 engages over 1,500 youth in 70 “Chapters” across Massachusetts in tobacco prevention efforts. These initiatives include advocating for pharmacy bans on tobacco products, educating decision-makers on the tobacco industry's influence on communities, and promoting the social norms message around youth tobacco use. To address the major challenge of providing sustainable linkages between local initiatives and the larger movement, HRiA developed a cost-effective online program (“The 84 Chapter Challenge”) which allows the Chapters to increase their online engagement with peers by sharing experiences, building networks, and participating in competitions. Based on a point system, the program rewards Chapters for posting their tobacco prevention activities on The84.org through a simple user interface. A multi-faceted approach involving a website and Facebook allows this program to appeal to both groups and individuals. Earlier marketing efforts focused on stimulating individual participation, which was labor intensive and relatively unsuccessful (<5% of users engaged.).  Focusing on groups allows for a streamlined website that easily accommodates participation, yielding better results with less effort.

Evaluation Methods and Results:  To evaluate the participation in the program, the website was designed to allow Chapters to report their activities. From July 2011 to March 2012, 46% of the Chapters actively participated in the program, Over 960 youth leaders were involved in at least one activity.  Over 125,000 peers were reached through the activities. The84.org had 4,350 unique visitors and 7,698 visits from July 2011 to March 2012. 152 updates were generated by the Chapters, compared to less than 10 posts by individual members in fiscal year 2008 when the individual-focused strategy was used. The 84 Facebook page currently has 800 likes, compared to 579 in July 2011, out of which 6.7% are 13-17 years old, 67% are 18-24 years old, and the remaining are over 24 years old.

Conclusions:  Stimulating ongoing engagement with youth is a challenge, particularly for an established public health topic like tobacco prevention. The group-centric online strategy was more successful than individual-focused in terms of the number of users engaged, the amount of content generated, and the amount of staff required to maintain the system.

Implications for research and/or practice: Since The 84 Movement is targeted to high school-aged youth, the number of members fluctuates with the school year, and bottoms out in the summer. Therefore, cultivating the engagement with new students is required at the beginning of each academic year.