Cdc's Rx Awareness Campaign: Use of Pretesting Research to Inform the Development of a Public Health Awareness Campaign

Theoretical Background and research questions/hypothesis:  The United States is facing an epidemic of prescription drug overdose (PDO) deaths. Between 1999 and 2014, the number of deaths due to PDO quadrupled and these numbers continue to rise. The Centers for Disease Control and Prevention (CDC) recognizes this threat to public health and has made raising awareness about the risks associated with taking prescription opioids a priority. To achieve this goal, CDC is developing an evidence-based, consumer-directed campaign that resonates with those at risk for PDO. To develop the campaign, two phases of formative research were conducted.

Methods:  In Phase 1 of the formative research (August 2016), we tested creative concepts including five “reality statements,” three tag lines (with two versions of each tag line), four videos, and four campaign posters.  Using Phase 1 results, creative concepts were modified and tested in Phase 2 (October -November 2016).  During Phase 2 we tested three reality statements, three tag lines, four reflection statements, two audio testimonials, one video testimonial, and three poster images. In both phases, we conducted two digital triads (one male and one female), and three IDIs (two males, one female) with men and women between 25-30 and 45-54 years of age.    

Results:  Phase 1 participants reported reality statements were believable, however some participants questioned whether just one prescription could lead to addiction and overdose. Most participants recommended that taglines be concise and incorporate the idea that misusing opioid pain medication could lead to “losing everything”.  Participants emphasized the importance of using personal stories (e.g., testimonials) about loss because they resonate with the target audience.  They also stressed the importance of using multiple media channels to reach a wide community. Participants said that videos depicting regular people who received prescriptions and later overdosed resonated with them.  In Phase 2, participants shared that campaign ads should not use scare tactics to keep people from taking opioid medications appropriately. Phase 2 participants most valued campaign messages that were specific, offered information prescription opioids risks, and the progression of addiction. Many participants offered recommendations to improve the relatability, believability and appeal of campaign materials. In both phases, participant’s reported that people become addicted because they take medication not as prescribed.  Phase 1 and 2 results were used to inform development of final Rx Awareness Campaign materials (billboard, online banner, radio and video ads) placed in four states January-April 2017.  

Conclusions:  The use of a two-phased, digital formative research was critical to gathering information on target audience perceptions of prescription opioid use, misuse and Rx Awareness campaign materials. Participants’ feedback proved essential to creating and refining campaign creative concepts, messages and ultimately materials that are relatable, believable, resonate with target audiences, and clearly communicate the risks and dangers of prescription opioids.  

Implications for research and/or practice:  Digital methods are an effective and efficient way to obtain expedited and critical feedback on sensitive issues (opioid use/misuse) from campaign target audiences. Results from both phases indicate the importance of using personal stories/testimonials to stress the severity of the opioid epidemic and the risks and dangers of prescription opioid use.