Developing a media literacy-based e-cigarette education program via medical record systems

This is a prospective, interventional pilot study that seeks to evaluate the impact of MediaSense, a media-literacy-based vaping prevention program, in adolescents including an oversample of those with asthma.

During July and December 2022, participants in Nebraska were recruited via electronic health record (EHR)-based messaging, and MediaSense was self-administrated by interactive e-learning with REDCap surveys before and after the intervention. Regression analysis evaluated changes in vaping media literacy, vaping expectancy, and harm perception pre- and post-intervention. Factor analysis was conducted on 22 items on usability, to determine which latent factors were most related to interactive e-learning modules.

Adolescents aged 12-17 years participated in the MediaSense intervention (n=67; 59.7% with asthma). The pre- and post-intervention surveys showed a 148% increase in vaping media literacy (ranging 0-6; 2.9 vs 4.5, p<0.0001). Vaping expectancy (ranging1-5) decreased from 3.6 to 1.2 (p<0.0001), and the perception of vaping as harmful rose from 40.3% to 86.0% (p<0.0001). Participants rated the intervention highly on usability, technical assistance, design, content clarity, navigation, flow, multimedia, interactivity, and learning outcomes. Two distinct factors were identified in the factor analysis: motivating and engaging content (Factor 1) and user-friendly module design (Factor 2). Participants with higher usability ratings of the e-modules (Factor 1: B=0.6; 95% CI: 0.3-0.9, p=0.0004; Factor 2: B=0.7; 95% CI: 0.4-1.0, p=0.0001), and those with asthma (vs no asthma: B=0.5; 95% CI: 0.1-0.9, p=0.01) had significantly higher vaping refusal and media literacy.

The MediaSense program demonstrated acceptability and feasibility in recruiting and preventing adolescent vaping through EHR and digital interventions. Media literacy helps adolescents to critically evaluate vaping-related marketing messages, resist persuasive marketing, and make informed decisions.