Health Promotion International最新文献

This study aimed to investigate young people's exposure to and perceptions of e-cigarette advertising to co-produce an advocacy video. This focus on e-cigarette marketing and its targeted appeal to young people comes at a crucial juncture, as policymakers in the UK and Scotland channel considerable efforts into shaping new regulations in response to these concerns, such as banning disposable e-cigarettes. The research to co-design a video was conducted with 33 young people aged between 12 and 16 living in the Central Belt of Scotland. The research comprised four stages: workshops, photo elicitation, focus groups and video development. Young people expressed concerns regarding the potential health effects of e-cigarettes, the ubiquity of e-cigarette advertising and products seemingly directed at young people, and the use of e-cigarettes among their peers. While none of our participants identified themselves as e-cigarette users, and all were below the age of 18, some mentioned seeing targeted advertisements for e-cigarettes online. These concerns were also reflected in participants' contributions to the video production process. Our findings highlight that young people feel overly exposed to e-cigarette advertising and they identified aspects of these adverts (including the use of vibrant colours and flavour variations) that they felt were designed to appeal specifically to young people. These findings suggest the need for stronger legislation to protect young people from the advertising and marketing of e-cigarettes. Further research might also usefully contribute to understanding counterarguments and marketing from public health advocates to limit the appeal of e-cigarettes to young people.

Children's engagement with smartphone-based (online) gaming content is rapidly increasing. There appears to be no existing objective evidence of children's exposure to this content captured in real time. Evidence on preteens' smartphone-based gaming is especially scarce. This study aimed to objectively explore the nature and extent of preteens' exposure to smartphone-based gaming content. Sixty-six children aged 11-13 years from 16 schools in the Wellington region of New Zealand used Zoom video teleconferencing software to record real-time, screen-shared internet use for 4 consecutive days. On average, children recorded 164 minutes each over the 4-day study period. Recordings were coded for gaming content by activity, using game applications and watching gaming content using social media. Game application characteristics were also recorded. Of every online hour recorded, 28.6% showed gaming content-using game applications (18%) and watching (10.7%). Male and low-deprivation children recorded more gaming content as part of their screen-shared internet use than female and high-deprivation children. Game application time comprised gameplay (56.6%), non-gameplay (43.4%), and included advertising 16.4% of the time. Most games were 'Advergames' [games including advertising (85.7%)], were free-to-play (98.4%), and included in-game purchases (87.3%). One-quarter (25.5%) included 'Random Items' (e.g. loot boxes) as part of these purchases, and 28.6% allowed users to interact with other users. While 'playing' using smartphone game applications, children are exposed to highly commercialized contexts that include manipulative design features, adult themes and advertising. Children, who are most vulnerable to online harms, must be protected in accordance with the United Nations Convention on the Rights of the Child.

The emergence of vaping represents a novel phenomenon, highlighting its distinctive role within contemporary society. Nevertheless, the comprehensive understanding of the cultural significance and social norms associated with vaping remains incomplete. This scoping review aimed to report the perspectives, motivations, and experiences of adolescents and young adults (10-25 years) engaging in the use of nicotine vapes. Peer-reviewed primary research published in English from 2003 to February 2024 was identified using the databases PubMed, Scopus, CINAHL, and PsycINFO. Qualitative studies reporting on the perspectives, motivations, and experiences of adolescents and young adults who currently engage in nicotine and tobacco vape use were included. Thematic analysis revealed three key themes in adolescents and young adults vaping: understanding and reasons for vaping, the challenges of addiction and withdrawal, and varied responses from families and caregivers. Adolescents and young adults are often introduced to vaping by peers and siblings, drawn by the desire to fit in and the appealing flavours. Despite awareness of potential health risks, addiction makes quitting difficult, leading to intense cravings and withdrawal challenges. Families show a spectrum of responses, from ignorance to reluctant acceptance, indicating a need for better awareness and intervention strategies to address adolescent vaping. Establishing a withdrawal pathway for vaping is imperative as an intervention strategy to address the prevalence of vaping among adolescents and young adults.

This article explores the impact of digital transformation on sexual and reproductive health promotion from an interdisciplinary perspective, focusing on the implications of rapidly evolving policy landscapes for the Australian health promotion workforce. We draw on 29 key informant interviews and workshops with 18 current sexual and reproductive health professionals (aged 18-29). Both groups were invited to reflect on how digital and data literacies are currently understood and applied within the Australian sexual and reproductive health promotion sector. Interviewees shared concerns related to digital and data literacy, equity, and the challenges of integrating digital technologies into health practice. Findings highlight the need for strategic approaches that shift focus away from individual literacies towards broader organisational capabilities. These capabilities include: an understanding of digital policy and platform governance (e.g. in relation to social media content moderation); an understanding of how health consumers and service users currently utilise digital systems to support sexual health and wellbeing; and an understanding of the ways digital equity and data justice can be undermined or advanced in organisational settings. We conclude with recommendations for enhancing workforce digital and data capabilities and integrating DDoH into health promotion policy and practice to improve health equity. Significantly, we conclude that dedicated resources and training are needed to address the complexities of DDoH in the sexual and reproductive health context.

Digital food marketing (DFM) of unhealthy foods and beverages (high in saturated fats, sugar and salt) to children and young people influences brand recall, recognition, purchase intentions and attitudes, and increases consumption of unhealthy foods and beverages. Understanding children's and parents' awareness of, and attitudes toward, such marketing is crucial for developing health-promoting advocacy and policy solutions. This registered systematic scoping review synthesized literature on children's, young people's and parents' attitudes and awareness of DFM. A structured search of Medline, PsycInfo, Academic Search Complete (Ebscohost), Scopus and CINAHL was conducted. Inclusion criteria were peer-reviewed studies focused on children (<18 years), young people (<24 years) or parents, published after 2000, examining attitudes or awareness of online marketing of food or non-alcoholic beverages. Data were extracted and charted in Excel. Forty studies were included for synthesis. Studies of children/young people (n = 31) show varying levels of awareness regarding DFM on social media and other digital media. While some understand social media marketing tactics, others struggle to recognize ads. Preferences lean towards influencer marketing and 'native' advertising styles. There is limited evidence on parents' views (n = 9 studies), but these suggest low parental awareness of digital marketing tactics targeting children, and unclear opinions on regulation. Overall, the findings suggest a need for a versatile, trans-disciplinary research and advocacy agenda to capture the complex and rapidly evolving digital marketing landscape, enhance critical digital literacies (including power inequalities) for both children and parents, increase knowledge-sharing and advocacy, and develop regulatory policies.

To bridge the gaps of mental health service in Malaysia, we developed a digital intervention protocol (RELATE-ME) aiming to restore social connectedness and well-being during the COVID-19 pandemic lockdown. Co-designed with a cross-disciplinary panel, we integrate principles of digital mental health, support group modality, psychoeducation elements, and community engagement into a 2-week online group program. To validate the protocol, we trained three community health workers (CHWs) to facilitate a briefer version of RELATE-ME with two groups of participants (six elders and six youths) in suburban Malaysia. After 4 days, they were interviewed regarding the feasibility and acceptability of this program. The interview transcripts were coded by the research assistant through an inductive-deductive method. Results showed that the majority of the participants reported the relationship with CHWs and peers as a motivator to sustain their engagement and it took time to build trust with each other. They appreciated the engaging group contents (e.g. relaxing and pleasant activities), sharing of their peers and skill-building lessons (e.g. learning of goal setting, stress management and relationship building). However, they faced the challenge of time constraints, family duties, low English literacy and digital literacy, especially among the elderly group. This finding suggested that RELATE-ME is a feasible protocol to increase social connectedness and well-being in the suburban area of a middle-income Asian country like Malaysia. Its effectiveness could be further enhanced through capacity building of CHWs, translating all contents into local languages and implementation in a physical setting.

Adolescents globally are calling for high-quality digital services to support and improve their health and well-being. Digital technologies are playing an increasing role in healthcare and whilst today's adolescents have been exposed to digital media since birth, there are unique challenges to their use that must be considered. This review aims to synthesize the literature on adolescent health promotion in the digital era. It provides evidence from adolescent perspectives and identifies that community-based and 'digital only' settings hold scope for further research to advance the field. The article recommends that when working with adolescents to develop digital health promotion tools, we should look to use youth engagement frameworks that are relevant to their context. Secondly, it demands stronger governance over digital media to protect adolescents, whilst allowing safe digital access. Finally, it demonstrates how listening to adolescents may help to address the emerging digital determinants of health and avoid exacerbating health disparities. Adolescents are powerful advocates to make global change. Stakeholders across research, policy and practice should examine how they incorporate adolescent voices to drive change in health promotion in the digital era.

Marketing of tobacco and vape products is effective at recruiting new users; yet, little is known about children's online exposure to such material. This research aimed to develop a methodology for assessing children's exposure to, and engagement with, online tobacco and vape marketing. This pilot study used data from the innovative Kids Online Aotearoa Study in which 156 11-13-year-olds from schools in the Wellington region of Aotearoa New Zealand used Zoom teleconferencing software to record real-time, screen-shared internet use for four consecutive days. We developed a coding framework to analyse the nature and extent of exposure to tobacco or vape marketing and applied it to a strategic subset of children's (n = 16) data. Twenty-one instances of tobacco or vape marketing were identified from 12 participants; four participants had no identified exposures. The findings show that children are exposed to such marketing online, despite legislation that should protect them; these insights improve understanding of the online marketing environment and may help to support global health promotion efforts in tobacco and nicotine control given the borderless nature of the online world. The Kids Online Aotearoa tobacco and vape marketing methodology and coding framework enables the direct assessment of children's exposure to online tobacco and vape marketing and is a valuable research tool to monitor and provide evidence to inform social and political action to protect children from online harm.

The World Health Organization and public health experts are calling for urgent restrictions on the online marketing of unhealthy food. The harmful effects of exposure to advertising for 'unhealthy foods', including discretionary foods high in fat, salt or sugar, particularly for children, has prompted a proposed policy action in Australia to prohibit all online unhealthy food marketing. We used a novel data donation infrastructure, the Australian Ad Observatory, to create a dataset of 1703 ads promoting top-selling unhealthy food brands that had been placed by 141 different advertisers on 367 individual Australians' Facebook feeds. We used this dataset to identify any targeting of unhealthy food ads towards young people (18-24), investigate harmful marketing practices by four of the top advertisers (KFC, McDonald's, Cadbury and 7-Eleven); and demonstrate how online advertising may be made observable and accountable. We find indications that young people (18-24), especially young men, are being targeted by unhealthy food, especially fast food, ads. We also find that unhealthy food brands use potentially harmful marketing strategies to appeal to children, young people, parents and the broader community, including cartoon characters, and associations with popular sports and greenwashing. The policy implications of our findings are that a broad prohibition on all forms of unhealthy food advertising online is desirable to protect not only children but also young people and the broader community. Such a prohibition will go one step towards addressing the commercial and digital determinants of health caused by harmful industries' use of online automated advertising.

Food marketing plays a substantial role in shaping adolescent diets, having wide-ranging ramifications for health behaviours and outcomes throughout the life course. Yet, there remains a dearth of research about how outdoor advertising as a specific channel of food marketing affects purchasing behaviours. We examine self-reported purchases made at retail food outlets by adolescents as it relates to the availability of outdoor food and beverage advertising around each participant's home, school, and along the journey to and from school. We also consider the impacts of sociodemographics and consumption attitudes on purchasing, as compared to the geographic availability of outdoor advertising. Data are drawn from a survey completed by 545 adolescents in 2018 across four secondary schools in the Middlesex-London region of Ontario, Canada. The availability of outdoor advertising in the home and school environment is marginally correlated with self-reported purchases made at fast food, table-based, grocery, and variety retail outlets. However, consumption attitudes, cultural background, and gender are significantly correlated with purchases, with substantially larger effect sizes. The overall results were consistent between estimating the availability of outdoor advertising in the immediate area surrounding the home and along the journey to and from school. There is considerable health promotion policy interest in regulating outdoor advertising around child-serving locations. However, scarce health promotion resources would be better allocated to educational programming that addresses the substantial role of consumption attitudes in affecting adolescent purchasing behaviour, as compared to the considerably weaker impact of outdoor food advertising observed in our analysis.