EMA and Content Analysis for Alcohol Marketing in Hong Kong In-school Adolescents
Study Details
Study Description
Brief Summary
The proposed study aims to assess adolescents' exposure to alcohol marketing and its effect on drinking attitudes and drinking behaviors. The three main research questions: (1) Is exposure to alcohol marketing associated with drinking attitude (perceive popularity, perceive social approval, positive expectancies)? (2) What are the contents of alcohol marketing that establish the brand capital of alcohol beverages in Hong Kong? (3) Does the brand capital of alcohol beverages mediate the relationship between (a) exposure to alcohol marketing and drinking attitudes? (b) exposure to alcohol marketing and alcohol consumption?
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
Study design
The proposed project is a combination of a time-based system-triggered ecological momentary assessment (EMA), which will collect real-time exposure to alcohol marketing and alcohol consumption, and a longitudinal survey. Consented participants will first complete a baseline questionnaire, followed by completing 3 regularly prompted EMA surveys via smartphone application (APP) every day for 21 consecutive days. The EMA will include questions of self-report exposure, brand capital (marketing receptivity and brand recognition), and alcohol consumption. One month after the EMA period, a telephone follow-up will be conducted to understand participants' drinking attitude and alcohol consumption.
Recruitment procedures
We will conduct both offline and online recruitment. The investigators have collaborated with the Hong Kong Council on Smoking and Health (COSH) to organize the leadership training (the Smokefree Teen project) annually since 2015. We will promote the study to the secondary school students (n=200) participating in this training camp. We will also send invitation letters to the 451 government and subsidized secondary schools. After receiving the schools' consent to join the study, our research assistant will contact these schools to plan the recruitment methods, including the distribution of recruitment posters and leaflets to the students with the help from the cooperators, organization of talks or recruitment booths to recruit participants in those schools. In addition, online recruitment advertisements will be disseminated in online discussion boards and social media (e.g., Facebook, Instagram) that Hong Kong adolescents usually visit. Volunteer participants can directly contact our research staff via telephone, email or submit an online application form via a Quick Response (QR) code. First, all volunteer participants will receive a web link for eligibility screening. Then our research assistant will contact eligible students via a phone call, and invite them for a face-to-face or virtual meeting via WhatsApp or Zoom. If they choose virtual meeting, the research assistant will mail a package including an invitation letter, consent form, and a pre-stamped return envelope, and request them to send back the signed consent form with the participant's and parent's signature. Afterwards, the research assistant will assist them in completing the baseline questionnaire, app installation and using the app in the virtual meeting. If participants choose the face-to-face meeting, the research assistant will complete all study procedures in the meeting, and request the participants to send their parent's signed consent after the meeting. Our second pilot study found that both virtual and face-to-face meeting are feasible in secondary school students.
EMA App
An EMA app will be developed in both iPhone operating system (IOS) and Android platform to administer the regular prompts automatically. Our research assistant will assist participants to install the EMA App in their own smartphone after obtaining study consent. To protect the privacy of participants, no personal information will be collected via the app. Participants only need to impute a 5-digit case number (such as last 5 digits of phone number) as an identifier. Participants will use the App to complete 3 time-based EMA each day for 21 consecutive days. Two systematic reviews on the length of the study period of EMA in the underage showed that compliance can be optimal when participants were prompted to complete about 3 EMA per day within 1 week or more. Once the App is installed and logged in, the participants will be asked to choose a start date for the 21-day EMA study. To facilitate the EMA on school days when they cannot use smartphone all the time, participants can create custom schedule of the 3 EMA prompts. The time gap between any two prompts must be longer than 3 hours to capture more information within the participants' waking hours. The first, second, and third prompt must range from 11:00 am and 1:00 pm, 16:00 pm to 18:00 pm, and 21:00 pm to 23:00 pm, respectively. All data will be uploaded to our server at home office immediately after each EMA completion for further analysis. Only the project administrators can access the datasets in the server with login name and password.
Main outcome measures - Exposure to alcohol marketing and content analysis
Alcohol marketing includes alcohol advertisement and promotion of drinking culture. Exposure to alcohol marketing will be enquired at baseline, each EMA survey, and the follow-up. If they report any exposure, they will be asked about (1) channels of exposure, (2) types of alcohol beverages, (3) whether they like it or not (e.g., negative, neutral, positive), (4) characters in the advertisement (e.g., beautiful young men/women, businessmen etc.), (5) drinking context (e.g., celebrate success, lunch/dinner, gathering, sports, etc.), and (6) tone of the commercial (e.g., humor, relaxation, masculinity, friendship, others, etc. Alternatively, the app will prompt participants to upload pictures or videos of the marketing content, so that they will not necessarily code the marketing themselves. Our research staff will also search alcohol ads in the popular social media platform such as Facebook and Instagram using the common names and brands of alcoholic beverages, and then code the ads using the above themes.
Follow-up
To reduce reactive effect from EMA, all participants will be followed up via telephone 1 month after completing the EMA survey. The survey includes drinking attitude and alcohol consumption. Participants are also requested to rate their satisfaction on EMA App, frequency and content of EMA survey by a 5-point Likert scale at the follow up.
Consent
Participation in the study is voluntary. The recruitment staff will first explain the project's details to the potential subjects who agree to join the study before seeking consent. The potential subjects will be assured that they can withdraw from the study anytime without any prejudice, and all the information will be kept confidential and results will be reported in an aggregate format. For participants who choose to complete the recruitment procedures virtually, a research assistant will mail them a package including an invitation letter, consent form, and a pre-stamped return envelope, and request that they send back the signed consent form with the theirs and their parent's signature. For participants who choose to complete the recruitment procedures face-to-face, the research assistant will obtain their signed consent in the meeting, and request that they send their parent's signed consent after the meeting.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Ecological momentary assessment (EMA) a repeated real-time data collection in real-world environment and allows modeling of within-person processes and temporal dynamics. |
Other: electronic diary
a smartphone application for self-documentation of drinking pattern
|
Outcome Measures
Primary Outcome Measures
- Exposure to alcohol marketing and content analysis [1 month]
Alcohol marketing includes alcohol advertisement and promotion of drinking culture. Exposure to alcohol marketing will be enquired at baseline, each EMA survey, and the follow-up.
Eligibility Criteria
Criteria
Inclusion Criteria:
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aged 13 to 18
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studying in secondary schools
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own a mobile smartphone with internet access
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stay in Hong Kong during the EMA study period
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being able to read and write Chinese.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Faculty of Medicine | Hong Kong | Hong Kong |
Sponsors and Collaborators
- The University of Hong Kong
Investigators
- Principal Investigator: Yee Tak Derek Cheung, Dr., The University of Hong Kong
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- GRF Alcohol