JMIR Publications

ABSTRACT

Background:

Many emerging adults (EAs) are prone to making unhealthy choices, which increase their risk for premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among EAs delivered over social media is limited. Social media is a platform for reaching EAs with cancer prevention recommendations and information more effectively than in settings such as healthcare, schools, and workplaces, particularly for EAs residing in rural areas where access to these settings is limited.

Objective:

This pragmatic randomized trial will evaluate a multi-risk factor intervention using a social media campaign designed with community advisors aimed at decreasing cancer risk factors among EAs. The trial will target EAs from diverse backgrounds living in rural counties in the “Four Corner” states of Arizona, Colorado, New Mexico, and Utah, using the social media campaign.

Methods:

A sample of EAs (n=1000) aged 18-26 residing in rural counties (RUCC codes 4-9) in the Four Corner states will be recruited from the Qualtrics’ research panel and enrolled in a randomized stepped-wedge, quasi-experimental design. Inclusion criteria include English proficiency and regular social media engagement. A social media intervention will promote guideline-related goals for increased physical activity, healthy eating, and HPV vaccination and reduced nicotine product use, alcohol intake, and solar ultraviolet radiation exposure. Campaign posts will also cover digital and media literacy skills and responses to misinformation, communication with family and friends, and referral to community resources. The intervention will be delivered over 12 months in Facebook private groups and will be guided by advisory groups of community stakeholders and EAs and focus groups with EAs. EAs will complete assessments at baseline, 12-weeks, 26-weeks, 39-weeks, 52-weeks, and 104-weeks post-randomization. Assessments will measure six cancer risk behaviors, theoretic mediators, and participants’ engagement with the social media campaign.

Results:

The trial is in its start-up phase. It is being led by a Steering Committee. Team members are working in three subcommittees to optimize our community engagement, the social media intervention, and the measures to be used. The Stakeholder Organization Advisory Board and Emerging Adult Advisory Board were formed and provided initial input on the priority of cancer risk factors to target, social media use by and for EAs, and community resources available. A framework for the social media campaign with topics, format, and theoretic mediators has been created.

Conclusions:

Social media can be used as a platform to counter misinformation and improve reliable health information to promote health behaviors that reduce cancer risk among EAs. Due to the popularity of online information sources among EAs, an innovative, multi-risk factor social media campaign has the potential to reduce their cancer risk behaviors. Clinical Trial: NCT05618158