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

Introduction: 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.

Methods: 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.

Results: 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.

Conclusions: 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.