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The rapid growth and diffusion of digital media technologies has changed the landscape of market segmentation in the last two decades, including its use in promoting prosocial and behavior change. New, population-specific and culturally appropriate prevention strategies can leverage the potential of digital media to influence health outcomes, especially for the greatest users of digital technology, including youth and young adults. Health behavior change campaigns are increasingly shifting resources to social media, creating opportunities for innovative interventions and new research methods. This article examines three case studies of digital segmentation: (1) tobacco control from the Truth Initiative, (2) community-based public health programs from the Centers for Disease Control and Prevention, and (3) substance use (including opioids) and other risk behavior prevention from Public Good Projects. These case studies of recent digital segmentation efforts in the not-for-profit, government, and academic sectors show that it increases reach and frequency of messages delivered to priority populations. The practice of digital segmentation is rapidly growing, shows early signs of effectiveness, and may enhance future public health campaigns. Additional research could optimize its use and effectiveness in promoting prosocial and behavior change campaign outcomes.

Background: Although there is debate on the effectiveness of youth-focused abstinence education programs, research confirms that parents can influence their children's decisions about sexual behavior. To leverage parent-based approaches to adolescent sexual health, the U.S. Department of Health and Human Services launched the Parents Speak Up National Campaign (PSUNC) to encourage parent-child communication about sex. Previous experimental studies have found the campaign to be efficacious in increasing parent-child communication. But to date, the actual reach of the campaign and its real-world effectiveness in promoting parent-child communication has not been established. The present study addresses this gap., Method: The authors surveyed 1,804 parents of 10- to14-year-old children from the nationally representative Knowledge Networks online panel. The survey included questions about parents' awareness of PSUNC ads and parent-child communication behaviors. The authors also analyzed market-level data on campaign gross rating points, a measure of market-level intensity of PSUNC advertising in the United States. Multivariate regressions were used to examine the association between PSUNC exposure and a three-item scale for parent-child communication., Results: Overall, 59.4% of parents in the sample reported awareness of PSUNC. The authors found that higher market-level PSUNC gross rating points were associated with increased parent-child communication. Similar relationships were observed between self-reported awareness of PSUNC and increased frequency of communication and recommendations to wait. These associations were particularly strong among mothers., Conclusions: This study provides the first field-based data on the real-world reach and effectiveness of PSUNC among parents. The data support earlier experimental trials of PSUNC, showing that the campaign is associated with greater parent-child communication, primarily among mothers. Further research may be needed to develop additional messages for fathers.

The American Legacy Foundation funded 13 state health departments for their Statewide Youth Movement Against Tobacco Use in September 2000. Its goal was to create statewide tobacco control initiatives implemented with youth leadership. The underlying theory behind these initiatives was that tobacco control efforts can best be accomplished by empowering youth. To evaluate these initiatives, the authors developed a conceptual framework for youth empowerment that was used as a guide in developing standardized cross-site measures. This article describes the domains and attributes used to operationalize psychological empowerment as an outcome of youth involvement in these initiatives and presents results of our two-stage structural equation modeling. We conclude with a summary of lessons learned to date and recommendations for applying these findings to work in the field.

This study examined adult and group influences on youth participation in youth empowerment (YE) Statewide Youth Movement Against Tobacco Use programs. Adults provide individual guidance to youth groups and through existing tobacco control networks affect the social context in which YE programs are implemented. The authors tested hypotheses about the direct and indirect relationships between adults, groups, and youth collective participation. They used data from adults and youths to develop a measurement model of four higher order factors: adult involvement, group structure, group climate, and collective participation. They tested relationships between these factors in a structural equation model. Results showed that adult involvement did not have a meaningful direct effect on group factors or collective participation. Group factors mediated the relationship between adult involvement and collective participation. Further research is needed on how to measure adult involvement and its relationship to youth participation.

This article presents a conceptual framework that was developed to guide a national evaluation of the American Legacy Foundation's (Legacy) Statewide Youth Movement Against Tobacco Use (SYMATU) program. This program was designed to develop youth-led, youth-directed initiatives within local communities. Two evaluation studies were designed and implemented from 2000 through 2003: a cross-site study that collected standard data elements across all 17 programs and a case study of five programs that collected formative data on variables thought to affect program implementation. In developing the youth empowerment (YE) conceptual framework, the authors started by reviewing literature to identify the concepts necessary for these types of initiatives and present a summary of their findings here. This article focuses on the development of the authors'overarching conceptual framework used to guide their evaluation studies. Other articles contained within this special issue present results from each of the SYMATU evaluation studies.