Clinical Takeaway
Tailoring cannabis prevention messages to address individual adolescent beliefs and countering initial resistance with rebuttal feedback shows promise in improving message effectiveness. The sequential approach of invalidating negative reactions before presenting tailored communications may overcome the one-size-fits-all limitations of traditional cannabis prevention campaigns. This strategy addresses documented disparities in how adolescents with different baseline attitudes respond to standard prevention messaging.

#26 A Rebuttal-Based Social Norms-Tailored Cannabis Intervention for At-Risk Adolescents.
Citation: Donaldson Candice D et al.. A Rebuttal-Based Social Norms-Tailored Cannabis Intervention for At-Risk Adolescents.. Prevention science : the official journal of the Society for Prevention Research. 2021. PMID: 33791930.
Design: 5 Journal: 0 N: 3 Recency: 0 Pop: 3 Human: 1 Risk: -2
- Preclinical only
Abstract: Many past cannabis prevention campaigns have proven largely ineffective due in part to the diversity of adolescents’ cannabis-relevant beliefs. The current studies evaluated the impact of a sequential multiple message approach tailored to the usage norms of adolescents expressing negative attitudes toward a cannabis prevention appeal. A multiple-message strategy was implemented-initial unfavorable message evaluations were invalidated using attitudinal rebuttal feedback prior to presenting a third tailored communication. Participants were cannabis-abstinent middle and high school students (ages 11 to 16). Study 1 (N = 808) compared effects of gain- and loss-framed messages tailored to each student’s normative usage perceptions. In Study 2 (N = 391), students were randomly assigned to receive a tailored or non-tailored message after receiving feedback meant to destabilize anti-message attitudes. For at-risk adolescents in Study 1 who perceived cannabis use as normative, a tailored gain-framed message resulted in the lowest usage intentions (p < .05). In Study 2, a conditional multiple-moderated mediation model showed that for high-risk teens with normative beliefs and pro-cannabis attitudes, exposure to a tailored gain-framed communication was associated with decreased cannabis attitude certainty, and lower usage intentions 2 months later (p < .05). Findings have implications for sequential messaging utilization in mass media campaigns and support the efficacy of tailored messages over a one-size-fits-all media approach. Further, results suggest that systematically weakening resistance to persuasive communications and tailoring messages consistent with individually perceived peer norms is an effective prevention strategy.
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