University of Southern California Dissertations and Theses

Youth advocacy for vape prevention

(USC Thesis Other)

Youth advocacy for vape prevention

PDF

Download a page range

Download transcript

Copy asset link

Request this asset

Transcript (if available)

Content

Youth Advocacy for Vape-Prevention
by
Daniel Wood Soto, MPH

Rossier School of Education
University of Southern California
A dissertation submitted to the faculty
in partial fulfillment of the requirements for the degree of
Doctor of Education

May 2023

© Copyright by Daniel Wood Soto 2023
All Rights Reserved

The Committee for Daniel Soto certifies the approval of this Dissertation

Kimberly Hirabayashi
Jennifer Unger
Kenneth Yates, Committee Chair

Rossier School of Education
University of Southern California
2023

iv

Abstract
Youth in the United States are faced with many challenges to their health, including making
decisions about vaping. In 2018, then US surgeon general Dr. Jerome Adams officially declared
a youth vaping epidemic. The US experienced a 900% increase in youth vaping from 2011-2015.
This curriculum aims to teach middle school students advocacy skills, empowering them to resist
powerful social media tobacco marketing. The youth advocacy for vape prevention curriculum,
rooted in social cognitive and sociocultural theory, will empower youth to advocate for vape
prevention among teens. Students will learn about the power of media to influence behavior, the
power of tobacco industry marketing on youth vaping rates, and advocacy strategies to prevent
youth vaping. Measurable outcomes will include declarative, intellectual, and cognitive
strategies for youth advocacy, identifying and resisting tobacco marketing in digital media, and
strategies for developing and disseminating youth-focused vape prevention digital media for
their peers. A final youth advocacy and digital media fair will be held where students present
their projects to the broader school community. We recommend that schools adopt this youth
vape prevention program and encourage youth advocacy as a method of reducing youth vaping
among students in the learning community and beyond.
Keywords: youth advocacy, tobacco prevention, social media

v

Dedication
To my amazing wife, Claradina. Thank you for always pushing me to be my best. You somehow
managed to keep our children and family afloat while I embarked on this journey. I am forever
grateful for your love and encouragement through my Master of Public Health and Doctor of
Education degrees. I love you always.

To my beautiful children, Toya and Talon, thank you for remaining that shining light in my life.
Your patience while I pressed through stages to obtain my EdD is an indication of your
unwavering love for mom and I. I am eternally grateful for your love and encouragement during
this process. I love you more, more, more….

Dad, even though you are no longer with us in physical form, I kept your memory with my at
every step of this process. When times got rough, your words of wisdom and “consejos” helped
keep me grounded and steadfast in completing this degree. I hope I made you proud.

Mom, thank you for giving me the tenacity and positivity to complete this educational journey. I
am forever grateful for your continued love and support always.

vi

Acknowledgements
I want to thank Dr. Yates for always being available when I needed feedback and nudges
to complete sections of my dissertation. You committed your time and effort above and beyond
measure, and I am forever grateful to you for this. Your dedication to all students is remarkable
and something I strive to model as an educator in higher education. Thank you for your
mentorship with my future career goals and for believing in me as a writer and scholar. Thank
you, Dr. Hirabayashi for your leadership in class and for your guidance with my dissertation. I
am truly honored that you agreed to be a committee member for my dissertation.
Thank you, Dr. Unger for your friendship, mentorship, and guidance with my
professional growth over the past 20 years. Thank you for agreeing to be a committee member
for my dissertation. I am truly honored to call you my friend and colleague in higher education
and in life outside of work. Your patience, encouragement, and flexibility when I thought I could
not make it through the EdD program truly helped me strive to do my best. Our family is blessed
to have you in our lives.
Finally, thank you to all my extended family and friends for your encouragement and
support with my educational journey

vii

Table of Contents
Abstract .......................................................................................................................................... iv
Dedication ....................................................................................................................................... v
Acknowledgments.......................................................................................................................... vi
List of Tables ................................................................................................................................. ix
List of Figures ................................................................................................................................. x
Chapter One: Overview of the Project and Needs Assessment ...................................................... 1
Problem of Practice ............................................................................................................. 3
Evidence of the Problem of Practice ................................................................................... 4
Importance of Solving the Problem .................................................................................... 5
Instructional Needs Assessment ......................................................................................... 7
Determination of the Learning Need ................................................................................ 12
Learning System and Environment ................................................................................... 13
Potential Issues with Power, Equity and Inclusion ........................................................... 14
Definition of Terms........................................................................................................... 15
Organization of the Design Blueprint ............................................................................... 15
About the Author .............................................................................................................. 16
Theories Informing the Author's Positionality .................................................................. 18
Chapter Two: Review of the Literature ........................................................................................ 21
Prior Attempts ................................................................................................................... 21
The Content of the Curriculum ......................................................................................... 23
Summary of the Curriculum Content ................................................................................ 37
Chapter Three: The Learning Environment and the Learners ...................................................... 41
Description of the Learning Environment ........................................................................ 41
Learner Characteristics ..................................................................................................... 43

xiii

Implications of the Learning Environment and Learner Characteristics for Design ........ 48
Chapter Four: The Curriculum ...................................................................................................... 50
Cognitive Task Analysis ................................................................................................... 50
Course Learning Goals ..................................................................................................... 52
Course Learning Outcomes ............................................................................................... 53
List of Units, Terminal, and Enabling Objectives ............................................................ 57
Overview of the Program .................................................................................................. 62
Scope and Sequence Table ................................................................................................ 72
Delivery Media Selection ................................................................................................. 73
General Instructional Platform Selection .......................................................................... 74
Specific Instructional Platform Selection ......................................................................... 76
Specific Media Choices .................................................................................................... 79
General Instructional Methods Approach ......................................................................... 80
Chapter Five: Implementation and Evaluation Plan ..................................................................... 84
Implementation Plan ......................................................................................................... 84
Evaluation Plan ................................................................................................................. 87
References ................................................................................................................................... 105
Appendix A: Course Overview ................................................................................................... 118
Appendix B: Lesson Overviews ................................................................................................. 126
Appendix C: Lesson Plans .......................................................................................................... 138
Appendix D: Pre-program Implementation Survey .................................................................... 160
Appendix E: Delayed Evaluation Items ...................................................................................... 168
Appendix F: Sample Data for Reports ........................................................................................ 178

ix

List of Tables
Table 1: Analysis of Learning Goals 39
Table 2: Scope and Sequence 72
Table 3: Key Considerations for Media Selection 78
Table 4: Media Choices in Middle School Advocacy for Anti-Vaping 80
Table 5: Indicators, Metrics, and Methods for External and Internal Outcomes 90
Table 6: Critical Behaviors, Metrics, Methods, and Timing for Evaluation 92
Table 7: Required Drivers to Support Critical Behaviors 95
Table 8: Evaluation of the Components of Learning for the Program 99
Table 9: Components to Measure Reactions to the Program 101
Table A1: Course Overview Instructional Activities 119
Table C1: Unit 1 Instructional Activities 141
Table D1: Pre-survey Items 160
Table D2: Tobacco Use Intentions 161
Table D3: Tobacco Use Curiosity 165
Table D4: Perceived Harm 166
Table E1: Curriculum Content 168
Table E2: Tobacco Use Intentions 171
Table E3: Tobacco Use Curiosity 174
Table E4: Tobacco Perceived Harm 176

x

List of Figures
Figure 1: Visual Overview of the Units 71
Figure A1: Visual Overview of the Units 125
Figure F1: Curriculum Satisfaction Impact 178
Figure F2: Intentions for Advocacy or Tobacco Use 179
Figure F3: Curriculum Satisfaction 180

1

Chapter One: Overview of the Project and Needs Assessment
Talon, a middle school student, is hanging out with his friends and playing video games.
Suddenly, his buddy Jackson plugs what looks like a USB device into Talon’s computer.
Thinking nothing of it, Talon continues playing his video game. After 10 minutes, his friend
Jackson removes the device he plugged in and begins puffing clouds of vapor in Talon’s room.
Intrigued, Talon asks why the product he is puffing on looks so much like a USB device. Jackson
mentions that it is an e-cigarette, and it is easy to hide from adults. He shares that cereal milk and
unicorn poop are his favorite flavors. Having never seen a vape product in real life, Talon
becomes curious and asks to see it. He looks closely and debates taking a puff to see if the cereal
milk flavor is similar to his morning cereal milk flavor. Jackson hears footsteps and quickly
grabs the e-cigarette from Talon’s hands to hide it from his parents. On this evening, Talon was
lucky enough not to give in to trying the e-cigarette Jackson was eager to share. While this
scenario is fictional, the harsh reality is that many U.S. youth face decisions that could have
long-term health consequences.
Every day in the United States, youth are exposed to the aggressive marketing tactics of
the tobacco industry. The tobacco industry spends approximately $1 million per hour marketing
products to the public (“Big Tobacco Spends Nearly $1 Million/Hr”, 2017). Youth exposure to
tobacco marketing includes video games showing tobacco use, television shows, social media,
YouTube, and convenience store advertisements (Vassey et al., 2022). One tobacco product
attracting a new generation of youth to tobacco initiation is vaping, broadly referring to
electronic cigarettes to inhale vaporized tobacco or synthetic nicotine. Vaping was first
introduced to the US market around 2007 and has quickly become the product of choice for
youth (Ali, 2020). Initially, vape products were not regulated at local or federal levels in contrast
2

with other tobacco products, which have been regulated by government action and settlement
agreements. This allowed the tobacco industry to market vape products as a “healthy” alternative
to combustible cigarettes, making the public perceive that vaping was harmless for one’s health.
Additionally, marketing tactics such as sex appeal, cartoon imagery, and sweet flavors appealed
to younger users. These tactics are similar to previous tobacco industry attempts at marketing
combustible cigarettes to youth (Truth Tobacco Industry Documents, 2022). According to
tobacco industry documents from the 1980s and 1990s, the tobacco industry has intentionally
worked to make products that appeal to youth. Products such as sugar-coated tobacco gumballs
and sweet flavors can gain more young smokers (Schor, 2014; Truth Tobacco Industry
Documents, 2022). Therefore, this curriculum addresses the need to discourage our youth from
vaping.
As illustrated in the previous paragraphs, the primary behavioral influence in adolescents’
lives is other adolescents. Bronfenbrenner’s social ecology model (1981) suggests that individual
behavior is shaped primarily by one’s immediate environment. The microsystem is most
influential and consists of one’s peers, family, school, and neighborhood (Bronfenbrenner,
1981). Additionally, Bronfenbrenner describes the mesosystem as interactions between the micro
system and a wider system called the exosystem which includes mass media (Bronfenbrenner,
1981). During adolescence, peers become the most influential members of one’s microsystem,
replacing parents, especially in decisions about risky behaviors such as substance use (Mason et
al., 2016). A recent survey among youth aged 13-18 years old found that 60% of youth reported
their first vaping experience was with friends (Groom et al., 2021). Additionally, Groom et al.,
(2021) found that youth were exposed to social media vape advertisements through their peer
networks. Thus, anti-vaping programs led by peers might hold promise.
3

The Problem of Practice
Adolescent substance use directly impacts learning for individual users and the
immediate learning environment for students who do not use substances. Exposure to peers using
nicotine products increases the likelihood of subsequent nicotine use among nonusers (Groom et
al., 2021; Ren & Lotfipour, 2019). Further, nicotine use among adolescents is associated with
impaired brain development and learning (Goriounova & Mansvelder, 2012). Recent data from a
national youth survey found that 10.5% of eighth-grade students, 19.3% of tenth-grade students,
and 24.7% of twelfth-grade students reported vaping in the past 30 days (Meich et al., 2021).
Thus, given the high rates of vaping among adolescents, it is essential to develop evidence-based
practices to prevent tobacco use initiation among youth.
Adolescent vaping in the school setting intrudes upon the learning environment for
middle school students and increases the likelihood that peers will initiate vaping (Kim & Chun,
2018; Lippert et al., 2019). The project described herein aligns with the California Department of
Education's (CDE) mission to ensure equitable learning outcomes and environments for all
students. Specifically, the CDE mission seeks to “Create strong, effective schools that provide a
wholesome learning environment through incentives that cause a high standard of student
accomplishment as measured by a valid, reliable accountability system.” (California Department
of Education, 2022). With over 6 million students enrolled in K-12 education in California, the
CDE is primarily responsible for administering education throughout California. As such, they
oversee the imperative to provide quality tobacco prevention education for students (California
Department of Education, 2022).
Students between 11-15 years old are the population of interest. The CDE is the primary
governing body for K-12 education with these students. As such, the CDE mission of providing a
4

safe learning environment for all students is at odds with the increased exposure to nicotine faced
by middle and high school students daily. The goal of the current project, to discourage nicotine
and tobacco use among adolescents, is directly in line with the goals and objectives of the CDE.
Evidence for the Problem of Practice
As a result of aggressive marketing, youth nicotine addiction has increased significantly.
A recent study analyzed national data collected via the Centers for Disease Control and
Prevention's (CDC) Youth Risk Behavior Surveillance System (YRBSS) data and found that
current e-cigarette use increased from 24% in 2015 to 32.7% in 2019 (Mirbolouk et al., 2022). In
2018, then US Surgeon General, Dr. Jerome Adams, announced that a youth vaping epidemic
was occurring in middle and high schools across the US (CDC, 2022). By 2018, one in five high
school students and one in 20 middle school students reported current use of e-cigarettes (CDC,
2022). This alarming statistic came when combustible tobacco use among teens was on a steady
decline due to effective tobacco prevention efforts. The 2022 Surgeon General’s Report on
tobacco use analyzed tobacco use rates among adolescents collected from the National Youth
Tobacco Survey (NYTS) and found that past 30-day youth tobacco use among high school
students increased from 1.5% in 2011 to 16% in 2015, indicating that the prevalence of vaping
had surpassed the prevalence of combustible cigarette use (CDC, 2022). According to the
Surgeon General’s Report, these percentages equate to 2.4 million high school students and
620,000 middle school students reporting vaping at least one time in the past 30 days–CDC’s
criterion for “recent” use (CDC, 2022). In this announcement, Dr. Adams noted nicotine
addiction's impact on learning, memory, and attention among students (CDC, 2022). Therefore,
to keep youth engaged in learning, it is imperative to address the youth vaping epidemic as a
problem of practice for US K-12 education systems.
5

The learning environment for many middle and high school students (11-18 years old) is
negatively impacted by tobacco use. All California K-12 schools have anti-tobacco/substance use
policies on campus, and yet rates of vaping among adolescents remain high. According to the
National Youth Tobacco Survey (NYTS), 13.4% of high school and 4% of middle school
students reported the past 30-day use of tobacco products in 2021. Further, many middle and
high school teachers are required by the California Department of Education, pursuant to
education code 51202, to implement evidence-based substance use prevention curricula
beginning in grades 6-12 (Alcohol, Tobacco & Other Drug Prevention, 2016). However, many
evidence-based curricula offered by CDE do not include vaping, and it is unknown if they are
implemented with fidelity. As such, it is essential to provide schools with current vape
prevention interventions for adolescents.
Importance of Solving the Problem
An increase in marketing by the tobacco industry illustrates the importance of solving
this problem. Marynak et al., (2018), analyzed 2016 NYTS survey data and found 11.5 million
high school students and 8.9 million middle school students were exposed to e-cigarette
advertisements, an increase of 13% compared to 2014 data. While vaping among youth increased
steadily from 2011-2019, rates plateaued during the COVID-19 pandemic (Mirbolouk et al.,
2022) . By 2021, youth vaping has remained steady, with 14% of high school students and 4 %
of middle school students reporting vaping tobacco products in the last 30 days (NYTS, 2022).
However, it is possible that the prevalence of vaping will continue to increase as adolescents
return to school and experience peer influence, after being isolated from peer influence for
several years.
6

There are several explanations for the youth vaping epidemic, including aggressive
marketing by the tobacco industry, the use of flavors to attract youth, and peer influence. While
the industry claims that they market only to adults, a recent CDC survey reports that adolescents
exposed to tobacco advertisements found them appealing (CDC Tobacco Free, 2022). Tobacco
industry marketing to youth is not new. Tobacco companies have intentionally marketed to youth
since the start of the tobacco industry. Several inside documents highlight the industry goal of
recruiting new young users under 18 years (Truth Tobacco Industry Documents, 2022). With
bright colors and cartoon imagery, it is not surprising to note that many youth find vape products
appealing. Historically, the tobacco industry has targeted youth by offering scholarships to
students, sponsoring music festivals, investing in social media campaigns, and introducing
flavors that appeal to youth (“4 Marketing Tactics”, 2018).
In 2021, approximately 85% of youth who vaped reported using flavored products
(NYTS, 2022). Flavored tobacco products attract youth by masking nicotine's harsh flavor while
enticing youth with sweet flavors. A 2019 youth survey found that 72.2% of high school students
and 59.2% of middle school students who vape reported vaping flavored e-cigarettes (Cullen et
al., 2018). The authors reported that fruit, mint, and sweet candy flavors were the most reported
(Cullen et al., 2018).
Often, the tobacco industry markets these sweet and creative flavorings by using brightly
colored packaging and cartoon imagery to promote their products. This approach of using
cartoons and bright colors is strikingly similar to the tobacco industry’s use of Joe Camel, a
cartoon camel character, to market cigarettes in the 1980s and 1990s. By 1997, the Federal Trade
Commission determined that the tobacco industry's use of a cartoon character, Joe Camel,
contributed to increased youth use of tobacco and resulted in significant injury to youth health
7

and safety (“Joe Camel Advertising Campaign,” 1997). However, nearly 15 years after this
critical ruling, e-cigarettes were allowed to circumvent policy and continue using cartoon
imagery to market their products. Thus, it is essential to counter this increased marketing by
fostering independent thinking, self-regulation, and a commitment in our youth to refrain from
vaping. By refusing to engage in vaping, our youth will avoid the negative physical, mental, and
social consequences of its use.
Several studies have illustrated the negative impact of vaping on adolescent health. The
CDC has outlined the role of nicotine on the developing brain, including dysregulation of the
brain responsible for impulse control, learning, and mental health (CDC, 2022). Further, studies
of adolescent cohorts frequently show that early exposure to nicotine may lead to substance use
disorders later in life. For example, Unger et al., (2016) conducted a study that followed a cohort
of Los Angeles County high school students. They found that early exposure to e-cigarettes was
associated with higher rates of combustible cigarette and cannabis use in young adulthood
(Chadi et al., 2019; Unger et al., 2016). Early use of e-cigarettes is also associated with adverse
learning outcomes among middle and high school students. For example, Dearfield et al., (2021)
found that early exposure to e-cigarettes and combustible cigarettes was associated with lower
academic performance. It is imperative to address the issue of youth vaping and address
prevention efforts among middle school students before more significant initiation occurs in high
school.
Instructional Needs Assessment
According to Smith and Ragan (2005), it is critical to conduct a needs assessment prior to
engaging in curriculum design. In order to address the problem of vaping, it is essential to begin
by conducting a needs assessment of middle school students (Mantey et al., 2021). According to
8

the CDC, tobacco prevention interventions are most effective when implemented with youth
before they initiate tobacco use (Guidelines for School Health Programs to Prevent Tobacco Use
and Addiction, 1994). Wang et al., (2019, as cited in Mantey et al., 2021) reported that
approximately 10.5% of middle and 27.5% of high school students reported past-month e-
cigarette use; these data would suggest that middle school would be the ideal time to implement
a vaping prevention intervention. Thus, the initial target population for this curriculum is middle
school students.
Smith and Ragan (2005), outline three primary conditions as guides for conducting a
needs assessment; (a) assess if there is a problem to be addressed among the population of
interest; (b) assess if there is something new that learners need to learn; (c) conduct an
assessment of learning or training programs to ensure goals are being met. (Smith & Ragan,
2005).
The authors describe three different models; (a) the problem model; (b) the innovation
model; and (c) the discrepancy model. Each of the models has specific applications. The problem
model is used to assess if a problem exists in an organization or learning environment that should
be addressed (Smith & Ragan, 2005). To learn about an organizational problem, one must ask
members of the organization questions that will elicit non-evasive responses. Further, the
researcher must work to determine if the problem identified is the result of poor employee or
learner performance or if, in fact, external conditions, e.g., faulty equipment or standardized
testing, are the issue (Smith & Ragan, 2005). Finally, the researcher must determine the proper
solution to the problem/problems identified (Smith & Ragan, 2005).
The innovation model proposed by Smith and Ragan (2005) is used to determine if there
have been changes in the learning environment that should be addressed via a curriculum. This
9

includes environmental factors that impact performance in the school setting (Smith & Ragan,
2005). In order to properly conduct an assessment properly using the innovation model, the
researcher must assess if there have been significant changes in personnel, policies, or
educational philosophies that are impacting student learning (Smith & Ragan, 2005). Further,
one must determine learning goals that are affected by this innovation. Finally, the researcher
must work closely with stakeholders to decide if the learning goals are appropriate and are of
high priority for the organization or learning environment (Smith & Ragan, 2005). Once it is
determined that the innovation that has been identified is important, one must work closely with
various stakeholders (e.g. teachers, parents, and principals) to begin designing learning activities
that will help address the impact of the innovation on learning.
Finally, as described by Smith and Ragan (2005), the discrepancy needs assessment
model is a “summative evaluation” model that assumes all learning goals are properly identified,
and instruction is offered related to these goals (Smith & Ragan, 2005). This model aims to
determine how well organizational goals are being achieved and whether or not there is a gap
between what is intended for learners and the actual outcomes achieved (Smith & Ragan, 2005).
Once these gaps in learning have been identified, it is crucial to design or modify existing
curricula to meet the needs of students in the learning environment (Smith & Ragan, 2005).
For the current curriculum, an innovation model outlined by Smith and Ragan (2005) will
be used to assess the needs of adolescents in middle school. Following the innovation model will
allow a better understanding of the nature of vaping among adolescents. Further, it will help
identify the impact of specific changes in school policies related to vaping and tobacco use
among adolescents.
Additionally, the project will rely on Bandura’s (1977) social cognitive theory (SCT).
10

SCT suggests that an individual often adopts behaviors (positive or maladaptive) when exposed
to role models being rewarded for exhibiting a particular behavior (Bandura, 1998). Specifically,
SCT explains human behavior as a factor of observed behavior and a cognitive process of
evaluating rewards, benefits, and potential consequences of certain behaviors. In other words,
people do not simply observe behavior and copy it. Instead, there is a cognitive process taking
place, which Bandura describes as the mediational process. There are 4 mediational processes
described by Bandura:
1. Attention - observed behavior must grab one’s attention.
2. Retention - behavior observed must be memorable to the observer for future replication.
3. Reproduction - one must have the ability to reproduce the observed behavior.
4. Motivation - rewards and punishments are considered before reproducing the behavior.
Rewards must outweigh perceived costs for replicating the behavior (Mcleod, 2016).
SCT is an essential theory as a basis for several existing youth tobacco prevention
programs (Bandura, 1998; MacKinnon et al., 2002; Parcel et al., 1995). This theory is critical to
the current curriculum because it is the primary foundation for a student-driven model where
learners observe digital media prevention messaging developed by their peers in a manner that is
cognitively tailored to resonate with youth. It is hypothesized that the youth-driven approach will
strengthen the four mediational processes listed above and thus will result in longer-lasting
benefits of the youth vaping prevention program.
Bandura’s social cognitive theory (1977; 1998; 2004) has been used in television, digital
media, and radio broadcasting as a guide for content development specifically oriented toward
behavioral change. Bandura (2004) suggests comprehensive approaches to health promotion
must include changing social systems that have broad effects on human health. Several
11

evaluation studies focusing on television shows and short commercials geared towards changing
behaviors show positive effects of peer modeling on increasing motivation and perceived self-
efficacy among those who watched them (Bandura, 1991; Derzon & Lipsey, 2002; LaRose &
Eastin, 2004; Mares & Woodard, 2005; Martin & Bush, 2000; Schunk & Zimmerman, 2007;
Smith, 2002). In addition, social cognitive theory shows promise as a foundation for adolescent
vape prevention digital media messaging. In their recent publication, Cartujano-Barrera et al.,
(2022) evaluated vape prevention messaging among Black and Latino adolescents in the United
States. The authors found that the most impactful vape prevention messages were those that
focused on social norms which were modeled by individuals from similar demographics
(Cartujano-Barrera et al., 2022). These findings, and those previously mentioned from
international studies, support the current approach to using social cognitive theory as a
foundation for youth development of digital media content surrounding vape prevention.
For the purposes of this needs assessment, the innovation model, as described by Smith
and Ragan (2005), will be applied to an adolescent vaping curriculum that is youth-driven. The
present curriculum will allow youth to design and implement vape prevention messaging and on-
campus activities to increase awareness among their peers of the strong influence of mass
marketing on youth intentions to vape. This approach will be used as opposed to the traditional
“top-down” approach, where adults decide how messaging should be delivered to a generic
group of youth. By using peer networks to design youth prevention messaging, it is hypothesized
that there will be an increase in acceptance of the messaging among students and decreased
intentions to vape. The remaining sections will outline the learning environment for students,
including detailed descriptions of the need to address adolescent vaping. Further, discussing the
impact of vaping and nicotine addiction on student learning and development will elucidate the
12

need to conduct an evidence-based vaping prevention program for adolescents.
Determination of the Learning Need
The first section of this chapter discussed the need for tobacco prevention among
adolescents to prevent addiction and subsequent learning deficits and health concerns later in
life. Nicotine's impact on brain development early in life further highlights the need for vape
prevention programs in order to allow all adolescents to learn uninhibited by tobacco addiction.
The present intervention has been designed to address attitude learning directly in an effort to
prevent youth uptake of tobacco products.
According to Smith and Ragan (2005), in order to teach an attitude conducive to resisting
tobacco products, it is essential to consider the cognitive, behavioral, and affective components
of learning. While primarily focusing on changing one’s attitudes and motivations towards a
certain behavior (affective domain), it is critical also to consider the cognitive domain (actually
knowing how to do something) and the behavioral component (internalizing the attitude being
taught) (Smith & Ragan, 2005). For the present intervention, youth will be taught the value of
resisting the intention to vape. The affective domain (knowing why) is the most important
cognitive area to sustain behaviors for resisting tobacco products. An important component of
the affective domain is having role models teach the behavior at hand (Smith & Ragan, 2005).
The learning need was conducted via literature review and conducting interviews with
experts in the field of tobacco control. This assessment led to the discovery that while there are a
few interventions geared towards vape prevention among adolescents, none of them are
evidence-based. The current tobacco prevention programs designated as evidence-based by CDE
do not address vaping among adolescents. Further, non-evidence-based programs that address
vaping tend to be implemented in a controlled setting, such as a classroom or clinic, and rely on a
13

“top-down” approach to teaching youth about the dangers of vaping. While this model is popular
and has shown some positive results in preventing youth from tobacco initiation, rates of vaping
continue to rise. As a result, the purpose of this curriculum is to provide an alternative method
for adolescent vape prevention. The proposed curriculum will review what students already
know about the dangers of vaping and ask students to use social media as a means of advocating
for a healthy lifestyle. If this curriculum is successful, adolescents will develop effective digital
media messaging addressing the youth vaping epidemic while also modeling healthy behaviors
that will reduce the likelihood of youth initiation of vaping.
The Learning System and Environment
The learning system consists of “...all factors that affect and are affected by the learning
that takes place…” (Smith & Ragan, 2005, p. 49). For this curriculum, the learning environment
is non-formal (Malcolm et al., 2003). Malcolm et al., (2003) suggest that non-formal learning
exists when information is shared horizontally rather than through a top-down approach. The
curriculum will use a blended approach to learning where middle school students will be
presented with course materials in synchronous, face-to-face format and will also have access to
asynchronous materials, including organized online content. Students will work as a team
learning about essential factors influencing youth tobacco initiation and develop their own
messaging to be disseminated among their social networks. Curriculum content will be presented
by a trained facilitator. This will take place during an after-school program or a health course,
depending on the school's preference. No formal assessments or grades will be assigned to
students who participate.
14

Potential Issues with Power, Equity, and Inclusion
Many tobacco prevention programs are designed and implemented by adult researchers
or policymakers who use a top-down approach to designing and implementing prevention
messaging. Approaches towards preventing youth initiation of tobacco use tend to view youth as
passive recipients of information from adults and community leaders. Current programs
emphasize the need to address risk and protective factors contributing to adolescent tobacco
initiation (Antin et al., 2018). Numerous interventions at multiple levels work in concert to
reduce adolescent tobacco use, including state and local policies against marketing toward youth
and community or classroom interventions primarily focusing on addressing personal and social
factors such as self-esteem, peer pressure, and family influence (Antin et al., 2018). Many state
and local county agencies enact policies such as minimum age requirements, zoning
requirements for tobacco sales, and state-sponsored media campaigns that focus on vilifying the
tobacco industry or highlighting future negative health impacts of smoking on adolescents. In a
recent study among adolescents in the San Francisco Bay Area, Antin et al., (2018) found that
many youth, particularly from marginalized populations, tend to think more in the present and
are not as impacted by the adverse health claims of most public health campaigns. In short, youth
tend to focus on the “here and now” and the perceived positive effect of tobacco use at the
moment often supersedes potential adverse health effects as a deterrent (Antin et al., 2018).
While these traditional approaches may be somewhat practical for communities with
resources to access them, several low SES communities in LA county continue to suffer from
high rates of tobacco use, including adolescent tobacco use. Further, rates of vaping, in
particular, remain relatively high. A recent report from the Los Angeles County Department of
Public Health indicates that 30% of high school students have ever used an e-cigarette in their
15

lifetime, and 10% of high school students reported past 30-day e-cigarette use (News Release,
2019). Finally, many of these efforts are ineffective in low-income communities of color in Los
Angeles County, where rates of adolescent tobacco use remain the highest (Froelich, 2020;
Wheeler et al., 2020).
Several reasons may explain the increased rates of vaping in these communities,
including lack of access to evidence-based prevention and cessation programs in many LA
County middle schools, lack of parent education programs that reach working-class parents, and
a higher concentration of vape shops and liquor stores in low income/marginalized communities
of color in LA County (Froelich, 2020; Wheeler et al., 2020). Although much thought and
research are put into designing and implementing county-wide tobacco prevention efforts,
adolescents in many Los Angeles communities remain affected by high rates of e-cigarette use.
Definition of Terms
The following is a list of terms that apply to the development, implementation, and discussion of
this youth vape prevention curriculum:
● Vaping refers to the use of any electronic device to inhale nicotine-infused products. Note
this includes the use of box mods, cigalikes, pod devices such as JUUL or Puff Bar, vape
pens, and other similar devices (US Food and Drug Administration, 2022). The products
can contain nicotine derived from the tobacco plant or synthetic nicotine.
● Digital Media refers to youth-developed videos, photos, Graphics Interchange Format
(GIF), or other content developed for web-based platforms, including social media,
YouTube, and similar digital media outlets (Dewdney et al., 2013).
Organization of the Design Blueprint
The present curriculum design is divided into five chapters. The first chapter outlines the
16

dangers of adolescent vaping and the need to address further prevention methods specifically
aimed at middle school students. There is also an outline of the curriculum goals and a
discussion on the learning environment. Chapter 2 presents important theoretical foundations to
guide the design and content of this curriculum. Chapter 3 discusses the population of interest,
middle school students, and the context of learning. Chapter 4 includes a detailed discussion of
the overall curriculum and the different lessons that make up the curriculum. This outline
includes learning goals and objectives, demonstrations and role-playing, practice and feedback,
assessments, and discussions of curriculum content. Chapter 5 will address the implementation
and evaluation of the curriculum.
About the Author

As the author of this curriculum on preventing adolescent vaping, I realize the need to
discuss my background and potential bias toward the development, implementation, and
evaluation of this curriculum. It is a privilege to have the opportunity and time to be enrolled in
an Ed.D program. My path toward higher education was far from traditional. My father
immigrated to the United States from Mexico in the 1960s, and my mother was born and raised
in the Los Angeles area. I grew up in a primarily Latino neighborhood in southeast Los Angeles
and was exposed to substance abuse among peers, parents, and other relatives at a young age.
This impacted my life as day-to-day survival became more primary than school. As a result, I
attended continuation school and worked hard to graduate with a high school diploma. I moved
away from home at the age of 17 and did not return. Instead, I decided to attend junior college at
the suggestion of a close friend. This experience exposed me to the idea that one can have a job
exploring the lived experiences of oppressed populations, which I gravitated towards
immediately. After six years as a full-time undergraduate student while also working full-time to
17

support my schooling, I graduated with honors from UC Davis with a degree in Sociology.
After my undergraduate degree, I began looking into career options. Knowing I wanted to
work with underserved youth populations, I immediately accepted a position as a counselor at a
level 12 group home working with socially emotionally disturbed (SED) youth ages 14-18. This
position allowed me to share my experiences growing up with youth in similar situations that I
had growing up. Homelessness, substance abuse, and systematic oppression often dictated many
of these young men’s futures. After 2 years as a counselor and medical director, I shifted my
focus from treatment to prevention. At this juncture, I discovered the field of Public Health. I
began working part-time as a researcher at University X (a pseudonym) for a tobacco cessation
intervention geared towards youth attending continuation school, also known as high-risk
populations. Quickly I began learning the importance of implementation fidelity and program
evaluation. I was honored to be a part of a curriculum that became one of a handful of evidence-
based substance use prevention and cessation programs. Further, while working at University X,
I was fortunate to receive tuition remission and obtain a Master of Public Health degree. This
was something I never imagined possible. It also opened up opportunities for teaching at
California State Universities throughout the Los Angeles area.
My story is one of resilience, as I have worked hard to fight against oppressive systems
all along the way. My current role as project director in the department of population and public
health sciences at University X, is one I cherish after working in tobacco control over the past 18
years. However, even now, oppressive systems are at play and I continue to fight to be allowed
to teach in our department and maintain grant funding in order to do important work that directly
benefits the local communities where I grew up and still live. During my time as a project
manager in tobacco control research, I have gained a great appreciation for the role of
18

understanding etiology and important antecedents to addiction. However, I have also felt that we
as researchers should do more than collect and analyze data. This is why I chose to write my
dissertation on developing a curriculum that will help prevent youth from becoming addicted to
nicotine. It is important to me that youth from underserved communities have a program that
resonates with their lived experiences. It is my hope that by learning how to take ownership of
their decisions on whether or not to use tobacco in middle school, they may translate some of the
skills learned from this curriculum and use them for navigating a world where oppression and
discrimination often infiltrate opportunities for personal growth and prosperity.
Theories Informing Author’s Positionality
Social justice theory (Bell, 2016) posits that access to quality education should be
equitable for all racial and ethnic groups in society (Bell, 2016). This goal is often critiqued as
being widely unattainable in modern U.S. society. The present youth vaping curriculum is
heavily influenced by this theory of social justice. In an attempt to address youth vaping, it is
important to consider inequities that exist based on racial categories. For example, in their
seminal work on acculturative stress, Smart and Smart (1995), describe the Hispanic
acculturation experience in the U.S. as problematic in the sense that many Hispanic values are
often in direct conflict with the broader social context in which they are living. The authors argue
that the “melting pot” theory of immigration is primarily derived from an eastern and western
European immigrant experience but does not explain the acculturation process for many
Hispanic groups (Smart & Smart, 1995). As a result, many Hispanic immigrants feel isolated and
experience stressors that are somewhat unique to that population.
While working for many years in tobacco control among marginalized populations, I
have learned how these acculturative stressors may be a contributing factor to increased
19

substance use among Hispanic adolescents. It is difficult to disentangle the role of structural
racism from personal stressors related to acculturation. However, given that high rates of youth
tobacco use tend to be concentrated in lower-income high Hispanic populated neighborhoods,
one can see the lack of social equity in terms of concentrated pockets of retailers selling these
devices in their communities.
In addition, critical race theory (Ladson-Billings, 1995; CRT) informs my positionality.
Critical race theory originated as a theory among legal scholars of the late 1970s and early 1980s
as a result of observed racial disparities that existed even after certain policies geared towards
eliminating said disparities, such as Brown v. Board of education, were passed. In 1995, Dr.
Gloria Ladson-Billings used tenets of this theory and applied it to explain continued racial
disparities in education in America. According to Ladson-Billings, racial disparities in education
persist due to three main propositions: (a) race continues to be the main factor determining
inequity in the United States; (b) United States society is primarily based on property rights; (c)
the intersection of race and property allows us to better understand social–and consequently
school-based–disparities.
The disparities highlighted in CRT are present in my positionality. CRT, as described by
Ladson-Billings, resonates with my lived experience. As a first-generation Latinx male born and
raised in Southern California, I grew up in an education system that allowed me to fall through
the cracks. Attending schools in low-income neighborhoods further complicated my experience
and eventually I ended up in continuation high school. Fortunately, I was able to learn from my
previous experiences and began to have an interest in attending college. It was at that point in my
educational development that I discovered and learned about structural racism that contributed to
the lack of opportunities and eventually my lack of progress as a student in the K-12 setting.
20

In sum, students develop an interest in vaping as early as middle school. The evidence
above illustrates that interventions for vaping should be developed for middle school students.
Increasing youth advocacy and knowledge of digital media as a means for youth advocacy may
serve an important role in reducing youth intentions to vape. In Chapter 2, the literature that
informs the content of the curriculum will be reviewed.

21

Chapter Two: Review of the Literature

This literature review is conducted in three sections. The first section is an analysis of
prior attempts at addressing the youth vaping epidemic via school-based curricula. The second
section is an in-depth literature review that will inform the content of the curriculum. The final
section analyzes the content of the curriculum from the perspective of knowledge types.
Prior Attempts
Previous attempts at preventing tobacco use have relied heavily on structured approaches
often taught by trained adults. One such program, Project Towards No Drug Abuse, is an
evidence-based program developed by researchers at the University of Southern California. This
curriculum, created in 1997, incorporates 12 interactive sessions focusing on three critical
cognitive factors, including (a) motivational Factors; (b) skills building; and (c) healthy decision-
making (About – TND, 2022). There is a series of training teachers must attend to implement
project TND with high school students properly. Adherence to implementation fidelity increases
the likelihood of reducing substance use among at-risk youth (Sussman, 2015).
Several high schools in Southern California offer after-school programs for youth. One
such program, the Beyond the Bell (BTB) program in the Los Angeles Unified School District
(LAUSD), seeks to offer students access to safe, supervised learning environments beyond
school hours (Beyond the Bell, 2022). Working with the Los Angeles Unified School District
(LAUSD) has offered the author insight into current tobacco prevention education efforts being
conducted in Southern California high schools. Several enrichment programs are offered through
BTB, including a program focusing on vape prevention. This vape prevention and education
program is offered to students at various high schools in the district. Throughout the year,
students in this program work on developing campaign messages for different tobacco
22

prevention events on campus. The program relies on input from experts in tobacco control and
gathers resources from credible sources such as CDC, NIH, the TRUTH campaign, and other
similar tobacco control organizations. The primary goal of the BTB Vape Abatement program is
to present this information to parents, teachers, administrators, and students so they become
aware of the dangers of vaping and learn about healthy alternatives to vaping.
The BTB program, while not a structured curriculum, does offer students the opportunity
to produce videos regarding the dangers of vaping. This is an important step toward increasing
awareness about vaping among high school students with the potential to increase awareness of
negative health effects of vaping and other tobacco use. However, the BTB tobacco curriculum is
not primarily focused on youth advocacy for vape prevention. The BTB and other after-school
programs also do not have built-in mechanisms for students to distribute videos to peers at the
middle or high school level. Finally, the BTB program does not have a thorough evaluation
component to assess knowledge, attitudes, and vaping behavior among high school students in
this district.
Finally, there are several vape prevention training interventions for youth and young
adults offered by corporations, and some developed by universities. The Stanford Tobacco
Prevention Toolkit is an excellent example of a curriculum that draws from current literature to
teach students refusal skills and the dangers of tobacco use. Their website contains several
curricula geared towards tobacco cessation, smokeless tobacco prevention, hookah awareness,
and general instructional slides for conveying the adverse health risks of tobacco use (Stanford
Toolkit, 2023). Additionally, CVS Health funded classroom-based tobacco prevention
curriculum, “Catch my Breath,” includes lessons specifically targeting vape prevention in
schools and community clinics (Baker et al., 2022; Kelder et al., 2021). Finally, several tobacco
23

industry sponsored school based youth tobacco prevention curricula have proven to be
ineffective and in some cases have been associated with increase rates of tobacco use to youth
exposed to that curricula (Evidence Brief, 2022) However, most of the current vape prevention
curricula are either afterthoughts with new vape modules tacked onto existing, and somewhat
dated, tobacco prevention curricula, or they are newly developed classroom-based instruction
that are not evidence-based. A recent meta-analysis conducted by Liu & Halpbern–Flescher
(2020) found that five prevention programs and two existing cessation programs conducted an
evaluation of their e-cigarette components (Liu et al., 2020). The authors concluded that current
programs lacked e-cigarette dedicated materials and more evidence-based resources and tools are
needed in order to address youth vaping prevention (Liu et al., 2020).
The vape prevention examples above are not meant to be an exhaustive list of all tobacco
prevention efforts; rather, they are presented in order to highlight the importance of
systematically developing tobacco prevention programs for youth and identifying limitations of
current curricula. Several vape prevention curricula and after-school programs miss important
theoretical factors for youth information retention and learning. One of these factors is based on
Bandura’s (1997) theory of social learning in which students should see relatable models. Many
of the above-referenced school-based interventions utilize a top-down approach that does not
allow for peer modeling of healthy alternatives to vaping. Also, many after-school programs do
not have structured lessons that increase self-efficacy for youth advocacy, which is a critical
factor for assuring behavior change among youth.
The Content of the Curriculum
This curriculum was designed after carefully reviewing the literature on adolescent
vaping and prevention efforts. Recent data from the National Youth Tobacco Survey (NYTS)
24

indicated that 14% of high school students and 4% of middle school students reported vaping
tobacco products in the last 30 days (NYTS, 2022). Youth vaping initiation is associated with
peer influence, school environment, tobacco industry marketing to youth, and family modeling
of tobacco use (Chen-Sankey et al., 2019; Lippert et al., 2019; Struik et al., 2020). Evidence-
based tobacco prevention programs, such as Project EX or Project TND, have been
longitudinally evaluated to show long-term prevention effects compared to control groups who
did not receive the intervention (Sussman, 2020; Sussman, 2015). These are two of a handful of
evidence-based tobacco prevention curricula that show evidence of long-term tobacco use
prevention relative to control groups. Incorporating pre-scripted activities such as mock game
shows scenarios, mock talk shows, and other peer modeling scenarios helped participants recall
prevention messages and other critical components of TND and EX for several years of post-
survey data collection.
Additionally, a quasi-experimental study conducted by Park and Chang (2020)
incorporated similar role-play activities and active engagement of students in the curriculum by
having youth develop vape prevention messaging for social media alongside trained facilitators.
Both of these substance use prevention programs relied on students researching, learning, and
actively engaging via mock game shows (TND/Project EX) and social media content
development (Park & Chang, 2020). These student learning approaches show promise for long-
term retention of vape prevention messages among youth exposed to the curricula. Additionally,
there is a greater potential that youth who are not part of the social media prevention curricula
may see the content developed and model their behavior change for preventing vaping. This is
consistent with Bandura’s SCT, which emphasizes the importance of social modeling; therefore,
25

modeling vape prevention activities in videos may lead to positive outcomes for youth who view
the videos on social media.
The present intervention is tailored to prevent youth vaping by briefly reinforcing
mandatory middle school vape prevention messaging while allowing youth autonomy to develop
vape prevention messaging that resonates with their age group. The curriculum is designed to
address the California Department of Education (CDE) requirement to offer developmentally
appropriate tobacco prevention education to K-12 students, with particular attention to 6th-9th
grade students (CDE, 2002). Below is a review of the literature on specific learning goals
relevant to vape prevention among middle school students (Students - Alcohol, Tobacco & Other
Drug Prevention (CA Dept of Education), n.d.).
The Power of Media and Society
Foundational to student development of impactful digital media content on vape
prevention is an understanding of how digital media is used to influence human emotion and
behavior in politics, marketing, and health behaviors. Specific attention to how social media
impacts emotions and emotional contagion is relevant for two reasons. First, youth must learn
how their emotions and behaviors are influenced by digital media including television, movies,
and social media. Secondly, in order for youth to develop advocacy messages for anti-vaping,
they must fully understand how their words, images, and message dissemination will influence
the behaviors of their peers and online social networks.
Clark and Paivio (1991) describe a theory of dual coding (DCT) and learning. This theory
describes ways in which learning is impacted by concrete, verbal, and nonverbal (imagery-
associative) processes (Clark & Paivio, 1991). DCT suggests these processes are highly
dependent on personal history, context, and the subtle spreading of activation among students
26

(Clark & Paivio, 1991). This theory is helpful in explaining the potential for digital media
content to affect users. According to DCT, words and text evoke positive and negative visual
images. This is known as referential connections (Clark & Paivio, 1991). For example, the word
school may evoke negative visual images and feelings of anxiety for some. Additionally,
associative connections between text and emotions may occur. For example, the word school
may evoke verbal associations such as “boring” or “afraid” (Clark & Paivio, 1991). These
referential and associative connections described in DCT help lay the foundation for
understanding the power of digital media on emotions and behaviors. These constructs will also
help guide middle school students in understanding the importance of selecting words and
imagery that will evoke the intended emotions of empowerment and advocacy for vape
prevention.
Another core concept related to digital media and emotions includes emotional contagion.
Goldneberg and Gross (2020) describe several ways in which digital media, including social
media, blogs, forums, and video streaming, impact user emotions. Pekrun (2017) further explains
how emotion during adolescence significantly affects student learning and achievement. Students
must understand the impact of positive and negative emotional activation and how this impacts
learning (Pekrun, 2017). Digital media has the potential impact emotions strongly. When people
spend time online, they experience the emotions of those they witness online (Goldenberg &
Gross, 2020). This transfer of emotion is known as digital emotional contagion, and it is
characterized by the type of digital media platform, e.g., video hosting vs. social media, and the
amount of upregulating of emotions these platforms impose on users (Goldenberg & Gross,
2020). For example, social media has a vested interest in upregulating user emotions, particularly
perceived positive emotions, to keep users engaged and make the social media platform
27

profitable (Goldenberg & Gross, 2020). Many corporations implement this upregulation of
emotions and emotional contagion to market their products and encourage users to like, share
and even promote their products and services. Youth who learn about the power of social media
to impact behavior may use this platform to encourage positive health behaviors, including
messaging to prevent vaping among their peers.
In sum, digital media has the power to affect the emotions of the user. The literature
reviewed above suggests how these psychological perspectives may influence an individual’s
behavior. Emphasis is placed on the role of social media and its impact on user emotions,
including emotional contagion and the effects of upregulating emotions to keep users engaged in
social media platforms. With individuals being susceptible to changing behavior based on
imagery and messaging, the literature reveals that the tobacco industry has used this strategy to
market its products to youth who are particularly susceptible to these marketing approaches.
Current Trends in Social Media and Their Influence on Society
Social media has evolved to include several prominent outlets for expressing oneself and
often allows users to create alternative portrayals of self. User engagement has grown to
influence the outcomes of elections, the emotions of users, and individual behaviors. Algorithms,
bots, and artificial intelligence (AI) are ways in which companies market products to users
(Bradshaw & Howard, 2018; Kreps, 2020). Some online malicious groups use these same tactics
to post digital media content impacting user emotions and in some cases influencing the
outcomes of political elections. Bradshaw et al., (2018) found online bots were responsible for
impacting the 2016 U.S. presidential election by artificially manufacturing consensus around a
particular candidate via fake likes, re-tweets, and follows. The authors note there are online
28

sources to help identify bots. However, the average user of social media is inherently poor at
detecting bots online (Bradshaw & Howard, 2018).
One’s emotional state has been shown to be influenced by one’s environment and close
peers. Emotional contagion has been a proven in-person concept in lab settings for many years,
where one’s positive or negative emotions are directly affected by people around them (Fowler
& Christakis, 2008; Rosenquist et al., 2011). However, little was known about the impact of
remote emotional contagion via social media until a 2014 study conducted by the core data
science team at Facebook. Kramer et al., (2014) conducted a study where they intentionally
manipulated Facebook posts for two experimental groups. One treatment group saw 90%
negative emotion posts on their news feeds, while another treatment group saw 90% positive
emotion content in their news feeds (Kramer et al., 2014). They found that when positive
emotions were reduced, users tended to only post negative emotional posts in their feeds
(Kramer et al., 2014). This study, while ethically controversial, provided experimental evidence
to support the idea that emotional contagion may occur on a massive scale via social media
(Kramer et al., 2014). It also provides evidence that emotional contagion is possible without
being in person with peers and can have a significant impact on user behaviors.
The aforementioned studies support the idea that social media may be used by
adolescents to develop and disseminate messaging that highlights the advantages of not vaping.
It is possible to develop digital media that will impact positive emotions via social media. Many
of the AI, bot, and algorithm tactics tend to disproportionately scapegoat communities of color
and other priority populations (Kreps, 2020). Empowering youth with knowledge of trends in
social media use and their influence on emotions and society will help them identify how their
29

emotions are potentially manipulated to use vape products. As such, it is important that youth
learn the strategies used by the tobacco industry to influence youth's uptake of vape products.
The Power of the Tobacco Industry To Change Behavior
The increase in youth vaping is associated with exposure to tobacco marketing via social
media and other digital media content. Much of this content is developed by the tobacco industry
while some ads that appeal to youth are developed by social media influencers, often paid by the
tobacco industry to promote a specific product or digital media content shared by peers (Chen-
Sankey et al., 2019) developed by the tobacco industry. Youth will be able to articulate findings
from the literature pointing to different ways social media is used to promote vaping behavior
and other tobacco product use among teens. Specifically, youth will articulate ways social media
is used to target youth for tobacco promotion and increase youth initiation of vaping.
Historically, the tobacco industry uses specific marketing strategies to increase the use of
tobacco products among younger populations. Examples of this marketing include cartoon
characters used as brand mascots, such as Joe Camel, sponsoring monster truck events for youth,
for example, the skoal bandit truck, and many other tactics to increase and normalize tobacco
products to youth. These tactics resulted in increased rates of tobacco use among minors during
the 1970s through the early 1980s (Jones & Silvestri, 2010). In 1998 several states sued the
major tobacco corporations for targeting minors and increasing tobacco use rates. As a result, a
settlement was reached, the Master Settlement Agreement (MSA) between tobacco companies
and several state attorneys generals greatly restricted or eliminated tobacco industry marketing
through traditional channels such as event sponsorship, television ads, promotional item
giveaways, and use of cartoon imagery for branding to name a few (Jones & Silvestri, 2010; C.
King & Siegel, 2001; Lewis et al., 2004). It is important to note that the MSA was only binding
30

to the big tobacco companies that existed at the time and signed it, and it only regulated certain
forms of tobacco sponsorship and advertising via print media and television. Additionally, the
MSA did not apply to new emerging vape companies of the mid-2000s and 2010s.
As vaping became more prominent in the mid-2000s and 2010s, big tobacco as well as
small start-up vape companies such as Juul began to use the same marketing tactics from earlier
years, including bright colors, cartoon imagery, and new flavors to attract youth to use their
products (Soneji et al., 2019). There was one important difference: social media was becoming
more popular among youth at this time and, therefore, ripe grounds for promoting and
normalizing vaping among teens (Jones & Silvestri, 2010; C. King & Siegel, 2001; Lewis et al.,
2004). Big tobacco companies, vape start-ups, and local vape shops that mixed their own e-
liquids began relying heavily on social media to promote vaping (O’Brien et al., 2020; Soneji et
al., 2019). During this time, vape companies spent billions of dollars to develop clever digital
media and sponsor social media influencers to promote their products on their social media posts
(Chen-Sankey et al., 2019; O’Brien et al., 2020; Struik et al., 2020).
During this same time period of increased marketing of vape products via social media,
there was also an increase in the prevalence of vaping among youth. Several studies have found
an increased influence of tobacco marketing via social media on youth use rates and lower
perceived risk of using vape products (Chen-Sankey et al., 2019; Cho et al., 2019; O’Brien et al.,
2020; Pierce et al., 2018). Findings highlight different mechanisms used to promote pro-vaping
attitudes among adolescents, including social media content developed by the tobacco industry,
content developed by social media influencers, and content disseminated among peer networks
(Chen-Sankey et al., 2019; Cho et al., 2019; Vannucci et al., 2020). A recent meta-analysis on
social media use and youth risk behaviors conducted by Vannucci et al., (2020) suggests social
31

media, according to the “super peer” theory, acts in such a way as to impart particularly profound
pressure on youth to engage in risky behaviors including substance use initiation. Thus, social
media presents a unique approach to tobacco marketing with the potential to significantly impact
youth perceptions of vaping as safe or intriguing.
Other studies have further described the effects of tobacco marketing via social media.
Cho et al., (2019) conducted research identifying mechanisms that impact youth receptivity of
pro-tobacco vaping ads via social media. The authors found social media motivations such as
self-expression and perceived media realism had a moderating effect on attitudes toward e-
cigarette use among adolescents (Cho et al., 2019). They highlight the concept of perceived
media realism and its role in making marketing via social media somewhat unique in that users
are both the creators and consumers of digital media content (Cho et al., 2014, 2019). The
concept of perceived media realism leads to greater persuasion among users as it relates to the
perceived authenticity of sponsored tobacco promotions disseminated via social media
influencers. Specifically, the authors note that greater social realism motivations among users
were associated with a greater impact of e-cigarette social media messaging on positive attitudes
toward e-cigarette use among adolescents (Cho et al., 2014, 2019). Thus, by using social media
to promote vaping and other tobacco products to youth, the tobacco industry can potentially
change youth behavior and subsequent vaping.
Social media is a platform used to impact emotion and is used by the tobacco industry to
market e-cigarettes and other tobacco products. By using social media, tobacco companies are
able to engage with youth in unique ways that promote vaping by highlighting the use of flavors,
technology, and popularity via social media influencers. The present curriculum will leverage the
results from the aforementioned studies to teach adolescents specific ways the tobacco industry
32

influences behavior via social media. Students will be able to articulate the role of social media
on vape behavior and how the tobacco industry, social media influencers, and peers create digital
media to market and sell vape products to youth. It is expected that youth in the present
intervention will work together to incorporate lessons learned from the history of tobacco
marketing on social media in their digital media about the dangers of vaping.
Given the power of tobacco industry marketing via social media, it is important for youth
to understand their agency to avoid being influenced to engage in vaping. Although rates of
youth vaping have continued to increase at a significant rate, youth have the ability to counter
marketing efforts that encourage youth initiation. Youth agency is an important concept to
understand. Specifically, youth who better understand their role in social media engagement and
their ability to impact positive health behaviors among their peers have increased self-efficacy
for youth advocacy to prevent tobacco use among their peers.
The Power of Agency
In order for youth to develop impactful digital messaging to counter tobacco use, it is
critical to first teach them about the importance of the role our environment plays in our
decision-making. It is also critical students learn the importance of agency and how this concept
is used in health promotion. Bandura (1998) suggested one approach to conducting health
promotion while developing his social cognitive theory. He suggests that a health promotion
requires a comprehensive approach including changes in social systems that have detrimental
effects on health rather than a singular focus on changing one’s behavior. Health promotion
messages should be individually tailored and individualized interventions are more effective at
behavior change than uniform interventions (Bandura, 1998). This approach to health promotion
messaging will serve as a guide for developing youth-driven vape prevention digital media
33

targeted to their referent groups. Youth-developed messaging supports Bandura’s assertion that
people make healthy choices by comparing themselves to standards or norms from their
representative groups (Bandura, 1998). Using computer technology, such as social media, allows
the sharing of self-regulatory efficacy in a personalized way with greater efficiency (Bandura,
1998).
Youth exercising agency to develop vape prevention messaging will be more effective
when incorporated with the broader social context of the school environment. Several studies
have found that tobacco prevention programs have a greater impact when they incorporate
components of Bronfenbrenner’s socio-ecological theory including the micro, meso, exo, and
macro systems of an individual’s environment (Leonard, 2011; Lippert et al., 2019). A recent
study conducted by Lippert et al., (2019) investigated environmental factors that influence youth
vaping. The authors analyzed youth vaping intentions over time in the context of school and
community environments. Initially (2011) teen vaping depended heavily on school context for
youth modeling behaviors on how to use novel devices first introduced in the market. As
products evolved and were on the market over time (2011-2017), youth had access to peer
modeling and celebrity modeling of e-cigarette use via social media, which had a significant
impact on youth use of e-cigarettes and slowly diminished the impact of the school environment
on youth e-cig use (Lippert et al., 2019). Youth in the present curriculum will advocate for
community support and school reforms as it relates to youth vape prevention. As youth progress
through the curriculum, they will learn the efficacy of youth as advocates for tobacco prevention.
The Power of Youth Advocacy as Agents for Tobacco Prevention
Digital media developed by youth is particularly impactful for engagement and behavior
change. Developing youth self-efficacy is key to youth advocacy and empowerment when
34

developing vape prevention messaging. Participatory action research (PAR) is an effective
approach to mobilizing adolescents as active developers of health promotion messaging and
programs for positive change (Flicker et al., 2008). Flicker et al., (2008) extended Pablo Friere’s
pedagogy of the oppressed to youth by incorporating advocacy and empowerment to social
change via community participation for social change. Additionally, the authors incorporate the
power of electronic media in PAR, e-PAR, which includes youth as active agents and users of
electronic media for positive health changes in their local communities (Flicker et al., 2008).
Evaluating several youth-led health promotion programs, including smoking prevention, Flicker
et al., (2008) found this approach of youth advocacy had lasting effects on individuals, their
social groups, community organizations, and across youth-led groups.
Incorporating youth advocacy for tobacco prevention shows efficacy across racial and
ethnic groups as well. A recent study among primarily African American and Latino/a youth
found empirical evidence suggesting youth empowerment is critical when implementing youth
vape prevention messaging via social media (Park & Chang, 2020). Working with facilitators,
youth developed tobacco prevention messaging and disseminated them among various digital
media platforms. Engaging youth directly in the process of tobacco prevention messaging
increased empowerment in the following domains, intrapersonal - individuals’ capacity to
influence other people’s lives including family, friends, and their local environment;
interactional - knowledge about problems that exist in their communities and adolescent
assertiveness to address these problems (e.g. smoking rates in low SES communities and among
youth); and behavioral - adolescent actions for empowerment and reduced smoking intentions
(Park & Chang, 2020). Additionally, Holden et al., (2005) suggest measuring and incorporating
35

components of youth empowerment as it applies to tobacco control leading to lasting results of
reduced intentions to smoke.
These findings support the assertion that youth agency and advocacy will lead to lasting
outcomes when implementing vape prevention curricula. Youth have the power to advocate for
change in their local environments. Empowering youth to be active participants in youth tobacco
prevention effectively improves the authenticity of vape prevention messaging while
simultaneously reducing intentions to use tobacco products among youth involved in these
programs. In order to do so, youth must be able to understand and articulate current trends in
social media and how social media content is developed to influence society. Additionally,
youth, in particular, have grown up using social media, and many are experts in developing
digital media content. This positions youth as vital advocates for vape prevention if they develop
the necessary skills to do so.
Youth Advocacy Skills
In order to prevent youth vaping through the development of impactful vape-prevention
digital media content, youth must gain relevant advocacy skills. Several programs exist and have
merit for training youth on essential skills necessary for becoming youth advocates among their
peers. Evaluation results from youth-led public health advocacy programs show promise for
behavioral change among participants as well as more relevant messaging for peers (K. M. King
et al., 2015; Millstein & Sallis, 2011; Winkleby et al., 2004). Winkleby et al., (2004) conducted a
comparison of continuation high school students who were part of an advocacy group (treatment)
vs students enrolled in drug and alcohol abuse intervention (control). Advocacy training was
based on social learning and empowerment theory and included training in 3 components 1.
Dispel myths about smoking and increase awareness of environmental influences on tobacco use
36

in their community and school; 2. Youth advocacy training - develop advocacy skills, practice
persuasive communication skills, develop and present assessments of tobacco in their
community, choose an advocacy project that would be carried out through the semester; and 3.
Facilitators assisted students in developing, implementing, and evaluating their advocacy
projects (Winkleby et al., 2004). Winkleby et al., (2004) found evidence for long-term reductions
in smoking among those who were part of the advocacy intervention. Thus, engaging youth in
advocacy could reduce intentions to smoke among participants and may contribute to policy
change in the community that reduces tobacco use among their peers (Winkleby et al., 2004). It
is important to outline key elements of effective youth advocacy training for participants of the
present curriculum on vape prevention.
There are many public health advocacy programs that have laid a foundation for the
present curriculum. Millstein and Sallis (2011) conducted a youth obesity prevention program
that relied heavily on youth advocacy training. The authors drew heavily from several youth
tobacco prevention advocacy programs. They outline the importance of teaching youth
advocacy, which involves interacting with political systems, media, immediate community, and
organizations (Millstein & Sallis, 2011). Similarly, King et al., (2015) found evidence that youth
who took part in a two-week public health advocacy training program developed and maintained
reduced intentions to use tobacco products. The authors paired high school students with an adult
mentor with expertise in various public health topics including tobacco control (K. M. King et
al., 2015). Drawing from Social Ecological Theory and the Theory of Planned Behavior, the
authors outlined specific domains for their youth advocacy training. These included assessing
community needs and health topics, capacity building, planning and implementation of
37

campaigns, and evaluation and presentation (K. M. King et al., 2015). Following this outline
allows youth to build self-efficacy and collective efficacy when advocating for vape prevention.
Developing youth advocacy skills for vape prevention shows promise because youth tend
to have increased enthusiasm and optimism, which can be used to create community-based
changes. Additionally, youth advocacy has the potential to maximize change impact as political
leaders and decision-makers are usually less cynical about youth motives and therefore less
likely to reject their requests outright. Finally, the benefits of youth advocacy for vape prevention
will likely prove to be bi-directional in that they benefit society and also directly benefit youth
participating in the present curriculum.
Summary of the Curriculum Content

The literature review provided a substantial amount of information regarding the impact
of social media on youth vaping initiation. The present curriculum will utilize five learning goals
derived from the literature on social media, tobacco industry marketing, and behavioral change.
Using Smith and Ragan’s (2005) knowledge types as a guide, the curriculum will address youth
vaping prevention by teaching declarative knowledge and procedural knowledge necessary to
change youth attitudes toward vaping and becoming advocates for anti-vaping. More
specifically, the learning goals are as follows:
1. Learners will learn how to articulate the power of media and society to their peers.
This will increase youth motivation to seek ways to combat the power of media and
society.
2. Learners will be able to articulate to their peers how social media has evolved and how
it changes peoples’ emotions and behaviors. Learners will use this knowledge as a
foundation to develop their own digital media content.
38

3. Learners will be able to identify and articulate marketing methods used by the tobacco
industry, particularly marketing to youth. Additionally, learners will be able to articulate
ways the tobacco industry uses digital media to increase youth vaping rates
4. Learners will learn how to use their own agency on social media to counter pro-
tobacco influences on youth.
5. Learners will learn how to implement youth advocacy skills as per the research base
rubric to prevent their peers from initiating vaping. Youth advocacy skills will be used to
develop digital media content for dissemination to their peers via social media.
The learning goals above are further illustrated in Table 1.
39

Table 1

Analysis of the Learning Goals

Learning goal Declarative knowledge Intellectual skills Cognitive strategies Attitudes
When communicating
with their peers
about vaping, youth
will articulate the
power of media and
society to influence
our behaviors.
Know the meaning of
communicating;
vaping; media;
society; influence;
behavior
Effectively articulate
ideas and
relationships.
Elaborate in their own
words on their
current knowledge
about the power of
media to influence
behavior and that of
social media
Value communicating
with peers about the
power of media and
society to influence
our behaviors. Be
confident in
communicating
with peers.
When communicating
with their peers
about vaping, youth
will articulate how
the evolution and
current state of
social media has
greater impact on
emotions and
behavior
Know the meaning of
vaping; social
media; evolution;
emotions; emotional
contagion;
influence; behavior
change
Identify and articulate
how social media
has evolved to
influence emotions
and behaviors.
Articulate current
knowledge of how
social media affects
behaviors and
connect this to the
current youth-
oriented platforms
Have confidence
when
communicating that
emotions and
behavior may be
positively
influenced by social
media.
When communicating
with peers about
vaping, youth will
be able to identify
and articulate ways
the tobacco industry
markets their
Describe the ways
tobacco companies
use digital media to
market vaping;
identify types of
marketing that
appeals to youth;
Identify and articulate
tobacco marketing
in social media that
attracts youth to
vaping.
Elaborate on their
current knowledge
of marketing
products on social
media and how this
might occur with
tobacco marketing
Have confidence
when speaking
about ways the
tobacco industry
markets vape
products to youth
and the association
40

Learning goal Declarative knowledge Intellectual skills Cognitive strategies Attitudes
products on social
media and how
social media
marketing is linked
to youth vaping.
articulate how youth
vaping is associated
with the tobacco
industry social
media marketing
to youth. with high rates of
youth vaping.
When given the
choice to engage in
vaping, learners will
exercise their
agency in becoming
an advocate to
counter pro-tobacco
influence by
creating social
media
Describe the meaning
of choice; vaping;
social media
Be able to exercise
agency; be able to
create social media
Elaborate on how
learners exercise
independence
(agency) in their
lives and how this
may be applied to
youth vape
prevention.
Believe in the value of
advocating. Have
confidence that
youth have the
power of agency on
their decisions
whether or not to
use vape products.
When implementing
anti-vape digital
media content for
their peers, youth
will incorporate 2-3
advocacy strategies
from the curriculum
materials.
Describe youth
advocacy strategies;
anti-vaping;
describe behavior
change
Be able to exercise
advocacy skills to
address youth
vaping. Identify and
describe examples
of anti-vaping youth
advocacy
Elaborate on how
youth use advocacy
for change and how
this may be applied
to advocacy to
prevent youth
vaping
Believe in the value of
youth advocates for
change. Have
confidence in their
ability to impact
change for youth
vape prevention

41

Chapter Three: The Learning Environment and The Learners

This chapter addresses the learning environment and the learners. The learning
environment starts with a definition and then applies it to this proposed curriculum. The section
on the learners describes and applies the various considerations regarding learner characteristics
important to this curriculum.
Description of the Learning Environment
Smith and Ragan (2005) suggest that all learning environments encompass not only a
context, such as a school, home, or business, but also the nonphysical temporal and social
context in which learning takes place. The learning environment may include an assessment of
the broader community morals and taboos (Smith & Ragan, 2005). For example, designers must
understand whether the broader community is accepting of middle school students learning about
tobacco control including the tobacco industry’s tactics to market their products to youth such as
sex appeal or violence in media campaigns. Additionally, knowing the morals and beliefs of the
instructors will help developers draft content that is not overly contrary to intrinsic beliefs. Smith
and Ragan (2005) advise that curriculum designers take time to understand not only the physical
environment but also the social and community factors that impact learning.
The youth vape prevention curriculum proposed will take place at middle school
campuses in Southern California. As such, the learning environment will include a classroom,
access to wifi, student Chromebooks, and digital editing software. This program is intended to be
nonformal in that it will not be taught during regular class time nor will it be part of the
traditional curriculum. Rather, it will be offered to students as part of after-school programs or
school clubs that meet during school hours. In the sections that follow, various aspects of the
learning environment are described further. However, the curriculum will be adaptable in the
42

event that schools request to make it part of their formal curriculum on tobacco education that is
required by the California Department of Education.
Teacher/Trainers/Facilitator Characteristics
Facilitators of this program will be graduate students from public health, social work, or
media training programs. It is expected that the facilitator will have experience working with
middle school students, understand how to use social media, pass criminal background checks
(live scan), and be knowledgeable about the youth vaping epidemic. Facilitators will know how
to use digital media and will be trained on specific lessons from the present vape prevention
curriculum.
Existing Curricula/Programs
According to the California Department of Education (CDE) Education Code 51202
requires that schools offer tobacco prevention lessons to students that outline the effects of
tobacco on the human body (Students - Alcohol, Tobacco & Other Drug Prevention (CA Dept of
Education), n.d.). Project Towards No Drug Abuse (TND), Stanford Tobacco Prevention
Toolkit, and the CVS sponsored “Catch My Breath” curriculum are examples of school-based
vape prevention curricula. Additionally, the California Department of Education offers funding
to districts to implement supplemental training to students via their Tobacco Use Prevention
Education (TUPE) program.
While it is not necessary that the present vape prevention curriculum fit within the
aforementioned evidence based curricula, it is possible it may serve as a useful tool for the
afterschool programs implemented via the TUPE program. Additionally, the present curricula
will be designed to increase youth advocacy and may be implemented independent of TUPE. It
will be important to consult the school district implementing this vape prevention curriculum to
43

determine whether the school has an existing TUPE program or if they would prefer this
curriculum be implemented independently during a unique after-school program for students.
Available Equipment and Technology
Students in middle school will have access to cell phones in order to create social media
content. According to a recent national survey, approximately 66% of middle school students
indicate they have access to a cell phone (Versel, 2018). Additionally, 95% students in K-12
schools in California have chromebooks and wifi access at school and in their homes (Aguilar et
al., 2021). For students who do not have their own cell phones, the curriculum will provide
tablets or other devices to record media. All digital media creation activities will be conducted in
a group setting. In addition to hardware such as phones or computers, students will need access
to basic video editing software or apps available for free online. Facilitators will assess software
needs and recommend the proper software to use for developing vape prevention videos.
Classroom Facilities and Learning Climate
The middle school anti-vape curriculum proposed here will require on-campus facilities
in order to meet with students on campus during after school hours. Schools in Los Angeles
County often provide class space for students to assemble and work on school sponsored clubs,
sports teams, or music programs. The author of this curriculum has collaborated with local
districts for 15 years on tobacco control efforts. Middle schools encourage youth to embrace
refusal skills to prevent vaping on campus. They work closely with their district and the local
office of education to identify activities where students may get involved in tobacco and vape
prevention activities.
Learner Characteristics
To develop relevant curricula for a specific target population, it is important to consider
44

learner characteristics. According to Smith and Ragan (2005), designers of curricula often fail to
meet their goals because they do not analyze the characteristics of learners. Specifically,
curriculum developers should analyze the learning characteristics of the target population to
ensure the curriculum addresses similarities and differences, levels of knowledge, and core
attributes of the target population in order to maximize interest, attention, and retention of
curriculum content (Smith & Ragan, 2005).
The present curriculum is intended to target middle school adolescents living in various
parts of the United States. It is intended to be flexible for various demographic groups (e.g.
gender identity, racial/ethnic groups, socioeconomic status) and levels of knowledge regarding
adolescent vaping. This section addresses key attributes of the target population including ability,
self-efficacy, and prior knowledge.
Cognitive Characteristics
Knowing the cognitive characteristics of the specific target population is important for
curriculum development. Smith and Ragan (2005) specify key cognitive characteristics including
several general characteristics and specific knowledge necessary to tailor a curriculum. Below is
a discussion of the different characteristics considered for the present curriculum on adolescent
vaping for middle school students.
General Characteristics
General characteristics include aspects of cognitive development such as aptitudes, level
of visual literacy, level of cognitive development, and cognitive processing styles (Smith &
Ragan, 2005). It is important to consider each of these characteristics for learners in order to
properly design each learning lesson. This will help ensure the content and pace of the
curriculum are sufficient for the target population’s learning characteristics.
45

General Aptitudes
General aptitudes may be broken down into two constructs, single factor aptitude and
multiple factor aptitude (Smith & Ragan, 2005). According to Smith and Ragan (2005), single
factor aptitude refers to one’s intelligence and is normally measured by the intelligence quotient
(IQ) score. Another way to measure aptitude is by measuring multiple factor aptitude. Smith and
Ragan (2005) define multiple factor aptitude as a construct consisting of “multiple specialized
aptitudes” or “clusters of aptitudes” each learner possesses.
For the present curriculum with middle school students, we will refrain from
measurements of IQ as this method of measurement has been consistently shown to be racially
biased towards non-Hispanic white populations scoring higher. Thus, it is not an appropriate
measure for a curriculum geared to address vaping among all communities including
communities of color. Rather, the multiple aptitude measurement would be most appropriate. All
participating students will be from the general population of middle school students drawn from
schools in southern California. It is assumed they possess multiple aptitudes that are grade and
age appropriate for learning methods of vape prevention and digital media development
contained in the present curriculum. Although some material will be new information, lessons
will be developed so more complicated concepts are age appropriate and easily understood by
middle school student learners.
Prior Knowledge
Prior knowledge among middle school students will be considered while developing
lessons to achieve learning goals. Considering learner general and specific knowledge while
developing curriculum content will increase learner motivation and engagement (Alley, 2019).
Additionally, participants will have general and specific knowledge of developing social media
46

content and vaping among teens. This curriculum is designed to increase these areas of general
and specific knowledge while also adding to adolescent knowledge of agency and advocacy.
General World Knowledge
General world knowledge, according to Smith and Ragan (2005), varies by age, culture,
and other intrinsic and external factors. For the present curriculum, it is assumed that middle
school youth have a general knowledge of the harmful effects of vaping based on grade level and
health courses that cover topics on substance use prevention. This curriculum will not assume
prior knowledge and will supplement general knowledge with examples of the harmful effects of
vaping, marketing to youth, and health outcomes. It is also assumed that youth have a general
knowledge of social media. The current curriculum will teach youth more details on how social
media influences behavioral outcomes and vaping behaviors.
Specific Prior Knowledge
It is expected that middle school youth will have some prior knowledge about developing
social media videos, stories, and other content. However, foundational knowledge will be taught.
This level of knowledge will help youth tailor digital media content to their peers for vape
prevention. Youth advocacy knowledge will be supplemented by the facilitator via literature
derived curriculum content. It is safe to presume that knowledge and implementation of youth
advocacy strategies will vary among learners. Smith and Ragan (2005) state learners sometimes
may have been exposed to specific knowledge of particular tasks or concepts; however, it is not
safe to assume learners retain information simply because they were exposed to it in the past.
Therefore, the present curriculum will take steps to ensure each lesson achieves set learning
goals even if some prior knowledge is present among learners.
47

Physiological Characteristics
Several physiological characteristics must also be considered when developing a
curriculum for middle school students. When instruction includes audiovisual, auditory, and
visual detail, it is critical to understand the physiological characteristics of sensory perception
(Smith & Ragan, 2005). The present curriculum will require students to develop digital media
content that requires basic hearing, visual and other sensory processing. It is expected that
students and facilitators will have sensory skills necessary to work with visual and audio media.
Affective Characteristics
Affective characteristics of middle school learners may vary by individual. Smith and
Ragan (2005) suggest it is important to consider the moral development of learners. This is
particularly important with developing a curriculum which seeks to address attitude change, such
as attitudes towards vape initiation. Key characteristics to consider include general interests,
motivations, and attributions for success also known as locus of control (Smith & Ragan, 2005).
Middle school students participating in this cohort will likely have similar psychological
characteristics mentioned above. However, the curriculum sessions are designed with careful
consideration of these affective characteristics in order to determine what types of examples to
use and how to develop relevancy statements that resonate with middle schoolers.
Social Characteristics
Social characteristics of middle school students will likely evolve over time. A literature
review conducted by Hoffman et al., (2006) posits youth tobacco use is influenced by several
factors, including peer influence, small group influence, and broader societal influences. The
authors point to an evolution of influences on youth tobacco behavior as an important factor for
intervention implementation (Hoffman et al., 2006). As such, it is important to assess social
48

characteristics such as peer relationships, moral development, race/ethnicity, socioeconomic
status, and feelings toward authority (Smith & Ragan, 2005). According to Smith and Ragan
(2005), curriculum developers must consider stages of moral development and social
characteristics as they evolve with age and affect the impact of curriculum design on learner
engagement. Understanding the social characteristics of the target audience will help facilitators
when grouping students on projects based on their level of moral development. This is
particularly critical when attitude lessons and motivational portions of the curriculum are being
developed (Smith & Ragan, 2005).
Implications of the Learning Environment and Learner Characteristics for Design
Assessing and understanding learner characteristics have a direct impact on curriculum
design. The aforementioned factors of prior knowledge, affective characteristics, and social
characteristics help guide design of specific lessons so teaching techniques and activities are
relevant to the target population. Specifically, instruction strategies such as pace of the
presentations, statements used by facilitators that are relevant to learners, level of concreteness
vs abstraction, reading level, and terminology used are all dependent on a deep understanding of
learner characteristics. For the present curriculum, lessons will incorporate strategies that are
culturally relevant and are designed for 12-14 year old middle school students' level of
proficiency.
The learning environment is also an important factor for ensuring adequate understanding
of curriculum content for learners. Confirming that the school setting is supportive of vape
prevention content is important because students are influenced by social factors including
family, schools, and especially peers (Bandura, 1998). Additionally, curriculum efficacy will be
achieved by ensuring students have access to cell phones and software to develop digital media.
49

Providing cell phones and access to relevant digital media software for students who do not have
them will ensure vape prevention messages are effective at convincing peers to resist vaping.

50

Chapter Four: The Curriculum
This chapter re-introduces the overall purpose and course goals of the vape prevention
advocacy curriculum for adolescents. It is structured in two parts. The first section describes the
steps taken to conduct a curriculum analysis including conducting a cognitive task analysis as
described by (Clark & Estes, 2008). This section also includes a description of the information
processing analysis as described by Smith and Ragan (2005). Both of these processes were used
to document expert knowledge related to tobacco prevention. This led to the refinement and
further development of major steps needed for the vape prevention advocacy curriculum.
The second part of this chapter includes a detailed description of the major units of the
curriculum as well as a lesson analysis. This lesson analysis was conducted to decide on specific
lessons to be taught regarding youth vaping, youth advocacy and increasing digital media
literacy. Additionally, conducting a lesson analysis informed the design of the units, timing and
content of lessons, and sequencing of lessons to achieve maximum instructional efficiency.
Cognitive Task Analysis
The curriculum design began with a cognitive task analysis (CTA) to better understand
how to develop a tobacco control curriculum with middle school students. Specific learning
objectives, as described by Smith and Ragan (2005), were identified, and incorporated into the
present vape prevention curriculum. These goals were derived following the “bootstrapping”
process defined by Clark and Estes (2008) where the author reviewed the literature on youth
tobacco prevention and conducted a subject matter expert (SME) interview to identify tasks
needed to ensure competence for performing the task of advocating for vaping prevention.
Smith and Ragan (2005) describe this inquiry process as information processing analysis.
According to Smith and Ragan, information-processing analysis helps identify steps needed to
51

achieve curriculum goals (Smith & Ragan, 2005). Beginning with a Google search on “how to
prevent youth vaping” led the author to specific steps outlined online. Next, identifying and
interviewing a subject matter expert at the University of Southern California (USC) Department
of Population and Public Health Sciences helped further contextualize specific goals needed for a
vape prevention curriculum specifically targeting middle school youth. The SME interview was
important because this person has over 10 years of experience in youth tobacco prevention and
she provided critical insight to differentiate the present curriculum from current evidence-based
curricula on preventing youth tobacco initiation. Working with the SME, the author identified a
gap in the literature where current prevention efforts lacked focus on youth advocacy, digital
media literacy, and a particular emphasis on preventing vaping among youth. In sum,
implementing the bootstrapping methodology outlined by Clark and Estes in conjunction with
the information-processing analysis approach outlined by Smith and Ragan lead to innovative
approaches to increase digital media literacy among middle school students, use of existing
knowledge of dangers of vaping among adolescents to develop impactful digital media messages
for vape prevention that resonates with their peers. The CTA resulted in the following
information:
1. Objective: To reduce youth vaping through the use of advocacy skill development using
digital media.
2. Cue: Literature reviews indicate middle school is the best stage of adolescent
development to implement tobacco prevention interventions.
3. Condition: The vape prevention curriculum will be implemented in person immediately
after school when the campus is open for after-school clubs, sports, and other activities.
4. Standards: The standard for the performance of the task is determined by the presence or
52

absence of vaping or intentions to vape among students in the curriculum.
5. Equipment: Participation will require students to have access to their own smartphones,
school provided google chromebooks, wifi, and digital media apps or computer software.
6. Steps: The curriculum implements five major steps to teach youth vape prevention by
increasing digital media literacy, self-efficacy, and advocacy skills. Sources that
informed each step are indicated in parentheses.
1. Understand the power of media and society (LIT, SME, CTA)
2. Describe current trends in social media and their influence on society (LIT, SME, CTA)
3. Understand the power of the tobacco industry to change behavior (LIT, SME, CTA)
4. Understand the power of agency (LIT, SME, CTA)
5. Incorporate the power of youth advocacy as agents for tobacco prevention (LIT, SME,
CTA)
These major steps are the topics that make up the core units for the youth vape prevention
curriculum. The literature review, cognitive task analysis, and an interview with a subject matter
expert support the content validity and sequence of the topics as presented. Below is a
description of analyzing the curriculum content further in order to develop unit goals and unit
objectives.
Course Learning Goals
Upon completing the literature review, subject matter expert interview, and cognitive task
analysis, it is important to develop a list of learning goals for each objective. Smith and Ragan
(2005) define learning goals as statements of purpose or intentions of what learners will be able
to do after completing instruction. Further, it is important that these goals are specific and
measurable outcomes of what learners will know or be able to do after each unit of instruction
53

and, moreover, following the completion of the curriculum. Below is a list of the course learning
goals derived from the major steps revealed in the cognitive task analysis.
1. When communicating with their peers about vaping, youth will articulate the power of
media and society to influence our behaviors.
2. When communicating with their peers about vaping, youth will articulate how the
evolution and current state of social media impacts emotions and behavior.
3. When communicating with peers about vaping, youth will be able to identify and
articulate ways the tobacco industry markets its products on social media and how social
media marketing is linked to youth vaping.
4. When given a choice to engage in vaping, learners will exercise their agency in becoming
an advocate to counter pro-tobacco influence by creating social media.
5. When implementing anti-vape digital media content for their peers, youth will
incorporate 2-3 advocacy strategies from the curriculum materials.
Course Learning Outcomes
Gagne (as cited in Smith and Ragan, 2005) developed a system of categorizing learning
outcomes that includes six cognitive domains. The domains include declarative knowledge,
intellectual skills, cognitive strategies, attitudes, psychomotor skills, and learning enterprises
(Smith & Ragan, 2005). Gagne’s conditions of learning help guide the development of each
learning unit because each condition likely requires qualitatively different knowledge and skills.
Hence, proper curriculum design requires careful consideration and outlining of the broader
curriculum goals and how learning outcomes, as described by Gagne, impact instructional design
and evaluation.
Below is a description of learning outcomes for vape prevention for each learning goal.
54

The learning outcomes include the learning goal followed by a description of the declarative
knowledge, intellectual skills, cognitive strategies, and attitudes learners will need to achieve to
perform each learning goal.
1. When communicating with their peers about vaping, youth will articulate the power of
media and society to influence our behaviors.
a. Declarative
i. Know the meaning of communicating; vaping; media; society; influence;
behavior.
b. Intellectual skills
i. Effectively articulate ideas and relationships.
c. Cognitive strategies
i. Elaborate in their own words on their current knowledge about the power
of media to influence behavior and that of social media.
d. Attitudes
i. Value communicating with peers about the power of media and society to
influence our behaviors. Be confident in communicating with peers.
2. When communicating with their peers about vaping, youth will articulate how the
evolution and current state of social media has a significant impact on emotions and
behavior.
a. Declarative
i. Know the meaning of vaping; social media; evolution; emotions;
emotional contagion; influence; behavior change.
b. Intellectual skills
55

i. Identify and articulate how social media has evolved to influence emotions
and behaviors.
c. Cognitive strategies
i. Articulate current knowledge of how social media affects behaviors and
connect this to the current youth oriented platforms.
d. Attitudes
i. Have confidence when communicating that emotions and behavior may be
positively or negatively influenced by social media.
3. When communicating with peers about vaping, youth will be able to identify and
articulate ways the tobacco industry markets their products on social media and how
social media marketing is linked to youth vaping.
a. Declarative
i. Describe the ways tobacco companies use digital media to market vaping;
identify types of marketing that appeals to youth; articulate how youth
vaping is associated with tobacco industry social media marketing.
b. Intellectual skills
i. Identify and articulate tobacco marketing in social media that attracts
youth to vaping.
c. Cognitive strategies
i. Elaborate on their current knowledge of marketing products on social
media and how this might occur with tobacco marketing to youth.
d. Attitudes
i. Have confidence when speaking about ways in which the tobacco
56

industry markets vape products to youth and the association with high
rates of youth vaping.
4. When given the choice to engage in vaping, learners will exercise their agency in
becoming advocates to counter pro-tobacco influence by creating social media.
a. Declarative
i. Describe the meaning of choice; vaping; social media.
b. Intellectual skills
i. Be able to exercise agency; be able to create social media.
c. Cognitive strategies
i. Elaborate on how learners exercise independence (agency) in their lives
and how this may be applied to youth vape prevention.
d. Attitudes
i. Believe in the value of advocating. Have confidence that youth have
power of agency on their decisions whether or not to use vape products.
5. When implementing anti-vape digital media content for their peers, youth will
incorporate 2-3 advocacy strategies from the curriculum materials.
a. Declarative
i. Describe youth advocacy strategies; anti-vaping; describe behavior
change.
b. Intellectual skills
i. Be able to exercise advocacy skills to address youth vaping. Identify and
describe examples of anti-vaping youth advocacy.
c. Cognitive strategies
57

i. Elaborate on how youth use advocacy for change and how this may be
applied to advocacy to prevent youth vaping.
d. Attitudes
i. Believe in the value of youth advocates for change. Have confidence in
their ability to impact change for youth vape prevention.
List of Units, Terminal, and Enabling Objectives
Following the iterative process outlined above, the youth vape prevention curriculum will
consist of 5 units in sequential order based on a concept-related structure. Learners will be taught
foundational steps of content followed by more applied units for digital media development and
youth advocacy. Each unit will be taught over a period of two weeks via six one hour
synchronous sessions with middle school students during after school hours. Based on content
analysis and literature review, the units are outlined below.
● Unit 1: The power of media and society
○ Terminal objective: When communicating with their peers about vaping, youth
will articulate the power of media and society to influence our behaviors in a 30
second “elevator pitch” using a rubric.
○ Enabling Objectives:
■ Declarative
● Given the list of words, learners will define and give examples and
nonexamples of communicating; vaping; media; society; influence;
behavior per the definitions provided.
■ Intellectual skills
58

● Given a conversation with their peers, learners will effectively
articulate ideas and relationships about the power of media and
society to influence our behaviors.
■ Cognitive strategies
● When asked about the power of media and society, learners will
elaborate in their own words on their current knowledge about the
power of media to influence behavior.
■ Attitudes
● Given a conversation with their peers, learners will value
communicating with peers about the power of media and society to
influence our behaviors.
● Given a conversation with their peers, learners will be confident in
communicating with peers.
● Unit 2: Current trends in social media and their influence on society
○ Terminal objective: When communicating with their peers about vaping, youth
will articulate in a 60 second “elevator speech” how the evolution and current
state of social media has a greater impact on emotions and behavior per a rubric.
○ Enabling objectives:
■ Declarative
● When given a list of terms, learners will give examples and non-
examples of vaping; social media; evolution of social media;
emotions; emotional contagion; influence; behavior change.
■ Intellectual skills
59

● Given a conversation with peers, learners will identify and
articulate how social media has evolved to influence emotions and
behaviors.
■ Cognitive strategies
● When asked about the evolution of social media and its impact on
behavior, learners will articulate two examples of how social
media affects behaviors and connect this to the current youth
oriented social media platforms.
■ Attitudes
● Given a conversation with peers, learners will have confidence that
emotions and behavior may be positively influenced by social
media.
● Unit 3: The power of the tobacco industry to change behavior
○ Terminal objective: When communicating with peers about vaping, learners will
identify and articulate in a 60 second “elevator speech” two ways the tobacco
industry markets their products on social media and how social media marketing
is linked to youth vaping per a rubric.
○ Enabling objectives:
■ Declarative
● When given a list of social media images and terms, learners will
describe ways tobacco companies use digital media to market
vaping; identify types of marketing that appeals to youth; articulate
how youth vaping is associated with tobacco industry social media
60

marketing.
■ Intellectual skills
● Given a conversation with peers, learners will identify and
articulate how tobacco marketing in social media attracts youth to
vaping.
■ Cognitive strategies
● When asked about tobacco marketing in social media, learners will
elaborate on their current knowledge of marketing products on
social media and how this might occur with tobacco marketing to
youth.
■ Attitudes
● Given a conversation with peers, learners will have confidence
describing ways the tobacco industry markets vape products to
youth and the association with high rates of youth vaping.
● Unit 4: The power of agency
○ Terminal objective: When communicating with peers about the choice to engage
in vaping, learners will exercise their agency in becoming an advocate to counter
pro-tobacco influence by creating one to two 60 second social media messages to
prevent youth vaping per a rubric.
■ Declarative
● When given a list of terms, learners will give examples and non-
examples of choice; vaping; social media.
■ Intellectual skills
61

● Given a conversation with peers, learners will be able to identify
and articulate ways to exercise agency; be able to create social
media that resonates with their peers.
■ Cognitive strategies
● When asked about agency, learners will elaborate in their own
words how to exercise independence (agency) in their lives and
how this may be applied to youth vape prevention.
■ Attitudes
● Given the opportunity to develop digital media with peers, learners
will believe in the value of advocating.
● While developing digital media with peers, learners will have
confidence that youth have power of agency on their decisions
whether or not to use vape products.
● Unit 5: The power of youth advocacy as agents for tobacco prevention
○ Terminal objective: When implementing anti-vape digital media content for their
peers, learners will incorporate 2-3 advocacy strategies from the curriculum
materials.
■ Declarative
● When given a list of scenarios, learners will give examples and
non-examples of youth advocacy strategies; anti-vaping; and
behavior change.
■ Intellectual skills
62

● Given a conversation with peers, learners will exercise advocacy
skills to address youth vaping.
● Given a conversation with peers, learners will identify and describe
examples of anti-vaping youth advocacy.
■ Cognitive strategies
● When asked about youth advocacy, learners will elaborate on how
youth use advocacy for change and how this may be applied to
advocacy to prevent youth vaping.
● Given advocacy strategies, learners will select two advocacy
strategies to develop vape prevention digital media.
■ Attitudes
● While developing digital media content for their peers, learners
will believe in the value of youth advocates for change by
choosing to advocate. .
● While developing digital media content for their peers, learners
will have confidence in their ability to impact change for youth
vape prevention.
Overview of the Program
The present youth vape prevention curriculum was initially derived using a
“bootstrapping” process where a google search initially revealed steps to advocate against youth
vaping. The author then proceeded to conduct an interview with a subject matter expert (SME) in
order to identify gaps in the literature on youth tobacco prevention. The SME interview revealed
a trend in youth exposure to tobacco advertisements via social media which has been shown to
63

be associated with youth tobacco initiation. The author proceeded with a literature review on the
impact of digital media on youth vaping, the impact of social media on emotions and behavior,
and the role of youth advocacy for behavior change. This inquiry process helped the author
identify five major tasks learners will complete in order to increase media literacy and prevent
vape initiation. The course overview is located in Appendix A.
The major tasks are ordered intentionally from easy to difficult in terms of prerequisite
knowledge needed to perform each learning goal. Each learning goal mentioned above is
organized according to Bloom's taxonomy for learning as described by Anderson and Krathwohl
(2001). Units are organized such that the curriculum begins with lessons focusing on declarative
knowledge and ending with units on procedural knowledge. Smith and Ragan (2005) recommend
this approach in order to reduce cognitive overload among learners. This is particularly important
for the present vape prevention curriculum because it will be taught to middle school students
after school. Beginning with content that allows for prior knowledge to guide the lesson plan
allows for reduced cognitive overload and increased likelihood of continued participation among
middle school students. The major units are designed to allow them to be taught during after
school programs or in class and will last for 45 minutes. Each lesson includes introduction
activities that activate prior knowledge of content taught in a previous lesson and culminating
activities to close out each unit. The lesson overviews for each unit can be found in Appendix B.
One fully developed lesson and its associated materials can be found in Appendix C. The list of
units and their respective lessons are as follows.
Unit 1: The power of media and society
64

1. Terminal objective for Unit 1: When communicating with their peers about vaping, youth
will articulate the power of media and society to influence our behaviors in a 30 second
“elevator pitch” using a rubric.
a. Lesson 1: Learning the vocabulary of vaping and advocacy.
i. Lesson 1 objectives:
1. Given the list of words, learners will define and give examples and
nonexamples of communicating; vaping; media; society; influence;
behavior per the definitions provided.
b. Lesson 2: Effectively articulating ideas
i. Lesson 2 objective
1. Given a conversation with their peers, learners will effectively
articulate ideas and relationships about the power of media and
society to influence our behaviors.
c. Lesson 3: Strategies for self growth (Cognitive strategies)
i. Lesson 3 objective
1. When asked about the power of media and society, learners will
elaborate in their own words on their current knowledge about the
power of media to influence behavior.
d. Lesson 4: Practice, Practice Practice for value and confidence (Attitudes)
i. Lesson 4 objectives
1. Given a conversation with their peers, learners will value by
choosing to communicate with peers about the power of media and
society to influence our behaviors.
65

2. Given a conversation with their peers, learners will be confident in
communicating with peers.
Unit 2: Current trends in social media and their influence on society
1. Terminal objective for Unit 2: When communicating with their peers about vaping, youth
will articulate in a 60 second “elevator speech” how the evolution and current state of
social media has a greater impact on emotions and behavior per a rubric.
a. Lesson 1: Learning the vocabulary of social media evolution, emotions, influence
and behavior change.
i. Lesson 1 objectives:
1. When given a list of terms, learners will give examples and non-
examples of vaping; social media; evolution; emotions; emotional
contagion; influence; behavior change.
b. Lesson 2: Effectively articulating ideas
i. Lesson 2 objectives:
1. Given a conversation with peers, learners will identify and
articulate how social media has evolved to influence emotions and
behaviors.
c. Lesson 3: Strategies for digital media literacy growth (cognitive strategies)
i. Lesson 3 objectives:
1. When asked about the evolution of social media and its impact on
behavior, learners will articulate two examples how social media
affects behaviors and connect this to the current youth oriented
social media platforms.
66

d. Lesson 4: Implementing digital media literacy for confidence and value with
peers (Attitudes)
i. Lesson 4 objective:
1. Given a conversation with peers, learners will have confidence that
emotions and behavior may be positively influenced by social
media.
Unit 3: The power of the tobacco industry to change behavior
1. Terminal objective for Unit 3: When communicating with peers about vaping, learners
will identify and articulate in a 60 second “elevator speech” two ways the tobacco
industry markets their products on social media and how social media marketing is linked
to youth vaping per a rubric.
a. Lesson 1: Learning visual and verbal tobacco marketing cues in social media
i. Lesson 1 objective:
1. When given a list of social media images and terms, learners will
describe ways tobacco companies use digital media to market
vaping; identify types of marketing that appeals to youth; articulate
how youth vaping is associated with tobacco industry social media
marketing.
b. Lesson 2: Effectively articulating ideas
i. Lesson 2 objective:
1. Given a conversation with peers, learners will identify and
articulate how tobacco marketing in social media attracts youth to
vaping.
67

c. Lesson 3: Digital media literacy and tobacco marketing knowledge growth
(Cognitive strategies)
i. Lesson 3 objective:
1. When asked about tobacco marketing in social media, learners will
elaborate on their current knowledge of marketing products on
social media and how this might occur with tobacco marketing to
youth.
d. Lesson 4: Building confidence in digital media literacy and tobacco marketing
strategies (Attitudes)
i. Lesson 4 objective:
1. Given a conversation with peers, learners will have confidence
describing ways the tobacco industry markets vape products to
youth and the association with high rates of youth vaping.
Unit 4: The power of agency
1. Terminal objective for Unit 4: When communicating with peers about the choice to
engage in vaping, learners will exercise their agency in becoming an advocate to counter
pro-tobacco influence by creating one to two 60-second social media messages to prevent
youth vaping per a rubric.
a. Lesson 1: Vocabulary used to prevent youth vaping
i. Lesson 1 objective:
1. When given a list of terms, learners will give examples and non-
examples of choice; vaping; social media
b. Lesson 2: Effectively articulating ideas to peers verbally and via social media
68

i. Lesson 2 objectives:
1. Given a conversation with peers, learners will be able to identify
and articulate ways to exercise agency.
2. Given the opportunity to develop vape prevention digital media,
learners will be able to create social media content that resonates
with their peers.
c. Lesson 3: Understanding and implementing agency (Cognitive strategies)
i. Lesson 3 objectives:
1. When asked about agency, learners will elaborate in their own
words how to exercise independence (agency) in their lives and
how this may be applied to youth vape prevention.
d. Lesson 4: Strengthen the value and confidence of youth agency for vape
prevention (Attitude)
i. Lesson 4 objectives:
1. Given the opportunity to develop digital media with peers, learners
will believe in the value of advocating.
2. While developing digital media with peers, learners will have
confidence that youth have power of agency on their decisions
whether or not to use vape products.
Unit 5: The power of youth advocacy as agents for tobacco prevention
1. Terminal objective for Unit 5: When implementing anti-vape digital media content for
their peers, learners will incorporate 2-3 advocacy strategies from the curriculum
materials.
69

a. Lesson 1: Vocabulary and descriptions of youth advocacy
i. Lesson 1 objectives:
1. When given a list of scenarios, learners will give examples and
non-examples of youth advocacy strategies; anti-vaping; and
behavior change.
b. Lesson 2: Effectively articulate advocacy strategies
i. Lesson 2 objectives:
1. Given a conversation with peers, learners will exercise advocacy
skills to address youth vaping.
2. Given a conversation with peers, learners will identify and describe
examples of anti-vaping youth advocacy.
c. Lesson 3: Strategies for youth advocacy (Cognitive strategies)
i. Lesson 3 objectives:
1. When asked about youth advocacy, learners will elaborate on how
youth use advocacy for change and how this may be applied to
advocacy to prevent youth vaping.
2. Given advocacy strategies, learners will select two advocacy
strategies to develop vape prevention digital media.
d. Lesson 4: Increase value and confidence in youth advocacy via social media
(Attitudes)
i. Lesson 4 objectives:
1. While developing digital media content for their peers, learners
will believe in the value of youth advocates for change by
70

choosing to advocate. .
2. While developing digital media content for their peers, learners
will have confidence in their ability to impact change for youth
vape prevention.

Visual Overview of the Units and Lessons
Figure 1 represents the units for the youth vape prevention curriculum. It was created by
the author using Canva.com. Each unit and its relation to the learning goals are shown in the
scope and sequence table.

71

Figure 1
Visual Overview of the Units

72

Scope and Sequence Table
The scope and sequence table is used as a visual guide to the units and corresponding
lessons for the present curriculum (Smith & Ragan, 2005). Developing this table is helpful to
ensure there are no gaps or unnecessary overlaps in each unit (Smith & Ragan, 2005). For the
present curriculum, the scope refers to “what” is being taught while the sequence refers to the
lessons for each unit of instruction (Smith & Ragan, 2005). Outlining the lessons for each unit
helped determine areas where cognitive load may be reduced and areas where reinforcing
learning objectives is necessary to achieve the overall goals of each unit. Table 2 is a visual
representation of the scope and sequence of the youth advocacy and vape prevention curriculum.

Table 2
Scope and Sequence Table for A Curriculum for Middle School Advocacy for Anti-Vaping
Learning goal (LG) Unit 1 Unit 2 Unit 3

Unit 4 Unit 5 Summative
assessment
Lesson 1 -- 4 1 – 4 1 – 4 1 – 4 1 – 4 N/A
When communicating with
their peers about vaping,
youth will articulate the
power of media and society
to influence our behaviors.
I R R R M
When communicating with
their peers about vaping,
youth will articulate how
the evolution and current
state of social media has a
greater impact on emotions
and behavior.

P I R R M
73

Learning goal (LG) Unit 1 Unit 2 Unit 3

Unit 4 Unit 5 Summative
assessment
When communicating with
peers about vaping, youth
will be able to identify and
articulate ways the tobacco
industry markets their
products on social media
and how social media
marketing is linked to youth
vaping.

P I R R M
When given the choice to
engage in vaping, learners
will exercise their agency in
becoming an advocate to
counter pro-tobacco
influence by creating social
media.
P I R M
When implementing anti-vape
digital media content for
their peers, youth will
incorporate 2-3 advocacy
strategies from the
curriculum materials.

P I R M
Note. The letters in the table represent the following: I = Introduced; R = Reinforced; M=
Mastered

Delivery Media Selection
When selecting the proper media to deliver a curriculum, it is important to note that the
type of media does not directly impact learning or motivation (Clark et al., 2010). Rather, Clark
et al., (2010) argue that the media type should be chosen so that learning content is accessible
and affordable and works to enable the delivery of the content within the time allocated for
learners. As such, the media selected for this youth vape prevention curriculum will take into
74

consideration cost, relatively easy accessibility for students, and ability to be implemented in the
1.5-hour time allotted for the after-school program. It is likely that different media will be
selected based on lesson plans and learning goals developed for each unit.
General Instructional Platform Selection in Terms of Affordances

Based on the recommendations of Clark et al., (2010), the present curriculum will be
implemented with specific attention to three key affordances of media selection including access,
consistency, and cost. The curriculum will be delivered using a blended approach that
incorporates in-person synchronous instruction during an after-school program and online
materials accessible asynchronously to middle school students. As such, media selection will
take into consideration youth access to wifi, laptops, and on-campus locations. Lessons will be
administered on campus and will be cost-effective for schools. Each lesson will last 1.5 hours
and take place in a designated classroom or library space on campus. Below is a description of
accessibility, consistency, and cost as it relates to media selection for the youth vape prevention
curriculum.
Access
It is of utmost importance that youth have access to course materials and content.
According to Clark et al., (2010), media selection has an impact on access. Given the learning
goals of increasing digital media literacy, youth agency and advocacy, and development of
youth-developed vape prevention digital media, the media selected will be primarily electronic
content. The curriculum will be offered in a blended format. Lessons will be taught
synchronously in person with facilitators over a time span of 10 days. Additionally, students will
have access to asynchronous digital materials and instructional content via the project website.
Students will need access to Chromebooks and internet access. Providing course content in a
75

blended format increases accessibility to course content and the likelihood of continued use and
reinforcement of curriculum goals as students may access course materials long after the in-
person instruction has concluded.
Consistency
Clark et al., (2010) suggest that media selection takes into consideration the cognitive
abilities of the learner. Specifically, when selecting media for instruction, one must begin with a
consideration of the cognitive abilities needed to perform a learning task and then proceed with
an analysis of the type of method needed for the learner population (Clark et al., 2010). Clark et
al., (2010) suggest there is a variance in the cognitive abilities of learners, requiring some
tailoring of instruction and materials based on learners’ prerequisite knowledge and cognitive
abilities. As such, consistency in delivery is needed to ensure all learners achieve learning
outcomes regardless of potential learning barriers. For the present curriculum, theoretical
foundations used to guide the development of each lesson helps provide consistency in terms of
content. For example, the use of information processing theory helps determine the structure of
the course from simple concepts to more complex constructs for learners. This helps ensure the
content is delivered in a consistent manner for learners’ cognitive abilities.
Additionally, synchronous in-person instruction allows curriculum developers an
opportunity to observe lessons to be sure facilitators are implementing the curriculum content
with fidelity to the original design. While some portions of the lessons may need to be
customizable to accommodate individual learners, the present design of in-person instruction
based on pre-developed electronic materials, combined with asynchronous curriculum content
available online, helps ensure the vape prevention curriculum is available to learners with
varying pre-requisite knowledge.
76

Cost
There are several costs associated with the youth vape prevention curriculum. These costs
include on-campus technology such as computers, wifi, digital software, facilities, instructional
team (graduate students), and cell phone service plans. Some California schools have state
funding for implementing tobacco prevention education through a state grant titled the Tobacco
Use Prevention Education (TUPE) program. Other schools have budgets allocated for substance
use (including tobacco) prevention. These funds will cover the costs to cover paid stipends to
graduate students from local universities to serve as facilitators of instruction. Additionally,
schools will pay for Chromebooks and wifi which will be used for research and development of
digital media content. Licenses for digital media editing software will be paid for by schools.
Finally, according to a recent PEW article, approximately 95% of youth have access to a
smartphone (Schaeffer, 2019). They will use their own smartphones to record material, edit with
free applications, and disseminate content via social media. These costs will not exceed normal
costs associated with cell plans youth already have.
Specific Instructional Platform Selection in Terms of Restrictions
When selecting the types of media to use in instruction, Clark et al., (2010) recommend
considering three key content restrictions including conceptual authenticity, immediate feedback,
and special sensory requirements. Conceptual authenticity refers to the ability of the curriculum
to sufficiently provide the conditional requirements for learners to apply the new training (Clark
et al., 2010). Another important consideration for curriculum development is that of sensory
requirements. This can be described as sensory information required beyond visual and aural
information (Clark et al., 2010). Sensory information such as smell, taste, or touch is limited to
in-person training and must be considered when drafting lessons (Clark et al., 2010). Finally,
77

curriculum development must include a description of when and how learners will receive
immediate feedback if required. This concept requires an expert facilitator to observe and
provide corrective feedback to learners while they engage in curriculum activities (Clark et al.,
2010).
Conceptual authenticity for the current vape prevention curriculum is required because
the curriculum is designed with careful consideration of the real-life contexts where youth see
tobacco ads on social media, identify ways to advocate healthy alternatives, and provide proper
conditions in which to implement digital media for advocacy. Conceptual authenticity can also
be referred to as the first part of an “if-then” statement (Clark et al., 2010). For example with the
present youth vape prevention curriculum, if one wishes to develop social media content, then
follow the steps outlined in the rubric to do so.
The youth vape prevention curriculum is delivered in person via a graduate student
facilitator. Therefore, it is possible to observe and provide immediate feedback to learners while
implementing lessons. Finally, since lessons require the development of digital media content, it
is necessary that youth are able to use video and audio recording devices and upload content
online. This requires certain sensory requirements, knowing how to record, edit and upload
content, which are addressed in person with facilitators and peers in a group setting. Other
sensory requirements include the use of body language while role-playing scenarios and
receiving immediate feedback from expert facilitators and peers. Therefore, it is critical that the
present curriculum lessons be administered via synchronous in-person activities. Table 3 clarifies
key considerations for media selection for the youth vape prevention curriculum.

78

Table 3

Key Considerations for Media Selection, Middle School Advocacy for Anti-vaping

Key consideration Media considerations
Conceptual authenticity Youth will benefit from working with peers to
build supportive relationships.
Youth will work with peers to ensure the
authenticity of digital media messaging and
advocacy skills.
Immediate feedback Psychosocial skills such as articulating anti-
vape messaging and the influence of
tobacco marketing will require expert
facilitator feedback.
Interpersonal skills required for advocacy will
require in-person interaction with peers and
immediate feedback from expert
facilitators.
Special sensory requirements Skilled facilitators will guide students on the
use of visual, auditory, and digital media
editing for efficient messaging via social
media.

Client Preferences or Specific Conditions of the Learning Environment
Client preference is a critical consideration for the development of curricula and
determining learning proper media. For the present curriculum, the clients are middle schools.
Middle schools will prefer that the curriculum be conducted in person. However, due to school
curriculum requirements, it is very likely that schools prefer the curriculum be administered after
school hours so as not to interfere with regular class time. Additionally, middle schools will
support the use of Google Sites to house student project drafts, learning materials, and training
videos from each lesson. Google Sites is a free website that allows users to share files, upload
digital media content, and facilitate online discussion. This is in line with many California
schools’ use of Google classroom, so many students will likely have google accounts ready to
79

access and create their own Google website. The client preferences for this curriculum align well
with the planned blended format for implementation. Middle schools will offer us a location on
campus to conduct learning sessions synchronously in person and middle school students will
have access to media needed for asynchronous portions of the curriculum.
Specific Media Choices
Based on the three media considerations above, access, consistency, and cost, the Middle
School Advocacy for Anti-Vaping will be implemented using specific media for maximum
efficiency. Specific emphasis in selecting proper media includes the blended approach to
teaching which includes in-person synchronous lessons combined with asynchronous materials
accessible online. Additionally, facilitators will be graduate students from the local university
graduate programs in communications, media design, and public health. Utilizing graduate
students will help ensure professionalism on the part of the facilitator while also incorporating
critical knowledge graduate students have acquired through their professional training.
Conducting lessons in person benefits student-to-student interaction, peer support for advocacy,
and immediate feedback. Using an online platform, Google Sites helps with reinforcing lesson
goals and will provide the opportunity for students to continue using skills developed during in-
person learning outside of in-person sessions. The cost for specific media selection is relatively
low, with stipends for graduate students, associated costs for accessing on-campus facilities, and
possible digital media editing software. Table 4 summarizes how instruction will be delivered as
well as the purpose and benefits of media selection.

80

Table 4
Media Choices in Middle School Advocacy for Anti-Vaping
Media Purpose Benefits
Live instructor
(graduate
students)
To facilitate knowledge increase
regarding marketing and tobacco
use among youth.
To provide feedback on knowledge
and skill development.
To maintain a supportive peer-to-
peer learning environment.
Peer support.
No additional cost to the
school.
Live feedback.
Control over the learning
environment

Peer and mentor
models
To provide social support.
To validate the use of advocacy
skills.
To model the advocacy skills being
taught.
To provide authentic feedback on
the performance of advocacy
skills being taught.
To provide feedback on digital
media content being developed
for peers.
Social validation.
Vicarious learning.
Feedback from an authentic
audience.

Google Sites or
other content
management
system
To house and deliver content in a
consistent and cost-effective way.
To aid the construction of anti-vape
digital media content for peers.
Free to use.
Provides a platform for
text, audio, and video
content.
Easily reproduced and
shared.
Allows multiple
contributors to work on
and review digital media
content.
Digital portfolios will be
permanent and accessible
for future reference.

General Instructional Methods Approach

Several theories have been used to develop the present curriculum. This section will
describe each theory in detail and discuss its application to various lessons. Three primary
81

theories that helped guide curriculum design include cognitive load theory (Kirschner, 2002),
sociocultural theory (Vygotsky, 1978), and social cognitive theory (Bandura, 1986) (Bandura,
1986). These theories were selected due to the target audience, middle school students, and the
desire for mastery of curriculum content, advocacy, and vape prevention.
Cognitive Load Theory
Cognitive load theory (CLT) describes limitations to working memory which helps
curriculum designers develop lessons that optimize learning and reduce the chance of cognitive
overload among learners (Kirschner, 2002). Specifically, CLT suggests that some learning tasks
may impose significant “intrinsic load,” with competing elements the learner must attend to in
order to learn a concept, which results in sub-optimal learning (Smith & Ragan, 2005). In
addition to intrinsic load, working memory is also impacted by the modality and manner in
which new material is introduced to the learner causing extraneous and germane cognitive load
(Kirschner, 2002). According to Kirschner (2002), limitations to the working memory of learners
can be minimized when instruction is designed with particular attention to adjusting teaching
modalities, coding multiple elements of learning content into one cognitive schema, and by
automating rules while administering lesson plans. Several techniques have been proposed in the
literature to reduce cognitive load, including but not limited to, segmenting lesson content,
pretraining on specific definitions prior to using them in instruction, and eliminating redundancy
(Smith & Ragan, 2005).
The present curriculum has been designed with careful thought to reduce cognitive
overload among middle school students. Particularly, the units and corresponding lessons are
organized in a manner to introduce information that aligns with students’ pre-existing knowledge
in the early phase. Final lessons focus on implementing the newly acquired terminology and
82

knowledge about marketing and tobacco use for youth advocacy and digital media messaging.
Social Cognitive Theory
Social cognitive theory (SCT) was postulated by Albert Bandura in 1986 as a way to
explain human interaction with self and the social environment. A core concept of SCT is that of
reciprocal determinism in which human cognitive development is the result of personal
cognition, affect and biological factors, behaviors, and environmental influences (Pajares, 2007).
This interaction between agency and one’s environment, also known as reciprocal determinism,
establishes humans as self-organizing, proactive, and self-regulating beings who shape their own
identities which, in turn, influences their immediate social environment (Pajares, 2007).
It is thus important that the present curriculum seeks to increase youth belief in self-
control and agency. Units and lessons have been designed with specific attention to increasing
self-efficacy toward advocacy for youth vape prevention. Additionally, creating a supportive
learning environment among peers, partnering schools, and the broader community will increase
youth agency to resist vaping and develop anti-vaping digital media content for their peers. As
such, SCT is a central theory guiding the present curriculum development.
Sociocultural Theory
Lev Vygotsky’s sociocultural theory was also used to guide curriculum development. The
sociocultural theory argues human development is mediated via social interactions (McCleod,
2022). Vygotsky presents a theory where knowledge and cognitive development take place via
social interaction where members of one’s community help make sense of new information and
concepts (McLeod, 2022).
The present curriculum incorporates several lessons guided by sociocultural theory. Peer-
to-peer work groups help increase knowledge of skills necessary to develop digital media and
83

how to disseminate media through various channels. Additionally, graduate student facilitators
tend to be more knowledgeable about the subject matter and will serve the role of increasing
knowledge and cognitive processes related to marketing, emotional contagion via social media,
and youth advocacy techniques. These strategies align with Vygotsky’s sociocultural theory by
allowing for peer collaboration for problem-solving and designing social media content. As such,
this approach to collaborative learning is aligned with Vygotsky’s sociocultural learning theory.

84

Chapter Five: Implementation and Evaluation Plan
Curriculum design and development require careful consideration of the steps and
processes necessary for implementation and evaluation. Previous chapters presented the problem
of practice and the youth advocacy for vape prevention’s purpose, goals, learning objectives, and
outcomes. This chapter will outline the youth advocacy for vape prevention curriculum
implementation plan and evaluation criteria. Conducting a well-planned evaluation helps ensure
the program goals are met, identifies areas for improvement, and maximizes the transfer of
learning to behavior and subsequent curriculum goals (Kirkpatrick & Kirkpatrick, 2016). Below
is a description of the current youth vape prevention curriculum's implementation and evaluation
plan.
Implementation Plan
In order to implement the youth advocacy for vape prevention curriculum with fidelity
and impact, Smith and Ragan (2005) identified four main areas for effective implementation --
diffusion, dissemination, adoption, and stakeholders. Diffusion is essential when implementing
curricula as it allows for an analysis of how information and innovations from the curriculum
spread to members of the social system (Smith & Ragan, 2005). Additionally, understanding the
intentional dissemination of innovative information among social networks is essential (Smith &
Ragan, 2005). Dissemination is particularly relevant to the present curriculum, given the goal of
increasing knowledge of spreading information via social media among youth social networks. It
is expected that youth who participate in the curriculum will become advocates for vape
prevention. Therefore, monitoring the diffusion and dissemination of information is a critical
component of curriculum content and development.
Smith and Ragan (2005) also point to the importance of considering adoption by
85

stakeholders when implementing curricula. Adoption is when organizations decide to implement
concepts of the curriculum as the preferred course of action (Smith & Ragan, 2005). Adoption of
curriculum content is a process that involves awareness, interest, appraisal, trial, adoption, and
finally, integration of curriculum content as part of the organizational objectives (Smith &
Ragan, 2005). As such, stakeholders within communities and organizations must have a vested
interest in curriculum content and support adoption and integration (Smith & Ragan, 2005).
Awareness of innovation is the first step in successfully implementing a curriculum. This
includes awareness that the curriculum is available in a given setting and a conscious desire to
learn more about the intervention content (Smith & Ragan, 2005). In order to gain support from
schools, the curriculum team will first work to engage school administrators and seek approval
from district superintendents for the youth advocacy for vape prevention curriculum.
Additionally, a community advisory board (CAB) will be established and school administrators
will be part of the CAB. Once district approval and school principal support are obtained, the
curriculum will be advertised to youth and parents at schools via school email, robocalls to
parents, and school announcements to students. If schools wish to have teachers implement the
curriculum in class, teachers will be recruited based on their willingness to participate in
facilitator training conducted by the curriculum team. Training and recruitment materials will
appeal to the intrinsic value of youth empowerment and advocacy for vape prevention. This will
result in an increased interest in learning more about the curriculum and its content. Smith and
Ragan (2005) cite interest as a key component of the successful implementation of innovative
curricula. The aforementioned informational materials, orientations, and pieces of training will
help individuals form tentative positive opinions about the youth advocacy for vape prevention
curriculum.
86

Effective implementation also must include evaluation, trial, adoption, and integration
(Smith & Ragan, 2005). Evaluation requires the designer to consider and mentally plan the
implementation of the curriculum carefully. Additionally, initial small-scale implementation and
content evaluation will help provide participant feedback (Smith & Ragan, 2005). As such, the
youth advocacy for vape prevention curriculum will employ a pilot run of the curriculum,
including feedback from participants and facilitators on critical areas of curriculum content.
Revisions will be made based on feedback. Facilitators will be asked to take notes after each
lesson and provide a summary of suggested edits to the curriculum development team. During
the pilot implementation, the curriculum development team will send trained staff to sit in the
back of the room, take notes on program implementation, and provide feedback to facilitators,
particularly regarding fidelity to the design. Finally, students who participate in the pilot
implementation will be asked to provide feedback via student focus groups midway through and
after curriculum implementation. Analyzing qualitative data will assist in identifying areas of
improvement for the youth advocacy for vape prevention curriculum.
Finally, including stakeholders such as teachers and school administrators in pilot
development will increase the adoption and integration of the youth advocacy for vape
prevention curriculum. According to Smith and Ragan (2005), it is essential to include
representation of those whom the curriculum will directly impact as part of the implementation
and refinement process. This helps establish rapport and increase the authenticity of curriculum
content. Further, including stakeholders in the adoption process helps ensure curriculum
integration in the organization. The present curriculum will include a community advisory board
(CAB) of teachers, parents, and administrators to guide implementation efforts. The CAB will
meet in person or via zoom to review pilot implementation plans and qualitative focus group
87

findings and advise on best practices for adoption and full integration of the youth advocacy for
vape prevention curriculum in middle school settings.
Evaluation Plan
Youth vaping in the United States has steadily increased, with many national youth
surveys reporting marketing via social media, flavored products, and perceived use among peers
help explain increases in youth vape initiation (Alpert et al., 2021; Chen-Sankey et al., 2019;
Cullen, 2018; Pierce et al., 2018). Several studies have shown that youth vaping of nicotine
products impacts overall adolescent health. Health impacts of youth vaping include poor brain
development and adverse effects on school performance (CDC, 2022; Cullen, 2018; Dearfield et
al., 2021; Surgeon General’s Advisory on E-Cigarette Use Among Youth | Smoking & Tobacco
Use | CDC, 2022). While several tobacco prevention curricula exist, currently, there are no
evidence-based curricula specifically addressing youth vaping, youth advocacy, and social media
messaging to peers. The present youth advocacy for vape prevention curriculum will increase
youth self-efficacy for vape advocacy and prevention while reducing intentions to vape among
participants and peers in their social networks. Additionally, providing an evidence-based vape
prevention curriculum will address the need to implement evidence-based vape prevention
curricula in California schools per California Department of Education (CDE) requirements.
Evaluation Framework
The present youth advocacy for vape prevention curriculum will be evaluated using the
Kirkpatrick New World model (Kirkpatrick & Kirkpatrick, 2016). The new world model is
distinguished from the previous Kirkpatrick evaluation model in that the value of training is
established at the start of curriculum development, and evaluation is designed at the beginning.
Additionally, the new world model reverses the order of evaluation planning and implementation
88

with Level 4 evaluation of results planned first, followed by Level 3, Level 2, and Level 1 in
descending order (Kirkpatrick & Kirkpatrick, 2016). Following this order of planning, outcomes
are planned first. This approach emphasizes outcomes as the most crucial measure of success
while also allowing the implementation of an evaluation model where curriculum developers
may identify areas of improvement in Level 3 to Level 1, make required changes, and re-
evaluate outcomes in level 4 (Kirkpatrick & Kirkpatrick, 2016). Below is a description of the
evaluation plan for the present curriculum, including descriptions of Levels 4-1 and related
variables of interest.
Level 4: Results and Leading Indicators
Kirkpatrick and Kirkpatrick (2016) connect Level 4 learning goals to an organization’s
mission and purpose. California Department of Education requires schools to provide quality
evidence-based substance use prevention curricula to students beginning in 5th grade (California
Department of Education, 2022). The youth advocacy for vape prevention curriculum supports
California middle and high school goals to keep students from engaging in vaping and nicotine
addiction. The curriculum aims to increase youth empowerment via youth advocacy for vape
prevention. Youth will increase advocacy skills and existing knowledge about the dangers of
vaping. As a result, participants will have increased self-efficacy and reduced intentions to vape.
Level 4 results, as defined by Kirkpatrick and Kirkpatrick (2016) include identifying
leading indicators of organizational training. Leading indicators help provide individualized
target goals and contribute to organizational success (Kirkpatrick & Kirkpatrick, 2016).
Additionally, identifying leading indicators helps establish a connection between critical
behaviors of the curriculum and desired outcomes (Kirkpatrick & Kirkpatrick, 2016). Leading
indicators include internal and external indicators for identifying curriculum success. Internal
89

indicators are evident within the organization and are usually among the first to appear when
conducting Level 4 evaluation (Kirkpatrick & Kirkpatrick, 2016). Internal indicators for the
present youth vape prevention curriculum include the number of students who completed the
intervention, decreased intentions to vape among students on campus, increased student
satisfaction with the curriculum, increased positive mention of the curriculum by the Parent
Teacher Association (PTA) on school campuses, and increased student interest in advocacy
topics other than vaping. Facilitators and the curriculum development team will work with
school administrators to collect data for measuring internal indicators.
Kirkpatrick and Kirkpatrick (2016), define external indicators as a measure of customer
or benefactor response to critical behaviors performed by members of their organization.
Examples include customer satisfaction, increased sales volume, or positive press commentary
(Kirkpatrick & Kirkpatrick, 2016). The youth advocacy for vape prevention curriculum external
indicators includes positive mention of the curriculum by the local media outlets, school board
members, and local county offices of education. Additionally, the present curriculum will
measure external indicators based on unsolicited requests by surrounding schools to implement
the youth advocacy for vape prevention curriculum at their schools. Finally, a measurement of
success will include increased interest by the California Department of Education (CDE) in the
positive results of the curriculum. Internal and external indicators are described in Table 5,
including units of measurement and methods used to measure each indicator.

90

Table 5

Indicators, Metrics, and Methods for External and Internal Outcomes

Outcome Metric(s) Method(s)
External outcomes
Increased positive
mentions of the school
and anti-vape program
from the school board.
The number of positive
mentions of the youth
advocacy for vape prevention
at school board meetings.
Principal and staff collect data,
including meeting minutes,
from school board meetings.
Increased positive media
mention of the school
and anti-vape
curriculum in local
news media.
The number of positive
mentions of the youth
advocacy for vape prevention
in local news media.
The curriculum development
team compiles data from local
news outlets regarding the
youth advocacy for vape
prevention curriculum.
Increased reporting of
anti-vaping curriculum
results to local county
office of education.
The number of positive
mentions of the youth
advocacy for vape prevention
at the county office of
education meetings.
School district staff collect data,
including meeting minutes,
from the county office of
education meetings.
Increased interest by the
California Department
of Education (CDE) in
positive results of the
anti-vape curriculum.
The number of inquiries the
California Department of
Education (CDE) makes to
curriculum developers
regarding curriculum results.
Curriculum developers will
document inquiries made by
the CDE to learn more about
the youth advocacy for vape
prevention curriculum.
Increased interest from
surrounding schools via
unsolicited referrals for
the youth anti-vape
curriculum.
The number of unsolicited
requests to implement the
curriculum in surrounding
schools.
Curriculum developers will
document the number of
unsolicited requests received
by surrounding schools.
Internal outcomes
Increase the number of
students who complete
the curriculum.
The number of students who
complete the youth advocacy
for vape prevention
curriculum.
Curriculum facilitators will
keep roll for students who
participate in all lessons of
the curriculum.
Increased interest for
advocacy in topics
other than vaping
Number of times youth request
to use advocacy skills from
the curriculum to advocate for
other topics.
Curriculum facilitators will
keep track of the number of
times students request to
advocate for other topics.
Decreased intentions for
vaping among students.
Number of students who report
lower intentions to vape.
Survey data from pre and post-
survey of student satisfaction.
Increased participation
and involvement among
parents.
The number of parents who
agree to allow their child to
participate in the youth
Curriculum team will keep track
of the number of parents who
provide parent consent for
91

Outcome Metric(s) Method(s)
advocacy for vape prevention
curriculum.
their child to participate in the
curriculum.
Increased positive
mention of school and
anti-vape curriculum
among the Parent
Teacher Association
(PTA) members.
Number of positive mentions of
the vape prevention
curriculum at PTA meetings.
School administrators will
collect data, including
meeting minutes, from PTA
meetings.
Increased student
satisfaction with the
anti-vape curriculum.
Number of students who report
satisfaction with the
curriculum.
Survey data from pre and post-
survey of student satisfaction.

Level 3: Behavior
In order to evaluate curriculum effectiveness, it is important to ensure that the critical
behaviors being taught are implemented by students. Kirkpatrick & Kirkpatrick (2016) outlined
level three as behavioral changes that learners apply when they return to work. Further, Mayer
(2011) posits a behaviorist view that suggests changes in knowledge may be inferred from
observing behavior. According to the behaviorist view, observable changes in behavior post
instruction is evidence that learning has occurred (Mayer, 2011). Smith and Ragan (2005)
describe the implementation of new skills and knowledge in real life and future tasks as the
process of transfer of information. Unfortunately, many training programs do not have a plan to
evaluate whether participants are performing the learning goals or a way to hold learners
accountable (Kirkpatrick & Kirkpatrick, 2016). The new Kirkpatrick model highlights Level 3
behavior as the most critical measure of a curriculum’s success as it establishes the degree to
which learners apply what they have learned during the training when they implement them in
real-life situations (Kirkpatrick & Kirkpatrick, 2016).

92

Critical Behaviors Required to Perform the Course Outcomes
Kirkpatrick and Kirkpatrick (2016) outline critical behaviors in curricula that greatly
influence the results identified in Level 4. It is important to carefully identify a few critical
behaviors that, if performed regularly, will have the most impact on Level 4 outcomes
(Kirkpatrick & Kirkpatrick, 2016). These critical behaviors must be specific, measurable, and
observable to be monitored. The overall learning goals and outcomes for the current youth vape
prevention curriculum were developed via CTA and represent the critical behaviors learners
must implement to achieve desired outcomes. The critical behaviors are further described in
Table 6, along with a description of the metrics and methods used.

Table 6
Critical Behaviors, Metrics, Methods, and Timing for Evaluation
Critical behavior for
course outcomes
Metric(s)
(Unit of measure)
Method(s)
(How measured)
Timing
(How often)
When
communicating
with their peers
about vaping,
youth will
articulate the
power of media
and society to
influence our
behaviors.
Number of times
youth mention the
power of media in
society.
Observations of
conversations
collected by
curriculum
facilitators, teachers,
parents, and school.
Pre and post-survey data
collected from
students.
Pre and post-survey
with students.
Pre-survey
implemented
before lessons
begin, post-
survey
immediately after
the end of all
units and another
post-survey 3
months after end
of curriculum.
Teacher and
administrator
interviews to
assess
observations of
critical behaviors.
93

Critical behavior for
course outcomes
Metric(s)
(Unit of measure)
Method(s)
(How measured)
Timing
(How often)
When
communicating
with their peers
about vaping,
youth will
articulate how the
evolution and
current state of
social media has a
greater impact on
emotions and
behavior.
Number of times
youth mention
social media has
evolved to have an
effect on emotions
and behaviors.
Observations of
conversations
collected by
facilitators, teachers,
parents, and school.
Pre and post survey data
collected from
students.

Pre and post-survey
with students.
Pre-survey
implemented
before lessons
begin, post-
survey
immediately after
the end of all
units and another
post-survey 3
months after end
of curriculum.
Teacher and
administrator
interviews to
assess
observations of
critical behaviors.

When communicating
with peers about
vaping, youth will
be able to identify
and articulate ways
the tobacco industry
markets its products
on social media and
how social media
marketing is linked
to youth vaping.
Number of times
youth mention
strategies tobacco
and vape companies
use to market
products on social
media.
Number of times
youth acknowledge
tobacco marketing
on social media is
linked to youth
vaping rates.
Observations of
conversations
collected by
facilitators, teachers,
parents and school.
Pre and post-survey data
collected from
students.
Each class session
and during media
production and
advocacy
workshops.
Data collected for
measuring
internal
outcomes.
When given the
choice to engage in
vaping, learners will
exercise their
agency in becoming
an advocate to
counter pro-tobacco
influence by
Validated survey
measure on tobacco
use and intentions
to use tobacco
products.
Number of times
youth develop
advocacy media
Primary investigator of
the curriculum will
implement pre/post
surveys with students
and evaluate changes
in youth intentions to
vape.
Before the first
lesson is
implemented and
one month after
the completion of
all lessons.

94

Critical behavior for
course outcomes
Metric(s)
(Unit of measure)
Method(s)
(How measured)
Timing
(How often)
creating social
media
content for vape
prevention
When implementing
anti-vape digital
media content for
their peers, youth
will incorporate 2-3
advocacy strategies
from the curriculum
materials.
Number of vape
prevention
advocacy strategies
present in digital
media content and
dissemination.
Review of digital media
storyboards and
dissemination plans
by facilitators.

During and after
media production
and advocacy
workshops.

Required Drivers
In the new world Kirkpatrick model, the authors call for identifying required drivers as
part of Level 3 evaluation. Required drivers are actions and processes to encourage, reward,
reinforce, and monitor the performance of critical behaviors from a curriculum (Kirkpatrick &
Kirkpatrick, 2016). Additionally, learners can apply critical behaviors learned in a curriculum to
new contexts. Support and accountability are two types of required drivers (Kirkpatrick &
Kirkpatrick, 2016). Support drivers include processes and systems that reinforce, encourage, and
reward critical behaviors. Accountability drivers are those that organizations may monitor. The
present youth vape prevention curriculum will incorporate several drivers to promote and support
critical behaviors among students. Table 7 outlines examples of processes that will be put in
place to motivate learners to perform critical behaviors. The method, timing, and critical
behavior impacted are also identified.

95

Table 7
Required Drivers to Support Critical Behaviors
Method(s) Timing Critical behaviors supported
1, 2, 3, 4, and 5
Reinforcing
Provide checklists as learning
aids to reinforce procedures
taught in class.
At the beginning and during
all lessons.
1 - 5
Provide school presentations
of student work to parents,
teachers, and
administrators.
Immediately after each course,
ongoing.
1 - 5
Best practices for youth
advocacy shared peer-to-
peer.
Immediately after each course,
ongoing.
1-5
Digital links provided to
students that summarize
best practices for
articulating the power of
media on emotion,
behavior, advocacy, and
youth vaping.
Immediately after each course,
ongoing.
1-5
Encouraging
Teacher, principal, parent and
facilitator feedback on vape
prevention messaging.
Immediately after each lesson.
Ongoing.
1-5
Peer and facilitator mentoring
or youth advocacy
strategies in digital media
content.
Immediately after each lesson.
Ongoing.
1-5
Rewarding
Students will have the
opportunity to share anti-
vape digital media content
with their peers, parents,
teachers, and administrators
at a culminating symposium
for the school community.
Once per semester. Ongoing
basis.
1-5
Digital media advocacy for
anti-vaping awards
throughout the school year.
Once per semester. Ongoing
basis.
1-5
Youth advocate team of the
year award.
Once per semester. Ongoing
basis.
1-5
96

Method(s) Timing Critical behaviors supported
1, 2, 3, 4, and 5
School award for student
performance on youth
advocacy for vape
prevention.
Once per semester. Ongoing
basis.
1-5
Monitoring
Post survey with students Immediately after completing
the curriculum. Another
post-survey 3 months after
completing the curriculum.
1-5
Focus group with teachers and
administrators after
implementation of
curriculum on campus.
Once per semester. 1-5
Survey data on rates of vaping
among students on campus.
Collected during pre and post-
survey data collection.
1-5

Organizational Support
In order to ensure training is well received, it is imperative to have organizational
support. Kirkpatrick and Kirkpatrick (2016) suggest only collaborating with organizations where
the curriculum being proposed is truly a critical mission for the partnering organization.
Otherwise, it is likely to be seen as overly time-consuming and will likely fail. For the present
vape prevention curriculum, the curriculum development team will ensure school districts,
school principals, teachers, and parents buy into the core mission of increasing youth advocacy
to reduce vaping among adolescents in the community. It is critical that the entire school
community buy-in and not merely agree to participate. As such, the curriculum development
team will meet with district officials and school board members to discuss the high rates of
vaping among students in Los Angeles County.
While most schools in California are required by the education code to offer substance
use prevention lessons to students, not all schools necessarily agree on the duration and
frequency of these lessons and may not completely buy into the idea that youth prevention is
97

mission critical for their campus. Therefore, rapport with school community members will help
curriculum developers assess the level of school buy-in before agreeing to include the school in
the youth advocacy for vape prevention curriculum. Schools selected will have a vested interest
in preventing vaping among students and subsequently improving student health and well-being.
Youth will be recruited in class to participate in the curriculum and will have some prior
knowledge of youth vaping and the effects of youth advocacy to deliver vape prevention
messaging. Youth who provide both parental consent and student assent will be invited to
participate in the curriculum. School community knowledge and support will help facilitate
parent knowledge of the importance of the vape prevention curriculum and will likely result in
increased parent consent rates.
Level 2: Learning
As stated earlier, Mayer (2011) attributed changes in behavior to changes in knowledge.
Kirkpatrick and Kirkpatrick (2016) further outlined the evaluation of learning by including
measures of knowledge, attitude, and skills. The new world Kirkpatrick model expanded on
learning evaluation by including evaluations of motivational factors such as confidence and
commitment (Kirkpatrick & Kirkpatrick, 2016). They also note that learning is simply a means
to achieving desired curriculum outcomes. As such, Smith and Ragan (2005) assert learning
goals describe what learners should be able to do after they have completed training programs.
Terminal learning objectives for the youth advocacy for vape prevention curriculum described
below represent sub-parts of the learning goals.
Terminal Learning Objectives
During instruction for the youth advocacy for vape prevention curriculum, middle school
youth will implement advocacy skills for vape prevention. Specifically, youth will be able to:
98

1. Meet with peers and articulate the power of media and society to influence our behaviors
in a 30-second “elevator pitch” using a rubric.
2. Communicate with their peers about vaping and articulate in a 60-second “elevator
speech” how the evolution and current state of social media has a greater impact on
emotions and behavior per a rubric.
3. Identify and articulate in a 60-second “elevator speech” two ways the tobacco industry
markets its products on social media and how social media marketing is linked to youth
vaping per a rubric.
4. Exercise agency in becoming an advocate to counter pro-tobacco influence by creating
one to two 60-second social media messages to prevent youth vaping per a rubric.
5. Implementing anti-vape digital media content for their peers incorporating 2-3 advocacy
strategies from the curriculum materials.
Components of Learning Evaluation
Assessing Level 2 progress requires carefully considering the number of assessments of
the learning activities associated with each enabling objective. Kirkpatrick and Kirkpatrick
(2016) suggest focusing on minimally invasive evaluation instruments to conduct formative
evaluation during curriculum implementation. In order to assess knowledge, skills, attitudes,
confidence, and commitment to learning objectives, it is critical to consider implementing
qualitative and quantitative assessments for each terminal learning objective during and after
each session (Kirkpatrick & Kirkpatrick, 2016). The present youth advocacy for vape prevention
curriculum will implement a series of observations, survey assessments, and demonstration
activities during each unit of instruction to assess learning toward terminal objectives. The data
collected will also be used to evaluate participant satisfaction and the relevance of curriculum
99

content. Table 8 provides a detailed outline of methods used to assess each component of
learning and when they will occur during the learning experience.

Table 8
Evaluation of the Components of Learning for the Program.
Method(s) or activity(ies) Timing
Declarative knowledge “I know it.”
Checks on learning At the end of each lesson and beginning of next
lesson to activate prior knowledge.
A short quiz to measure content knowledge At the end of each unit.
Procedural skills “I can do it right now.”
Practice advocacy using scenarios At the end of each unit.
A short activity to implement advocacy
messages in digital media
At the end of each lesson
Attitude “I believe this is worthwhile.”
Short rating scale survey item At the end of each unit.
Observation At the end of each unit.
Confidence “I think I can do it on the job.”
Give survey after every class At the end of each lesson.
Students are asked to demonstrate confidence in
implementing advocacy skills in digital
media content developed
At the end of each unit.
Ask students to share confidence in receiving
the support necessary to successfully apply
advocacy skills for vape prevention.
At the end of each unit.
Commitment “I will do it on the job.”
Post-survey 3 months after completing the
curriculum assessing frequency of
implementing vape prevention advocacy
messaging in digital media content.
3 months after completing the curriculum
100

Method(s) or activity(ies) Timing
Open ended assignment asking students to share
ways they plan to apply what they learned
when advocating for vape prevention.
During the final lesson of the curriculum and
again 3 months later.
Ask students to share ways they will support
one another when advocating for vape
prevention.
At the end of the curriculum.

Level 1: Reaction
Level 1 evaluation is important for understanding participant satisfaction during the
training. Kirkpatrick and Kirkpatrick (2016) describe Level 1 evaluation as a measurement of
participant engagement, satisfaction, and relevance to their jobs. It is a level of evaluation that is
important in terms of formative adjustments that may be made to increase participant
satisfaction. However, it is important to keep this level of evaluation somewhat brief in order to
save time for evaluating Level 3 and Level 4 outcomes (Kirkpatrick & Kirkpatrick, 2016).
Common methods for Level 1 evaluation include instructor observations or pulse checks, asking
the class briefly how things are going, which are implemented while conducting the training.
End-of-course surveys are also a common technique for collecting valuable information on
participant satisfaction related to course content (Kirkpatrick & Kirkpatrick, 2016). Table 9
provides a summary of methods used and timing for conducting Level 1 evaluation for the
present curriculum.

101

Table 9
Components to Measure Reactions to the Program.
Method(s) or tool(s) Timing
Engagement
Incorporate pulse checks in lessons to allow
facilitators to pause and gauge participant
engagement.
Units 1 - 5
Learner engagement and feedback to facilitators
during instruction.
Units 1 - 5
Ask students to summarize information
presented in the lesson.
End of each lesson.
Relevance
Ask students to share what information they
find most relevant to their experiences using
social media.
End of each unit.
Ask students what information they find most
relevant to their plans for youth advocacy for
vape prevention.
End of each unit.
Customer Satisfaction
Ask students if the material presented was
useful for youth advocacy efforts on social
media.
Mid way through the curriculum and again at
the end of the curriculum.
Ask if participants would recommend this
program to their peers.
End of curriculum.

Evaluation Tools
Formative, process, and outcome evaluation requires carefully considering evaluation
tools implemented to collect corresponding data. When designing evaluation instruments, it is
imperative to ensure that survey items and open-ended questions accurately measure
respondents’ perceptions based on their responses (Kirkpatrick & Kirkpatrick, 2016). In order to
accomplish accurate results, the authors recommend that evaluation instruments follow generally
accepted psychological measurement principles. Additionally, Kirkpatrick and Kirkpatrick
102

(2016) propose incorporating a blended approach where survey instruments and individual
survey items are designed to measure dimensions from Level 1 through Level 4 evaluation. The
blended approach helps ensure reducing survey fatigue among participants. Finally, evaluations
should be learner-centered and specifically tailored to the core concepts of individual programs.
The authors suggest avoiding a “one size fits all” approach when designing evaluation measures.
The timing of implementing evaluation instruments is an important consideration based
on evaluation purposes. Delaying the evaluation allows curriculum participants time to
implement what they learned in the training to their jobs, what types of support they are
receiving (L3), and the kinds of results they are achieving (L4) (Kirkpatrick & Kirkpatrick,
2016). For the present youth advocacy for vape prevention curriculum, a baseline survey will be
implemented to establish pre-existing knowledge and intentions to vape among learners. The
sample baseline survey can be found in Appendix D. A post-survey will be administered
immediately following the completion of the course and another post-survey administered 3
months after course completion. These post-surveys will be designed for Level 1 - Level 4
outcomes.
Pre-Program Implementation Baseline Survey
A pre-program survey will be implemented to establish baseline measures of Level 1 -
Level 4 outcomes. Results from the baseline survey will be compared with delayed surveys to
allow for evaluation of the effectiveness of the curriculum on Level 3 and Level 4 outcomes. The
pre-program implementation survey is located in Appendix D.
Immediately Following the Program Implementation
An evaluation instrument will be administered to students immediately after the
completion of the curriculum. The post-curriculum survey will include measures to focus on
103

Level 1 - Level 4 outcomes. The survey items will be phrased in a manner to elicit responses on
participant satisfaction and will contain Likert and open-ended questions. Likert questions will
have response options ranging from 1, strongly disagree, to 5, strongly agree, whereas open-
ended questions will ask participants to describe their learning experience with the curriculum.
The post-curriculum evaluation instrument, Appendix E, lists survey items and corresponding
levels of analysis, such as L1 for Level 1, L2 for Level 2, L3 for Level 3, and L4 for Level 4.
Delayed For a Period After the Program Implementation
Approximately 3 months after concluding the curriculum, the evaluation survey
administered immediately following the program implementation shown in Appendix E will be
administered again for Level 1, Level 2, Level 3, and Level 4. The survey will include items
from the baseline survey assessing intentions to vape and knowledge about the impact of social
media on emotions and vaping among adolescents. Results from pre and post-surveys will be
analyzed and reported as part of Level 3, Level 4, and Level 5 outcomes. The instrument is
identical to the survey administered immediately following the completion of the curriculum. A
combination of Likert scale and open-ended questions are included.
Data Analysis and Reporting
Data analysis and reporting includes data collected in the formative phase of the
curriculum and continues through post-survey data collection. Conducting data analysis at early
phases and at the end of the curriculum allows for identifying what is and is not working during
curriculum development. Kirkpatrick and Kirkpatrick (2016) suggest analyzing data to answer
three key questions: (a) Does the training meet expectations? (b) If not, why not? and (c) If so,
why? Finally, conducting baseline and follow-up surveys facilitates changes in Level 3 and
Level 4 behavioral outcomes which will be of importance to stakeholders of the curriculum.
104

Data collected for the youth advocacy for vape prevention curriculum includes qualitative
and quantitative data. Specifically, a baseline survey will assess pre-existing knowledge among
middle school students related to social media's influence on emotions, behavior, and youth vape
rates. Baseline and follow-up surveys will also assess youth intentions to vape nicotine products.
Data comparing pre/post changes in intentions to vape, increase in knowledge for social media
influence on behaviors, and methods used by youth for advocacy towards vape prevention.
Examples of school reports are presented in Appendix F. Aggregate data will be compiled for
curriculum outcomes among all participating schools and will be shared via the curriculum
website. Reports will include quantitative data, as well as participant testimonials, gathered from
middle school students. Sharing de-identified data online will provide transparency for
curriculum impacts to potential partner schools and will serve as a resource for parents,
administrators, and school district officials to share with their stakeholders.

105

References
4 marketing tactics e-cigarette companies use to target youth. (2018, August 9). Truth Initiative.
https://truthinitiative.org/research-resources/tobacco-industry-marketing/4-marketing-
tactics-e-cigarette-companies-use-target
About – TND. (2022). Project Toward No Drugabuse. https://tnd.usc.edu/?page_id=37
Aguilar, S. J., Galperin, H., & Le, T. V. (2021). Closing the homework gap in California:
Promoting broadband for K-12 families beyond the pandemic [Preprint]. EdArXiv.
https://doi.org/10.35542/osf.io/qfjsv
Alcohol, Tobacco & Other Drug Prevention. (2016). Calfornia School Boards Association.
https://www.cde.ca.gov/ls/he/at/tobpolicyregs.asp
Ali, F. R. M. (2020). E-cigarette Unit Sales, by Product and Flavor Type—United States, 2014–
2020. MMWR. Morbidity and Mortality Weekly Report, 69.
https://doi.org/10.15585/mmwr.mm6937e2
Alley, K. M. (2019). Fostering middle school students’ autonomy to support motivation and
engagement. Middle School Journal, 50(3), 5–14.
https://doi.org/10.1080/00940771.2019.1603801
Alpert, J. M., Chen, H., Riddell, H., Chung, Y. J., & Mu, Y. A. (2021). Vaping and Instagram: A
Content Analysis of e-Cigarette Posts Using the Content Appealing to Youth (CAY)
Index. Substance Use & Misuse, 56(6), 879–887.
https://doi.org/10.1080/10826084.2021.1899233
Anderson, L., & Krathwohl, D. (2001). Taxonomy for Learning, Teaching, and Assessing, A: A
Revision of Bloom’s Taxonomy of Educational Objectives, Abridged Edition (1st edition).
Pearson.
106

Antin, T. M. J., Hunt, G., & Sanders, E. (2018). The “here and now” of youth: The meanings of
smoking for sexual and gender minority youth. Harm Reduction Journal, 15(1), 30.
https://doi.org/10.1186/s12954-018-0236-8
Baker, K. A., Campbell, N. J., Noonan, D., Thompson, J. A., & Derouin, A. (2022). Vaping
Prevention in a Middle School Population Using CATCH My Breath. Journal of
Pediatric Health Care, 36(2), 90–98. https://doi.org/10.1016/j.pedhc.2021.07.013
Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory (pp. xiii,
617). Prentice-Hall, Inc.
Bandura, A. (1991). Social Cognitive Theory of Moral Thought and Action. In Handbook of
Moral Behavior and Development. Psychology Press.
Bandura, A. (1998). Health promotion from the perspective of social cognitive theory.
Psychology & Health, 13(4), 623–649. https://doi.org/10.1080/08870449808407422
Bell, Lee Anne. (n.d.). Theoretical Foundations for Social Justice Education.
Beyond the Bell. (2022, November). [Institution]. Beyond the Bell. https://btb.lausd.net/
Big Tobacco spends nearly $1 million/hr on marketing and promotion. (2017, November 2).
Truth Initiative. https://truthinitiative.org/research-resources/tobacco-industry-
marketing/new-report-tobacco-industry-spends-nearly-1-million
Bradshaw, S., & Howard, P. N. (2018). Challenging Truth and Trust: A Global Inventory of
Organized Social Media Manipulation (p. 26). University of Oxford.
https://demtech.oii.ox.ac.uk/research/posts/challenging-truth-and-trust-a-global-
inventory-of-organized-social-media-manipulation/
Bronfenbrenner, U. (1981). The Ecology of Human Development: Experiments by Nature and
Design. Harvard University Press.
107

California Deptartment of Education. (2022). California Department of Education.
https://www.cde.ca.gov/be/ag/ag/vmgoals.asp
Cartujano-Barrera, F., Hernández-Torrez, R., Cai, X., Orfin, R. H., Azogini, C., Chávez-Iñiguez,
A., Santa Cruz, E., Bansal-Travers, M., Wilson, K. M., McIntosh, S., Ossip, D. J., &
Cupertino, A. P. (2022). Evaluating the Immediate Impact of Graphic Messages for
Vaping Prevention among Black and Latino Adolescents: A Randomized Controlled
Trial. International Journal of Environmental Research and Public Health, 19(16),
10026. https://doi.org/10.3390/ijerph191610026
CDC. (2022, November 8). Quick Facts on the Risks of E-cigarettes for Young People. Centers
for Disease Control and Prevention. https://www.cdc.gov/tobacco/basic_information/e-
cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-
Adults.html
CDCTobaccoFree. (2022, August 22). Tobacco Industry Marketing. Centers for Disease Control
and Prevention.
https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/marketing/inde
x.htm
Chadi, N., Schroeder, R., Jensen, J. W., & Levy, S. (2019). Association Between Electronic
Cigarette Use and Marijuana Use Among Adolescents and Young Adults: A Systematic
Review and Meta-analysis. JAMA Pediatrics, 173(10), e192574.
https://doi.org/10.1001/jamapediatrics.2019.2574
Chen-Sankey, J. C., Unger, J. B., Bansal-Travers, M., Niederdeppe, J., Bernat, E., & Choi, K.
(2019). E-cigarette Marketing Exposure and Subsequent Experimentation Among Youth
and Young Adults. Pediatrics, 144(5), e20191119. https://doi.org/10.1542/peds.2019-
108

1119
Cho, H., Li, W., Shen, L., & Cannon, J. (2019). Mechanisms of Social Media Effects on
Attitudes Toward E-Cigarette Use: Motivations, Mediators, and Moderators in a National
Survey of Adolescents. Journal of Medical Internet Research, 21(6), e14303.
https://doi.org/10.2196/14303
Cho, H., Shen, L., & Wilson, K. (2014). Perceived Realism: Dimensions and Roles in Narrative
Persuasion. Communication Research, 41(6), 828–851.
https://doi.org/10.1177/0093650212450585
Clark, R.E., & Estes, F. (2008). Turning research into results: A guide to selecting the right
performance solutions. Information Age Pub Inc.
Clark, R. E., Yates, K., Early, S., & Moulton, K. (2010). An Analysis of the Failure of Electronic
Media and Discovery- Based Learning. In Handbook of improving performance in the
workplace (Vol. 3). Wiley & Sons.
Cullen, K. A. (2018). Notes from the Field: Use of Electronic Cigarettes and Any Tobacco
Product Among Middle and High School Students — United States, 2011–2018. MMWR.
Morbidity and Mortality Weekly Report, 67. https://doi.org/10.15585/mmwr.mm6745a5
Dearfield, C. T., Chen-Sankey, J. C., McNeel, T. S., Bernat, D. H., & Choi, K. (2021). E-
cigarette initiation predicts subsequent academic performance among youth: Results from
the PATH Study. Preventive Medicine, 153, 106781.
https://doi.org/10.1016/j.ypmed.2021.106781
Derzon, J. H., & Lipsey, M. W. (2002). A meta-analysis of the effectiveness of mass-
communication for changing substance-use knowledge, attitudes, and behavior. In Mass
media and drug prevention: Classic and contemporary theories and research (pp. 231–
109

258). Lawrence Erlbaum Associates Publishers.
Dewdney, A., Curran, J., & Ride, P. (2013). The Digital Media Handbook (2nd ed.). Routledge.
https://doi.org/10.4324/9780203066942
Evidence Brief: Tobacco Industry Sponsored Youth Prevention Programs in Schools | Smoking
and Tobacco Use | CDC. (2022, November 30).
https://www.cdc.gov/tobacco/basic_information/youth/evidence-brief/index.htm
Flicker, S., Maley, O., Ridgley, A., Biscope, S., Lombardo, C., & Skinner, H. A. (2008). e-PAR:
Using technology and participatory action research to engage youth in health promotion.
Action Research, 6(3), 285–303. https://doi.org/10.1177/1476750307083711
Fowler, J. H., & Christakis, N. A. (2008). Dynamic spread of happiness in a large social
network: Longitudinal analysis over 20 years in the Framingham Heart Study. BMJ, 337,
a2338. https://doi.org/10.1136/bmj.a2338
Froelich, W. (2020). Incidence of Tobacco & Vaping in Low-Income, Ethnically Dense
Communities. Oncology Times, 42(11), 32.
https://doi.org/10.1097/01.COT.0000669736.04162.19
Goriounova, N. A., & Mansvelder, H. D. (2012). Short- and Long-Term Consequences of
Nicotine Exposure during Adolescence for Prefrontal Cortex Neuronal Network
Function. Cold Spring Harbor Perspectives in Medicine, 2(12), a012120–a012120.
https://doi.org/10.1101/cshperspect.a012120
Groom, A. L., Vu, T.-H. T., Landry, R. L., Kesh, A., Hart, J. L., Walker, K. L., Wood, L. A.,
Robertson, R. M., & Payne, T. J. (2021). The Influence of Friends on Teen Vaping: A
Mixed-Methods Approach. International Journal of Environmental Research and Public
Health, 18(13), 6784. https://doi.org/10.3390/ijerph18136784
110

Guidelines for School Health Programs to Prevent Tobacco Use and Addiction
(Recommendations and Reports No. 43; Morbidity and Mortality Weekly Report
(MMWR), pp. 1–18). (1994). Centers for Disease Control (CDC).
https://www.cdc.gov/mmwr/preview/mmwrhtml/00026213.htm
Hoffman, B. R., Sussman, S., Unger, J. B., & Valente, T. W. (2006). Peer Influences on
Adolescent Cigarette Smoking: A Theoretical Review of the Literature. Substance Use &
Misuse, 41(1), 103–155. https://doi.org/10.1080/10826080500368892
Joe Camel Advertising Campaign Violates Federal Law, FTC Says. (1997, May 28). Federal
Trade Commission. https://www.ftc.gov/news-events/news/press-releases/1997/05/joe-
camel-advertising-campaign-violates-federal-law-ftc-says
Jones, W. J., & Silvestri, G. A. (2010). The Master Settlement Agreement and Its Impact on
Tobacco Use 10 Years Later: Lessons for Physicians About Health Policy Making. Chest,
137(3), 692–700. https://doi.org/10.1378/chest.09-0982
Kelder, S. H., Mantey, D. S., Van Dusen, D., Vaughn, T., Bianco, M., & Springer, A. E. (2021).
Dissemination of CATCH My Breath, a middle school E-Cigarette prevention program.
Addictive Behaviors, 113, 106698. https://doi.org/10.1016/j.addbeh.2020.106698
Kim, H. H.-S., & Chun, J. (2018). Analyzing Multilevel Factors Underlying Adolescent
Smoking Behaviors: The Roles of Friendship Network, Family Relations, and School
Environment. Journal of School Health, 88(6), 434–443.
https://doi.org/10.1111/josh.12630
King, C., & Siegel, M. (2001). The Master Settlement Agreement with the Tobacco Industry and
Cigarette Advertising in Magazines. New England Journal of Medicine, 345(7), 504–511.
https://doi.org/10.1056/NEJMsa003149
111

King, K. M., Rice, J. A., Steinbock, S., Reno-Weber, B., Okpokho, I., Pile, A., & Carrico, K.
(2015). Kentucky Teen Institute: Results of a 1-Year, Health Advocacy Training
Intervention for Youth. Health Promotion Practice, 16(6), 885–896.
https://doi.org/10.1177/1524839915588294
Kirkpatrick, J. D., & Kirkpatrick, W. K. A. (2016). Kirkpatrick’s Four Levels of Training
Evaluation. ATD Press.
Kirschner, P. A. (2002). Cognitive load theory: Implications of cognitive load theory on the
design of learning. Learning and Instruction, 12(1), 1–10. https://doi.org/10.1016/S0959-
4752(01)00014-7
Kramer, A. D. I., Guillory, J. E., & Hancock, J. T. (2014). Experimental evidence of massive-
scale emotional contagion through social networks. Proceedings of the National Academy
of Sciences, 111(24), 8788–8790. https://doi.org/10.1073/pnas.1320040111
Kreps, S. (2020). The role of technology in online misinformation (Foreign Policy at Brookings,
p. 11). Brookings. https://www.brookings.edu/research/the-role-of-technology-in-online-
misinformation/
LaRose, R., & Eastin, M. S. (2004). A Social Cognitive Theory of Internet Uses and
Gratifications: Toward a New Model of Media Attendance. Journal of Broadcasting &
Electronic Media, 48(3), 358–377. https://doi.org/10.1207/s15506878jobem4803_2
Leonard, J. (2011). Using Bronfenbrenner’s Ecological Theory to Understand Community
Partnerships: A Historical Case Study of One Urban High School. Urban Education,
46(5), 987–1010. https://doi.org/10.1177/0042085911400337
Lewis, M. J., Yulis, S. G., Delnevo, C., & Hrywna, M. (2004). Tobacco Industry Direct
Marketing after the Master Settlement Agreement. Health Promotion Practice,
112

5(3_suppl), 75S-83S. https://doi.org/10.1177/1524839904264596
Lippert, A. M., Corsi, D. J., & Venechuk, G. E. (2019). Schools Influence Adolescent E-
Cigarette use, but when? Examining the Interdependent Association between School
Context and Teen Vaping over time. Journal of Youth and Adolescence, 48(10), 1899–
1911. https://doi.org/10.1007/s10964-019-01106-y
LISTING OF DEPARTMENT OF PUBLIC HEALTH PRESS RELEASES. (2019, August 9). New
Release, County of Los Angeles Public Health.
http://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=21
17
Liu, J., Gaiha, S. M., & Halpern-Felsher, B. (2020). A Breath of Knowledge: Overview of
Current Adolescent E-cigarette Prevention and Cessation Programs. Current Addiction
Reports, 7(4), 520–532. https://doi.org/10.1007/s40429-020-00345-5
MacKinnon, D. P., Taborga, M. P., & Morgan-Lopez, A. A. (2002). Mediation designs for
tobacco prevention research. Drug and Alcohol Dependence, 68, 69–83.
https://doi.org/10.1016/S0376-8716(02)00216-8
Malcolm, J., Hodkinson, P., & Colley, H. (2003). The interrelationships between informal and
formal learning. Journal of Workplace Learning, 15(7/8), 313–318.
https://doi.org/10.1108/13665620310504783
Mantey, D. S., Omega-Njemnobi, O., Ruiz, F. A., Vaughn, T. L., Kelder, S. H., & Springer, A.
E. (2021). Association between observing peers vaping on campus and E-cigarette use
and susceptibility in middle and high school students. Drug and Alcohol Dependence,
219, 108476. https://doi.org/10.1016/j.drugalcdep.2020.108476
Mares, M.-L., & Woodard, E. (2005). Positive Effects of Television on Children’s Social
113

Interactions: A Meta-Analysis. Media Psychology, 7(3), 301–322.
https://doi.org/10.1207/S1532785XMEP0703_4
Martin, C. A., & Bush, A. J. (2000). Do role models influence teenagers’ purchase intentions and
behavior? The Journal of Consumer Marketing, 17(5), 441–453.
https://doi.org/10.1108/07363760010341081
Mason, M., Mennis, J., Light, J., Rusby, J., Westling, E., Crewe, S., Way, T., Flay, B., &
Zaharakis, N. (2016). Erratum to: Parents, Peers, and Places: Young Urban Adolescents’
Microsystems and Substance Use Involvement. Journal of Child and Family Studies,
25(5), 1712–1712. https://doi.org/10.1007/s10826-016-0392-y
Mayer, R. E. (2011). Applying the Science of Learning. Pearson/Allyn & Bacon.
McCleod Saul. (2022, August 18). Lev Vygotsky’s Sociocultural Theory—Simply Psychology.
Vygotsky’s Sociocultural Theory of Cognitive Development.
https://www.simplypsychology.org/vygotsky.html
Mcleod, S. (n.d.). [Lev Vygotsky’s Sociocultural Theory]. Retrieved January 4, 2023, from
https://www.simplypsychology.org/vygotsky.html
Meich, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick,
M. E. (2021). Monitoring the Future national survey on drug Use, 1975-2020: Volume I,
Secondary school students (pp. 1–551). University of Michigan.
Millstein, R. A., & Sallis, J. F. (2011). Youth advocacy for obesity prevention: The next wave of
social change for health. Translational Behavioral Medicine, 1(3), 497–505.
https://doi.org/10.1007/s13142-011-0060-0
Mirbolouk, M., Boakye, E., Obisesan, O., Osei, A. D., Dzaye, O., Osuji, N., Erhabor, J., Stokes,
A. C., El-Shahawy, O., Rodriguez, C. J., Hirsch, G. A., Benjamin, E. J., DeFilippis, A. P.,
114

Marie Robertson, R., Bhatnagar, A., & Blaha, M. J. (2022). E-cigarette use among high
school students in the United States prior to the COVID-19 pandemic: Trends, correlates,
and sources of acquisition. Preventive Medicine Reports, 29, 101925.
https://doi.org/10.1016/j.pmedr.2022.101925
O’Brien, E. K., Hoffman, L., Navarro, M. A., & Ganz, O. (2020). Social media use by leading
US e-cigarette, cigarette, smokeless tobacco, cigar and hookah brands. Tobacco Control,
tobaccocontrol-2019-055406. https://doi.org/10.1136/tobaccocontrol-2019-055406
Pajares, F. (2012). Motivational role of self-efficacy beliefs in self-regulated learning.
In Motivation and self-regulated learning (pp. 111-139). Routledge.
Parcel, G. S., O’Hara-Tompkins, N. M., Harrist, R. B., Basen-Engquist, K. M., McCormick, L.
K., Gottlieb, N. H., & Eriksen, M. P. (1995). Diffusion of an effective tobacco prevention
program. Part II: Evaluation of the adoption phase. Health Education Research, 10(3),
297–307. https://doi.org/10.1093/her/10.3.297
Park, E., & Chang, Y.-P. (2020). Using Digital Media to Empower Adolescents in Smoking
Prevention: Mixed Methods Study. JMIR Pediatrics and Parenting, 3(1), e13031.
https://doi.org/10.2196/13031
Pierce, J. P., Sargent, J. D., Portnoy, D. B., White, M., Noble, M., Kealey, S., Borek, N., Carusi,
C., Choi, K., Green, V. R., Kaufman, A. R., Leas, E., Lewis, M. J., Margolis, K. A.,
Messer, K., Shi, Y., Silveira, M. L., Snyder, K., Stanton, C. A., … Hyland, A. (2018).
Association Between Receptivity to Tobacco Advertising and Progression to Tobacco
Use in Youth and Young Adults in the PATH Study. JAMA Pediatrics, 172(5), 444.
https://doi.org/10.1001/jamapediatrics.2017.5756
Ren, M., & Lotfipour, S. (2019). Nicotine Gateway Effects on Adolescent Substance Use.
115

Western Journal of Emergency Medicine, 20(5), 696–709.
https://doi.org/10.5811/westjem.2019.7.41661
Rosenquist, J. N., Fowler, J. H., & Christakis, N. A. (2011). Social network determinants of
depression. Molecular Psychiatry, 16(3), Article 3. https://doi.org/10.1038/mp.2010.13
Schaeffer, K. (2019, August 23). Most U.S. teens who use cellphones do it to pass time, connect
with others, learn new things. Pew Research Center. https://www.pewresearch.org/fact-
tank/2019/08/23/most-u-s-teens-who-use-cellphones-do-it-to-pass-time-connect-with-
others-learn-new-things/
Schor, J. B. (2014). Schor, J. B. (2014). Born to buy: The commercialized child and the new
consumer cult. Simon and Schuster.
Schunk, D. H., & Zimmerman, B. J. (2007). Influencing Children’s Self-Efficacy and Self-
Regulation of Reading and Writing Through Modeling. Reading & Writing Quarterly,
23(1), 7–25. https://doi.org/10.1080/10573560600837578
Smart, J. F., & Smart, D. W. (1995). Acculturative Stress of Hispanics: Loss and Challenge.
Journal of Counseling & Development, 73(4), 390–396. https://doi.org/10.1002/j.1556-
6676.1995.tb01770.x
Smith, D. (2002). The theory heard ’round the world.: (301142003-030) [Data set]. American
Psychological Association. https://doi.org/10.1037/e301142003-030
Smith, Patricia L., & Ragan, Tillman J. (2005). Instructional Design (3rd ed.). John Wiley &
Sons, Inc.
Soneji, S., Knutzen, K. E., Tan, A. S. L., Moran, M. B., Yang, J., Sargent, J., & Choi, K. (2019).
Online tobacco marketing among US adolescent sexual, gender, racial, and ethnic
minorities. Addictive Behaviors, 95, 189–196.
116

https://doi.org/10.1016/j.addbeh.2019.03.015
Stanford Toolkit. (2023). Tobacco Prevention Toolkit. Tobacco Prevention Toolkit.
https://med.stanford.edu/tobaccopreventiontoolkit.html
Struik, L. L., Dow-Fleisner, S., Belliveau, M., Thompson, D., & Janke, R. (2020). Tactics for
Drawing Youth to Vaping: Content Analysis of Electronic Cigarette Advertisements.
Journal of Medical Internet Research, 22(8), e18943. https://doi.org/10.2196/18943
Students—Alcohol, Tobacco & Other Drug Prevention (CA Dept of Education). (n.d.). Retrieved
March 6, 2023, from https://www.cde.ca.gov/ls/he/at/tobpolicyregs.asp
Surgeon General’s Advisory on E-cigarette Use Among Youth | Smoking & Tobacco Use | CDC.
(2022, December 5). Smoking & Tobacco Use.
https://www.cdc.gov/tobacco/basic_information/e-cigarettes/surgeon-general-
advisory/index.html
Sussman, S. (Ed.). (2020). The Cambridge Handbook of Substance and Behavioral Addictions.
Cambridge University Press.
Sussman, Steven S. (2015). Handbook of Adolescent Drug Use Prevention: Research,
Intervention Strategies, and Practice. American Psychological Association.
https://www.jstor.org/stable/j.ctv1chs715
Truth Tobacco Industry Documents. (2022). Truth Tobacco Industry Documents.
https://www.industrydocuments.ucsf.edu/tobacco/
Unger, J. B., Soto, D. W., & Leventhal, A. (2016). E-cigarette use and subsequent cigarette and
marijuana use among Hispanic young adults. Drug and Alcohol Dependence, 163, 261–
264. https://doi.org/10.1016/j.drugalcdep.2016.04.027
US Food and Drug Administration. (2022). E-Cigarettes, Vapes, and other Electronic Nicotine
117

Delivery Systems (ENDS). FDA. https://www.fda.gov/tobacco-products/products-
ingredients-components/e-cigarettes-vapes-and-other-electronic-nicotine-delivery-
systems-ends
US Tobacco Company Times: Vol 2, No 7—Truth Tobacco Industry Documents. (2022).
Tobacco Industry Documents.
https://www.industrydocuments.ucsf.edu/tobacco/docs/#id=fnpn0030
Vannucci, A., Simpson, E. G., Gagnon, S., & Ohannessian, C. M. (2020). Social media use and
risky behaviors in adolescents: A meta‐analysis. Journal of Adolescence, 79(1), 258–274.
https://doi.org/10.1016/j.adolescence.2020.01.014
Vassey, J., Galimov, A., Kennedy, C. J., Vogel, E. A., & Unger, J. B. (2022). Frequency of
social media use and exposure to tobacco or nicotine-related content in association with
E-cigarette use among youth: A cross-sectional and longitudinal survey analysis.
Preventive Medicine Reports, 30, 102055. https://doi.org/10.1016/j.pmedr.2022.102055
Versel, L. (2018, February 8). As Cell Phones Proliferate in K-12, Schools Search for Smart
Policies. Education Week. https://www.edweek.org/technology/as-cell-phones-
proliferate-in-k-12-schools-search-for-smart-policies/2018/02
Wheeler, D. C., Do, E. K., Hayes, R. B., Fugate-Laus, K., Fallavollita, W. L., Hughes, C., &
Fuemmeler, B. F. (2020). Neighborhood Disadvantage and Tobacco Retail Outlet and
Vape Shop Outlet Rates. International Journal of Environmental Research and Public
Health, 17(8), Article 8. https://doi.org/10.3390/ijerph17082864
Winkleby, M. A., Feighery, E., Dunn, M., Kole, S., Ahn, D., & Killen, J. D. (2004). Effects of an
Advocacy Intervention to Reduce Smoking Among Teenagers. Archives of Pediatrics &
Adolescent Medicine, 158(3), 269. https://doi.org/10.1001/archpedi.158.3.269
118

Appendix A: Course Overview
The youth advocacy for vape prevention is designed to encourage middle school youth to
become impactful advocates for health. The present iteration focuses on advocacy for youth vape
prevention. Youth who complete this curriculum will learn the role of social media to influence
user emotions and behavior, ways the tobacco industry uses social media to market tobacco
products to youth, the power of social media for youth advocacy, and how to develop digital
media content for youth advocacy. There are a total of five units of instruction for this
curriculum. The entire curriculum is delivered synchronously by a trained facilitator. Curriculum
resources are available to students asynchronously in Google Sites. The duration of each lesson
will be 30-45 minutes to allow flexibility for school based implementation during scheduled
class time or as part of an after school program.
Course Overview
Students and facilitators will have access to personal iPhone or Android devices for video
recording, iMovie or equivalent digital media editing software, and Microsoft office software.
For students who do not have recording devices, one will be provided. Students will also have
access to slack, videos, images, slides, course handouts, and readings. Digital materials will be
shared via Google Sites.
Learner Characteristic Accommodations
Asynchronous curriculum material will be offered in English and Spanish for students
who prefer reading in Spanish. Facilitators will be trained to accommodate Spanish language
media for students who wish to develop youth advocacy messaging in Spanish. For students who
do not have access to an iPhone or Android device, the curriculum team will provide an android
tablet or iPad for recording and digital media editing.
119

Facilitator’s Notes
Youth who participate in the youth advocacy for vape prevention curriculum will have
varying levels of pre-existing knowledge of the effects of social media on emotions and
behaviors. Additionally, some youth will have high levels of knowledge for using social media
and developing digital media content, while others may be more novices. It is important for the
facilitator to informally assess learner knowledge by informally asking students to share their
experience using social media and what they may have heard about how social media influences
behavior. Finally, facilitators should ask students to reflect on why they are taking this course on
youth advocacy and any previous experiences they may have participated in or witnessed for
youth advocacy and how it impacted their thoughts or behaviors for a given topic. Table A1
shows the instructional activities.

Table A1
Instructional Activities for the Course Overview
Instructional
sequence
Time

Description of the
learning activity
Instructor
action
Learner
action
Introduction 5 Provide motivation
by drawing the
learner’s
attention to the
problem of youth
vaping
influenced by
several factors
including social
media and how
this may be
addressed by
youth advocacy.
Provide the
Introduce the
course and
purpose and goal
using images and
video of harms
of tobacco use
and successful
youth advocacy
campaigns.
Show images of
a facilitator
working with a
student and a
final image of
Ask learners to
write down their
personal goal for
the course and
how they can
immediately
apply it.
120

Instructional
sequence
Time

Description of the
learning activity
Instructor
action
Learner
action
overall purpose
of the course to
teach effective
youth advocacy
strategies for
advocating to
prevent youth
vaping.
the student’s “ah
ha” moment of
understanding
the success of
youth advocacy.

Ask the learners to
write down their
personal goal of
what they want
to get out of the
course and how
they would
immediately
apply it.
Course goal 5 Provide an
introduction to
the youth
advocacy for
vaping course
goals and
objectives.
Present the course
goal and
outcomes.
Learners will have
access to school
supplied
chromebooks to
take notes.

Ask learners to
connect and
write the goal
and outcomes to
their personal
goal for youth
advocacy and
application to
youth vape
prevention.
121

Instructional
sequence
Time

Description of the
learning activity
Instructor
action
Learner
action
Reasons for
the course
10 Stimulate
motivation by
describing the
opportunity
being provided
to the learners
and the risk that
will be avoided
if the youth
advocacy for
vape prevention
course is
mastered.

Benefits:
Identify and
articulate ways
social media
influences
behavior and
emotions.

Learn vocabulary
of vape
prevention and
youth advocacy.

Learn strategies for
self-growth.

Identify and
articulate ideas
about youth
agency,
advocacy, and
digital media
marketing for
healthy choices.

Identify tobacco
industry
marketing on
Ask the learners to
answer questions
such as: “What
is the value for
me in this
course” and
“Can I do it?”
and
“Will I need and
use
what I will learn
for youth
advocacy via
social media?”
“What are the
negative
consequences?”
Ask learners to
write down their
answers and
describe how
their personal
goals connect
with the course
goals for youth
advocacy and
vape prevention.
122

Instructional
sequence
Time

Description of the
learning activity
Instructor
action
Learner
action
social media that
appeals to youth.

Describe ways
vaping is
promoted on
social media.

Articulate how
tobacco
marketing is
linked with rates
of youth vaping.

Identify and
develop
advocacy
strategies for
countering pro-
tobacco
influence on
social media

Youth will use
their expertise in
digital media
creation to
develop vape-
prevention
content for social
media

Identify and
develop effective
methods for
disseminating
youth developed
vape prevention
digital media
content.

Risks avoided:
123

Instructional
sequence
Time

Description of the
learning activity
Instructor
action
Learner
action
Implementing
ineffective youth
advocacy
strategies.

Being influenced
by social media
to use vape
products.

Reduce the risk of
allowing social
media to
influence
negative health
behaviors.

Avoid influence of
social media on
youth negative
emotions.

Reduce risk of
vape initiation
among peers.

Reduce risk of
developing
digital media that
is confusing or
conveys an
unintended
message about
youth vaping.

124

Instructional
sequence
Time

Description of the
learning activity
Instructor
action
Learner
action
Course
overview
10 Show all the units
in the course to
provide a mental
model and assist
the learners to
organize their
learning. See
figure A1.

Provide a
description of the
activities,
definitions, video
recording and
editing software,
and artifacts that
will be used in
each unit.
Facilitator will
review the
course overview
handout and
discuss how each
unit relates to
achieving the
course goal. See
figure A1. The
facilitator will
also introduce
Google Sites and
share all
asynchronous
resources
available to
learners.

Ask learners to
review the
course overview
handout, access
Google Sites on
their
chromebooks,
and ask any
clarifying
questions.
Total time 30

125

Figure A1
Visual Overview of the Program

126

Appendix B: Lesson Overviews
This section contains the overviews for each lesson. Each lesson overview consists of the
terminal objective, enabling objectives, and an overview of the learning activities. Finally, the
summative assessment for each unit is also outlined.
Unit 1: The Power of Media and Society
This first unit focuses on introducing students to the power of media and its impacts on
society. It will be delivered synchronously to students in a classroom setting. The summary will
cover the primary characteristics of increasing student knowledge and articulation of the power
of media and society.
Terminal Objective
When communicating with their peers about vaping, youth will articulate the power of
media and society to influence our behaviors in a 30 second “elevator pitch” using a rubric.
Enabling Objectives
The enabling objectives for this unit are comprised of the following:
1. Declarative
a. Given the list of words, learners will define and give examples and nonexamples
of communicating; vaping; media; society; influence; behavior per the definitions
provided.
2. Intellectual skills
a. Given a conversation with their peers, learners will effectively articulate ideas and
relationships about the power of media and society to influence our behaviors.
3. Cognitive strategies
127

a. When asked about the power of media and society, learners will elaborate in their
own words on their current knowledge about the power of media to influence
behavior.
4. Attitudes
a. Given a conversation with their peers, learners will value communicating with
peers about the power of media and society to influence our behaviors.
b. Given a conversation with their peers, learners will be confident in
communicating with peers.
Learning Activities
● After introductions and attention activities and learning objectives, assess prior
knowledge about the declarative knowledge of communicating; vaping; media; society;
influence; behavior.
● Teach any necessary prerequisite declarative knowledge by providing definitions and
examples and nonexamples.
● Provide opportunities for learners to generate their own examples and nonexamples.
● Model the procedure for effectively articulating ideas and relationships about the power
of media and society to influence our behaviors.
● Provide practice and feedback for effectively articulating ideas and relationships about
the power of media and society to influence our behaviors.
● Provide opportunities to effectively articulate ideas and relationships about the
power of media and society to influence our behaviors.
● Provide messages and models of value for communicating with peers about the
power of media and society to influence our behaviors.
128

● Ask learners to reflect on their learning and discuss with others their own thought
processes to create their elevator pitch on the power of media and society to
influence our behaviors.
Summative Assessment
When communicating with their peers about vaping, youth will articulate the power of
media and society to influence our behaviors in a 30 second “elevator pitch” using a rubric.
Students will be asked to deliver their elevator pitch to each other. The listener will grade the
elevator pitch using a rubric.

Unit 2: Current Trends in Social Media and Their Influence on Society
The second unit focuses on the evolution of social media and how it has evolved to
impact the emotions and behaviors of the end users. It will be delivered synchronously to
students in a classroom setting. The summary will cover the primary characteristics of increasing
student knowledge and articulation of the power of social media to influence behavior.
Terminal Objective
When communicating with their peers about vaping, youth will articulate in a 60 second
“elevator speech” how the evolution and current state of social media has a greater impact on
emotions and behavior per a rubric.
Enabling Objectives
1. Declarative
a. When given a list of terms, learners will give examples and non-examples of
vaping; social media; evolution of social media; emotions; emotional contagion;
influence; behavior change.
129

2. Intellectual skills
a. Given a conversation with peers, learners will identify and articulate how social
media has evolved to influence emotions and behaviors.
3. Cognitive strategies
a. When asked about the evolution of social media and its impact on behavior,
learners will articulate two examples how social media affects behaviors and
connect this to the current youth oriented social media platforms.
4. Attitudes
a. Given a conversation with peers, learners will have confidence that emotions and
behavior may be positively influenced by social media.
Learning Activities
● After introductions and attention activities and learning objectives, assess prior
knowledge about the declarative knowledge of communicating; social media; emotions;
emotional contagion; behavior change.
● Teach any necessary prerequisite declarative knowledge by providing definitions and
examples and nonexamples.
● Provide opportunities for learners to generate their own examples and nonexamples.
● Model the procedure for effectively articulating ideas and relationships about the
current state of social media, emotional contagion, and behavior change.
● Provide practice and feedback for effectively articulating ideas and relationships about
the current state of social media, emotional contagion, and behavior change.
● Provide opportunities to effectively articulate ideas and relationships about the
power of media and society to influence our behaviors.
130

● Ask learners to reflect on their learning and discuss with others their own thought
processes to create their elevator pitch on the use of social media to positively
impact emotions and behaviors.
Summative Assessment
When communicating with their peers about vaping, youth will articulate in a 60 second
“elevator speech” how the evolution and current state of social media has a greater impact on
emotions and behavior per a rubric. Students will be asked to deliver their elevator pitch to each
other. The listener will grade the elevator pitch using a rubric.

Unit 3: The power of the tobacco industry to change behavior
The third unit focuses on ways the tobacco industry uses social media to impact behavior.
It will be delivered synchronously to students in a classroom setting. The summary will cover the
primary characteristics of increasing student knowledge and articulation of the tobacco industry
to influence positive perceptions of their products among youth.
Terminal objective
When communicating with peers about vaping, learners will identify and articulate in a
60 second “elevator speech” two ways the tobacco industry markets their products on social
media and how social media marketing is linked to youth vaping per a rubric.
Enabling objectives
1. Declarative
a. When given a list of social media images and terms, learners will describe ways
tobacco companies use digital media to market vaping; identify types of
marketing that appeals to youth; articulate how youth vaping is associated with
131

tobacco industry social media marketing.
2. Intellectual skills
a. Given a conversation with peers, learners will identify and articulate how tobacco
marketing in social media attracts youth to vaping.
3. Cognitive strategies
a. When asked about tobacco marketing in social media, learners will elaborate on
their current knowledge of marketing products on social media and how this
might occur with tobacco marketing to youth.
4. Attitudes
a. Given a conversation with peers, learners will have confidence describing ways
the tobacco industry markets vape products to youth and the association with high
rates of youth vaping.
Learning Activities
● After introductions and attention activities and learning objectives, assess prior
knowledge of the declarative knowledge of ways tobacco companies use digital media
to market vaping; identify types of marketing that appeals to youth; articulate how
youth vaping is associated with tobacco industry social media marketing.
● Teach any necessary prerequisite declarative knowledge by providing definitions and
examples and nonexamples.
● Provide opportunities for learners to generate their own examples and nonexamples.
● Model the procedure for effectively articulating ideas and relationships between
tobacco company digital media marketing; types of marketing that appeals to youth;
and increases in youth vaping.
132

● Provide practice and feedback for effectively articulating ideas and relationships about
tobacco company digital media marketing; types of marketing that appeals to youth;
and increases in youth vaping.
● Provide opportunities to effectively articulate ideas and relationships about tobacco
company digital media marketing; types of marketing that appeals to youth; and
increases in youth vaping.
● Ask learners to reflect on their learning and discuss with others their own thought
processes to create their elevator pitch describing two ways the tobacco industry
markets their products on social media and how social media marketing is linked to
youth vaping.

Summative Assessment
When communicating with peers about vaping, learners will identify and articulate in a
60 second “elevator speech” two ways the tobacco industry markets their products on social
media and how social media marketing is linked to youth vaping per a rubric. Students will be
asked to deliver their elevator pitch to each other. The listener will grade the elevator pitch using
a rubric.

Unit 4: The Power of Agency
The fourth unit focuses on the positive impacts of youth agency on society. It will be
delivered synchronously to students in a classroom setting. The summary will cover the primary
characteristics of implementing strategies for youth advocacy using social media.
Terminal Objective
When communicating with peers about the choice to engage in vaping, learners will exercise
133

their agency in becoming an advocate to counter pro-tobacco influence by creating one to two
60-second social media messages to prevent youth vaping per a rubric.
Enabling Objectives
1. Declarative
a. When given a list of terms, learners will give examples and non-examples of
choice; vaping; social media.
2. Intellectual skills
a. Given a conversation with peers, learners will be able to identify and articulate
ways to exercise agency; be able to create social media that resonates with their
peers.
3. Cognitive strategies
a. When asked about agency, learners will elaborate in their own words how to
exercise independence (agency) in their lives and how this may be applied to
youth vape prevention.
4. Attitudes
a. Given the opportunity to develop digital media with peers, learners will believe in
the value of advocating.
b. While developing digital media with peers, learners will have confidence that
youth have power of agency on their decisions whether or not to use vape
products.
Learning Activities
● After introductions and attention activities and learning objectives, assess prior
knowledge of the declarative knowledge of choice; vaping; social media.
134

● Teach any necessary prerequisite declarative knowledge by providing definitions and
examples and nonexamples.
● Provide opportunities for learners to generate their own examples and nonexamples.
● Model the procedure for effectively articulating ideas and relationships about choice,
advocacy, vaping, and social media.
● Provide practice and feedback for effectively articulating ideas and relationships about
choice, advocacy, vaping, and social media.
● Provide opportunities to effectively articulate ideas and relationships about choice,
advocacy, vaping, and social media.
● Provide messages and models of value for becoming an advocate and developing
digital media content countering pro-tobacco influence on youth vaping.
● Ask learners to reflect on their learning and discuss with others their own thought
processes to create digital media content countering pro-tobacco influence on youth
vaping.

Summative Assessment
When communicating with peers about the choice to engage in vaping, learners will
exercise their agency in becoming an advocate to counter pro-tobacco influence by creating one
to two 60 second social media messages to prevent youth vaping per a rubric. Students will be
asked to deliver their 60 second social media messages to each other. The listener will grade the
youth vape prevention social media messages using a rubric.

135

Unit 5: The Power of Youth Advocacy as Agents for Tobacco Prevention
The fifth unit focuses on strategies for implementing youth advocacy for tobacco
prevention. It will be delivered synchronously to students in a classroom setting. The summary
will cover the primary characteristics of implementing advocacy strategies for youth tobacco
prevention.
Terminal Objective
When implementing anti-vape digital media content for their peers, learners will
incorporate 2-3 advocacy strategies from the curriculum materials.
Enabling Objectives
1. Declarative
a. When given a list of scenarios, learners will give examples and non-examples of
youth advocacy strategies; anti-vaping; and behavior change.
2. Intellectual skills
a. Given a conversation with peers, learners will exercise advocacy skills to address
youth vaping.
b. Given a conversation with peers, learners will identify and describe examples of
anti-vaping youth advocacy.
3. Cognitive strategies
a. When asked about youth advocacy, learners will elaborate on youth advocacy
strategies; anti-vaping; and behavior change.
b. Given advocacy strategies, learners will select two advocacy strategies to develop
vape prevention digital media.
4. Attitudes
136

a. While developing digital media content for their peers, learners will believe in the
value of youth advocates for change by choosing to advocate.
b. While developing digital media content for their peers, learners will have
confidence in their ability to impact change for youth vape prevention.
Learning Activities
● After introductions and attention activities and learning objectives, assess prior
knowledge of the declarative knowledge of youth advocacy strategies; anti-vaping; and
behavior change.
● Teach any necessary prerequisite declarative knowledge by providing definitions and
examples and nonexamples.
● Provide opportunities for learners to generate their own examples and nonexamples.
● Model the procedure for effectively articulating ideas and relationships about youth
advocacy strategies; anti-vaping; and behavior change.
● Provide practice and feedback for effectively articulating ideas and relationships about
youth advocacy strategies; anti-vaping; and behavior change.
● Provide opportunities to effectively articulate ideas and relationships about youth
advocacy strategies; anti-vaping; and behavior change.
● Provide messages and models for the value of youth advocates for change and
choosing to become an advocate by developing and disseminating digital media
content countering pro-tobacco influence on youth vaping.
● Ask learners to reflect on their learning and discuss with others their own thought
processes to become a youth advocate by developing and disseminating digital
media content countering pro-tobacco influence on youth vaping.
137

Summative Assessment
When implementing anti-vape digital media content for their peers, learners will
incorporate 2-3 advocacy strategies from the curriculum materials. Students will be asked to
deliver their digital media messages to each other. The listener will identify 2-3 advocacy
strategies incorporated in the student-developed digital media advocacy messages using a rubric.

138

Appendix C: Lesson Activities Design and Materials
This section contains an overview of the lessons for the curriculum. The overviews
contain descriptions of learning objectives, instructional activities, and descriptions of
summative assessments. A list of materials and facilitator notes are also included.
Unit 1: The Power of Media and Society
This is the first unit of a 5-unit instructional program on youth advocacy for vape
prevention. The purpose of this unit is to prepare learners to learn more about the power of media
on societal norms, emotions, and behaviors. The duration of this unit is 45 minutes.
Learning Objectives
The terminal objective for this units is when communicating with their peers about
vaping, youth will articulate the power of media and society to influence our behaviors in a 30-
second “elevator pitch” using a rubric.
Enabling Objectives:
○ Declarative
■ Given the list of words, learners will define and give examples and non-
examples of communicating; vaping; media; society; influence; behavior
per the definitions provided.
○ Intellectual skills
■ Given a conversation with their peers, learners will effectively articulate
ideas and relationships about the power of media and society to influence
our behaviors.
○ Cognitive strategies
139

■ When asked about the power of media and society, learners will elaborate
in their own words on their current knowledge about the power of media
to influence behavior.
○ Attitudes
■ Given a conversation with their peers, learners will value communicating
with peers about the power of media and society to influence our
behaviors.
■ Given a conversation with their peers, learners will be confident in
communicating with peers.
Summative Assessment
When communicating with their peers about vaping, youth will articulate the power of
media and society to influence our behaviors in a 30-second “elevator pitch” using a rubric.
Students will be asked to deliver their elevator pitches to each other. The listener will grade the
elevator pitch using a rubric.
Lesson Materials
The materials required for the lesson will be as follows:
● unit 1 slide deck
● checklist for prior knowledge assessment
● elevator pitch rubric
● chromebook
Learner Characteristic Accommodations
Middle school students who are motivated but may be intimidated by youth advocacy or
may not have the skills to do so. Facilitators must be sure to emphasize the practicality and
140

importance of this course throughout. To support students who may not speak up during
synchronous instruction, asynchronous curriculum material will be offered on google sites.
These materials will be available in English and Spanish for students who prefer reading in
Spanish or are motivated to develop digital media content in Spanish. Facilitators will be trained
to accommodate Spanish language media for students who wish to develop youth advocacy
messaging. To give all students an equal opportunity to participate in the present curriculum,
principles of universal design for learning (UDL) will be used in compliance with the Americans
with Disabilities Act (ADA). For students who do not have access to an iPhone or Android
device, the curriculum team will provide an android tablet or iPad for recording and digital
media editing.
Facilitator’s Notes
This is the first unit in the youth advocacy for vape prevention curriculum. This lesson
focuses on the power of media to influence emotion and behavior. As such, it is important to
informally assess previous knowledge among learners regarding ways media, including social
media, influence behaviors. Use the checklist and ask students to work in pairs and discuss ways
media influences behavior, be sure students provide examples. Allow time for students to present
their thoughts on the power of media to influence behavior. It is essential for the facilitator to
model ways to articulate the power of media to influence behaviors in a 30-second “elevator
pitch.” Conclude the lesson by allowing students to work independently to develop their own 30-
second elevator pitch and go back to working in pairs delivering the elevator pitch to each other.
Lessons and descriptions are provided in Table B1.

141

Table C1
Unit 1 Instructional Activities
Instructional
sequence
Time Description of the
learning activity
Instructor
action/decision
(supplantive)
Learner action/
decision
(generative)
Gain
attention
5 Review major
characteristics of
youth advocacy.
Review examples of
media influence on
emotions and
behavior.
Assess prior
knowledge by asking
learners to work in
pairs to discuss, in
their own words,
examples of media
influences on
emotions and
behaviors.

Once learners have met
to discuss in pairs,
allow time for
students to present
examples. Facilitator
to write examples on
the whiteboard.

Clarify any
misconceptions and
answer any
participant
questions.
Ask learners to
complete the prior
knowledge check by
articulating ways
they have noticed
media influencing
youth emotion and
behavior.
Encourage learners to
ask any clarifying
questions based on
the prior knowledge
check.
Learning
objectives
2 Instructor will
articulate the unit
learning objective.
Given the need to
effectively advocate
for youth vape
prevention, learners
will learn about the
power of media to
influence behavior.
Describe the lesson
learning objectives.
Ask learners to take
note of the
objectives of the
lesson.

Ask learners if they
have any questions
about the objectives.
Reasons for
learning as
benefits and
3 The purpose for
learning and risks
and benefits
Share the benefits of
learning about ways
media influences
Ask learners to share
benefits of learning
about the power of
142

Instructional
sequence
Time Description of the
learning activity
Instructor
action/decision
(supplantive)
Learner action/
decision
(generative)
risks associated with the
lesson are reviewed
and discussed.

Benefits:
The ability to identify
and articulate ways
media influences
behavior.

The ability to design
and deliver a 30
second “elevator
pitch” on different
ways media
influences emotions
and behaviors.

Risks avoided:
Avoid unintended
consequences while
articulating
messages about the
effects of media on
youth vape behavior.
Learners avoid the
potential negative
impacts of media on
their own emotions
and behaviors.
emotions and
behavior in order to
develop effective
messaging for
advocacy.

Share what potential
risks they perceive
learning about media
influences on
emotions and
behavior for
developing media
messages on youth
vape prevention.

media and society on
emotion and
behavior. Ask
learners to share
why learning about
these things
beneficial for youth
advocacy on vape
prevention.

Ask participants to
share potential risks
of describing the
power of media and
society while
developing messages
for youth vaping
prevention.

Overview
Prior
Knowledge
New
Knowledge
Learning
Strategies

(What you
already
know...what

5
Lesson overview that
includes a brief
content outline and
an overview of the
approach to youth
advocacy including
understanding how
media impacts
emotions and
behaviors. Review
of the enabling
Summarize the process
that will be followed
for the present
lesson and following
units. Participants
will also be given
the course overview
handout to help
illustrate where the
present lesson fits
Ask learners to listen
as the facilitator
shares the agenda of
what is to come in
the lesson and
outline new
knowledge that will
be taught.

Ask for any clarifying
questions.
143

Instructional
sequence
Time Description of the
learning activity
Instructor
action/decision
(supplantive)
Learner action/
decision
(generative)
you are
going to
learn...and
how you are
going to
learn it.)
objectives. Review
of prior knowledge
of media, vaping,
media influence on
emotions and
behaviors, and prior
knowledge of youth
advocacy.

Presentation of new
knowledge with a
brief overview of the
meaning of youth
advocacy, media,
emotions, behavior,
and imagery used in
media to impact
emotions.

within the units of
the curriculum.

Describe new
knowledge that will
be learned and
conclude with the
learning strategies
that will be followed
in the lesson.
Answer any
clarifying questions.

Prerequisite
knowledge

2
The meaning of media,
social media,
influence on
emotion, behavior,
society, and the role
of youth advocacy.
Participants
elaborate on this
information by
thinking about how
it might apply to
their daily lives and
local communities.
Present and review the
meaning of media,
emotion, behavior,
and youth advocacy.

Provide examples and
nonexamples.

Ask participants if they
have any further
questions regarding
in class course
material and lesson
plans.

Ask learners to draw
on the information
they learned from
their own
experiences with
media and impacts
on emotions or
behavior.

Ask learners to create
examples and
nonexamples of the
power of media and
society.

Ask learners for any
clarifying questions.
Learning
guidance
Lecture
Demo.

5
Model how to
incorporate
knowledge of media
influence on emotion
Demonstrate the
guidelines outlined
in the slides to draft
a 30-second elevator
Ask learners to follow
along using the
rubric on developing
a 30-second elevator
144

Instructional
sequence
Time Description of the
learning activity
Instructor
action/decision
(supplantive)
Learner action/
decision
(generative)
and behavior in a 30
second elevator
pitch.
pitch on the power
of media and society
following the rubric.

Tell learners that they
will follow a similar
path towards
developing their own
30-second elevator
pitch.
pitch on the power
of media and
society.
Practice and
feedback

10
Create a 30 second
elevator pitch on the
power of media to
influence society.
Using the rubric,
provide feedback on
student drafts of
their own 30-second
elevator pitch on the
power of media and
society.
Ask learners to outline
steps for creating a
30-second elevator
pitch on the power
of media and
society.
Authentic
assessment
5 Facilitators will write
down steps for
drafting an effective
30-second elevator
pitch outlining the
impact of media on
society..
Using a rubric,
facilitators will give
feedback to learners
as they develop their
own 30-second
elevator pitch on the
impacts of media on
emotions, behavior
and society.
Ask learners to create a
new 30-second
elevator pitch that
includes mention of
media, emotion,
behavior and impact
of media on society.
Retention
and transfer
5 Learners will practice
delivering their 30-
second elevator pitch
on the power of
media and society.
Learners will be asked
to post a recording
of their 30-second
elevator pitch to the
google site page for
their class.
Provide learners an
opportunity to
present their 30-
second elevator pitch
on the power of
media and society
peer-to-peer. One
peer will deliver the
pitch while the other
grades their response
on the provided
rubric checklist.
Ask learners to share
their experience
delivering the 30-
second elevator pitch
with their peers.
145

Instructional
sequence
Time Description of the
learning activity
Instructor
action/decision
(supplantive)
Learner action/
decision
(generative)
Big ideas

5 The key takeaways are
discussed: Why is it
important to identify
ways media
influences emotion,
behavior, and
society? Why is it
important to use this
information to create
positive messaging
for youth advocacy?
Ask learners to
individually generate
at least one big idea
that emerged from
the lesson.

Ask learners to share
the big idea learned
with their assigned
partner. Allow
students to share big
ideas that emerged
out loud with the
entire class.
Advance
organizer for
the next unit
2 The instructor will
explain the next unit.
Thank learners for
their participation.
Explain the
importance of
identifying the goals
and outcomes of
instruction.
Ask learners to think
about the importance
of identifying the
goals and outcomes
of instruction.

Total Time 50
146

Lesson Materials: Slides for Lesson 1

Lesson Duration 50 Minutes

This is the first lesson of five. This program is designed to allow students to tap into their
creativity and implement advocacy skills to prevent youth vaping. The purpose of this lesson is
to introduce students to the power of media to impact emotions and behaviors. Youth will
develop a 30-second elevator pitch to teach their peers the impact of media on society.

147

Instructional Sequence: Gain Attention
Time: 5 Minutes

Instructor Action: Review major characteristics of youth advocacy. Review examples of media
influence on emotions and behavior. Assess prior knowledge by asking learners to work in pairs
to discuss, in their own words, examples of media influences on emotions and behaviors. Once
learners have met to discuss in pairs, allow time for students to present examples. Facilitator to
write examples on the whiteboard. Clarify any misconceptions and answer any participant
questions.

Learner Action: Ask learners to complete the prior knowledge check by articulating ways they
have noticed media influencing youth emotion and behavior.
Encourage learners to ask any clarifying questions based on the prior knowledge check.

148

Instructional Sequence: Learning Objectives
Time: 2 minutes

Instructor Action: Review and describe the learning objectives with learners.

Learner Action: Ask learners to take note of the objectives of the lesson. Ask learners if they
have any questions about the objectives.

149

Instructional Sequence: Reasons for Learning
Time: 3 minutes

Instructor Action: Share the benefits of learning about ways media influences emotions and
behavior in order to develop effective messaging for advocacy.

Share what potential risks they perceive learning about media influences on emotions and
behavior for developing media messages on youth vape prevention.

Learner Action Ask learners to share benefits of learning about the power of media and society
on emotion and behavior.

Ask learners to share why learning about these things beneficial for youth advocacy on vape
prevention.

Ask participants to share potential risks of describing the power of media and society while
developing messages for youth vaping prevention.

150

Instructional Sequence: Overview Prior Knowledge, New Knowledge, and Learning Strategies
Time: 5 minutes

Instructor Action: Lesson overview that includes a brief content outline and an overview of the
approach to youth advocacy, including understanding how media impacts emotions and
behaviors. Review of the enabling objectives. Review of prior knowledge of media, vaping,
media influence on emotions and behaviors, and prior knowledge of youth advocacy.
Presentation of new knowledge with a brief overview of the meaning of youth advocacy, media,
emotions, behavior, and imagery used in media to impact emotions.

Summarize the process that will be followed for the present lesson and following units.
Participants will also be given the course overview handout to help illustrate where the present
lesson fits within the units of the curriculum.

Describe new knowledge that will be learned and conclude with the learning strategies that will
be followed in the lesson. Answer any clarifying questions.

Learner Action: Ask learners to listen as the facilitator shares the agenda of what is to come in
the lesson and outline new knowledge that will be taught.

Ask for any clarifying questions.

151

Instructional Sequence: Overview Prior Knowledge, New Knowledge, and Learning Strategies
Time 5 minutes

Instructor Action: Lesson overview that includes a brief content outline and an overview of the
approach to youth advocacy, including understanding how media impacts emotions and
behaviors. Review of the enabling objectives. Review of prior knowledge of media, vaping,
media influence on emotions and behaviors, and prior knowledge of youth advocacy.

Presentation of new knowledge with a brief overview of the meaning of youth advocacy, media,
emotions, behavior, and imagery used in media to impact emotions.

Summarize the process that will be followed for the present lesson and following units.
Participants will also be given the course overview handout to help illustrate where the present
lesson fits within the units of the curriculum.

Describe new knowledge that will be learned and conclude with the learning strategies that will
be followed in the lesson. Answer any clarifying questions.

Learner Action: Ask learners to listen as the facilitator shares the agenda of what is to come in
the lesson and outline new knowledge that will be taught.

Ask for any clarifying questions.
152

Instructional Sequence: Pre-requisite Knowledge
Time: 2 minutes

Instructor Action: Present and review the meaning of media, emotion, behavior, and youth
advocacy. Provide examples and nonexamples.

Ask participants if they have any further questions regarding in class course material and lesson
plans.

Learner Action: Ask learners to draw on the information they learned from their own experiences
with media and impacts on emotions or behavior.

Ask learners to create examples and nonexamples of the power of media and society.

Ask learners for any clarifying questions.

153

Instructional Sequence: Learning Guidance, Lesson Demo
Time: 5 minutes

Instructor Action: Model how to incorporate knowledge of media influence on emotion and
behavior in a 30 second elevator pitch.

Demonstrate the guidelines outlined in the slides to draft a 30-second elevator pitch on the power
of media and society following the rubric.

Tell learners that they will follow a similar path towards developing their own 30-second
elevator pitch

Learner Action: Ask learners to follow along using the rubric on developing a 30-second elevator
pitch on the power of media and society

154

Instructional Sequence: Practice and Feedback
Time: 10 minutes

Instructor Action: Using the rubric, provide feedback on student drafts of their own 30-second
elevator pitch on the power of media and society

Student Action: Create a 30-second elevator pitch on the power of media to influence society.
Ask learners to outline steps for creating a 30-second elevator pitch on the power of media and
society.

155

Instructional Sequence: Authentic Assessment
Time: 5 minutes

Instructor Action: Facilitators will write down steps for drafting an effective 30-second elevator
pitch outlining the impact of media on society.

Using a rubric, facilitators will give feedback to learners as they develop their own 30-second
elevator pitch on the impacts of media on emotions, behavior and society.

Student Action: learners will create a new 30-second elevator pitch that includes mention of
media, emotion, behavior and impact of media on society.

156

Instructional Sequence: Retention and Transfer
Time: 5 minutes

Instructor Action: Provide learners an opportunity to present their 30-second elevator pitch on
the power of media and society peer-to-peer. One peer will deliver the pitch while the other
grades their response on the provided rubric checklist.

Student Action: Learners will practice delivering their 30-second elevator pitch on the power of
media and society.

Ask learners to share their experience delivering the 30-second elevator pitch with their peers.

Instructor Note: Learners will be asked to post a recording of their 30-second elevator pitch to
the google site page for their class.

157

Instructional Sequence: Big Ideas
Time: 5 minutes

Instructor Action: The key takeaways are discussed: Why is it important to identify ways media
influences emotion, behavior, and society? Why is it important to use this information to create
positive messaging for youth advocacy?

Student Action: Ask learners to individually generate at least one big idea that emerged from the
lesson.

Ask learners to share the big idea learned with their assigned partner. Allow students to share big
ideas that emerged out loud with the entire class.

158

Instructional Sequence: Advance organizer for the next unit
Time: 2 minutes

Instructor Action: The instructor will explain the next unit.
Thank learners for their participation. Explain the importance of identifying the goals and
outcomes of instruction.

Ask learners to think about the importance of identifying the goals and outcomes of instruction.

159

Lesson Materials: Rubric
Youth Advocacy for Vape Prevention
30-second Elevator Pitch on Media
Rubric

Title and author(s):

Description: You are being asked to share what you know about media and how it
sometimes changes peoples’ emotions and behavior. Think about how you would share this
on social media like Tictok or Instagram. Take a minute to write down your thoughts and
then share your “elevator pitch” with your friend. You have 30-45 seconds to tell your story.
Below are some tips to help you get started.

1. Introduce yourself.
2. Explain that you are in this class and what it is you are learning about.
3. Explain what media is and how it changes peoples’ emotions and behavior, provide
an example.
4. Provide a call to action (what do you want your friends to do now that they know
media can change our emotions and behavior).

4 points 3 points 2 points 1 point SCORE
Introduction clear

Information shared was easy to understand

Creativity

Interesting

Entertainment value

Call to action was clear

My favorite part of your elevator pitch was…

I wish you also mentioned…

160

Appendix D: Pre-program Implementation Survey
This section outlines copies of the pre-program survey items. The surveys are intended to
measure pre-existing knowledge, attitudes, beliefs, and behaviors for Level 1 - Level 4 outcomes
of the youth advocacy for vape prevention curriculum. The tables are formatted as D1 - D4,
where D1 lists survey items measuring curriculum content and D2 - D4 are measures of tobacco
use, intentions to use, and perceived negative consequences of use.

Pre Survey Items for the Youth Advocacy for Vape Prevention Curriculum
Table D1
Curriculum Content Assessment
Rating scale items: Answers rated on a Likert scale from
(1) strongly disagree to (5) strongly agree:
1 2 3 4 5
The tobacco industry uses social media to increase young people to
vape. (L3)

I am confident when describing how social media affects youth
vaping. (L3)

I am confident in being a youth advocate for vape prevention. (L3)
I am confident when speaking to my friends about ways the
tobacco industry markets products to youth. (L3)

I am confident in designing social media content to prevent youth
vaping. (L3)

161

Rating scale items: Answers rated on a Likert scale from
(1) strongly disagree to (5) strongly agree:
1 2 3 4 5
Social media impacts the emotions of users. (L3)
Social media may be used to change youth behaviors. (L4)
I believe it is important for me to be a youth advocate for vape
prevention. (L2)

Table D2
Tobacco Use Intentions
Would you try any of the following substances if one of your best friends offered it to you?
Definitely
not (1)
Probably
not (2)
Probably
yes (3)
Definitely
yes (4)
Cigarettes
Electronic cigarettes with
nicotine

Electronic cigarette without
nicotine or hash oil

Juul
162

Definitely
not (1)
Probably
not (2)
Probably
yes (3)
Definitely
yes (4)
Disposable vape
(Puff Bar, Mojo, Cali Bar,
Hyppe Bar, Ezzy, etc.)

IQOS or other heated tobacco
devices
(devices that heat, but don't
burn, shredded tobacco leaves)

Dissolvable tobacco products
like Snus
(moist powder smokeless
tobacco, Swedish snus)

Nicotine pouches
(smokeless nicotine pouches,
Zyn, Velo, On!)

Flavored nicotine gums,
lozenges, tablets, and/or
gummies (Lucy, Rogue,
REVEL, Krave)

163

Do you think you would use any of the following substances in the next year?
Definitely
not (1)
Probably not
(2)
Probably
yes (3)
Definitely
yes (4)
Cigarettes
Electronic cigarettes with
nicotine
Electronic cigarette without
nicotine or hash oil
Juul
Disposable vape
(Puff Bar, Mojo, Cali Bar,
Hyppe Bar, Ezzy, etc.)
IQOS or other heated tobacco
devices
(devices that heat, but don't
burn, shredded tobacco leaves)
Dissolvable tobacco products
like Snus

164

Definitely
not (1)
Probably not
(2)
Probably
yes (3)
Definitely
yes (4)
(moist powder smokeless
tobacco, Swedish snus)
Nicotine pouches
(smokeless nicotine pouches,
Zyn, Velo, On!)
Flavored nicotine gums,
lozenges, tablets, and/or
gummies (Lucy, Rogue,
REVEL, Krave)

Table D3
Tobacco Use Curiosity
Are you curious about using any of the following substances?
Definitely
not (1)
Probably
not (2)
Probably
yes (3)
Definitely
yes (4)
Cigarettes
Electronic cigarettes with nicotine
165

Definitely
not (1)
Probably
not (2)
Probably
yes (3)
Definitely
yes (4)
Electronic cigarette without
nicotine or hash oil
Juul
Disposable vape
(Puff Bar, Mojo, Cali Bar, Hyppe
Bar, Ezzy, etc.)
IQOS or other heated tobacco
devices
(devices that heat, but don't burn,
shredded tobacco leaves)
Dissolvable tobacco products like
Snus
(moist powder smokeless tobacco,
Swedish snus)
Nicotine pouches
(smokeless nicotine pouches, Zyn,
Velo, On!)
166

Definitely
not (1)
Probably
not (2)
Probably
yes (3)
Definitely
yes (4)
Flavored nicotine gums, lozenges,
tablets, and/or gummies (Lucy,
Rogue, REVEL, Krave)

Table D4
Tobacco Perceived Harm
Do you think using these products would be bad for your health?
Strongly
Disagree
(1)
Disagree
(2)
Agree
(3)
Strongly
Agree
(4)
Cigarettes
Electronic cigarettes with nicotine
Electronic cigarette without
nicotine or hash oil
Juul
Disposable vape
(Puff Bar, Mojo, Cali Bar, Hyppe Bar,
Ezzy, etc.)
167

Strongly
Disagree
(1)
Disagree
(2)
Agree
(3)
Strongly
Agree
(4)
IQOS or other heated tobacco devices
(devices that heat, but don't burn,
shredded tobacco leaves)
Dissolvable tobacco products like Snus
(moist powder smokeless tobacco,
Swedish snus)
Nicotine pouches
(smokeless nicotine pouches, Zyn, Velo,
On!)
Flavored nicotine gums, lozenges,
tablets, and/or gummies (Lucy, Rogue,
REVEL, Krave)

168

Appendix E: Delayed Evaluation Items
This section outlines copies of the post-program survey items. The surveys are intended
to measure Level 1 - Level 5 outcomes of the youth advocacy for vape prevention curriculum.
The tables are formatted as E1 - E4 where E1 lists survey items measuring curriculum content,
and E2 - E4 are measures of tobacco use, intentions to use, and perceived negative consequences
of use.

Table E1
Curriculum Content
Rating scale items: Answers rated on a Likert scale from (1) strongly disagree to
(5) strongly agree:
1 2 3 4 5
I liked this youth advocacy for vape prevention training. (L4)
I liked having access to course materials online. (L1)
I am confident in using skills I learned in this class for vape
prevention advocacy (L4)

My participation in the course was encouraged by the facilitator.
(L1)

This youth advocacy training held my interest. (L1)
What I learned from this course will help me be a youth advocate.
(L1)

169

Rating scale items: Answers rated on a Likert scale from (1) strongly disagree to
(5) strongly agree:
1 2 3 4 5
During class, we discussed how to apply what we learned. (L1)
I am confident in using advocacy lessons learned in class while
making digital videos for vape prevention. (L3)

I will recommend this class to my friends. (L1)
I believe it will be important for me to apply what I have learned to
create advocacy messages online. (L2)

I feel confident about applying what I learned about youth
advocacy. (L2)

My teachers support me using lessons learned from this class for
youth advocacy. (L3)

My parents support me using the lessons I learned from this class
for youth advocacy. (L3)

I am confident when describing how social media affects youth
vaping. (L3)

I am confident when speaking to my friends about ways the
tobacco industry markets products to youth. (L3)

170

Open-ended questions:
Was there anything about your experience in this course that made it hard to learn? (L1)
What course material did you find to be most helpful for making vape prevention videos?
(L1)
Was there any course material that was a waste of time (if so, please describe)? (L1)
Are there any ways in which this program can be improved? (L1)
What are the most important things you learned in this course? (L2)
Describe how important it is for you to apply what you learned in this course for youth
advocacy. (L2)
What additional support would help you implement what you learned? (L2)
Describe how you plan to use youth advocacy for vape prevention lessons for advocating
other topics? (L2)
Describe ways your school may support you using youth advocacy strategies for vape
prevention. (L2)
How will you support your friends when they are using advocacy lessons for vape
prevention? (L2).
What is the first thing that you plan to apply from what you learned in this course to youth
advocacy for vape prevention? (L2)

171

Table E2
Tobacco Use Intentions
Would you try any of the following substances if one of your best friends offered it to you?
Definitely
not (1)
Probably
not (2)
Probably
yes (3)
Definitely
yes (4)
Cigarettes
Electronic cigarettes with
nicotine
Electronic cigarette without
nicotine or hash oil
Juul
Disposable vape
(Puff Bar, Mojo, Cali Bar,
Hyppe Bar, Ezzy, etc.)
IQOS or other heated tobacco
devices
(devices that heat, but don't
burn, shredded tobacco leaves)
172

Definitely
not (1)
Probably
not (2)
Probably
yes (3)
Definitely
yes (4)
Dissolvable tobacco products
like Snus
(moist powder smokeless
tobacco, Swedish snus)
Nicotine pouches
(smokeless nicotine pouches,
Zyn, Velo, On!)
Flavored nicotine gums,
lozenges, tablets, and/or
gummies (Lucy, Rogue,
REVEL, Krave)

Do you think you would use any of the following substances in the next year?
Definitely
not (1)
Probably not
(2)
Probably
yes (3)
Definitely
yes (4)
Cigarettes
Electronic cigarettes with
nicotine
173

Definitely
not (1)
Probably not
(2)
Probably
yes (3)
Definitely
yes (4)
Electronic cigarette without
nicotine or hash oil
Juul
Disposable vape
(Puff Bar, Mojo, Cali Bar,
Hyppe Bar, Ezzy, etc.)
IQOS or other heated tobacco
devices
(devices that heat, but don't
burn, shredded tobacco leaves)
Dissolvable tobacco products
like Snus
(moist powder smokeless
tobacco, Swedish snus)
Nicotine pouches
(smokeless nicotine pouches,
Zyn, Velo, On!)
174

Definitely
not (1)
Probably not
(2)
Probably
yes (3)
Definitely
yes (4)
Flavored nicotine gums,
lozenges, tablets, and/or
gummies (Lucy, Rogue,
REVEL, Krave)

Table E3
Tobacco Use Curiosity
Are you curious about using any of the following substances?
Definitely
not (1)
Probably
not (2)
Probably
yes (3)
Definitely
yes (4)
Cigarettes
Electronic cigarettes with nicotine
Electronic cigarette without
nicotine or hash oil

Juul
Disposable vape
(Puff Bar, Mojo, Cali Bar, Hyppe
Bar, Ezzy, etc.)

175

Definitely
not (1)
Probably
not (2)
Probably
yes (3)
Definitely
yes (4)
IQOS or other heated tobacco
devices
(devices that heat, but don't burn,
shredded tobacco leaves)

Dissolvable tobacco products like
Snus
(moist powder smokeless tobacco,
Swedish snus)

Nicotine pouches
(smokeless nicotine pouches, Zyn,
Velo, On!)

Flavored nicotine gums, lozenges,
tablets, and/or gummies (Lucy,
Rogue, REVEL, Krave)

176

Table E4
Tobacco Perceived Harm
Do you think using these products would be bad for your health?
Strongly
Disagree
(1)
Disagree
(2)
Agree
(3)
Strongly
Agree
(4)
Cigarettes
Electronic cigarettes with nicotine
Electronic cigarette without
nicotine or hash oil
Juul
Disposable vape
(Puff Bar, Mojo, Cali Bar, Hyppe Bar,
Ezzy, etc.)
IQOS or other heated tobacco devices
(devices that heat, but don't burn,
shredded tobacco leaves)
Dissolvable tobacco products like Snus
(moist powder smokeless tobacco,
Swedish snus)
177

Strongly
Disagree
(1)
Disagree
(2)
Agree
(3)
Strongly
Agree
(4)
Nicotine pouches
(smokeless nicotine pouches, Zyn, Velo,
On!)
Flavored nicotine gums, lozenges,
tablets, and/or gummies (Lucy, Rogue,
REVEL, Krave)

178

Appendix F: Sample Data for Reports
This section outlines samples of data representation for school and community reports.
These images represent the type of data analysis that will be used to highlight curriculum
outcomes for various stakeholders. The images are displayed as Figure F1 - F3.

Figure F1
Curriculum Satisfaction and Impact

179

Figure F2
Intentions for advocacy or tobacco use

180

Figure F3
Curriculum Satisfaction

Abstract (if available)

Linked assets

University of Southern California Dissertations and Theses

Conceptually similar

PDF

Stress, health, and mental wellness in the high school setting

PDF

Practical data science: a curriculum for community colleges

PDF

A curriculum for faculty implementation of culturally relevant instruction in a community college classroom

PDF

Culturally responsive pedagogy: a curriculum for secondary education teachers

PDF

Retaining racially minoritized students in community college STEM programs

PDF

Disrupting career exploration: a curriculum for traditionally marginalized students to become agents of their own future

PDF

Supporting learners with attention deficit hyperactivity disorder: a professional development curriculum for elementary teachers

PDF

Mitigating the risk of veteran suicide: an evaluation study of suicide prevention resiliency implementation

PDF

Aligning mission and practice: social justice curriculum for Jewish secondary day school students

PDF

Professional development for teachers to meet the needs of neurodiverse learners

PDF

Incorporating teacher self-care into teacher education: a curriculum for pre-service teachers to increase teacher wellness and prevent teacher burnout

PDF

Culturally relevant pedagogy strategies for preservice teachers in urban classrooms

PDF

Cultural risk and protective factors for tobacco use behaviors and depressive symptoms among American Indian adolescents in California

PDF

Teaching literary criticism: a curriculum with an emphasis on religion

PDF

A curriculum to integrate social justice anchors standards into K–5 curriculum

PDF

ELD instruction across the content areas: a professional development program for teachers

PDF

A case study in how middle school counselors mentor students at risk for emerging academic disengagement

PDF

Applying culturally relevant pedagogy in the classroom: a course for secondary, public, urban school educators

PDF

My college coach: An online college admission counseling program for high school students

PDF

The strategic application of instructional design principles for law enforcement training and education

Asset Metadata

Creator Soto, Daniel Wood (author)

Core Title Youth advocacy for vape prevention

School Rossier School of Education

Degree Doctor of Education

Degree Program Education

Degree Conferral Date 2023-05

Publication Date 04/24/2023

Defense Date 04/11/2023

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag OAI-PMH Harvest,social media,tobacco prevention,youth advocacy

Format theses (aat)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Yates, Kenneth (committee chair), Hirabayashi, Kimberly (committee member), Unger, Jennifer (committee member)

Creator Email danielws@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC113078014

Unique identifier UC113078014

Identifier etd-SotoDaniel-11702.pdf (filename)

Legacy Identifier etd-SotoDaniel-11702

Document Type Dissertation

Format theses (aat)

Rights Soto, Daniel Wood

Internet Media Type application/pdf

Type texts

Source 20230425-usctheses-batch-1030 (batch), University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the author, as the original true and official version of the work, but does not grant the reader permission to use the work if the desired use is covered by copyright. It is the author, as rights holder, who must provide use permission if such use is covered by copyright.

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA

Repository Email cisadmin@lib.usc.edu