Communication and Social Determinants of Cancer Preventive Behaviors in Adolescents From Low Socio-Economic Backgrounds in India: A Cross-Sectional Study.

PURPOSE: Promoting cancer preventive behaviors among adolescents, especially those from lower socioeconomic backgrounds, is crucial due to the significant impact of health behaviors in adolescence on disease risk in adulthood. With India witnessing a rise in cancer incidence and mortality, adolescence becomes a pivotal stage for establishing healthy habits, emphasizing the need for early cancer prevention efforts. METHODS: This cross-sectional study used survey data from 2242 adolescents attending public schools of Mumbai, India. Multiple logistic regression was conducted to determine the associations between cancer preventive behaviors and: (1) the individual and social determinants of health, and (2) media exposure. FINDINGS: Merely 21.5% of the adolescents ate fruits and vegetables daily, 50% of the adolescents exercised 3 or more times a week, and 20% of the adolescents admitted having used tobacco and/or supari. Girls were found to have lower odds of exercising, as well as using tobacco and/or supari. Wealth and father's education were positively associated with all 3 cancer preventive behaviors. Media exposure was negatively associated, with television exposure linked to reduced fruits and vegetables consumption, while movies and social media exposure were associated with increased tobacco and/or supari use. INTERPRETATION: Our findings suggest that individual and social determinants of health and media exposure can influence cancer preventive health behaviors in low socio-economic status (SES) adolescents. Efforts to increase awareness to promote cancer preventive behaviors among the adolescents, particularly low SES adolescents, a population more vulnerable to poor health outcomes, is critical.

This study investigates factors that can influence cancer preventive behaviors among low socioeconomic status (SES) adolescents, focusing on dietary habits, physical activity, and avoidance of tobacco and areca nut. Our study gathered data from an underrepresented population of India, which is more vulnerable to poor health outcomes and have less access to health care. Our findings can alert public health officials, policy makers and non-governmental organizations to target this population and customize their intervention strategies to promote health and prevent cancer.

Association between mass media exposure and infant and young child feeding practices in India: a cross-sectional study.

The first two years of life is a critical window for good nutrition. Promoting infant and young child feeding (IYCF) practices in the first two years can help improve child survival and promote healthy growth and development. Assessment of IYCF practices is important, especially in developing countries like India where optimal IYCF practices can potentially prevent 12% of all deaths under 5 years of age, to promote awareness and intervene appropriately. The objective of our study is to generate evidence for the association between different types of mass media and appropriate IYCF practices in India, including optimal breastfeeding and appropriate complementary feeding practices. A positive association between them can point to intervention at scale. We analyzed data from India's National Family Health Survey 5 (NFHS-5), 2019-2021. Multivariable logistic regression was used to examine the association of appropriate IYCF practices with mass media exposure. After controlling for demographics and socioeconomic status, the analyses showed that, overall, women who had exposure to television followed by newspaper and movies, had higher odds of adopting the recommended IYCF practices. The results also showed that the association of media exposure varied for different IYCF practices by geography. For instance, in the rural areas, television exposure was positively associated with all the IYCF practices, but in the urban areas, television exposure was positively associated with only early initiation of breastfeeding [OR 1.25; (95% CI 1.1-1.42)]. The study strengthens our understanding that an appropriate selection of mass media channels for intervention programs can promote IYCF practices at scale. Appropriately selecting the type of mass media to create awareness about different IYCF practices, in specific urban-rural settings, could help customize intervention programs to successfully influence IYCF behaviors.

COVID-19 News and Misinformation: Do They Matter for Public Health Prevention?

An infodemic caused by a rampant spread of a mixture of correct and incorrect information in a connected world creates uncertainty about and dismissal of proven public health measures. Two key factors that can influence COVID-19 preventive behaviors are information and self-efficacy. Misinformation (inaccurate or misleading information) can modify people's attitudes and behaviors and deter them from following preventive behaviors. Self-efficacy, on the other hand, has been linked to the likelihood to engaging in preventive behaviors. This cross-sectional study used a nationally representative survey of Americans from 2020 to determine the associations between (1) COVID-19 news sources and COVID-19 misinformation and (2) COVID-19 misinformation and COVID-19 prevention self-efficacy, using multivariable logistic regression. Results indicate that reliance on conservative sources for COVID-19 news is significantly associated with endorsing COVID-19 misinformation. In contrast, reliance on liberal sources, mainstream print, or social media for COVID-19 news are significantly negatively associated with endorsing COVID-19 misinformation. Furthermore, endorsing COVID-19 misinformation is related to low COVID-19 prevention self-efficacy, which, in turn, can modify COVID-19 preventive behaviors. These findings suggest that customizing health messages to debunk misinformation and increase self-efficacy for preventive behaviors can motivate individuals to comply with preventive behaviors and protect themselves from COVID-19.

Individual and social determinants of COVID-19 vaccine uptake.

BACKGROUND: COVID-19 has had a devastating impact and efforts are being made to speed up vaccinations. The growing problem of vaccine hesitancy may affect the uptake of COVID-19 vaccine. We examined the individual, communication and social determinants associated with vaccines uptake. METHODS: Data come from a nationwide online probability-based panel of 1012 representative adults in the United States and the survey was conducted before the vaccines were available. People under the federal poverty level and racial and ethnic minorities were oversampled. Our outcome variables of interest were likelihood of vaccinating self and likelihood of vaccinating people under one's care (such as children) measuring behavioral intentions. Independent variables included perceptions of risk, exposure to different media for COVID-19 news, political party identification, confidence in scientists and social determinants of health. Logistic regression analysis was used to ascertain the effects of independent variables on the two outcome variables. RESULTS: The results indicated that 68 and 65% agreed to get the vaccine for themselves and people under their care, respectively. Risk perceptions (severity of and susceptibility to COVID-19) were significantly associated with vaccine uptake. People who relied on "conservative" news outlets, Republicans, and who had low confidence in scientists are least likely to vaccinate self or children. Non-Hispanic Blacks and those with least schooling were also less likely to receive vaccine for themselves or people in their care. CONCLUSIONS: Our study identified race/ethnicity, risk perceptions, exposure to different media for COVID-19 news, party identification and confidence in scientists as factors that would be affecting COVID-19 vaccine uptake. The good news is that these are addressable through strategic public health communications, but a lot of work remains to be done with some urgency.

Adherence to COVID-19 mitigation measures among American adults: the need for consistent and unified messaging.

In the United States, elite and media communications about the risks of, and mitigation strategies for, COVID-19 have been characterized by lack of consensus. In this study, we draw from a nationally representative sample of American adults to examine the associations between exposure to different media and platforms (mainstream, conservative, liberal or social media) and adherence to COVID-19 mitigation measures such as physical distancing and mask use. We also examine the individual and social factors associated with adherence to mitigation measures. We find that exposure to conservative outlets, being republican, having low confidence in scientists and high perception of information overload are associated with low adherence. In contrast, exposure to liberal and mainstream news outlets, being democrat, having high confidence in scientists, and low perception of information overload are associated with high adherence. The findings suggest the need for consistent and unified public health messaging that cuts across partisan splits and the growing skepticism in science.

Association between different types of mass media and antenatal care visits in India: a cross-sectional study from the National Family Health Survey (2015-2016).

OBJECTIVE: To generate evidence for the association between different types of mass media and antenatal care (ANC) visits in India. DESIGN: A cross-sectional study design, analysing data from India's National Family Health Survey 4 (NFHS-4), 2015-2016. SETTING: Rural and urban India. PARTICIPANTS: From NFHS-4, women who had given birth in the last 5 years before survey administration were included in this study. Women with missing information about their number of ANC visits and their caste were excluded, leaving 187 894 women in the final analytical sample. PRIMARY OUTCOME MEASURES: Logistic regression analysis was conducted to determine the association of ANC utilisation with mass media exposure. RESULTS: Overall, our study showed that high exposure to all four types of mass media was positively associated with making at least eight ANC visits. In rural India, women who had high exposure to newspaper/magazine (adjusted OR (aOR), 1.43; 95% CI, 1.31 to 1.57), radio (aOR, 1.22; 95% CI, 1.09 to 1.37), television (aOR, 2.07; 95% CI, 1.94 to 2.2) and movies (aOR, 1.33; 95% CI, 1.2 to 1.47) were more likely to make at least eight ANC visits. In urban India, women who had high exposure to newspaper/magazine (aOR, 1.12; 95% CI, 1.02 to 1.24), radio (aOR, 1.37; 95% CI, 1.13 to 1.65), television (aOR, 1.39; 95% CI, 1.24 to 1.55) and movies (aOR, 1.23; 95% CI, 1.09 to 1.38) were more likely to make at least eight ANC visits. CONCLUSIONS: Our findings emphasise the need for increased awareness about adequate ANC visits in India, to improve maternal, neonatal and child health outcomes. Our study highlights that television penetration is broader than other forms of media and has the potential to create awareness about health in both urban and rural populations. These findings can inform ANC-related health awareness campaigns in the country to allocate resources to appropriate media sources to encourage healthy behaviours.

We Need the Lens of Equity in COVID-19 Communication.

The ongoing COVID-19 pandemic has brought forward the centrality of public communication as a force for information, and in highlighting the differential impact on diverse segments of the society. Information and communication technologies-led developments including social media have previously been discussed as instruments of democratization of knowledge. However, the evidence so far shows that the promise remains unfulfilled as upper socioeconomic groups acquire information at a faster rate than others. The communication inequalities have only reinforced the existing societal fault lines of race, class and place. As the first pandemic of the social media age, COVID-19 has also given rise to an "infodemic", providing fertile ground for the spread of information, misinformation and disinformation. With limited gatekeeping, an immense amount of unprocessed scientific information is being put forward to publics not trained in science. In this commentary, we offer some propositions on how disinformation on COVID-19 has become mainstreamed through social media's spiral of amplification and what role public communication has in an emergency from a lens of equity. We raise the question of whether the tremendous flow of scientific information during the COVID-19 pandemic has a differential impact on different socioeconomic groups. We propose that more systematic research is urgently needed to understand how mis/disinformation originate, spread and what their consequences are. In our view, research in health communication inequalities is foundational to mitigating the current off-line and online ravages of the pandemic.

Maternal knowledge, attitude and practices during childhood diarrhoea.

Diarrhoea and pneumonia account for most deaths in children aged < 5 years. However, most diarrhoeal deaths are preventable with appropriate hygienic measures and timely initiation of rehydration therapy. A cross-sectional study was conducted on 280 mothers with children aged 2-59 months with acute watery diarrhoea at a tertiary hospital. One-fifth of respondents were illiterate and only one-third of mothers pre-treated water to make it drinkable. Mean knowledge scores for hand washing, diarrhoea prevention and complications of diarrhoea were poor, though higher in educated mothers ( P < 0.05). Scores were similar for the first episode or repeat episodes of diarrhoea. Only 50.4% and 55.2% mothers knew the correct method of Oral Rehydration Solution (ORS) preparation and administration, respectively. Lack of adequate maternal knowledge and practices concerning childhood diarrhoea highlights the need for patient counselling and education, especially among the illiterate in India.

Targeted therapies in melanoma.

Advances in the biology of melanoma have provided insights about chemoresistance and its genetic heterogeneity in parallel with advances in drug design, culminating in recent major treatment breakthroughs. Although clinical benefit of targeted therapies has been unquestionable, future advances are only possible if we understand the interplay between genetic aberrations and role of other crucial nongenetic changes yet to be identified by such projects as the Cancer Genome Atlas Project in Melanoma. Combination therapies, either among small molecule inhibitors themselves and/or with immunotherapies, may be the optimal strategy to prevent development of drug resistance inherently linked with such targeted therapies.