An informed approach to the development of primary care pediatric firearm safety messages.

BACKGROUND: Firearm ownership is prevalent in the US and many children spend time in areas where firearms are not stored safely. The AAP recommends firearm safety counseling at pediatric well-visits. METHODS: We developed and tested six contextual messages to promote safe firearm storage based on: absence of harm, collective appeal to understanding child behavior, pediatrician's authority, evidence-based, fear appeal, and general safety considerations. One hundred four parents who keep firearms at home were recruited from Amazon Mechanical Turk Prime and viewed video messages and reported behavioral intentions and emotional reactions following each message. RESULTS: All six contextual messages were perceived as important and believable and increased parents' intentions to follow safety advice provided, but also elicited negative emotions. The authority message elicited more negative emotions and resulted in lower intentions to follow safe storage advice. CONCLUSIONS: Including firearm messages with other child safety advice merits further evaluation. Authority messages should be avoided.

Immunize the HPV Vaccine Rumors: Effects of Inoculation Messages and Tone of Voice on Parental Intention to Vaccinate Their Children.

The purpose of this study was to develop an effective health communication strategy to guide the decision-making process of parents considering getting their children HPV vaccines. Using inoculation theory and findings on tone of voice as theoretical frameworks, the present study conducted a 2 (message type: inoculation vs. supportive) × 2 (tone of voice: human voice vs. organizational voice) mixed experiment with a total of 231 U.S. parents (either mother or father of a child eligible for the HPV vaccine). The results revealed that HPV vaccination promotions based on the inoculation message were more likely to generate positive attitudes toward the vaccination, higher intention to vaccinate their children, and higher intention to spread positive word of mouth (WOM) about HPV vaccination. Also, HPV vaccination promotions in the human voice were likely to increase the WOM intention more than those in the organizational voice. In regard to an interaction effect, human voice turned out to be more effective than organizational voice to generate the WOM intention when it comes to supportive messages; inoculation-based messages were similarly effective across the human and the organizational voice condition.

The Impact of Retransmission and Modality on Communicating Health Research Findings via Social Media.

Social media is an increasingly popular tool for disseminating health research findings to members of the general public and may contribute to improving the effectiveness of science communication. This study was designed to investigate how retransmission (i.e., social media content shared by a familiar, credible organization) and modality (i.e., how the message is delivered) influence the effectiveness of communicating health research findings via social media. The findings from a 2 (source) X 3 (modality) X 2 (topic) mixed factorial design experiment (N= 517) indicated that source had a significant effect, such that posts that were retransmitted by a credible organization resulted in greater perceived source credibility, greater perceived message effectiveness, and greater likelihood of an individual to engage with the post on Facebook. Modality significantly increased perceived source credibility and perceived message effectiveness when posts were retransmitted by a credible source, indicating that modality made a difference when messages were elaborated as a function of the retransmission. Also, the topic of the post had a significant impact on the study's dependent variables of interest. Overall, the findings illustrate the potential of retransmission and modality as message features that can improve communication of health research findings on social media. Theoretical and practical implications are discussed.

The Third Rail of Pediatric Communication: Discussing Firearm Risk and Safety in Well-Child Exams.

This research endeavors to understand how pediatricians and parents discuss - or do not discuss - firearm risks for children during well-child visits. Through individual semi-structured interviews with 16 pediatric providers and 20 parents, the research explores discursive barriers to open conversation, perspectives on anticipatory guidance, and new ideas for culturally competent messaging. The research focuses particularly on how parents' and providers' perspectives on firearm risk communication are tied to cultural norms and expectations. One salient theme that emerged is that the American Academy of Pediatrics recommendation that pediatricians ask parents about ownership status is deemed undesirable by pediatricians and parents because of the delicate intercultural setting. Born out of pediatric and parent experiences, and mindful of culturally salient barriers, this study offers alternative strategies for discussing firearm risk in well-child exams.

Utilizing Audiovisual and Gain-Framed Messages to Attenuate Psychological Reactance Toward Weight Management Health Messages.

Guided by the psychological reactance theory, this study predicted that gain-framed messages and audiovisual content could counteract state reactance and increase the persuasiveness of weight management health messages. Data from a 2 (message frame: gain/loss) × 2 (modality: audiovisual/text) × 2 (message repetition) within-subjects experiment (N = 82) indicated that in the context of weight management messages for college students, gain-framed messages indeed mitigate psychological reactance. Furthermore, the modality and the frame of the health message interacted in such a way that gain-framed messages in an audiovisual modality generated the highest motivations to comply with the recommendations in the persuasive health messages.

What are Americans seeing? Examining the message frames of local television health news stories.

While local television news is the number-one source among Americans for health information, little attention has been given to what viewers are actually watching in these newscasts. Toward this end, a content analysis of local television health news stories (n = 416) was conducted, to examine how local health news stories utilize gain and loss message frames, and whether there are differences in story topics, location, length, presence of self-efficacy methods, and conflict, according to the message frames. Results showed that health news stories that dealt with advancements in treatment or philanthropic events were mainly reported using gain frames, while loss frame health news stories most frequently reported on statistics and trends. The majority of the health news stories were less than 30 seconds among all frames, and conflict appeared more often for the loss frames than gain frames. Furthermore, while efficacy information was mostly absent across all types of frames, gain frames were more likely than loss frames to present efficacy methods. Finally, efficacy information appeared most frequently in health-related statistical reports and prevention messages, while discrimination and health-policy stories had the least efficacy information in them.

Evaluating the Ozioma cancer news service: a community randomized trial in 24 U.S. cities.

OBJECTIVE: This community randomized trial evaluated effects of the Ozioma News Service on the amount and quality of cancer coverage in Black weekly newspapers in 24 U.S. cities. METHOD: We created and operated Ozioma, the first cancer information news service specifically for Black newspapers. Over 21 months, Ozioma developed community- and race-specific cancer news releases for each of 12 Black weekly newspapers in intervention communities. Cancer coverage in these papers was tracked before and during the intervention and compared to 12 Black newspapers in control communities. RESULTS: From 2004 to 2007, we coded 9257 health and cancer stories from 3178 newspaper issues. Intervention newspapers published approximately 4 times the expected number of cancer stories compared to control newspapers (p(12,21 mo)<.01), and also saw an increase in graphics (p(12,21 mo)<.01), local relevance (p(12 mo)=.01), and personal mobilization (p(12 mo)<.10). However, this increased coverage supplanted other health topics and had smaller graphics (NS), had less community mobilization (p(21 mo)=.01), and is less likely to be from a local source (NS). CONCLUSION: Providing news releases with localized and race-specific features to minority-serving media outlets can increase the quantity of cancer coverage. Results are mixed for the journalistic and public health quality of this increased cancer coverage in Black newspapers.

Generating Conflict for Greater Good: Utilizing Contingency Theory to Assess Black and Mainstream Newspapers as Public Relations Vehicles to Promote Better Health among African Americans.

The potential use of strategic conflict management ( Wilcox and Cameron, 2006; Cameron, Wilcox, Reber and Shin ( in press) as a health advocacy tool in US African-American and mainstream newspapers, arguing that escalation of conflict can increase effectiveness of health-related news releases. For health communicators focusing on at-risk populations with poor health outcomes, such goals would include increased awareness of health problems and solutions, along with increased motivation arising from indignation over health disparities. Content analysis of 1,197 stories in 24 Black and 12 mainstream newspapers showed that more conflict factors were present in Black vs. mainstream newspapers, suggesting a way to strategically place health messages in news releases disseminated to newspapers that motivate at-risk publics to better health. The findings suggest that conflict factors such as racial disparity data regarding health issues may enhance media advocacy.

Listen before you leap: Sri Lankan health professionals' perspectives on m-health.

Given the increasingly widespread use of mobile phones in the developing world, the application of this technology for healthcare (also referred to as m-health) has tremendous potential. However, there is a need for more research on factors that influence the sustainable and scalable adoption of m-health in developing countries. To fill this gap, in this study, drawing on the theory of diffusion of innovation, we conducted in-depth interviews with 29 health professionals in Sri Lanka to understand their views on the benefits and barriers to adopting m-health. Participants had mixed views on the adoption of this technology. Reasons for m-health adoption included efficiency and usefulness in emergency situations. Barriers to adoption included risks for miscommunication/misinterpretation and lack of systems/policies for implementing m-health technology. With regard to the innovation-decision process, most participants appear to be in the stages of "persuasion" and "decision"; with regard to degree of innovativeness, interviewees comprise a mix of "early adopters" and "laggards." Assuming mobile health apps afford improvements in health outcomes for developing countries, contextual factors in each national setting should inform design and implementation of m-health interventions.

Improving rates for screening colonoscopy: Analysis of the health information national trends survey (HINTS I) data.

BACKGROUND: Colonoscopy is an effective modality for colorectal cancer screening. The objectives of this study were to identify colorectal cancer knowledge and barriers to screening colonoscopy in the general US population. METHODS: Data was obtained from the health information national trends survey (HINTS I). The dataset (n = 6369) examined the influence of age, race, gender, education, income, media usage, and interactions with health care providers on knowledge, attitudes, and behavior regarding colonoscopic screening for colorectal cancer. RESULTS: The term 'colonoscopy' was recognized by 80% of participants (over the age of 35), however only 35% of respondents perceived it as a major method for colon cancer screening. Hispanics had the least awareness of colonoscopic screening (16% versus 39% non-Hispanic). Female gender, education, and income all correlated with knowledge and use of colonoscopic screening. There was a positive correlation between media usage and having a colonoscopy (r = 0.095, p < 0.01). Having a health care provider was strongly correlated with having undergone a colonoscopy (r = 0.249, p < 0.01). Reasons for not having a colonoscopy were 'no reason' (29%), 'doctor didn't order it' (24%), and 'didn't know I needed the test' (15%). Personalized materials were the preferred media for receiving cancer-related information. CONCLUSIONS: Knowledge of and participation in screening colonoscopy is low in the US population, especially among Hispanics. The most important immediate action is to increase physician referral for screening colonoscopy. Education materials focused on specific sociodemographic segments and targeted communication campaigns need to be developed to encourage screening.

Black newspapers as a tool for cancer education in African American communities.

BACKGROUND: Despite the long history, wide reach and unique influence of Black newspapers in many African American communities, no national studies have examined how these newspapers cover health and cancer issues, or reader perceptions of their coverage. DESIGN AND PARTICIPANTS: A two-year national sample of Black newspapers (n=24) and community-matched general audience newspapers (n=12) was reviewed, and 8,690 health and cancer stories were identified and content analyzed. A survey of 783 Black newspaper readers in the same 24 communities assessed reading frequency and perceptions of reporting for both types of newspapers, as well as readers' health concerns and cancer screening behaviors. RESULTS: As a proportion of total health coverage, Black newspapers published more cancer stories than general audience newspapers, and their stories were more likely to contain localized information, address disparities, focus on prevention, include calls to action for readers and refer readers to cancer information resources (all P<.001). Black newspaper readers identified cancer as the health issue that concerned them most, yet rated it the fourth most important health problem affecting African Americans. CONCLUSIONS: Black newspapers hold promise for helping to eliminate cancer disparities by increasing cancer awareness, prevention, and screening among African Americans.

Cancer coverage in general-audience and Black newspapers.

This article presents findings from the first study of cancer news coverage in a national sample of Black and general-audience newspapers. We compared 2,439 health news stories from 23 weekly Black newspapers to 2,767 health news stories from a constructed week sample of 12 daily general-audience newspapers, both collected between April 1, 2004, and March 31, 2005. Analyses examined differences in the amount and nature of cancer coverage, specifically cancer sites, disparities, localization, and personally mobilizing health information for readers. Cancer was the main topic in a higher proportion of health stories in Black newspapers than in general-audience newspapers (13.6% vs. 9.6%; p = .001). Among cancer stories, those in Black newspapers had more localization (p = .004), disparity information (p = .001), and personal mobilization information (p = .001) than those in general-audience newspapers. In neither type of newspaper did the distribution of stories by cancer site accurately reflect the impact of different cancers on population mortality.

"Willing but unwilling": attitudinal barriers to adoption of home-based health information technology among older adults.

While much research focuses on adoption of electronic health-care records and other information technology among health-care providers, less research explores patient attitudes. This qualitative study examines barriers to adoption of home-based health information technology, particularly personal electronic health records, among older adults. We conducted in-depth interviews (30-90 min duration) with 35 American adults, aged 46-72 years, to determine their perceptions of and attitudes toward home-based health information technology. Analysis of interview data revealed that most barriers to adoption fell under four themes: technological discomfort, privacy or security concerns, lack of relative advantage, and perceived distance from the user representation. Based on our findings, systems to promote home-based health information technology should incorporate familiar computer applications, alleviate privacy and security concerns, and align with older adults' active and engaged self-image.

Functional foods: delivering information to the oncology nurse.

Recent research suggests a beneficial role of nutrition as possible supportive therapy for cancer patients. A national survey of oncology nurses has shown that nutrition-related issues are an important subject discussed during nurse-patient meetings. The authors applied the activation theory of information exposure to oncology nurses in regard to nutrition information. Findings suggest that oncology nurses who consider nutrition important at a personal level tend to discuss nutrition more with patients and to seek more information about nutrition and cancer. Personal rather than professional motives appear to be triggers for the information search. Implications for health care communication professionals are discussed.