Improving health communication with photographic images that increase identification in three minority populations.

The homophily principle, that perceived similarities among people produce positive reactions, is a cross-cultural, global phenomenon. This study aimed to test the prediction that photographs that depict models similar to the target population improve health communication by increasing perceived identification in three racial/ethnic populations. Three separate nationally representative stratified samples (n = 1638) of African American, Hispanic and Native American adults were drawn from GfK's Knowledge Panel�. Participants read a message advocating increased physical activity and improved diets and completed measures on behavioral intentions, outcome and self-efficacy expectations and identification. The message contained photographs from a stock photograph service or photographs created for the research project to match the three minority populations, Real Health Photos (RHP). Structural equation modeling confirmed the theoretical hypothesis that RHP which matched the minority population increased behavioral intentions and was mediated by identification (P < 0.05) in all three racial/ethnic minority samples. Messages with only half of the matched RHP images had these same positive indirect effects among African Americans and Hispanics (P < 0.05). The impact of matching visual images in health messages to recipients derived from identification with the characters in images. Homophily and identification are hardwired, evolutionary, biological phenomena that should be capitalized on health educators with minority populations.

Alcohol warnings in TV beer advertisements.

OBJECTIVE: Mandated warnings are among the few steps Congress has taken to influence the use of legal substances such as alcohol. The usefulness of such warnings in discouraging abuse of alcohol is, however, controversial. This study examines the impact of televised warnings on probable antecedents of belief change not examined in previous research: confidence in beliefs about beer risks or benefits, and cognitive responses to the advertisements. METHOD: The present study (N = 75 male and female college students) tests four of the warnings recommended in Senate Bill 674 (1993--the "Thurmond bill") edited into randomly sampled television beer advertisements, using a between-subjects treatment-and-control experimental design. The four advertisements or advertisement/warning pairs were counterbalanced and analyzed as a repeated measures factor. RESULTS: The study indicated, as hypothesized, that subjects exposed to warnings tended to have less confidence in their generally skeptical assessments of beer risks--a likely precursor to belief change in resistant populations. Repeated exposure to the advertisements alone also appeared to lead to increased confidence in generally positive assessments of beer benefits, whereas repeated exposure to warnings led to decreased confidence in such assessments. Repeated exposure to warnings also may have primed negative reactions to subsequent beer advertisements. CONCLUSIONS: These results suggest mechanisms by which alcohol warnings may over time influence beliefs. Measures used here may serve as useful criterion variables in future studies on warnings. Further attention to optimizing warning content and presentation is recommended.

A cluster analysis of alcohol-related attitudes and behaviors in the general population.

OBJECTIVE: Alcohol use typologies have previously focused on chronic alcohol abusers and alcohol-dependent populations. This empirical typology was created to profile lifestyle patterns associated with nonclinical patterns of alcohol use. METHOD: This study used two surveys sent to a commercial mailback panel, sampled to construct a study population demographically representative of the general U.S. population (N = 2,910). A K-means cluster analysis of alcohol use predictor variables and alcohol use generated the typology. RESULTS: The results suggest five distinct psychobehavioral clusters, referred to by the modal patterns of alcohol use for each cluster: nondrinkers, light drinkers, moderate drinkers, episodic drinkers and regular heavy drinkers. These clusters were found to have predictive validity using related health behaviors, psychosocial variables, personality self-descriptors, and media use as criteria. In particular, moderate drinkers had double the income of any other cluster and showed consistently healthy exercise, cigarette use, and diet patterns as well as a relatively high ranking of health as a personal value. Episodic drinkers had the highest levels of sensation-seeking and drug use and were not health oriented in values and behaviors, although their total weekly consumption was only marginally greater than the moderate drinkers. CONCLUSIONS: The profile of the moderate drinker cluster is consistent with concerns about lifestyle confounds in the relationship between moderate alcohol consumption and cardiovascular health. The episodic drinker profile is consistent with relatively high risk behaviors; this cluster may be a good target for harm-reduction education and intervention efforts.

Male adolescents' reactions to TV beer advertisements: the effects of sports content and programming context.

OBJECTIVE: This study examines white male adolescent responses to TV beer advertisements with and without sports content and to nonbeer ads when embedded in sports and entertainment programming. METHOD: A total of 72 advertisements and 24 television program excerpts were randomly sampled from national television programming. White male adolescents (N = 157) recruited in a public school system each viewed six ads (one of each of three types of ad embedded in each of two types of programming) comprising the 2 x 2 x 3 factorial, within-subjects, mixed-model (random and fixed effects) experimental design along with an age-level blocking factor and random factors for commercial and program stimuli. Cognitive responses to each ad were content-analyzed. Individual difference variables including alcohol use behavior, sensation-seeking, masculinity and sports involvement were also measured. RESULTS: Subjects showed a consistent preference for beer ads with sports content. A significant three-way interaction between ad type, programming type and junior versus senior high-school age level also indicated that sports programming had an inconsistent effect on responses to beer ads but that nonbeer ads were responded to more positively during sports than during entertainment programming. Other analyses showed that subjects were more cognitively resistant to beer ads than to nonbeer ads. CONCLUSIONS: These results support public and official concerns that sports content in beer ads increase the ads appeal to underage youth. They do not support hypothesized concerns that sports programming might prime adolescents to be more receptive to beer ads. Implications for alcohol education efforts are discussed.

Co-expression of interleukin-6 and human growth hormone in apparently normal prostate biopsies that ultimately progress to prostate cancer using low pH, high temperature antigen retrieval.

Prostate cancer is the most common cancer in American men and the second leading cause of cancer deaths in this group. Both growth hormone (GH) and the inflammatory cytokine interleukin 6 (IL-6) have been implicated in prostate cancer progression. Studies in other systems have shown that an increase in GH results in an increase in IL-6 also. The current study demonstrated a parallel spatial and temporal expression of GH and IL-6 in cells in prostate cancer glandular acina cells. This study cannot determine if this expression is coincidental or causative, but it seems likely that the increase in GH could induce the expression of IL-6, since this is the case in other tissues. Optimal labelling for IL-6 in our study was achieved with low pH, high temperature antigen retrieval.

Theory and method in health audience segmentation.

Audience segmentation is widely regarded as essential to effective health communication campaign efforts. Nonetheless, its practice is typically ad hoc. The conceptual history and theoretical bases for audience segmentation are reviewed, and typical audience segmentation strategies for health communication efforts are described and critiqued. An analogy is drawn between the methodological problems associated with audience segmentation and those of multivariate classification and taxonomy in botany and zoology. Cluster analytic techniques responsive to these issues are described, as are applications of these techniques for analysis of health communication campaign audiences. Approaches that would permit widespread use of such segmentation strategies are discussed, and recommendations for such efforts are made.

Personal value of alcohol use as a predictor of intention to decrease post-college alcohol use.

This study examines the utility of a new measure of personal value of alcohol use in predicting intentions to reduce post-college alcohol use. This measure is intended to distinguish college students who drink due to situational norms versus intrinsic commitment to alcohol use. As expected, alcohol consumption quantity/frequency and frequency of consuming five or more drinks per occasion were unrelated to intention to reduce alcohol use after college. When these alcohol consumption measures were controlled using partial correlation, the personal value of alcohol measure was significantly and negatively related to intention to reduce alcohol use. Conversely, when personal value of alcohol use was controlled in partial correlations, the relationship between alcohol consumption variables and intention to reduce alcohol use after college became positive, though only at marginally significant levels. Implications are discussed.

Health lifestyles: audience segmentation analysis for public health interventions.

This article is concerned with the application of market segmentation techniques in order to improve the planning and implementation of public health education programs. Seven distinctive patterns of health attitudes, social influences, and behaviors are identified using cluster analytic techniques in a sample drawn from four central California cities, and are subjected to construct and predictive validation: The lifestyle clusters predict behaviors including seatbelt use, vitamin C use, and attention to health information. The clusters also predict self-reported improvements in health behavior as measured in a two-year follow-up survey, e.g., eating less salt and losing weight, and self-reported new moderate and new vigorous exercise. Implications of these lifestyle clusters for public health education and intervention planning, and the larger potential of lifestyle clustering techniques in public health efforts, are discussed.

Family communication patterns, rebelliousness, and adolescent reactions to anti-drug PSAs.

Research suggests that adolescents' family communication patterns should predict their reactions to anti-drug messages. The authors propose that the impact of such patterns is contingent upon the extent of adolescent rebelliousness. Fifty-one adolescents saw six anti-drug PSAs, and assessed whether they considered the messages believable and likely to persuade them and people they knew. Respondents were split into high/low groups with respect to conformity-orientation (authoritarian family communication patterns), conversation-orientation (open family communication patterns), and rebelliousness. As predicted, rebellious adolescents from the more authoritarian, conformity-oriented families considered the messages relatively less believable than did the non-rebellious adolescents from authoritarian, conformity-oriented families. Predicted negative relationships between family conversation-orientation and assessments of anti-drug PSA believability and persuasiveness were not found. Youth who had experimented with drugs, as predicted, did assess the anti-drug PSAs as less persuasive than those who did not.

Power distance and collectivist/individualist strategies in alcohol warnings: effects by gender and ethnicity.

This research examined the responses of 73 Mexican American and Anglo young adults to four televised drinking-and-driving warnings. Warnings were manipulated into collectivist (emphasizing risks to family and friends) and individualist (emphasizing risks to self) appeals, and into high and low power distance appeals by attributing or not attributing warnings to the Surgeon General. Females rated the collectivist warnings, and males the individualist warnings, more believable. Respondents on average responded to the collectivist warnings most positively, regardless of gender or ethnicity. Anglos rated warnings without the Surgeon General as the source more believable than warnings with the Surgeon General as the source; the opposite was true for Latinos. Other interactions were also found.

Cigarette advertisements in magazines: evidence for a differential focus on women's and youth magazines.

Cigarette advertisements in eight popular magazines from 1960 to 1985 were examined. The magazines were selected to represent different market segments, particularly women and youth. Across all eight magazines, the average number of cigarette ads per issue increased substantially following the 1971 television ban on cigarette ads. Moreover, beginning in the late 1960s and early 1970s, proportionately more ads were placed in women's and youth-oriented magazines than in magazines which targeted other population segments. These data suggest that the tobacco industry may have responded to decreases in the number of smokers and the per capita consumption of cigarettes with an enterprising attempt to recruit new smokers-particularly young people and women.

Detection of preneoplasia in histologically normal prostate biopsies.

P2X immunolabeling of prostate detected preneoplastic changes in apparently normal tissue. Labeling occurred in two well-defined stages before the diagnostic histological markers of cancer were visible. As cancer progressed, the location of P2X expression changed from confinement within individual nuclei in the acini (stage 1) to a cytoplasmic punctate label in the acinal epithelium, with an associated removal of nuclear stain (stage 2). Finally, in advanced cases, where clear morphological evidence of cancer was apparent, the P2X label condensed exclusively on the apical epithelium (stage 3). BPH/normal tissue was entirely devoid of P2X label. Biopsy samples (77) were tested in three categories. One group (35) were diagnosed as normal benign prostatic hyperplasia (BPH) on the basis of haematoxylin and eosin (H&E) stain, although underlying disease was suspected. Of these, 14 (40%) were clearly normal and appeared entirely devoid of label, 13 (37%) exhibited the first stage of P2X receptor labeling and the remaining eight (23%) exhibited second stage labeling. The accompanying H&E-stained sections of all these cases had a normal appearance. Low grade cancer biopsy samples with Gleason scores G4-7 (25) all revealed widespread second stage receptor labeling in areas of both normal and cancerous morphology, while 17 high grade cancer biopsy samples (Gleason G8-10) all showed third stage labeling along with some residual second stage labeling. The features of each P2X labeling stage occupied the entire histological area affected, offering more opportunity to diagnose the tissue than was supplied by the more-localised diagnostic features identified by H&E-stain. Besides detecting cases of preneoplasia in biopsies with a normal H&E appearance, this technique was also able to rule out the presence of neoplasia in purely hyperplasic prostates by the absence of any P2X labeling.Prostate Cancer and Prostatic Diseases (2001) 4, 92-96

Adolescent counterarguing of TV beer advertisements: evidence for effectiveness of alcohol education and critical viewing discussions.

The pervasiveness of American youth's exposure to alcohol advertising is well-documented, as is the correlational evidence linking such exposure to alcohol-related attitudes, use, and expectancies. While efforts to train young people to resist persuasive appeals are often made in alcohol education programs, little evidence exists concerning the effectiveness of such efforts. The present study (N = 83) found that recency of exposure to alcohol education classes and discussion of alcohol advertising in such classes predicts cognitive resistance (counterarguing) of such advertisements months or even years after class exposure. Age, gender, and ethnicity were statistically controlled. While females tended to counterargue the alcohol advertisements more than did males, there was no statistically significant difference in the impact of education on males and females.

Formative research activities to provide Web-based nutrition education to adults in the Upper Rio Grande Valley.

The Internet is a promising new tool for disseminating cancer prevention information. Barriers to full implementation include disparities in access and skill and availability of information relevant at the local level. A nutrition education Web site to promote fruit and vegetable intake is being produced for a tri-ethnic adult population in Colorado and New Mexico. Development is guided by findings from formative research including focus groups with local residents, a survey on computer and Internet use with 200 adults in 1998, an assessment of public access computer sites, and in-depth discussion with local community computer skills trainers.