Impact of Information Exposure on Perceived Risk, Efficacy, and Preventative Behaviors at the Beginning of the COVID-19 Pandemic in the United States.

This online survey took place on March 7, 2020 at the beginning of the COVID-19 outbreak in the United States. Participants (n = 698) completed an online survey in which they were asked to reflect on their mediated and interpersonal information consumption, in addition to reporting on risk perceptions, general efficacy perceptions, and preventative behaviors specific to COVID-19 in the past seven days. Participant age and chronic condition status were controlled for in all analyses. Time spent consuming news, social media, and health website information was not related to risk perceptions. Time spent on health websites predicted time spent having interpersonal conversations about COVID-19, as well as general efficacy levels. Following the Extended Parallel Process Model, perceived severity, perceived susceptibility, and general perceived efficacy predicted preventative behaviors. The vast majority of participants did report taking preventative action against COVID-19, most commonly in the form of hand washing, with many enacting stronger preventative behaviors that had yet to be recommended for the general population. Overall, mediated and interpersonal information exposure had minimal effects on perceived risk and perceived general efficacy, which in turn predicted 27.5% of the variance in preventative behavior. Efficacy was the most powerful among these predictors, and health websites, specifically governmental websites, appeared to be underutilized resources with the potential to promote efficacy during outbreaks. Further research is needed to understand causation in these relationships and to assist in successful message transmission.

Promoting Mental Health Help-Seeking Behavior Among First-Year College Students.

Awareness and utilization of mental health services on college campuses is a salient issue, particularly for first-year students as they transition into college life. The current study uses focus groups and surveys to test help-seeking messages for first-year students. In this formative research, Phase 1 focus-group participants (N = 47) discussed four message concepts related to awareness of symptoms of mental health problems and services available to students. Phase 2 participants (N = 292) viewed one of three message concepts and then completed items that measured their perceptions of the message. Focus-group results helped prioritize likely effectiveness of messages based on responses to message features and provided an understanding of mental health help-seeking perceptions among college students. The quantitative results indicate the messages have potential for increasing awareness of mental health issues, as well as promoting availability of campus resources. Implications for tailoring campaign messages to first-year students are discussed.

Evaluation of a Social Norms Approach to a Suicide Prevention Campaign.

Suicide is a leading cause of death for college-aged youth, and university counseling centers (UCC) strive to educate students about mental health issues and available campus services. The current research evaluates a college campus social norms campaign that used both peer and celebrity sources to promote help seeking among college students as a suicide prevention strategy. Postcampaign surveys of this quasi-experiment (n = 391) revealed that compared to students in the control neighborhood condition, students exposed to the campaign messages in the experimental neighborhood conditions were more likely to perceive students would refer a friend to the UCC and more likely to visit the UCC for a mental health concern. Students living in the intervention neighborhood with a peer message source reported a greater willingness to refer friends to the UCC compared to those who lived in the celebrity and control neighborhoods. Regardless of condition, students who reported seeing UCC messages reported greater effects than those who reported not viewing the messages (e.g., greater intentions to seek help and to talk to others about the UCC). Results of this study are discussed within a social norms framework and support the need for continued exposure to campaign messages to impact health outcomes.

Risk Belief and Attitude Formation From Translated Scientific Messages About PFOA, an Environmental Risk Associated With Breast Cancer.

Evidence regarding possible environmental causes of breast cancer is advancing. Often, however, the public is not informed about these advances in a manner that is easily understandable. This research translates findings from biologists into messages at two literacy levels about perfluorooctanoic acid (PFOA), a possible environmental contributor to breast cancer. The Heuristic Systematic Model (HSM) was used to investigate how ability, motivation, and systematic and heuristic processing lead to risk beliefs and, ultimately, to negative attitudes for individuals receiving translated scientific messages about PFOA. Participants (N = 1,389) came from the Dr. Susan Love Research Foundation's Army of Women. Findings indicated that ability, in the form of translated messages, predicted systematic processing, operationalized as knowledge gain, which was negatively associated with formation of risk beliefs that led to negative attitudes toward PFOA. Heuristic processing cues, operationalized as perceived message quality and source credibility, were positively associated with risk beliefs, which predicted negative attitudes about PFOA. Overall, more knowledge and lower literacy messages led to lower perceived risk, while greater involvement and ratings of heuristic cues led to greater risk perceptions. This is an example of a research, translation, and dissemination team effort in which biologists created knowledge, communication scholars translated and tested messages, and advocates were participants and those who disseminated messages.

Scientific Message Translation and the Heuristic Systematic Model: Insights for Designing Educational Messages About Progesterone and Breast Cancer Risks.

Results of ongoing scientific research on environmental determinants of breast cancer are not typically presented to the public in ways they can easily understand and use to take preventive actions. In this study, results of scientific studies on progesterone exposure as a risk factor for breast cancer were translated into high and low literacy level messages. Using the heuristic systematic model, this study examined how ability, motivation, and message processing (heuristic and systematic) influenced perceptions of risk beliefs and negative attitudes about progesterone exposure among women who read the translated scientific messages. Among the 1254 participants, those given the higher literacy level message had greater perceptions of risk about progesterone. Heuristic message cues of source credibility and perceived message quality, as well as motivation, also predicted risk beliefs. Finally, risk beliefs were a strong predictor of negative attitudes about exposure to progesterone. The results can help improve health education message design in terms of practitioners having better knowledge of message features that are the most persuasive to the target audiences on this topic.

An Experimental Study of Medical Error Explanations: Do Apology, Empathy, Corrective Action, and Compensation Alter Intentions and Attitudes?

Medical malpractice lawsuits are a growing problem in the United States, and there is much controversy regarding how to best address this problem. The medical error disclosure framework suggests that apologizing, expressing empathy, engaging in corrective action, and offering compensation after a medical error may improve the provider-patient relationship and ultimately help reduce the number of medical malpractice lawsuits patients bring to medical providers. This study provides an experimental examination of the medical error disclosure framework and its effect on amount of money requested in a lawsuit, negative intentions, attitudes, and anger toward the provider after a medical error. Results suggest empathy may play a large role in providing positive outcomes after a medical error.

Comparison of communication and personal characteristics of living kidney donors and a matched quota sample.

Deceased organ donation does not meet the need for kidney transplants. Thus, it is important to examine topics relevant to kidney donors such as communication leading to the donation decision and donor characteristics. This study reports personal characteristics and communication leading to the decision to donate among living kidney donors and a demographically matched quota sample. Donors had higher scores for compassion, while non-donors reported more volunteerism. Donors and non-donors did not differ in conversation or conformity orientations of family communication styles. Only 4.7% of donors reported being asked to donate directly. Matched respondents reported feeling more comfortable than unsettled with the idea of being asked directly and indicated a preference to learn of the need directly or indirectly, giving them the option to volunteer. The majority of donors were giving to family members and friends, and the matched sample indicated greater willingness to donate to immediate family members, followed by friends. Practical implications of the findings are offered.

Patient race and perceived illness responsibility: effects on provider helping and bias.

OBJECTIVES: Health care disparities represent a major issue impacting the quality of care in the USA. Provider biases have been identified as contributing to health care disparities. This study examined the helping intentions and biases reported by medical students based on patient race and perceived patient responsibility. The study was guided by the responsibility-affect-helping model (RAHM), which proposes that helping behaviour is a function of perceived responsibility and affect. METHODS: In a 2 × 3 online experiment, medical students (n = 231) viewed a health chart and dialogue for either a Black or a White patient, in which the dialogue included a manipulation of the patient's rationales for his non-compliance with diet recommendations (responsible, not responsible, no responsibility assigned). After viewing the manipulation, medical students completed measures regarding perceived patient responsibility, affect, intention to help, perceptions of the patient and ethnocentrism. RESULTS: The RAHM was supported, such that increased perceived patient responsibility led to increased provider anger and reduced provider helping intentions, whereas decreased perceived patient responsibility led to increased provider empathy and helping intentions. Additionally, an interaction effect between race and perceived patient responsibility occurred such that bias toward the Black patient was most likely to occur in the control condition. CONCLUSIONS: Perceived patient responsibility affects provider helping intentions and interacts with patient race to influence provider perceptions of patient characteristics. Communication on rationales for non-compliance as associated with perceived responsibility may lead to better or worse patient care as providers make attributions about patients based on these factors.

A 10-year content analysis of original research articles published in Health Communication and Journal Of Health Communication (2000-2009).

This study presents data from a content analysis of original research articles published in Health Communication and Journal of Health Communication from 2000 to 2009. The authors coded 776 articles using categories that identified health topics, theory, population characteristics, and methods used in each study. Distinctions between the published research in Health Communication and Journal of Health Communication are highlighted. Across both journals, findings demonstrated articles sometimes lack racial demographic information, primarily perform research in the United States, rely heavily on survey data, and often lack a theoretical framework. The top physical health topic addressed across both journals was cancer, and the top non-physical health topic addressed was the role of media in health. Journals displayed differences in several areas and those differences often mirrored each journal's stated objectives. Results are discussed in terms of their implications for expanding health communication research to be reflective of issues salient to public health within the United States and around the world.

The effects of heuristic cues, motivation, and ability on systematic processing of information about breast cancer environmental factors.

The heuristic systematic model is used to investigate how ability, motivation, and heuristic message cues predict knowledge scores for individuals receiving messages written for different literacy levels about 3 environmental risk factors for breast cancer. The 3 risk factors were the roles of genetics, progesterone, and ingesting perfluorooctanoic acid in breast cancer risk. In this study, more than 4,000 women participated in an online survey. The results showed support for the hypotheses that ability (measured as education, number of science courses, and confidence in scientific ability) predict knowledge gain and that those individuals who presented with the lower literacy level message had significantly higher knowledge scores across all 3 message topics. There was little support for motivation or heuristic cues as direct predictors of knowledge gain across the 3 message topics, although they served as moderators for the perfluorooctanoic acid topic. The authors provide implications for health communication practitioners.

Localized prostate cancer treatment decision-making information online: improving its effectiveness and dissemination for nonprofit and government-supported organizations.

The current study reports findings from evaluation research conducted to identify how online prostate cancer treatment decision-making information can be both improved and more effectively disseminated to those who need it most. A multi-method, multi-target approach was used and guided by McGuire's Communication Matrix Model. Focus groups (n = 31) with prostate cancer patients and their family members, and in-depth interviews with physicians (n = 8), helped inform a web survey (n = 89). Results indicated that physicians remain a key information source for medical advice and the Internet is a primary channel used to help make informed prostate cancer treatment decisions. Participants reported a need for more accessible information related to treatment options and treatment side effects. Additionally, physicians indicated that the best way for agencies to reach them with new information to deliver to patients is by contacting them directly and meeting with them one-on-one. Advice for organizations to improve their current prostate cancer web offerings and further ways to improve information dissemination are discussed.

Longitudinal associations with positivity, quarantining and pass/fail policy use on student GPAs during the first three semesters of the pandemic.

OBJECTIVE: This research sought to understand the effects of testing positive, quarantining, and pass/fail policy use on college student GPAs across three semesters from Spring 2020 to Spring 2021. PARTICIPANTS: 644 students were followed across three semesters. METHODS: Anonymized secondary data sets regarding student health behaviors, perceived stress, and satisfaction were combined with registrar data concerning demographic factors, COVID-19 infection, the need to quarantine, and converting grades to pass/fail (P/F). RESULTS: The use of P/F was associated with inflated GPAs when offered during Spring and Fall 2020. Students opting to use P/F were more likely to be low-income and achieve a lower GPA in Spring 2021 when the P/F option was no longer offered. Testing positive and quarantining did not have a significant association with student GPA. CONCLUSIONS: The research challenges the value of providing students the ability to convert grades to P/F during the pandemic.

Investigating the impact of message format, involvement, scientific literacy, and education on attitude toward reducing cancer risk through regulation.

Recent research links perfluorooctanoic acid (PFOA) to increased breast cancer risk. Efforts to inform the lay public about potential risks associated with PFOA need to be accessible in their content as many individuals, including highly educated ones, have low scientific literacy. This study investigates the role of message format, as well as personal involvement, scientific literacy, and education in influencing attitudes about PFOA regulation. Participants (N = 2,078) were exposed to one of three message formats about PFOA and then responded to survey questions related to their attitude about the need for new regulation. Results revealed that issue involvement was positively related to favorable attitude regarding new regulation, while education and advocacy status were negatively related; cancer experience, scientific literacy, and message format did not influence attitude about new regulation. Implications of the results are discussed as they relate to communicating uncertain risk information to inform and influence lay individuals.

Living kidney donor decision making and communication.

There is high demand for kidney donors in the United States, and it is widely accepted that living donation is optimal for individuals who need a kidney. Much research has focused on the potential recipient, but little has been studied about the communication and decision making of living kidney donors. Interviews assessed the communication and decision-making processes of 43 kidney donor volunteers. Almost all of the participants were not asked, but instead volunteered, to donate. The majority of donors reported having conversations with the recipient and speaking about their decisions with other individuals in their social networks besides the recipient. Some participants said that they stopped talking to others because of negative feedback. Future research should further examine the communication of donors with non-recipient others and potential methods of training recipients and donors to communicate effectively about the donation process.

Action tendency emotions evoked by memorable breast cancer messages and their association with prevention and detection behaviors.

Memorable messages about breast cancer sent by different sources, such as friends and family members, were analyzed for the action tendency emotions that they evoked. Negative emotions of fear, sadness, and anger, and positive emotions of hope and relief were analyzed for their associations with prevention and detection breast cancer behaviors. Messages that evoked fear were significantly more likely to be associated with detection behaviors, whereas messages that evoked relief were significantly less likely to be associated with detection behaviors than messages that did not evoke these emotions. These results are consistent with control theory and also show that friends and family are important sources of memorable messages about breast cancer.

How do perceptions of verbal statements and nonverbal actions as empathetic differ by medical appointment context?

OBJECTIVE: Empathy is a crucial component of the provider-patient relationship. This research tested a list of 18 verbal statements and 21 nonverbal actions, which healthcare providers can use to provide empathy. METHODS: Prior to rating the statements and behaviors for empathy, 466 participants were randomly assigned in an online experiment in which participants were asked to imagine they were in a medical appointment where they were experiencing either general stress, receiving bad news, or learning of a medical error which made them become emotional. RESULTS: Results indicated the most highly rated statement was "My entire staff is here for you." The most highly rated nonverbal action was spending extra time with the patient. Expectations of empathy were found to rise with severity of context. CONCLUSIONS: This research found statements/actions of empathy can be tailored to the context of the appointment. PRACTICE IMPLICATIONS: This research can be used to provide concrete examples regarding the frequently offered advice that physicians provide empathy to their patients.

The impact of personal and/or close relationship experience on memorable messages about breast cancer and the perceived speech acts of the sender.

BACKGROUND: Memorable messages and their speech acts (purposes of the messages) can promote protection against breast cancer and guide health behaviors. METHODS: Participants reported their personal, friends', and relatives' experiences with breast cancer and a memorable message about breast cancer if one came to mind. Those with a memorable message reported its perceived speech acts. RESULTS: Individuals who had personal and friend or relative experience with breast cancer were significantly more likely to recall memorable messages than other respondents. The most frequently perceived speech acts were providing facts, providing advice, and giving hope. CONCLUSIONS: This information should be used to form messages in future breast cancer protection campaigns.

Finding Common Ground: Can Provider-Patient Race Concordance and Self-disclosure Bolster Patient Trust, Perceptions, and Intentions?

BACKGROUND: Improvements in provider-patient relationships may help alleviate health disparities. Provider-patient race concordance and provider self-disclosure are variables that may help improve this relationship. PURPOSE: This study sought to answer if provider-patient race concordance and provider self-disclosure may improve patient trust, rapport, similarity, likeability, intention to disclose, satisfaction, behavioral intention to keep a provider, and intention to recommend a provider, while using empathy as a covariate. METHODS: Using 882 White or Black participants, the current research used a 2 × 2 online experimental design. Participants were asked to read a vignette in which they were told they had borderline high cholesterol and needed to eat a healthier diet, by either a Black or White male physician, who either self-disclosed or did not self-disclose regarding their own struggle to eat a healthy diet. After reading this vignette, participants were surveyed regarding the dependent variables of interest. RESULTS: Participants in a Black concordant dyad reported higher levels of similarity than those in any other dyad. Provider self-disclosure led to higher levels of trust, rapport, similarity, likeability, intention to disclose, satisfaction, behavioral intention to continue using the provider, and intention to recommend the provider. No interaction effects were found. CONCLUSION: While it is possible, based on past research, that race-concordant pairings may lead to trust via similarity, provider self-disclosure directly increased perceptions of trust as well as providing numerous other benefits. This study supports the importance of trainings for providers on health-related self-disclosure to benefit both parties in provider-patient dyads.

Reducing Health Disparities: Understanding the Unintended Effects of Health Care Professional and Patient Characteristics on Treatment.

CONTEXT: The responsibility-affect-helping model proposes that helping behavior is a function of perceived responsibility and affect. OBJECTIVE: To examine the effect of medical students' degree (DO or MD) and gender on attitudes toward patients and how these factors could act as moderators in the responsibility-affect-helping model. METHODS: This 2×3 experimental study included third- and fourth-year osteopathic (ie, DO) and allopathic (ie, MD) medical students. Students were given a survey that included the medical record and photograph of a fictitious male patient with diabetes and a message from the patient regarding his diet nonadherence. The patients differed in race (black or white) and the cause of diet nonadherence (healthy foods don't taste good, no reason given, or inability to access healthy foods). Survey items measured students' perception of the patient's responsibility for his nonadherence, level of anger, intention to help, level of sympathy, and ethnocentrism. Data were analyzed using a multivariate analysis of covariance with ethnocentrism as a covariate. RESULTS: Of 1520 potential students, 231 were included in the study. Mean (SD) responsibility scale scores showed that DO students viewed the patient who gave dislike of healthy food or no reason for their diet nonadherence as more responsible for his nonadherence than did MD students (4.69 [0.99] vs 3.93 [1.00] and 4.35 [0.88] vs 3.65 [1.01], respectively). Conversely, mean (SD) responsibility scores showed that DO students viewed patients who indicated lack of access to healthy food as his reason for diet nonadherence as less responsible for his nonadherence than did MD students (2.45 [0.94] vs 2.59 [1.08]) (F2,228=3.21, P<.05, η2=.03). Furthermore, female students perceived patients to be less responsible for their diet nonadherence than did male students (3.28 [1.22] vs 3.88 [1.22]) (F2,228=8.87, P<.01, η2=.04). Ethnocentrism was consistently a significant covariate for students' perception of patient characteristics, predicted patient behaviors, perception of the patient's responsibility for his nonadherence, students' level of anger, students' intention to help, and students' level of sympathy. CONCLUSION: Survey results showed that DO students perceived patients who reported dislike of healthy food or no reason for diet nonadherence as more responsible for their health issue and patients who indicated lack of access to healthy food as less responsible for their nonadherence than did MD students. Additionally, female students perceived patients to be less responsible for their health issue than did male students. Results of the current study indicate that physician demographic factors could be taken into account as proxy variables when using the responsibility-affect-helping model in the health care field.