Media Framing of Causes, Risks, and Policy Solutions for Cannabis-Impaired Driving: Does Medical vs. Non-Medical Cannabis Context Matter?

Driving under the influence of cannabis (DUIC) is a major cause of preventable death and a growing public health concern. News media coverage of DUIC may influence public perceptions of causal factors for DUIC, risks of DUIC, and potential policy solutions. This study examines Israeli news media coverage of DUIC, and contrasts media coverage according to whether news items refer to cannabis use for medical vs. non-medical purposes. We conducted a quantitative content analysis of news articles related to driving accidents and cannabis use (N = 299) from eleven of the highest circulation newspapers in Israel between 2008 and 2020. We apply attribution theory to analyze media coverage of accidents that were linked to medical cannabis, use compared with non-medical use. News items describing DUIC in the context of non-medical (vs. medical) cannabis use were more likely to: (a) emphasize individual causes (vs. social and political); (b) describe drivers in negative terms (vs. neutral or positive); (c) refer to an increased accident risk due to cannabis use (vs. inconclusive or low risk); and (d) call for increased enforcement rather than education. Results show that Israeli news media coverage of cannabis-impaired driving varied significantly depending on whether it referred to cannabis use for medical purposes, or non-medical purposes. News media coverage may influence public perceptions of the risks of DUIC, the factors that are associated with this issue, and potential policy solutions that may reduce the prevalence of DUIC in Israel.

Effects of Message Framing and Narrative Format on Promoting Persuasive Conversations with Others About the Flu Vaccine.

This study examines the effects of message framing (loss vs. gain) and format (narrative vs. expository) on intentions to discuss flu vaccination with a close social referent. We test the effects of video messages using a two-wave web-based randomized experiment among adults in Israel (baseline: N = 429, one-month follow-up: N = 241). Exposure to narrative messages was positively associated with intentions to discuss flu vaccination. Exposure to loss-framed messages was positively associated with increased likelihood of discussing vaccination with the referent at follow-up. Effects of message framing and format were moderated by concern for the referent's health. Findings support the use of persuasive messages to motivate interpersonal conversation to promote vaccination. Results contribute to theory on risk-framing by showing that audiences may evaluate loss-framed messages according to their risk perceptions, when greater concern for health risks motivate action, not only for one's own health but for another person's health.

Information Scanning Impacts Nonmedical Drug Use Among College Students: A Longitudinal Study of Scanning Effects.

Health information that is acquired through information scanning has been shown to play an important role in shaping individual beliefs and health behavior. This study examines the direct and indirect effects of the breadth of scanning from media and interpersonal sources about two risk behaviors (nonmedical use of amphetamines and marijuana) on subsequent drug use behavior through changes to perceived norms. We test effects of scanning using a longitudinal online survey design with data collected at six-month intervals over three time points among 800 Israeli undergraduate students in their freshman year. Of the 800 respondents who participated in the first wave, 62.4% completed the second wave (N = 499), among which 347 (69.5%) completed a follow-up 6 months later. Results of cross-lagged structural equation models find that scanning information about amphetamines from interpersonal sources at 6 months predicted an increased likelihood of nonmedical use of amphetamines at 12-months. In addition, young adults who scanned information about marijuana from media sources at 6 months reported greater nonmedical marijuana use at 12 months. Breadth of scanning about marijuana from media sources mediated the relationship between perceived norms and marijuana use at 12 months. Results also showed indirect effects of scanning at baseline on nonmedical drug use at 12 months through scanning from the same source at 6 months. These findings contribute to our understanding of the role of information scanning and perceived norms in shaping substance use behaviors, and suggest that scanning may serve as a potential early indicator of risk.

Exposure to Risk Information Detail (RID) in News Coverage of Anorexia Increases Self-Efficacy to Perform Risky Behaviors.

In an online randomized experiment with 419 Israeli adult women using two rounds of data collected at a one-month interval, we test the effects of exposure to messages with greater and lesser detail about behaviors that increase personal risk (RID: Risk Information Detail) on women's self-efficacy to perform the risky behaviors. Participants viewed news media videos about anorexia (or a control video about vaccination). Video messages varied according to the amount of detail provided regarding the specific risky behaviors (High vs. low RID), and message format (narrative or expository). Effects of exposure to RID on self-efficacy were mediated through response efficacy, both immediately after exposure and at one-month follow-up. The indirect effects of RID were not moderated by participants' risk of developing an eating disorder, or identification with the protagonist (messages with a narrative format). Implications for social cognitive theory, social learning processes, and unintended media effects are discussed.

Are COVID-19 health-related and socioeconomic stressors associated with increases in cannabis use in individuals who use cannabis for recreational purposes?

Background: The COVID-19 pandemic and associated public health measures implemented to mitigate transmission may increase stress, which, in turn, can be associated with changes in cannabis use. This study examined the associations between health-related and socioeconomic stressors associated with the COVID-19 pandemic, and reported increases in cannabis use. Indirect effects of health-related and socioeconomic stressors on increased cannabis use through cannabis coping motives were also tested. Methods: Cross-sectional survey data, based on responses from a convenience sample of 755 Israeli adults who reported frequent consumption of cannabis for recreational purposes, was analyzed using structural equation models. Results: About 35% of the respondents reported that they agreed to a large/very large extent that their cannabis use had increased since the COVID-19 pandemic had started. Both health and socioeconomic stressors were related to increased cannabis use during the pandemic, and coping motives mediated this relationship. The direct and indirect associations of socioeconomic stressors and increased cannabis use were stronger than the associations of health-related stressors. Conclusions: Cannabis consumption may serve as a means of coping with health and socioeconomic COVID-19 stressors. Particular attention should be placed on socioeconomic stressors as these may be particularly important in understanding coping related cannabis use during the COVID-19 pandemic.

The impact of a Facebook campaign among mothers on HPV vaccine uptake among their daughters: A randomized field study.

OBJECTIVE: The popularity of social networks provide an incredible opportunity to enhance the impact of preventive medicine programs. We aimed to assess whether a targeted Facebook campaign among mothers may increase the uptake of human Papilloma virus (HPV) immunization among their 8th-grade daughters. METHODS: This field study was conducted among the members of a state-mandated health organization in Israel. Included were all 21,592 members who were mothers to 14 year-old daughters in the 2018-19 school-year. A total of 17,271 (80%) were randomly allocated to the campaign arm and the rest (n=4,321) were selected as a reference group. The Facebook ads addressed issues and concerns regarding HPV-related diseases and HPV vaccine. Main outcome measures were Facebook metrics on exposure to campaign and HPV immunization among eighth grade daughters of the study participants. RESULTS: Between 8/2018-10/2018, Facebook ads were shown 1.8-million times (a reach of 88%). The uptake of HPV vaccine among daughters of women allocated to the campaign arm (55.3%) was similar (p = 0.749) to 55.0% in the control group. The only significant differences between study groups were observed when stratifying by SES level. In the lowest SES quartile, Facebook campaign significantly (p = .02) reduced vaccine uptake (35% vs. 39.0%), with a relative risk of 0.90 (95%CI: 0.82-0.98), while in the second SES quartile, Facebook campaign increased vaccine uptake from 52.6% to 55.8%, with a RR of 1.06 (95%CI,1.00-1.12). Among mothers in higher SES levels, daughters of exposed and unexposed mothers had similar immunization rates. CONCLUSIONS: Facebook campaign may increase the uptake of HPV vaccine among daughters to mothers of medium-to-low SES level, but it may reduce vaccination among lower SES groups.

Information Seeking as A Predictor of Risk Behavior: Testing A Behavior and Risk Information Engagement Model (BRIE).

Prior theoretical models of information seeking have examined its role, primarily, as a determinant of recommended behaviors. In this study, we develop and test the "behavior and risk information engagement" (BRIE) model, which accounts for the reciprocal effects of information seeking from interpersonal and media sources on two risk behaviors - nonmedical marijuana and amphetamine use. We test the model among young Israeli adults (N = 800) using a three-wave prospective observational study (at 6-month intervals). Autoregressive cross-lagged structural equation models showed good fit. Information seeking from interpersonal sources at baseline predicted amphetamine use and marijuana use at 6 months. In both models, seeking drug-related information from interpersonal sources at baseline was also a predictor of seeking information from media sources at 6 months. Information seeking from media sources at 6 months was also a significant predictor of amphetamine use at 12 months. Implications for theory and practice are discussed.

The effect of exposure to thin models and digital modification disclaimers on women's body satisfaction.

This study tests the effectiveness of public health initiatives aimed at reducing the adverse effects of exposure to thin images in advertising on women's body satisfaction. Using an online experiment with 195 Israeli adult women, we test the effects of message factors that are expected to influence body satisfaction-the model's body size, and the presence and size of disclaimers. Compared with advertisements featuring a thin model, exposure to an average sized model was indirectly and positively associated with body size satisfaction, through the perception of the model's body size. However, exposure to disclaimers regarding digital modification of the model did not influence body satisfaction. Moreover, irrespective of whether they were exposed to a disclaimer or not, most participants who viewed ads featuring thin models thought that the image had been digitally modified. The results call for further research on the effectiveness of disclaimer labels for promoting body satisfaction.

A Cross-Comparative Survey of Information Seeking and Scanning About Drug-Related Sources and Topics Among U.S. and Israeli College Students.

There is an increasing amount of drug-related information that is easily accessible from media and interpersonal sources. Recent research shows significant positive associations between information acquisition and nonmedical drug use intentions among college students. This study examines information about amphetamines and marijuana that was actively searched ("seeking") as well as information that was encountered during routine media use ("scanning"). Data are drawn from a cross-national comparative survey of college students in the United States (N = 734) and in Israel (N = 800). U.S. participants reported seeking and scanning information about marijuana across a broader range of sources than Israeli participants. Among U.S. and Israeli participants, the most frequently searched marijuana-related topics included the benefits of marijuana, negative effects of marijuana use, and political reasons why marijuana should be legal. Participants from both countries reported the benefits of amphetamines, and the negative effects of amphetamine use as the most frequently searched topics about amphetamines. Participants in both countries identified the internet and friends as the most popular sources of drug-related information and noted that physicians, friends, and the internet were the most trusted sources. Implications for research on information seeking and health communication are discussed.

The Moderated Influence of Perceived Behavioral Control on Intentions Among the General U.S. Population: Implications for Public Communication Campaigns.

This study reports results from a large population-based survey of U.S. adults showing perceived behavioral control (PBC) moderations of associations between (a) attitude and intention and (b) perceived norms and intention to engage in 6 health behaviors. Results are based on data collected from a nationally representative sample of U.S. adults ages 40-70 (N = 2,489) and extend understanding of how behavioral theory can be used to guide the design and evaluation of health communication campaigns. Ordinary least squares regression analyses show evidence of a significant positive PBC moderation of (a) attitude and intention and (b) perceived norms and intention such that attitude or perceived norms toward the behavior is more strongly associated with behavioral intention among participants reporting higher levels of PBC. Implications for message design and the evaluation of communication campaigns are discussed.

Nonmedical information seeking amid conflicting health information: negative and positive effects on prostate cancer screening.

This study investigates the impact of seeking information about the prostate-specific antigen (PSA) test on men's PSA test use during a period of conflicting recommendations. Analyses used longitudinal survey data collected in 2005 and 2006 from a nationally representative sample of U.S. males aged 40-70 years (n = 777). Cross-sectionally, nonmedical information seeking was significantly associated with increased odds of having a PSA test in the past year (Time 1 odds ratio [OR] = 9.74, p < .01, 95% confidence interval [CI] = 4.37, 21.70; Time 2 OR = 5.78, p < .01, 95% CI = 3.17, 10.55). However, lagged analyses showed that among men who had a PSA at Time 1, active seeking is associated with reduced odds of later having a PSA test (OR = 0.33, p < .05, 95% CI = 0.13, 0.85). Participants who had not had a PSA test in the past year very rarely sought information about PSA tests. Information acquisition in an environment of conflicting recommendations may influence adoption of cancer screening behaviors.

Does the number of cancer patients' close social ties affect cancer-related information seeking through communication efficacy? Testing a mediation model.

This study addresses whether having a broad social network of close friends equips cancer patients with increased efficacy to engage in communication about their cancer, which then leads to an increased likelihood of patients actively seeking cancer-related information. Guided by the theory of motivated information management, the study also tests whether the effect of the number of close social ties on information seeking is mediated, in part, by communication efficacy. Results are based on data collected from a randomly drawn sample from the Pennsylvania Cancer Registry of 2,013 cancer patients who completed mail surveys in the Fall of 2006. Results are consistent with a cross-sectional mediation effect in which the number of close social ties in one's social network is positively associated with communication efficacy (b = .17, p = .001), which, in turn, is positively associated with cancer-related information seeking (b = .13, p < .001).

The role of patient-clinician information engagement and information seeking from nonmedical channels in fruit and vegetable intake among cancer patients.

Previous research suggests positive effects of health information seeking on prevention behaviors such as diet, exercise, and fruit and vegetable consumption. The present study builds upon this research and strengthens causal claims from it by examining the lagged effect of patient-clinician information engagement on fruit and vegetable consumption as well as the indirect effect on the outcome through seeking information from nonmedical channels. The results are based on data collected from a randomly drawn sample of breast, prostate, and colorectal cancer patients from the Pennsylvania Cancer Registry who completed mail surveys in the Fall of 2006 and 2007. There was a 65% response rate for baseline subjects (resulting n = 2,013); of those, 1,293 were interviewed 1 year later, and 1,257 were available for our analyses. Results show a positive lagged main effect of patient-clinician information engagement at baseline on fruit and vegetable consumption at follow-up (B = 0.26, SE = 0.10, p = .01). The mediation analysis shows that patient-clinician information engagement leads to increased fruit and vegetable consumption among cancer patients, in part through patients' information seeking from nonmedical channels. Implications of these findings for the cancer patient population and for physicians are discussed.

Information seeking from media and family/friends increases the likelihood of engaging in healthy lifestyle behaviors.

The amount of cancer-related information available to the general population continues to grow; yet, its effects are unclear. This study extends previous cross-sectional research establishing that cancer information seeking across a variety of sources is extensive and positively associated with engaging in health-related behaviors. The authors studied how active information seeking about cancer prevention influenced three healthy lifestyle behaviors using a 2-round nationally representative sample of adults ages 40-70 years (n = 1,795), using propensity scoring to control for potential confounders including baseline behavior. The adjusted odds of dieting at follow-up were 1.51 (95% CI: 1.05, 2.19) times higher for those who reported baseline seeking from media and interpersonal sources relative to nonseekers. Baseline seekers ate 0.59 (95% CI: 0.28, 0.91) more fruits and vegetable servings per day and exercised 0.36 (95% CI: 0.12, 0.60) more days per week at 1-year follow-up compared with nonseekers. The effects of seeking from media and friends/family on eating fruits and vegetables and exercising were independent of seeking from physicians. The authors offer several explanations for why information seeking predicts healthy lifestyle behaviors: information obtained motivates these behaviors; information sought teaches specific techniques; and the act of information seeking may reinforce a psychological commitment to dieting, eating fruits and vegetables, and exercising.

The Effects of Perceived Normative Pressure and Observability of Behavior on Intention to Perform Sun Protection and Nutrition Behaviors on Behalf of Young Children among Parents.

This paper describes research on two normative concepts thought to impact health behaviors: injunctive and descriptive norms. The study tests whether the extent to which the same health behavior is enacted in an observable or non-observable setting will lead to variation in normative influence on parent intention. In on-line experiments conducted in winter 2009, 467 participants were randomized to a behavioral scenario in which the health behavior was described as occurring in an observable or non-observable setting. For sun protection behaviors, observability primed the influence of descriptive norms on intention. For nutrition behaviors, observability primed the influence of injunctive norms on intention. Across both conditions, observability of the behavioral scenario increased the strength of the association between norms and intention.

Looking beyond the Internet: examining socioeconomic inequalities in cancer information seeking among cancer patients.

The gap in cancer information seeking between high-socioeconomic-status (high-SES) cancer patients and low-SES cancer patients deserves serious attention, considering the importance of information and knowledge in cancer control. We thus explored the association of SES, as measured by education, with cancer patients' overall cancer information seeking, and with seeking from each source (i.e., the Internet, mass media, medical sources, and nonmedical interpersonal sources) and across two topic categories (i.e., treatment, quality of life). We then asked whether the effect of education on treatment information seeking is reduced among those who are particularly motivated to control treatment choices. We conducted a survey with breast, prostate, and colon cancer patients diagnosed in 2005 (n = 2,013), who were randomly drawn from the Pennsylvania Cancer Registry in the fall of 2006. We found that education was more strongly associated with Internet use than with the use of other sources regardless of topics. Also, when information was sought from mass media, education had a greater association with treatment information seeking than with quality-of-life information seeking. Preference for active participation in treatment decision making, however, did not moderate the effect of education on treatment information seeking. The implications of these findings for public health research and cancer patient education were discussed.

Seeking cancer-related information from media and family/friends increases fruit and vegetable consumption among cancer patients.

Previous research suggests positive effects of health information seeking on prevention behaviors such as diet, exercise, and fruit and vegetable consumption among the general population. The current study builds upon this research by examining the effect of cancer patients' active information seeking from media and (nonmedical) interpersonal sources on fruit and vegetable consumption. The results of this longitudinal study are based on data collected from a randomly drawn sample from the Pennsylvania Cancer Registry, comprising breast, prostate, and colorectal cancer patients who completed mail surveys in the fall of 2006 and 2007. There was a 65% response rate for baseline subjects (resulting n = 2013); of those, 1,293 were interviewed one year later and 845 were available for final analyses. We used multiple imputation to replace missing data and propensity scoring to adjust for effects of possible confounders. There is a positive effect of information seeking at baseline on fruit and vegetable servings at follow-up; seekers consumed 0.43 (95% CI: 0.28 to 0.58) daily servings more than nonseekers adjusting for baseline consumption and other confounders. Active information seeking from media and interpersonal sources may lead to improved nutrition among the cancer patient population.

Too Much Information? Excessive Media Use, Maladaptive Coping, and Increases in Problematic Cannabis Use during the COVID-19 Pandemic.

During a health crisis like the COVID-19 pandemic, the public depends on the media for accurate and up-to-date information. However, frequent use of media for COVID-19-related information may be associated with maladaptive coping, and with increased prevalence of substance use. This study examined indirect associations between the frequency of media use for information about COVID-19 and increases in cannabis use behaviors through maladaptive coping strategies. We use data from an online survey of Israeli adult cannabis users (N = 440), conducted in May of 2020, to test associations between media use frequency for COVID-19 information and three problematic cannabis use behaviors: increased cannabis use, increased use alone, and increased use before midday. Among all respondents, 41% agreed that their cannabis use had increased since the onset of the pandemic. Analyses showed that higher frequency of media use was positively associated with all three indicators of problematic cannabis use, and that associations were partly mediated by maladaptive coping strategies. Higher frequency of media use for information about COVID-19 may be an indicator of difficulty with coping and of increased risk of escalation of cannabis use. These results have implications for assessing and mitigating the risk of coping-motivated cannabis use during a crisis.

Israeli news media coverage of COVID-19 and use of cannabis and tobacco: A case study of inconsistent risk communication.

BACKGROUND: There is continued scientific debate regarding the link between risk of COVID-19 infection and increased disease severity and tobacco and cannabis use. The way this topic is presented in news media coverage may influence public attitudes and behavior and is thus an important topic of investigation. This study examines (1) the extent to which Israeli news media reported a positive (i.e., protective/therapeutic), negative (i.e., harmful), or inconclusive association between three types of substance use (tobacco, medical cannabis, recreational cannabis) and risk of COVID-19 infection and/or increased disease severity, and (2) the extent that this media coverage refers to scientific research. METHODS: A quantitative content analysis of news articles related to tobacco and cannabis use and COVID-19 (N = 113) from eleven of the highest circulation newspapers in Israel. RESULTS: News items were significantly more likely to mention increased COVID-19 risk for tobacco use, compared to cannabis use. All medical cannabis news items reported that medical cannabis use was associated with reduced COVID-19 risk. In contrast, news items about recreational cannabis use were more likely to describe a balanced or inconclusive risk for COVID-19, or increased risk. The majority of articles referred to scientific research. CONCLUSION: While Israeli news media reported a relatively consistent message about the increased risk of COVID-19 in relation to tobacco use, messages about cannabis use were less consistent in communicating risk information. Research should examine effects of media coverage of tobacco and cannabis use and COVID-19 on public perceptions and behaviors.

Factors Influencing the Adoption of Advanced Cryptographic Techniques for Data Protection of Patient Medical Records.

OBJECTIVES: Healthcare organizations that maintain and process Electronic Medical Records are at risk of cyber-attacks, which can lead to breaches of confidentiality, financial harm, and possible interference with medical care. State-of-the-art methods in cryptography have the potential to offer improved security of medical records; nonetheless, healthcare providers may be reluctant to adopt and implement them. The objectives of this study were to assess current data management and security procedures; to identify attitudes, knowledge, perceived norms, and self-efficacy regarding the adoption of advanced cryptographic techniques; and to offer guidelines that could help policy-makers and data security professionals work together to ensure that patient data are both secure and accessible. METHODS: We conducted 12 in-depth semi-structured interviews with managers and individuals in key cybersecurity positions within Israeli healthcare organizations. The interviews assessed perceptions of the feasibility and benefits of adopting advanced cryptographic techniques for enhancing data security. Qualitative data analysis was performed using thematic network mapping. RESULTS: Key data security personnel did not perceive advanced cybersecurity technologies to be a high priority for funding or adoption within their organizations. We identified three major barriers to the adoption of advanced cryptographic technologies for information security: barriers associated with regulators; barriers associated with healthcare providers; and barriers associated with the vendors that develop cybersecurity systems. CONCLUSIONS: We suggest guidelines that may enhance patient data security within the healthcare system and reduce the risk of future data breaches by facilitating cross-sectoral collaboration within the healthcare ecosystem.