A text message intervention to support latino dementia family caregivers (CuidaTEXT): feasibility study.

OBJECTIVES: To test the feasibility, acceptability, and preliminary efficacy of CuidaTEXT: a bidirectional text message intervention to support Latino dementia family caregivers. METHODS: CuidaTEXT is a six-month, bilingual intervention tailored to caregiver needs (e.g., education, problem-solving, resources). We used convenience sampling and reached 31 potential participants via clinics, registries, community promotion, and online advertising. We enrolled 24 Latino caregivers in a one-arm trial and assessed feasibility, acceptability, and preliminary efficacy within six months. RESULTS: None of the participants unsubscribed from CuidaTEXT and 83.3% completed the follow up survey. Most participants (85.7%) reported reading most text messages thoroughly. All participants reported being very or extremely satisfied with the intervention. Participants reported that CuidaTEXT helped a lot (vs not at all, a little, or somehow) in caring for their care recipient (71.4%; n = 15), for themselves (66.7%; n = 14), and understanding more about dementia (85.7%; n = 18). Compared to baseline, at six months caregiver behavioral symptom distress (0-60) decreased from 19.8 to 12.0 and depression (0-30) from 8.8 to 5.4 (p < .05). CONCLUSIONS: CuidaTEXT demonstrated high levels of feasibility, acceptability, and preliminary efficacy among Latino caregivers. CLINICAL IMPLICATIONS: CuidaTEXT's feasibility and potential for widespread implementation holds promise in supporting Latino caregivers of people with dementia.

Coverage and Framing of Immigration Policy in US Newspapers.

Policy Points Although immigration policy is recognized as a social determinant of health, less is known about how mechanisms, such as news coverage of policy, influence intermediary and proximal health processes like seeking health care. The extent of news coverage of federal, state, and local exclusionary or integration immigration policies can influence public agendas regarding immigrant inclusion and exclusion. Exclusionary federal immigrant policies have dominated the news across the United States over the past ten years, despite active immigrant integration policymaking at national, state, and local levels. CONTEXT: Immigration policymaking at federal, state, and local levels in the United States has proliferated in the past decade. While evidence demonstrates that immigration policy is a determinant of health, there has been limited examination of the mechanisms by which policy influences proximal health processes. News coverage has served as a central platform for debates over restrictive and inclusive immigration policies and may constitute an important health mechanism by shaping public agendas, influencing support for immigrant exclusion or inclusion, and framing policy issues, thereby influencing immigrants' social climates. This study sought to examine the extent of news coverage of exclusionary and inclusive immigration policy at federal and state levels and variations in messages about immigrants during two periods of extensive policymaking. METHODS: We conducted a quantitative content analysis of newspapers' coverage of immigration policy between 2010 and 2013 and between 2017 and 2019. We conducted a systematic NewsBank search of articles covering legislation, lawsuits, and other policies related to immigration (n = 931). Articles were coded for policy type and level, positive or negative framing of immigrants, and other characteristics. Our analysis then compared the patterns of the two periods. RESULTS: In both periods, the majority of coverage focused on exclusionary policies at the federal level, despite a significant increase in integration policies between 2017 and 2019. We found significant shifts in both the negative and positive framing of immigrants, from the dominant negative messages of immigrants as an economic drain to immigrants as criminals and the dominant positive messages of immigrants' economic contributions to immigrants as families. CONCLUSIONS: Since 2010, coverage of exclusionary federal policy has consistently dominated the news, as messages have increasingly described immigrants as either criminals or part of families. We discuss the health implications and future research directions of news coverages' role in influencing the immigration policy and social contexts that have been linked to health outcomes.

Segmented assimilation as a mechanism to explain the dietary acculturation paradox.

Latinos have disproportionately high rates of diet-related diseases which are associated with acculturation to the U.S. This negative shift in dietary quality is paradoxical in light of gains in income and education that would be expected to lead to better diet. We examined the extent to which the dietary acculturation paradox among Mexican Americans can be explained by segmented assimilation, a theory that considers how immigrants' and their descendants' trajectories of integration are influenced by a complex interplay of individual, social, and structural factors. First, we performed confirmatory cluster analysis to identify three assimilation segments (classic, underclass, and selective) based on education, income, and an acculturation proxy derived from language, nativity, and time in the U.S. among Mexican-origin participants (N = 4475) of the 2007-2016 National Health and Nutrition Examination Survey (NHANES). These segments were then used as independent variables in linear regression models to estimate the relationship between cluster and dietary quality (assessed by the Health Eating Index (HEI)) and the interaction between cluster and gender, controlling for marital status. There were strong effects of cluster on dietary quality, consistent with hypotheses per segmented assimilation theory. The classic assimilation segment had the poorest diet, despite having higher income and education than the underclass segment. The selective segment had higher or similar dietary quality to the underclass segment. Consistent with expectations, this difference was driven by the relatively higher consumption of greens and beans and whole grains of those in the selective and underclass segments. Overall, women had better diets than men; however, the strongest gender contrast was in the underclass segment. This study advances understanding of dietary acculturation and potential disparities in diet-related health outcomes.

Toward a Recipe for Deep versus Surface Level Tailoring: Mixed-Methods Validation of Message Features to Reduce Sugary Beverage Consumption.

Targeted marketing contributes to the overconsumption of sugary beverages, which contributes to obesity and diabetes disparities among African American and Latino populations in the U.S. Health communicators can similarly use culturally tailored messages to decrease sugary beverage consumption among these groups, yet the specific strategies to operationalize cultural tailoring-the message components essential for such tailoring-are ill-described. We sought to identify and validate authentically created, culturally tailored messages using a multiple step mixed-methods approach. First, we used a snowball approach to identify nutrition education messages targeting ethnic minorities about reducing sugary beverage consumption (N = 85). Via content analysis, we assessed message features (character gender and race/ethnicity), level of change of the appeal (individual or social), and level of cultural tailoring (surface level tailoring in the form of matching character gender and race/ethnicity with target audience versus deep structural tailoring in the form of appealing to values is an effective message strategy). The highest-rated videos were then validated by a sample of the target audience using a quantitative survey and qualitative comments (N = 76). The results inform theorizing on message tailoring and provide a validated pool of culturally relevant messages intended both to reduce intentions to consume sugary beverages and to engage in social change actions.

Health Information Seeking From an Intelligent Web-Based Symptom Checker: Cross-sectional Questionnaire Study.

BACKGROUND: The ever-growing amount of health information available on the web is increasing the demand for tools providing personalized and actionable health information. Such tools include symptom checkers that provide users with a potential diagnosis after responding to a set of probes about their symptoms. Although the potential for their utility is great, little is known about such tools' actual use and effects. OBJECTIVE: We aimed to understand who uses a web-based artificial intelligence-powered symptom checker and its purposes, how they evaluate the experience of the web-based interview and quality of the information, what they intend to do with the recommendation, and predictors of future use. METHODS: Cross-sectional survey of web-based health information seekers following the completion of a symptom checker visit (N=2437). Measures of comprehensibility, confidence, usefulness, health-related anxiety, empowerment, and intention to use in the future were assessed. ANOVAs and the Wilcoxon rank sum test examined mean outcome differences in racial, ethnic, and sex groups. The relationship between perceptions of the symptom checker and intention to follow recommended actions was assessed using multilevel logistic regression. RESULTS: Buoy users were well-educated (1384/1704, 81.22% college or higher), primarily White (1227/1693, 72.47%), and female (2069/2437, 84.89%). Most had insurance (1449/1630, 88.89%), a regular health care provider (1307/1709, 76.48%), and reported good health (1000/1703, 58.72%). Three types of symptoms-pain (855/2437, 35.08%), gynecological issues (293/2437, 12.02%), and masses or lumps (204/2437, 8.37%)-accounted for almost half (1352/2437, 55.48%) of site visits. Buoy's top three primary recommendations split across less-serious triage categories: primary care physician in 2 weeks (754/2141, 35.22%), self-treatment (452/2141, 21.11%), and primary care in 1 to 2 days (373/2141, 17.42%). Common diagnoses were musculoskeletal (303/2437, 12.43%), gynecological (304/2437, 12.47%) and skin conditions (297/2437, 12.19%), and infectious diseases (300/2437, 12.31%). Users generally reported high confidence in Buoy, found it useful and easy to understand, and said that Buoy made them feel less anxious and more empowered to seek medical help. Users for whom Buoy recommended "Waiting/Watching" or "Self-Treatment" had strongest intentions to comply, whereas those advised to seek primary care had weaker intentions. Compared with White users, Latino and Black users had significantly more confidence in Buoy (P<.05), and the former also found it significantly more useful (P<.05). Latino (odds ratio 1.96, 95% CI 1.22-3.25) and Black (odds ratio 2.37, 95% CI 1.57-3.66) users also had stronger intentions to discuss recommendations with a provider than White users. CONCLUSIONS: Results demonstrate the potential utility of a web-based health information tool to empower people to seek care and reduce health-related anxiety. However, despite encouraging results suggesting the tool may fulfill unmet health information needs among women and Black and Latino adults, analyses of the user base illustrate persistent second-level digital divide effects.

From "Infodemics" to Health Promotion: A Novel Framework for the Role of Social Media in Public Health.

Despite the ubiquity of health-related communications via social media, no consensus has emerged on whether this medium, on balance, jeopardizes or promotes public health. During the COVID-19 pandemic, social media has been described as the source of a toxic "infodemic" or a valuable tool for public health. No conceptual model exists for examining the roles that social media can play with respect to population health.We present a novel framework to guide the investigation and assessment of the effects of social media on public health: the SPHERE (Social media and Public Health Epidemic and REsponse) continuum. This model illustrates the functions of social media across the epidemic-response continuum, ranging across contagion, vector, surveillance, inoculant, disease control, and treatment.We also describe attributes of the communications, diseases and pathogens, and hosts that influence whether certain functions dominate over others. Finally, we describe a comprehensive set of outcomes relevant to the evaluation of the effects of social media on the public's health.

Public Awareness of Air Pollution and Health Threats: Challenges and Opportunities for Communication Strategies To Improve Environmental Health Literacy.

Accurate, timely information can be a powerful tool to mitigate harmful effects of air pollution. While national guidelines for environmental risk communication - based on risk and crisis communication principles - exist, little is known how these are operationalized, nor about the effectiveness of existing communication efforts. Moreover, a growing literature on environmental health literacy suggests that communication about environmental risks must move beyond individual behavior education to empower communities to mobilize to reduce environmental threats. This study aimed to identify and critically evaluate public sources of information about the causes and controllability of air pollution and its health effects, and potential disparities in information reach and utility. The case study triangulated data from three sources: Systematic analysis of the public information environment, interviews with regional expert stakeholders, and interviews with community residents. Three themes emerged: 1) Lack of clarity about responsibility for communicating about air quality (information sources), 2) Existing air quality communication strategies lack critical information including risk mitigation behaviors and long-term health impacts (information quality), and 3) Existing air quality communications fail to reach vulnerable populations (information reach). This study demonstrates that air quality communication is lacking yet crucially needed. Information about air pollution and health risks focuses on individual risk behaviors but is disseminated using channels that are unlikely to reach the most vulnerable populations. We discuss opportunities to improve the reach and impact of communication of air quality health risks, an increasingly important global priority, situating our argument within a critical environmental health literacy perspective.

Development of a Participatory Health Communication Intervention: An Ecological Approach to Reducing Rural Information Inequality and Health Disparities.

A strong and diverse communication infrastructure is essential for communication to improve health. When that infrastructure is weak, health information fails to reach appropriate audiences; this is a component of information inequality that contributes to health disparities. Approaches to addressing information inequality have either focused on individual-level barriers or exclusively on changing the information environment. Largely missing from information inequality interventions is a multilevel, ecological approach consistent with the ways in which information inequality affects health. This study addresses that gap by describing a participatory intervention in a rural, majority-Latino community. Previous work identified a weak information infrastructure as a major barrier to health: Residents struggled to find timely, relevant information, while stakeholders faced challenges knowing how to reach diverse audiences with critical health-related information. We employed participatory health communication asset mapping to identify health communication resources - safe, trusted spaces, and places - that served three distinct communication functions: informational (i.e., where health information can be provided), conversational (i.e., where residents feel comfortable discussing health issues), and connection (i.e., where a relationship exists). Through a six-step process, community leaders and residents identified communication resources and collaborated to create a communication resource map. We discuss how this study advances the theoretical understanding of integration of culture-centered and ecological approaches for communication to reduce health disparities.

Acculturation level and caregiver outcomes from a randomized intervention trial to enhance caregivers' health: evidence from REACH II.

OBJECTIVE: Latinos comprise a growing segment of the caregiver population and vary widely in acculturation, yet little is known regarding how acculturation might affect caregiver stress or intervention outcomes. This study examined the relationship between acculturation and burden, bother, and depression in Latino dementia caregivers at baseline and following an intervention. METHODS: This was a secondary data analysis of 211 Latino caregivers of older adults with dementia from Resources for Enhancing Alzheimer's Caregiver Health (REACH) II, a multisite randomized trial of caregiver interventions. Baseline and follow-up data were used to run mixed-effects models examining the main and moderating effect of acculturation on caregiver stress. RESULTS: No significant main effect of acculturation was found for any of the outcome measures, controlling for demographic covariates. Acculturation moderated the effect of the intervention on caregiver burden: those who were more acculturated benefited more from the intervention. CONCLUSION: Differential acculturation for Latino caregivers was not directly associated with caregiver burden, bother, or depression, but was associated with reducing burden from the intervention. Future research should explore by what mechanism acculturation influences caregiver burden following an intervention.

Understanding Spanish-Language Response in a National Health Communication Survey: Implications for Health Communication Research.

Spanish-speaking Latinos account for 13% of the U.S. population yet are chronically under-represented in national surveys; additionally, the response quality suffers from low literacy rates and translation challenges. These are the same issues that health communicators face when understanding how best to communicate important health information to Latinos. The Health Information National Trends Survey (HINTS) offers a unique opportunity to understand the health communication landscape and information needs of the U.S. POPULATION: We describe the challenges in recruiting Spanish-speaking HINTS respondents and strategies used to improve rates and quality of responses among Spanish-speaking Latinos. Cognitive interviewing techniques helped to better understand how Spanish-speaking Latinos were interpreting the survey questions, and the extent to which these interpretations matched English-speaking respondents' interpretations. Some Spanish-speaking respondents had difficulty with the questions because of a lack of access to health care. Additionally, Spanish-speaking respondents had a particularly hard time answering questions that were presented in a grid format. We describe the cognitive interview process, and consider the impact of format changes on Spanish-speaking people's responses and response quality. We discuss challenges that remain in understanding health information needs of non-English-speakers.

Cultural and Linguistic Adaptation of a Healthy Diet Text Message Intervention for Hispanic Adults Living in the United States.

Hispanics represent a critical target for culturally adapted diet interventions. In this formative research, we translated HealthyYouTXT, an mHealth program developed by the U.S. National Cancer Institute, into HealthyYouTXT en Español, a linguistically and culturally appropriate version for Spanish speakers in the United States. We report a three-stage, mixed-methods process through which we culturally adapted the text messages, evaluated their acceptability, and revised the program based on the findings. In Stage 1, we conducted initial translations and adaptations of the text libraries using an iterative, principle-guided process. In Stage 2, we used mixed methods including focus groups and surveys with 109 Hispanic adults to evaluate the acceptability and cultural appropriateness of the program. We used survey data to evaluate whether self-determination theory (SDT) factors (used to develop HealthyYouTXT) of autonomous motivation, controlled motivation, and amotivation and Hispanic cultural beliefs about familism, fatalism, and destiny predict program interest and its perceived efficacy. Mixed-methods analyses revealed substantial interest in HealthyYouTXT, with most participants desiring to use it and viewing it as highly efficacious. Both cultural beliefs (i.e., beliefs in destiny and, for men, high familism) and SDT motivations (i.e., autonomy) predicted HealthyYouTXT evaluations, suggesting utility in emphasizing them in messages. Higher destiny beliefs predicted lower interest, suggesting that they could impede program use. In Stage 3, we implemented the mixed-methods findings to finalize HealthyYouTXT en Español. The emergent linguistic principles and multistage, multimethods process can be applied in health communication adaptations.

Mapping the Health Information Landscape in a Rural, Culturally Diverse Region: Implications for Interventions to Reduce Information Inequality.

The media is an important source of health information, especially critical in rural communities with geographically-dispersed populations that are harder to reach through other channels. Yet health information is unequally distributed; these information disparities are compounded in rural areas, which may contribute to health disparities. We identify and describe health-related news in a culturally-diverse rural California county characterized by high levels of poverty, unemployment, low educational attainment, and over half of Mexican-origin. We conducted a census of all available print news sources and then used content analysis to identify and characterize all health information printed in a 6-month study period. A total of 570 health-related articles were published. Five newspapers accounted for more than 80% of published health-related articles (n = 466); only one targeted the majority Latino population. The most common topic was access to health care/insurance/policy (33%), followed by diet/nutrition (13%), infectious disease (10%), and general prevention (9%). Just over one-quarter of health-related articles included useful information. Differences across newspaper types existed: independent newspapers reported more on health-related events compared with chain newspapers, and both ethnic-targeted newspapers and independently-published papers were more likely to include useful information compared with chain newspapers. While this region suffers from high rates of obesity and diabetes, there were relatively few articles on obesity and diabetes themselves, or linking behavioral risk factors with these conditions. One area we found absent from coverage pertained to the numerous environmental health threats prevalent in this heavily polluted, agricultural area (just 40 articles discussed environmental health threats). We also discovered that coverage of social determinants of health was lacking (just 24 of the 570 health articles), which was notable in a region that suffers extreme economic, educational, and health disparities. This analysis of a rural region's local news coverage of health issues demonstrates significant opportunity to engage with rural local media, particularly ethnic media, to disseminate health information. Such a strategy holds considerable promise to advance public health goals using a multilevel approach: From an individual perspective, improving the amount and utility of the information can inform and educate publics in areas with otherwise low levels of health information access. From a policy perspective, improving coverage of the social determinants of health could shape public opinion to support policies that improve health.

Community Perspectives on Access to and Availability of Healthy Food in Rural, Low-Resource, Latino Communities.

INTRODUCTION: Attention has focused on the food environment as a result of the growing concern with obesity rates among Latinos in rural areas. Researchers have observed associations between a lack of physical access to affordable produce in areas where supermarkets and grocery stores are limited and poor dietary intake and obesity; these associations are high in rural, low-resource neighborhoods with a high population of Latino residents. We aimed to engage residents of low-resource, Latino-majority neighborhoods in discussions of food access in a rural yet agricultural community setting, which is typically described as a "food desert." METHODS: We used a mixed-methods approach and conducted 3 focus groups (n = 20) and in-depth interviews (n = 59) and surveys (n = 79) with residents of a rural yet agricultural community. We used thematic analysis to explore residents' perceptions of access to healthy foods. RESULTS: Residents (n = 79; mean age, 41.6 y; 72% female; 79% Latino; 53% Spanish-speaking) reported that dollar and discount stores in this agricultural area provided access to produce; however, produce at retail stores was less affordable than produce at nonretail outlets such as fruit and vegetable stands. Gifts and trades of fruits and vegetables from neighbors and community organizations supplied no-cost or low-cost healthy foods. Residents' suggestions to improve food access centered on lowering the cost of produce in existing retail outlets and seeking out nonretail outlets. CONCLUSION: Our findings contribute to understanding of the food environment in low-resource, rural yet agricultural areas. Although such areas are characterized as "food deserts," residents identified nonretail outlets as a viable source of affordable produce, while indicating that the cost of retail produce was a concern. Innovative policy solutions to increase healthy food consumption must focus on affordability as well as accessibility, and consider alternate, nonretail food outlets in agricultural areas.

Program evaluation of remote heart failure monitoring: healthcare utilization analysis in a rural regional medical center.

BACKGROUND: Remote monitoring for heart failure (HF) has had mixed and heterogeneous effects across studies, necessitating further evaluation of remote monitoring systems within specific healthcare systems and their patient populations. "Care Beyond Walls and Wires," a wireless remote monitoring program to facilitate patient and care team co-management of HF patients, served by a rural regional medical center, provided the opportunity to evaluate the effects of this program on healthcare utilization. MATERIALS AND METHODS: Fifty HF patients admitted to Flagstaff Medical Center (Flagstaff, AZ) participated in the project. Many of these patients lived in underserved and rural communities, including Native American reservations. Enrolled patients received mobile, broadband-enabled remote monitoring devices. A matched cohort was identified for comparison. RESULTS: HF patients enrolled in this program showed substantial and statistically significant reductions in healthcare utilization during the 6 months following enrollment, and these reductions were significantly greater compared with those who declined to participate but not when compared with a matched cohort. CONCLUSIONS: The findings from this project indicate that a remote HF monitoring program can be successfully implemented in a rural, underserved area. Reductions in healthcare utilization were observed among program participants, but reductions were also observed among a matched cohort, illustrating the need for rigorous assessment of the effects of HF remote monitoring programs in healthcare systems.

Seeking Information on Behalf of Others: An Analysis of Calls to a Spanish-Language Radio Health Program.

OBJECTIVE: Spanish-monolingual Latinos account for 13% of U.S. residents and experience multiple barriers to effective health communication. Information intermediaries/proxies mediate between the linguistically isolated and health care providers. This study characterizes the information needs of surrogate callers and their subjects to a U.S.-based Spanish-language radio health program. METHOD: Content analysis of calls placed (N = 281 calls). RESULTS: Women made 70% of calls; 39.1% of calls were on behalf of children, 11.0% on behalf of parents/older adults, and 18.5% on behalf of spouses/siblings/contemporary adults. Most common topics were disease symptoms/conditions (19.6%), cancer (13.9%), and reproduction/sexuality (12.9%). Calls for children were more likely than those for parents/other adults to pertain to current illness symptoms or conditions; calls for parents were more likely to be about cancer/chronic conditions. Half of all calls sought clarification about a previous medical encounter. CONCLUSION: Information-seeking surrogates may represent a useful strategy for linguistic minorities to overcome structural and individual barriers to health information access. Results suggest that Latinos are willing to seek information on behalf of friends and family and highlight the need for improved, culturally and linguistically appropriate health communication sources. PRACTICE IMPLICATIONS: Leveraging Latinos' natural familial social networks/willingness to share information may improve dissemination of culturally and linguistically appropriate health information. Further implications for patient activation and doctor-patient communication are discussed.

Fatalism and cancer risk knowledge among a sample of highly acculturated Latinas.

Fatalistic beliefs about cancer are associated with decreased likelihood of knowing about cancer risk factors and engaging in cancer prevention and screening behaviors. Research suggests that Latinas are especially likely to hold fatalistic beliefs. However, this research has been in less-acculturated, high-poverty convenience samples. This study examined cancer knowledge, cancer fatalism, and the association between fatalism and knowledge in a national sample of highly acculturated, middle-income Latinas (N = 715). Results indicate that cancer fatalism is pervasive, and knowledge about cancer risk factors is lacking among this population. Fatalistic beliefs are paradoxically associated with cancer knowledge. Opportunities for tailored communications to improve health behaviors and additional research to understand causes/effects of these findings are discussed in the context of a growing body of research about how to communicate health information to more-acculturated Latinos.

Examining the Role and Strategies of Advocacy Coalitions in California's Statewide Sugar-Sweetened Beverage Tax Debate (2001-2018).

PURPOSE: California's failed attempts to enact a statewide sugary beverage tax presents an opportunity to advance understanding of advocacy coalition behavior. We investigate the participation of advocacy coalitions in California's statewide sugar-sweetened beverage (SSB) tax policy debate. DESIGN: Document analysis of legislative bills and newspaper articles collected in 2019. SETTING: California. METHOD: A total of 11 SSB tax-related bills were introduced in California's legislature between 2001-2018 according to the state's legislative website. Data sources include legislative bill documents (n = 94) and newspaper articles (n = 138). Guided by the Advocacy Coalition Framework (ACF), we identify advocacy coalitions involved in California's SSB tax debate and explore strategies and arguments used to advance each coalitions' position. RESULTS: Two coalitions (public health, food/beverage industry) were involved in California's statewide SSB tax policy debate. The public health coalition had higher member participation and referred to scientific research evidence while the industry coalition used preemption and financial resources as primary advocacy strategies. The public health coalition frequently presented messaging on the health consequences and financial benefits of SSB taxes. The industry coalition responded by focusing on the potential negative economic impact of a tax. CONCLUSION: Multiple attempts to enact a statewide SSB tax in California have failed. Our findings add insight into the challenges of enacting an SSB tax considering industry interference. Results can inform future efforts to pass evidence-based nutrition policies.

Effects of ethnic targeting on the perceived effectiveness of cancer prevention messages among latinas and non-latina white women.

In general, efforts to target Latinos are made through Spanish-language messages, yet 75% of U.S. Latinos are bilingual or English dominant. Acculturation (adapting mainstream traits) is associated with increased lifestyle-related risk behaviors. Latinos maintain cultural traits and ethnic identification even as they appear to acculturate (e.g., through language). This raises questions about how to communicate health information to more-acculturated Latinos who are not reached by traditional Spanish outreach yet may not identify with general-market messages. This study tested the relative efficacy of English-language messages targeted to Latinas, compared with general-market messages, among highly acculturated Latina women and non-Latina White women. In this pair of online experiments, Latinas (n = 715) and non-Latina White women (n = 704) rated the perceived effectiveness of general-market versus Latina-targeted Pap smear and mammogram public service announcements. In 1 of 2 experiments ethnically targeted messages were rated relatively more effective for the intended audience and equally effective for the general audience. The author discusses implications for how campaigns reach U.S. Latinos across the acculturation spectrum.

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.