Disease Awareness and Prescription Drug Communications on Television: Evidence for Conflation and Misleading Product Impressions.

We conducted two experiments that tested for conflation of fictitious disease awareness and prescription drug promotional communications in a television advertising context and whether similarity, proximity, and number of exposures to the disease awareness communication contributed to this conflation. Study 1 involved a 1-h television segment, and Study 2 used a longitudinal design with participants exposed to communications over time. The promoted product was indicated to treat asthma. Participants (Study 1, n = 2190; Study 2, n = 1621) were adults who had experienced asthma or asthma symptoms. In Study 1, mere exposure to disease awareness communication prompted benefit and risk conflation, but the degree of similarity or proximity did not have an effect. In Study 2, similar ads prompted greater conflation of benefits than distinct ads, and greater conflation of risks occurred with greater proximity to disease awareness and promotional communications. In addition, asthma knowledge, health literacy, and perceived ad effectiveness increased conflation of benefits in both studies but tended not to modify the impact of similarity or proximity. The findings demonstrate the potential for disease awareness communications to confuse consumers regarding the benefits and risks of a drug.

Low-Income Caregivers' Attitudes and Behaviors on Children's Diets: Emergent Themes on Cultural Influences and Perceived Value of Nutrition Information from Healthcare Providers.

INTRODUCTION: Limited access to affordable, healthy food and identifying as African-American or Hispanic-American are associated with greater risk of childhood obesity, especially for low-income individuals. PURPOSE: To report on (1) the emergent theme of the influence of culture on primary caregivers' behaviors and motivations when preparing meals for their families; and (2) primary caregivers' perceptions of the nutritional information they receive from health care providers. METHODS: Twelve focus groups with low-income, adult primary caregivers of children ages 3 to 6 years were conducted in Texas and the DC-Maryland-Virginia region and were segmented by race/ethnicity and access to grocery stores. RESULTS: Culture emerged as an important theme in influencing which foods participants cook at home. In some cases, that influence spilled over into the child's diet. In other instances, the food that participants reported making for their children varied from the food they make for themselves. Participants reported having high trust in health care providers, but acknowledged that health care providers' nutritional advice might not always be applicable. DISCUSSION AND CONCLUSIONS: Our findings highlight the importance of considering the role culture might play in influencing and informing caregivers' decisions regarding children's diets, and also better understanding caregivers' perceptions of health care providers as a source of nutrition information for their children.

Women's Experience and Understanding of Food Cravings in Pregnancy: A Qualitative Study in Women Receiving Prenatal Care at the University of North Carolina-Chapel Hill.

BACKGROUND: Although the occurrence of food cravings during pregnancy is well established, there is a paucity of qualitative data on pregnant women's perceptions of and responses to food cravings. This study sought to assess and describe pregnant women's experiences and behaviors pertaining to food cravings. METHODS: Eight focus groups were conducted with 68 pregnant women in their second trimester from March 2015 to October 2016. Using a semistructured approach, the facilitator asked women open-ended questions regarding their experience of eating behaviors and food cravings. The content from the focus groups was analyzed using a bottom-up approach based on grounded theory and constant comparison analysis. RESULTS: Participants described cravings as urgent, food-specific, and cognitively demanding occurrences that were differentiated from hunger. They described beliefs surrounding the physiological causes of cravings and rationales for satisfying their cravings. Strategies used to manage cravings included environmental modifications to limit proximity and availability of craved foods, cognitive and behavioral strategies like distraction, and acceptance through satisfying the craving. Participants described food cravings as a psychologically salient aspect of their pregnancy, reporting a variety of emotional precursors and reactions surrounding their cravings. CONCLUSIONS: A better understanding of food cravings may assist with the development of interventions to improve eating behaviors and reduce eating-related distress during pregnancy. Acceptance regarding food cravings was indicated as a way to diffuse pregnancy-related stress. These findings contribute to our understanding of psychological influences on eating behaviors in pregnant women.

Evaluating the potential roles of body dissatisfaction in exercise avoidance.

Body dissatisfaction is linked to poor physical health, even after actual markers of health have been controlled for. This link is likely due to body dissatisfaction influencing health behaviors-more specifically, cardiovascular exercise. Modifiable reasons for this link have yet to be determined. We conducted a prospective study to evaluate whether active avoidance of exercise may explain the association of body dissatisfaction with exercise, and, if so, whether perceived barriers to exercise account for the association of body dissatisfaction and exercise avoidance. Baseline measures were collected via survey; physical activity was measured over time, via self-report. As expected, avoidance mediated the prospective relationship between dissatisfaction and exercise. Additionally, the relationship between body dissatisfaction and avoidance was mediated by embarrassment and fatigue. Interventions that boost body satisfaction and/or address perceptions of fatigue and embarrassment may be needed for individuals with body dissatisfaction to be more likely to participate in exercise-related programs.

Lack of prospective relationships of the Power of Food Scale with Body Mass Index and dieting over 2 years in U.S. emerging adults.

BACKGROUND: This study investigated prospective relationships of the Power of Food Scale (PFS), a self-report measure of hedonic hunger, with weight outcomes and dieting in U.S. young adults. METHODS: PFS (PFS-aggregate and subscales: PFS-available, PFS-present, PFS-tasted) was assessed in waves (W, years) 5 and 6 of a nationally representative cohort of 10th graders assessed annually (baseline n = 2785, 83% retention at W7). Internal consistency (Cronbach's α), 1-year stability (intraclass correlation coefficient, ICC) and confirmatory factor analysis (CFA) were examined. Analyses accounting for the complex survey design examined cross-sectional associations of W6 PFS with W6 BMI and dieting, and prospective relationships of PFS in each wave with BMI, 1-year BMI change (BMIΔ, W6-W5 and W7-W6), overweight/obesity onset (OWOB, moving to a higher risk weight category) and dieting in the following wave. Multiple imputations addressed missing data. RESULTS: Baseline participant mean ±â€¯SE age was 20.3 ±â€¯0.02 years. Mean BMI increased by approximately 0.6 kg/m2 from W5 through W7; OWOB occurred in 7.4% of participants between W5-W6; 9.0% between W6-W7. Approximately half the sample reported dieting in each wave. W6 weight outcomes were not associated with W6 PFS, but W6 dieting frequency was positively associated with W6 PFS-available, PFS-present, and PFS-aggregate (but not PFS-tasted) in multivariable models. PFS was not prospectively associated with weight outcomes. Positive prospective associations of PFS with dieting frequency were inconsistent across waves and with respect to inclusion of covariates. CONCLUSIONS: Greater PFS is associated with dieting cross-sectionally but was not a reliable indicator of susceptibility to future weight outcomes or dieting in young adults.

Disordered Eating Behaviors Are Not Increased by an Intervention to Improve Diet Quality but Are Associated With Poorer Glycemic Control Among Youth With Type 1 Diabetes.

OBJECTIVE: This study examines whether participation in an 18-month behavioral intervention shown previously to improve overall diet quality inadvertently increases disordered eating behaviors (DEBs) in youth with type 1 diabetes and investigates the association of DEB with multiple measures of glycemic control and variability. RESEARCH DESIGN AND METHODS: Participants reported DEB and diabetes management at baseline and 6, 12, and 18 months; masked continuous glucose monitoring, HbA1c, and 1,5-anhydroglucitol (1,5-AG) were obtained concurrently. Linear mixed models estimated the intervention effect on DEB, the association of DEB with diabetes adherence and measures of glycemic control and variability, and whether DEB modified glycemic trajectories. RESULTS: There was no intervention effect on DEB (P = 0.84). DEB was associated with higher HbA1c (P = 0.001), mean sensor glucose (P = 0.001), and percent sensor glucose values >180 mg/dL (P = <0.001); with lower 1,5-AG (P = 0.01); and with worse diabetes adherence (P = 0.03). DEB was not associated with percent sensor glucose values <70 mg/dL or any measures of glycemic variability. There was a significant DEB × time interaction effect for mean sensor glucose (P = 0.05) and percent sensor glucose values >180 mg/dL (P = 0.04). Participants reporting less DEB had a developmentally expected deterioration in glycemic control throughout the study. Participants reporting more DEB had poor glycemic control at baseline that remained poor throughout the study. CONCLUSIONS: Findings show a potential to improve diet quality without increasing DEB and indicate an association of DEB with persistent hyperglycemia but not hypoglycemia or glycemic variability.