Television News Media Consumption and Misperceptions about COVID-19 among US Populations at High Risk for Severe Health Outcomes Early in the Pandemic.

Research indicates that misperceptions that become part of people's initial mental models about an issue tend to persist and influence their attitudes even after the misperception has been corrected. Recent work on evolving mental models suggests that communication efforts about the ongoing COVID-19 pandemic and its aftermath may be improved by crafting messages that acknowledge biases and misunderstandings about the virus and other infectious diseases that may remain among members of the target audience. This study was designed to provide insight into such biases by: (1) establishing salient categories of COVID-related misperceptions in the earliest months of the pandemic in the United States among (a) the general population, and (b) demographic sub-populations at high risk of severe health outcomes; (2) identifying demographic predictors of misperceptions; and (3) examining the relationship between consumption of different television news outlets and agreement with misperceptions about COVID-19. A national sample of 1,000 adults in the United States (48.1% male; M age = 47.32, SD = 18.01; 72.9% White/Caucasian, 14.3% Black/African American, 15.9% Hispanic/Latinx) completed a survey between March 19 and March 25, 2020. Results identify prevalent classes of salient early COVID-19 misperceptions. Adjusting for numerous covariates, data indicated individuals over the age of 60 held the fewest COVID-related misperceptions among various demographic sub-populations, misperceptions were most prevalent among Black respondents, and increased consumption of television network news was associated with lower levels of misperception. Consumption of some 24-hour news networks (FOX and MSNBC) were significant positive correlates of misperceptions.

Evaluating the Feasibility of Continuing Medical Education for Disseminating Emerging Science on the Breast Cancer and Environment Connection.

Developing continuing medical education (CME) training programs is a strategy for communicating emerging science to health practitioners. This research tests the feasibility of using CME modules for translating and disseminating research findings from the Breast Cancer and Environment Research Program. Recent findings have identified certain windows of susceptibility, like during puberty, in which exposure to endocrine-disrupting chemicals can increase breast cancer risk later in life. In order to reach pediatric patients and their caregivers, using a Diffusion of Innovations framework, pediatric health-care providers were identified as opinion leaders. Two CME modules informed by theory and formative research were tested with a sample of pediatricians and pediatric nurse practitioners. Participants completed knowledge, attitude, intention, and behavior items immediately before and after exposure to a randomly assigned module, and then again 3 weeks later. Quantitative and qualitative results indicate knowledge gain and strong links between practitioners' intentions to enact and implemented behavior learned from training recommendations with parents and caregivers in their practices. Results indicate that CMEs can be an effective strategy for translational activities targeted to health providers in order to change behavior within practice.

The influence of organizational culture, climate and commitment on speaking up about medical errors.

AIM: Speaking up about medical errors is an essential behaviour for nurses in pursuit of their goal of maintaining patient safety. This study was designed to understand how a hospital's culture and climate can impact a nurse's active behaviour in this important health care activity. BACKGROUND: Research shows that while medical errors happen frequently, there is great variability on whether these errors are reported. As such, organizational culture, climate and commitment as well as employee perceptions associated with the reporting process were investigated to determine their impact on participants' intentions to speak up about medical errors. METHODS: Focus groups and one-on-one interviews were used to collect these data and were analysed using content analysis. RESULTS/KEY ISSUES: Nurses in the hospital perceive and understand both the benefits and barriers to reporting medical errors. Commonly reported benefits include patient safety, promoting education and awareness, and the improvement of internal processes or systems. Barriers include an inefficient reporting system and organizational influences such as perceived consequences and unequal status/position of the individual who made the error and the person reporting the error. Participants are aware that the organization believes that the responsibility to report medical errors falls to everyone. CONCLUSIONS: Results indicate that the organization's existing culture does not facilitate the reporting of medical errors and that the organizational climate interferes with the reporting process. Lastly, organizational commitment is not related to the perception of importance given to the reporting of medical errors by the hospital. IMPLICATIONS FOR NURSING MANAGEMENT: Nurses and nurse managers are an essential part of any hospital. In their role, they can effect change on the organization's culture and climate, but often do not realize the connection between organizational culture and patient safety. Results indicate that promoting organizational commitment to speaking up through the creation of a positive organizational culture can both promote speaking up about medical errors and increase patient safety.

Formative research identifying message strategies for a campus bicycle safety campaign using self-determination theory and the social norms approach.

This formative study investigates the utility of the social norms approach (SNA) and self-determination theory (SDT) in framing safe bicycling messages with the goal of increasing intention to use bicycle lanes on a university campus. In Study 1, observational data showed that the majority of campus bicyclists did not use designated bike lanes while cycling; thus, intention to use bicycle lanes was chosen as the dependent variable for Study 2. Survey data (n = 168) collected from college students measured SNA and SDT constructs related to intention to use bicycle lanes, including descriptive norms, injunctive norms, autonomy, competence, and relatedness. Results indicate that different aspects of both the SNA and SDT are viable approaches for developing bicycle safety campaign messages, as competence, relatedness, and injunctive norms were significant predictors of intention to use bicycle lanes. Implications for the development of campaign messages are discussed, and information is presented to assist other groups so they can use the same process to develop relevant campaign messages.

The Effect of Electronic Health Record Use and Patient-Centered Communication on Cancer Screening Behavior: An Analysis of the Health Information National Trends Survey.

The present study used the 2013 Health Information National Trends Survey (N = 3185) to examine the effects of patient-centered communication (PCC) and the use of electronic health records (EHRs) on the likelihood of patients receiving a recommended screening for cancer (i.e., mammogram, PSA test). Self-determination theory, a framework of self-initiated extrinsic behaviors, was applied to test mediation models of PCC and EHR use, respectively, through patient activation. The results demonstrated that PCC and EHR use predicted cancer screening (mediated through patient activation), but only for women recommended for biannual mammograms. The aforementioned relationship was not found for men who are recommended for prostate cancer screening. PCC and EHRs do appear to facilitate a patient's ability to take care of their own health, but only under certain circumstances. It was additionally found that men were more likely to report higher degrees of physician PCC when their physicians maintained an EHR, whereas women reported no difference. Future research should examine more nuanced personality factors that affect the perception of PCC in the presence of EHRs and the relationship between men's activation and likelihood of receiving a cancer screen.

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.

The Uncertainty Reducing Capabilities of Primary Care Physicians' Video Biographies for Choosing a New Doctor: Is a Video Worth More Than Two Hundred Words?

Choosing a primary care physician for the first time is an important decision, one that health care systems do not make particularly easy for prospective patients to make solely through the limited information provided on their websites. Without knowledge from others, a new patient is likely to have uncertainty about the physician he or she chooses. Three hundred and twenty participants completed an online experiment and were exposed to two biographies of different doctors with different media and either professional or personal information. Predictions generated by media richness theory revealed greater reductions in uncertainty for video biographies than traditional text biographies. Video biographies, and those containing personal information about the physician, were also related to higher levels of anticipated patient satisfaction and care quality. When asked to choose the physicians they would want to visit, participants overwhelmingly chose the physician with whom they perceived the greatest similarity to themselves, as well as the doctor who provided a video biography. Both theoretical and practical implications of this research are discussed.

Career Paths of Recipients of a Master's Degree in Health Communication: Understanding Employment Opportunities, Responsibilities, and Choices.

A growing number of institutions offer a master's degree in health communication to prepare individuals for applied work in the field, but there is very little literature on the career paths graduates pursue. The current study reports the results of a national survey that targeted the alumni of five institutions that offer the degree. Of the 522 total graduates to whom the survey was sent, 398 responded (76.2% response rate). Results show that the degree recipients have found employment in a wide variety of organizations across the country, including jobs within very prestigious organizations, such as the National Cancer Institute. Common job titles include manager, coordinator, communication associate/specialist, and program/project director. The most common job responsibilities include research activities, the development of health communication materials, project/program management, communication management, and social media/website management. The results also include stories of graduates across programs that illustrate details of career paths. The discussion of the findings addresses implications for career preparation, curriculum development, and advising.

Uncertainty and information-seeking patterns: A test of competing hypotheses in the context of health care reform.

This article integrates three uncertainty frameworks (i.e., uncertainty reduction, motivation to reduce uncertainty, predicted outcome value) to examine the relationship between uncertainty and information seeking in the context of health care reform. The study consisted of a pretest to assess model variables, tracking of online information seeking (by monitoring website use), and a posttest. Results indicate predicted outcome value theory is the best predictor of information seeking, which is subsequently associated with greater certainty and information recall. The data suggest uncertainty alone is not enough to motivate information seeking; individuals must perceive information to have appreciable value in order to spend time seeking it. Theoretical and practical applications, as well as avenues for future research, are presented.

Verbal Social Support for Newly Diagnosed Breast Cancer Patients during Surgical Decision-Making Visits.

This study reports an analysis of verbal social support strategies directed by surgeons and patients' companions to breast cancer patients using the social support behavior code (SSBC). Additionally, the influence of companions on the provision of social support is examined. Forty-six videotapes of appointments where treatment regimens were being decided were analyzed. Results demonstrated that the majority of units spoken by surgeons were coded as verbal social support, primarily in the form of informational social support. Companions' social support was lower (relative to surgeons) in nearly every category of social support assessed. Patients who brought companions were found to receive more network social support from surgeons. Overall, these results point to low emotional support from surgeons and companions for patients during these appointments, which indicates a need for modifications in empathy training for medical providers.

Reducing Communication Apprehension for New Patients Through Information Found Within Physicians' Biographies.

This study investigated whether state communication apprehension (CA) with physicians, for high CA patients, can be reduced before consultations by manipulating information found within physicians' online biographies. Participants were presented with three experimentally manipulated physician biographies and asked to choose which physician they would want to visit to get a hypothetical ailment checked out. Guided by uncertainty reduction theory, results support a path model where increases in perceived similarities between a patient and doctor led to greater uncertainty reduction, greater liking, and subsequent reductions in CA with the physician for high CA participants. In addition, the majority of participants decided to visit the physician with whom they perceived the greatest similarity. The importance of reducing CA in the medical context is discussed, as well as theoretical implications for communication researchers. The results also provide practical guidance for health care systems to help improve their current physician biographical offerings available to prospective patients.

Results from a national survey of health communication master's degree recipients: an exploration of training, placement, satisfaction, and success.

The field of health communication has seen substantial growth in recent years, but existing health communication research literature contains little information on individuals who practice health communication in applied settings. This study reports the results of a national survey that targeted the alumni of 5 institutions that offer a master's degree in health communication. Of the 522 total graduates to whom the survey was sent, 398 responded. Survey results provided information in a number of areas including undergraduate education background; criteria used to determine what type of master's degree in health communication to pursue; strategies used to gain employment; employment sector of first job after graduation; salaries received after completion of a master's degree in health communication; satisfaction with career choice after completion of master's degree; satisfaction with type of master's degree in health communication received; satisfaction with career choice after completion of master's degree; and the degree to which respondents felt their master's program in health communication prepared them to meet core competencies in the field. These findings have significant implications for the health communication field and the programs that prepare individuals for a career as a health communication practitioner.

Testing the Effects of the Addition of Videos to a Website Promoting Environmental Breast Cancer Risk Reduction Practices: Are Videos Worth It?

Searching for ways to reach wider audiences in more comprehensible ways, health promotion agencies might add videos to their current web offerings. While potentially costly and time consuming to create, the effect of these videos on websites has not received much attention. This study translated research about the potential breast cancer risk for young girls associated with the household chemical PFOA into two websites mothers with young daughters were randomly assigned to view (website with videos vs. website without videos). Results revealed participants in the video condition found the advocated risk protective behaviors easier to perform and stated they were more likely to perform them than those in the non-video condition. Approximately 15 days after exposure, those in the video condition performed on average one more protective behavior than those in the non-video condition. Results also suggest that agencies' efforts should focus on creating one quality video to place on a homepage, as video views declined the deeper people navigated into the site. Behaviors advocated should also be ones that can have lasting impacts with one-time actions, as effects wore away over time. Additional strategies are discussed for health promoters seeking to create videos to add to their current websites.

Math anxiety and exposure to statistics in messages about genetically modified foods: effects of numeracy, math self-efficacy, and form of presentation.

Health risks are often communicated to the lay public in statistical formats even though low math skills, or innumeracy, have been found to be prevalent among lay individuals. Although numeracy has been a topic of much research investigation, the role of math self-efficacy and math anxiety on health and risk communication processing has received scant attention from health communication researchers. To advance theoretical and applied understanding regarding health message processing, the authors consider the role of math anxiety, including the effects of math self-efficacy, numeracy, and form of presenting statistics on math anxiety, and the potential effects for comprehension, yielding, and behavioral intentions. The authors also examine math anxiety in a health risk context through an evaluation of the effects of exposure to a message about genetically modified foods on levels of math anxiety. Participants (N = 323) were randomly assigned to read a message that varied the presentation of statistical evidence about potential risks associated with genetically modified foods. Findings reveal that exposure increased levels of math anxiety, with increases in math anxiety limiting yielding. Moreover, math anxiety impaired comprehension but was mediated by perceivers' math confidence and skills. Last, math anxiety facilitated behavioral intentions. Participants who received a text-based message with percentages were more likely to yield than participants who received either a bar graph with percentages or a combined form. Implications are discussed as they relate to math competence and its role in processing health and risk messages.

Translating and testing breast cancer risk reduction messages for mothers of adolescent girls.

Emerging scientific findings regarding breast cancer science are typically presented only in discipline specific journals in which the general public and those at risk have limited access, creating a development-to-delivery gap between the state of the science and public knowledge. A lack of collaboration between scientists, communication experts, and community partners further compounds this lack of information available to the public. The present study translates recent scientific findings about environmental breast cancer risks into palatable magazine-style messages for mothers of young daughters as a strategy to meet the call for greater translation and dissemination of scientific results to the lay public. Results from focus groups indicate that mothers actually want more science in messages and greater explication of findings that indicate causality. Mothers also expect polished, professional messages that are representative of their daughters and provide a source for further information seeking purposes. Recommendations for future translation and message design endeavors are discussed.

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.

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.

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.

Concern as motivation for protection: an investigation of mothers' concern about daughters' breast cancer risk.

The present study surveyed mothers with daughters (N = 386) to investigate how mothers' concern about their daughters' breast cancer risk influenced intentions to engage in preventive behaviors. Using protection motivation theory as a framework, self-efficacy, response efficacy, and level of concern were posited to influence protective behavioral intention in distinct ways. Results from regression analyses indicate that self-efficacy, response efficacy, and mothers' concern are significant predictors of intentions to engage in preventive behaviors with daughters. In addition, a content analysis of mothers' open-ended reasons for their concern about their daughters' breast cancer risk yield a list of specific concerns and trends that vary by concern level and individual comment valence. The authors discuss implications for incorporating mothers' concerns into breast cancer prevention messages as a novel strategy for campaign designers.

Social norms, self-identity, and attention to social comparison information in the context of exercise and healthy diet behavior.

Social norms research has identified a range of distinct norms based on different referent groups that confer influence across a number of behaviors. The current survey study extends social norms research in two ways. First, this research tests the distinctiveness of four types of social norms: distal peer descriptive, distal peer injunctive, proximal peer descriptive, and proximal peer injunctive norms. Second, the current study examines the relationship between social norms and intentions to exercise and maintain a healthy diet, and includes self-identity and attention to social comparison information as moderators of the social norms and intention relationship. Results revealed the distinctiveness of the four types of social norms. Proximal peer descriptive and proximal peer injunctive norms were related to intention to exercise and intention to maintain a healthy diet, while distal peer injunctive norms were related only to intention to have a healthy diet. Additionally, self-identity was a significant moderator. Results are discussed within the context of implications for social norms campaigns.