Testing Emphasis Message Frames and Metaphors on Social Media to Engage Boaters to Learn about Preventing the Spread of Zebra Mussels.

Message frames are often used to communicate about invasive species due to the additional meaning they provide. They appear in calls to action like "join the battle against invasive species," "unwelcome exotics," or "Stop Aquatic Hitchhikers." However, little is known about how stakeholders respond to these message frames. This research tested five common message emphasis frames used in invasive species communication. These message frames were placed in social media advertisements about zebra mussels to determine the impact each message frame had on user online behavior. For cost-per-click (CPC), ANOVA showed effects for framing and gender. Model coefficients revealed that Hitchhiker and Protective had significantly higher CPC than Science, and that women had a higher CPC. For comments, ANOVA showed effects for framing and gender. Model coefficients revealed that no frame had a significantly different effect on comments than Science, and that women commented on posts less. For shares, ANOVA showed effects for framing. Model coefficients revealed that Hitchhiker was shared more than Science. It is important to note that neither Militaristic nor Nativist outperformed Science on any measured outcome. Coupled with ethical considerations, our results suggest the use of Nativist and Militaristic frames are not necessary to influence online behavior. Message frames without ethical issues can be used to achieve the outcomes we tested without compromising message effectiveness. Within this article, we provide background on commonly used invasive species message frames, explain our methods for testing how they impact user behavior, and suggest limitations and applications of this work.

Lifestyle segmentation and political ideology: Toward understanding beliefs and behavior about local food.

This research sought to better understand local food consumers and take steps to begin to identify how targeted messages could engage different groups. In order to accomplish these aims, data was collected through a survey mailed to a random sample of Wisconsin households with a final sample size of 577. These consumers were then segmented based on variables related to the food related lifestyle (FRL) and political ideology. Political ideology was included as it influences the media to which individuals pay attention, and how they interpret messages. Identified groups were further profiled with variables related to local food purchasing, frequency of shopping at farmers' markets and natural food stores, willingness to pay a premium for local food, perceptions related to local food, communication habits, and demographics. Five segments were identified, with three standing out as likely consumers of local produce. The liberal, "Adventurous" consumers showed a strong interest in local food, perceiving local food to be superior for its environmental benefits, among other reasons. The "Traditional" and "Rational" groups were not interested in local food for environmental reasons, and may find such messages unappealing. In order to engage these other groups, messages should address the high quality of local food, how it can be incorporated into traditional recipes (for the "Traditional" group), and ways to make local food affordable and convenient to buy (for the "Rational" group).

Interactivity, Presence, and Targeted Patient Care: Mapping e-Health Intervention Effects Over Time for Cancer Patients with Depression.

This study examined the interplay of depression and different types of e-health interventions on breast cancer patients' perceived healthcare competence, emotional processing, and social well-being over time. The three e-health interventions--Internet Only as a control condition, CHESS (Comprehensive Health Enhancement Support System) Only, and CHESS with a Human Mentor, a cancer information specialist--provided varying degrees of interactivity and presence. A total of 328 women with breast cancer participated in one of the three interventions for a 6-month period. Women were further split into two groups based on reported levels of depression. For perceived healthcare competence and social well-being, results revealed significant interaction effects for intervention type by depression over time, such that breast cancer patients with higher levels of depression benefited most from the CHESS with Mentor intervention over the 6-month study period. For emotional processing, depressed cancer patients benefited more from the CHESS with Mentor than the other two interventions, regardless of time. These findings have (a) theoretical implications on how mental health factors can intersect with interactivity and presence to influence psychosocial outcomes, (b) conceptual implications for the role of human interaction within e-health systems, and (c) practical implications for the development of e-health interventions for cancer patients with depression.

The Effects of Expressing Religious Support Online for Breast Cancer Patients.

The growth of online support groups has led to an expression effects paradigm within the health communication literature. Although religious support expression is characterized as a typical subdimension of emotional support, we argue that in the context of a life-threatening illness, the inclusion of a religious component creates a unique communication process. Using data from an online group for women with breast cancer, we test a theoretical expression effects model. Results demonstrate that for breast cancer patients, religious support expression has distinct effects from general emotional support messages, which highlights the need to further theorize expression effects along these lines.

The role of the family environment and computer-mediated social support on breast cancer patients' coping strategies.

Despite the importance of family environment and computer-mediated social support (CMSS) for women with breast cancer, little is known about the interplay of these sources of care and assistance on patients' coping strategies. To understand this relation, the authors examined the effect of family environment as a predictor of the use of CMSS groups as well as a moderator of the relation between group participation and forms of coping. Data were collected from 111 patients in CMSS groups in the Comprehensive Health Enhancement Support System "Living with Breast Cancer" intervention. Results indicate that family environment plays a crucial role in (a) predicting breast cancer patient's participation in CMSS groups and (b) moderating the effects of use of CMSS groups on breast cancer patients' coping strategies such as problem-focused coping and emotion-focused coping.

It is out of my hands: how deferring control to God can decrease quality of life for breast cancer patients.

OBJECTIVE: This paper seeks to contribute to the understanding of how and why religion affects psychosocial health outcomes. We propose a theoretical model predicting that when women with breast cancer defer control to God they will experience fewer breast cancer related concerns. Deferring control to God, however, should also reduce the likelihood that they take a proactive coping approach, which will be exacerbated by lowered breast cancer concerns. We therefore predict that this passive coping style will ultimately result in lower levels of quality of life. METHODS: Data were collected as part of a randomized clinical trial funded by the National Cancer Institute. A total of 192 women with breast cancer participated in a computer-mediated social support group. Deferring control to God statements were captured by using computer-aided content analysis of discussion posts. Psychosocial outcomes were measured using longitudinal survey data. Analysis was performed using structural equation modeling. RESULTS: The results of our analysis largely confirm our mediation model for which we find significant model fit. As predicted, deferring control to God leads to lower levels of breast cancer concerns but also to more passive coping styles. Ultimately, deferring control to God can lead to lower levels of quality of life. CONCLUSIONS: Our study demonstrates how and why religious coping can lead to both positive and negative psychosocial health outcomes. Health care practitioners should encourage patients who are relying on religion to keep their end of the bargain and maintain an active coping style.

The process and effect of supportive message expression and reception in online breast cancer support groups.

OBJECTIVE: To better understand the process and effect of social support exchanges within computer-mediated social support (CMSS) groups for breast cancer patients, this study examines (1) the dynamic interplay between emotional support giving and receiving and (2) the relative effects of emotional support giving and receiving on patients' psychosocial health outcomes. METHODS: Data was collected from 177 patients who participated in online cancer support groups within the Comprehensive Health Enhancement Support System (CHESS) during the 4-month intervention. Data included (1) pretest and/or post-test survey scores of demographic, disease-related, and psychosocial factors, (2) automatically collected CHESS usage data, and (3) computer-aided content analysis of social support messages posts. RESULTS: Hierarchical regression analyses revealed that those who receive higher levels of support from others have fewer breast cancer-related concerns (ß = - 0.15, p<0.05), while those who give higher levels of support to others reframe their own problems in a positive light and adopt more positive strategies for coping (ß = 0.16, p<0.05). In addition to these positive effects, partial correlation analysis indicated that these two supportive behaviors are reciprocal. CONCLUSIONS: We concluded that supportive exchanges of receiving and giving play positive, but different, roles in predicting psychosocial health outcomes. Moreover, emotional support giving and receiving tend to reinforce each other. Our findings help practitioners, health-care providers, and health system designers make sense of diverse social support processes among cancer patients participating within CMSS groups.

Creating a bond between caregivers online: effect on caregivers' coping strategies.

Numerous studies have investigated the effect of Interactive Cancer Communication Systems (ICCSs) on system users' improvements in psychosocial status. Research in this area, however, has focused mostly on cancer patients, rather than on caregivers, and on the direct effects of ICCSs on improved outcomes, rather than on the psychological mechanisms of ICCS effects. To understand the underlying mechanisms, this study examines the mediating role of perceived caregiver bonding in the relation between one ICCS (the Comprehensive Health Enhancement Support System [CHESS]) use and caregivers' coping strategies. To test the hypotheses, a secondary analysis of data was conducted on 246 caregivers of lung cancer patients. These caregivers were randomly assigned to (a) the Internet, with links to high-quality lung cancer websites, or (b) access to CHESS, which integrated information, communication, and interactive coaching tools. Findings suggest that perceived bonding has positive effects on caregivers' appraisal and problem-focused coping strategies, and it mediates the effect of ICCS on the coping strategies 6 months after the intervention has begun.

Validity and reliability of the Early Childhood Caries Perceptions Scale (ECCPS) to assess health beliefs related to early childhood caries prevention among primary caregivers of children under 5 years of age.

Primary caregivers' child oral health care beliefs and practices are major factors in the prevention of Early Childhood Caries (ECC). This study assessed the validity and reliability of a newly-developed scale--the Early Childhood Caries Perceptions Scale (ECCPS)--used to measure beliefs regarding ECC preventive practices among primary caregivers of young children. The ECCPS was developed based on the Health Belief Model. The construct validity and reliability of the ECCPS were examined among 254 low-socioeconomic status primary caregivers with children under five years old, recruifed from 4 Bangkok Metropolitan Administration Health Centers and a kindergarten school. Exploratory factor analysis (EFA) revealed a four-factor structure. The four factors were labeled as Perceived Susceptibility, Perceived Severity, Perceived Benefits and Perceived Barriers. Internal consistency measured by the Cronbach's coefficient alpha for those four factors were 0.897, 0.971, 0.975 and 0.789, respectively. The ECCPS demonstrated satisfactory levels of reliability and validity for assessing the health beliefs related to ECC prevention among low-socioeconomic primary caregivers.

Barriers and opportunities for integrating social science into natural resource management: lessons from National Estuarine Research Reserves.

The need for cross-disciplinary scientific inquiries that facilitate improved natural resource management outcomes through increased understanding of both the biophysical and human dimensions of management issues has been widely recognized. Despite this broad recognition, a number of obstacles and barriers still sometimes challenge the successful implementation of cross-disciplinary approaches. Improving understanding of these challenges and barriers will help address them and thereby foster appropriate and effective utilization of cross-disciplinary approaches to solve natural resource management challenges. This research uses a case study analysis of the United States National Estuarine Research Reserve System to improve understanding of the critical factors that influence practitioners' decisions related to incorporating social science into their natural resource management work. The case study research is analyzed and evaluated within a Theory of Planned Behavior framework to (1) determine and describe the factors that predict practitioners' intent to incorporate social science into their natural resource related activities and (2) recommend potential strategies for encouraging and enabling cross-disciplinary approaches to natural resource management. The results indicate that National Estuarine Research Reserve practitioners' decisions related to incorporating social science are primarily influenced by (1) confidence in their own capability to incorporate social science into their work and (2) beliefs about whether the outcomes of incorporating social science into their work would be valuable or beneficial.

Measuring risk/benefit perceptions of emerging technologies and their potential impact on communication of public opinion toward science.

This study presents a systematic comparison of two alternative measures of citizens' perceptions of risks and benefits of emerging technologies. By focusing on two specific issues (nanotechnology and biofuels), we derive several insights for the measurement of public views of science. Most importantly, our analyses reveal that relying on global, single-item measures may lead to invalid inferences regarding external influences on public perceptions, particularly those related to cognitive schema and media use. Beyond these methodological implications, this analysis suggests several reasons why researchers in the area of public attitudes toward science must revisit notions of measurement in order to accurately inform the general public, policymakers, scientists, and journalists about trends in public opinion toward emerging technologies.

Predictors of supportive message expression and reception in an interactive cancer communication system.

Social support in computer-mediated settings is an important variable in health communication research, yet little is known about the factors that influence the amount of social support one gives and receives in online support groups. To shed some light on this issue, the authors examined demographics, disease-related factors, psychosocial factors, and strategies for coping with breast cancer as potential determinants of which patients provide support to others and which ones consume it. Data collected from 177 participants in the Comprehensive Health Enhancement Support System "Living With Breast Cancer" program revealed that individuals who are younger, have higher levels of positive reframing, and lower levels of self-blame are more likely to provide emotional support in online settings. In contrast, individuals who are more educated, have less perceived availability of social support, and have lower levels of religious coping are more likely to receive emotional support from others. The authors discuss the theoretical and practical implications for providing effective psychosocial support for women with breast cancer.

Explicating an evidence-based, theoretically informed, mobile technology-based system to improve outcomes for people in recovery for alcohol dependence.

Post-treatment relapse to uncontrolled alcohol use is common. Currently available communication technology can use existing models for relapse prevention to cost-effectively improve long-term relapse prevention. This paper describes: (1) research-based elements of alcohol consumption-related relapse prevention and how they can be encompassed in self-determination theory (SDT) and Marlatt's cognitive behavioral relapse prevention model, (2) how technology could help address the needs of people seeking recovery, (3) a technology-based prototype, organized around sexual transmitted disease and Marlatt's model, and (4) how we are testing a system based on the ideas in this article and related ethical and operational considerations.

Predictors and Effects of Training on an Online Health Education and Support System for Women with Breast Cancer.

Many breast cancer patients currently turn to Internet-based education and support to help them cope with their illness. This study explores the role of training in influencing how patients use a particular Interactive Cancer Communication System (ICCS) over time and also examines what pre-test characteristics predict which people are most likely to opt in or out of training in the first place. With use of pre-test survey and unobtrusive individual records of ICCS system use data (N = 216), nonparametric tests revealed that only having a later stage of cancer predicted whether or not patients participated in training. Results indicated that participating in training was a significant predictor of higher levels of using the CHESS system. In particular, the repeated measures analysis of covariance found the significant interaction as well as main effect of group (i.e., training vs. no training) and time (i.e., individual's CHESS usages at different times) in interactive and information CHESS services, suggesting that 1) the training group has a higher level of usage than the no training group, 2) both of the groups' usage decreased over time, and 3) these joint patterns hold over time. Practical guidelines for future ICCS campaign implementation are discussed.

Giving and receiving social support in online substance use disorder forums: How self-efficacy moderates effects on relapse.

OBJECTIVE: Individuals in recovery for substance use disorders (SUDs) increasingly use online social support forums, necessitating research on how communicating through these forums can affect recovery. This study examines how giving and receiving support within an SUDs recovery forum predict substance use, and considers whether effects vary according to participants' self-efficacy. METHODS: We applied content analysis to 3440 messages that were posted by 231 participants in an online SUDs forum. Surveys assessed social support reception and substance use at three timepoints. We assessed relationships between giving and receiving support and substance use (risky drinking days, illicit drug use days), and the interactions between self-efficacy and social support in predicting substance use outcomes. RESULTS: Receiving more emotional support was associated with reduced illicit drug use at 6 and 12 months. For those with low self-efficacy, giving more emotional support predicted less risky drinking at month 12, whereas giving more informational support predicted more risky drinking at month 12. CONCLUSION: These results suggest conditional benefits of exchanging support in an online SUDs forum, depending upon type of support (informational versus emotional), the participants' role (giver or receiver), and their self-efficacy. PRACTICE IMPLICATIONS: We discuss implications for designing and using peer-to-peer support platforms.

Effects of using online narrative and didactic information on healthcare participation for breast cancer patients.

OBJECTIVES: To determine the effects of online narrative and didactic information on breast cancer patients' healthcare participation and the interaction effects of race. SAMPLE: 353 breast cancer patients (111 African Americans) using an eHealth program with narratives (audiovisual and text) and didactic information (text only). MEASURES: healthcare participation scale (0, 4 months), online information use. ANALYSES: hierarchical regression. RESULTS: Narrative (beta=0.123, p<0.01) and didactic (beta=0.104, p<0.05) information use had independent and positive effects on healthcare participation. Effects of both were significantly greater for African Americans. CONCLUSIONS: Findings are consistent with and advance prior research on online learning processes and outcomes for breast cancer patients: (1) benefits accrue with using a variety of online learning tools; (2) African Americans use and benefit more from online narrative and didactic information than do Caucasians. PRACTICE IMPLICATIONS: eHealth programs should provide both didactic and narrative information-especially for African Americans and might consider making greater use of interactive and audiovisual formats. As patients increasingly use of the web for cancer information, clinicians should provide lists of web high quality resources that provide both narrative and didactic information.

Communicating about self and others within an online support group for women with breast cancer and subsequent outcomes.

Research suggests communicating too much about one's self within an online support group may amplify breast cancer patients' focus on their own problems and exacerbate negative emotions while focusing on others may have the opposite effects. This study explored how pronoun usage within an online support group was associated with subsequent mental health outcomes. There were 286 patients recruited into the study who filled out the pre-test and 231 completed post-tests four months later with survey measures including breast cancer-related concerns and negative emotions. Messages were analyzed using a program counting first person and relational pronouns. A positive relationship was found between use of first person pronouns and negative emotions.

Expressing positive emotions within online support groups by women with breast cancer.

Based upon Fredrickson's Broaden-and-Build Theory of Positive Emotions, this study examined the role of expressing positive emotions in online support groups for women with breast cancer. Underserved women with breast cancer in rural Wisconsin and Detroit, Michigan were recruited from 2001 to 2003, and they were given access to online support groups. Both pretest and four-month posttest surveys were conducted with a sample of 231 women. Messages from 96 active participants were analyzed using a computerized text analysis program. Psychological benefits that occurred following the expression of positive emotions were greater among those who expressed more negative emotions.

Empowering processes and outcomes of participation in online support groups for patients with breast cancer, arthritis, or fibromyalgia.

Ever since the rise of online support groups it has been presumed that there is an empowering effect from patients' participating in these groups, despite a lack of evidence to back up this assumption. In this study we explored if, and in which ways, patients feel empowered by participation. Additionally, we studied which empowering and disempowering processes occur as a result of taking part in these groups. To accomplish this aim, we interviewed 32 participants of online support groups. This analysis revealed the following empowering processes: exchanging information, encountering emotional support, finding recognition, sharing experiences, helping others, and amusement. Disempowering processes were mentioned far less often. Empowering outcomes mentioned were being better informed; feeling confident in the relationship with their physician, their treatment, and their social environment; improved acceptance of the disease; increased optimism and control; enhanced self-esteem and social well-being; and collective action. This article demonstrates that participation in online support groups can make a valuable contribution to the emergence of empowered patients.

Doctor-patient relationship as motivation and outcome: examining uses of an Interactive Cancer Communication System.

OBJECTIVE: To examine how the pre-existing doctor-patient relationship predicts conceptually distinct service use within an Interactive Cancer Communication System (ICCS) for underserved women with breast cancer and in turn how service utilization influences the doctor-patient relationship. METHODS: Study sample included 231 recently diagnosed, lower income breast cancer patients. Participants were provided a free computer, Internet access and training in how to use an ICCS called the Comprehensive Health Enhancement Support System (CHESS) "Living with Breast Cancer" program. Survey data was collected at pre-test and 4-months after using the system, and use data about how women used the system was also collected. RESULTS: The only statistically significant predictor of service use was that patients with a more negative appraisal about the doctor-patient relationship used the Ask an Expert service more frequently, and there were trends toward a more negative appraisal of the doctor-patient relationship being associated with higher use of Information and Interactive services. Conversely, there was a trend toward a more positive appraisal predicting higher use of the Discussion Group service. In terms of statistically significant effects, more frequent utilization of Information services was associated with a more positive appraisal of the doctor relationship. CONCLUSION: While a more negative perception of the doctor-patient relationships at pre-test was associated with higher use of most of the conceptually distinct services within this ICCS, use of the Information services was associated with having a more positive appraisal of the doctor-patient relationship at post-test suggesting that high-quality information on the Internet can serve to improve patients' satisfaction with their doctor.