Virtual reality for public health: a study on a VR intervention to enhance occupational injury prevention.

BACKGROUND: Agriculture is one of the most hazardous occupations in the USA. Especially, tractor rollover incidents are the leading cause of farming-related injuries or deaths. This study examines the effect of a VR intervention (Virtual Reality Intervention for Safety Education; VRISE) on behavioral intentions for occupational safety and identifies a psychological mechanism that shows how the immersive technology works. METHODS: VRISE was developed by a multidisciplinary team of agricultural educators, computer scientists and communication specialists. It was designed to provide a virtual environment where users practice tractor operation and try to avoid several rollover hazards. The participants (291 high school students) were recruited at the 2019 National Future Farmers Association Convention & Expo and randomly assigned to one of three conditions: two different types of control groups (Control1: No treatment group and Control2: 2D Screen group) and the treatment group. RESULTS: Findings show that, through the immersive VR experience, the VR intervention enhanced perceived threat of tractor-related accidents which in turn, led to improved behavioral intentions for tractor safety. CONCLUSIONS: Findings shed light on the effectiveness of a VR intervention to improve public health outcomes, especially in occupational safety education, where unsafe practices often result in injury and fatality.

Increasing Perceived Risk of Opioid Misuse: The Effects of Concrete Language and Image.

Risk perception is a critical determinant for individuals' health behavior change, especially for behaviors with distal future consequences. Building on construal-level theory, this study investigates if and how thinking concretely about the negative consequences of opioid misuse influences people's risk perception toward opioid misuse. Two message cues - images and concrete (vs. abstract) language - are proposed to influence concrete thinking and perceived temporal distance, which in turn influence risk perception directly and through negative affect. Using a factorial online experiment with Amazon Mechanical Turk workers (N = 220), this study found that messages using concrete language made people think more concretely about the negative consequences of opioid misuse. Perceived concreteness, in turn, increased risk perception and negative affect. Negative affect also increased risk perception. The use of images decreased perceived temporal distance, which in turn, changed risk perception through its influence on negative affect. Theoretical and practical implications are discussed.

The Influence of Stigmatizing Messages on Danger Appraisal: Examining the Model of Stigma Communication for Opioid-Related Stigma, Policy Support, and Related Outcomes.

Drug overdose is a leading cause of injury and death in the United States, and opioids are among the most significant of causes. For people with opioid use disorders (OUDs), opioid stigma can lead to devastating consequences, including anxiety and depression. Still, mass media may stigmatize people with OUDs by ascribing stigmatizing labels (e.g., "opioid addict") and other stigma features to those individuals. However, it is unclear how these stigmatizing messages influence public perceptions of people with OUDs and public support for rehabilitation and Naloxone administration policies. The model of stigma communication (MSC) provides a framework for understanding these relationships. This study used the MSC in two online factorial experiments, the first among college undergraduates (N = 231) and the second among Amazon Mechanical Turk workers (N = 245), to examine how stigmatizing messages about people with OUDs influence stigma-related outcomes. Results reveal that opioid stigma messages influence different outcomes depending on the content of those messages. Classification messages with a stigmatizing mark (e.g., "Alex appears unkempt") and label (e.g., "opioid addict") led to greater perceptions of dangerousness and threat in both studies. High stigma classification messages also led to an increased desire for behavioral regulation and social distance in Study 2. Structural equation modeling in Study 1 also supported the applicability of the MSC in the opioid context. Implications for health communication theory development and practice are discussed.

Man shall not live by bread alone: the role of perceived emotional support in low-income adults' health outcomes.

BACKGROUND: Adults with low income have limited access to valuable health resources thus presenting a major obstacle to improving their health. Although there are diverse health enhancement programs for low-income populations, relatively few focus on emotional support despite the positive impact of perceived emotional support on health. This study examines the interaction of perceived emotional support and income on the overall health status and psychological well-being of adults with low income. METHODS: Secondary data were collected from the Health Information National Trends Survey (Cycle 4). A total of 3677 respondents completed the survey, including 889 adults with low income, as determined by their eligibility for the Supplemental Nutrition Assistance Program (SNAP). Ordinary-least square hierarchical regression analysis was conducted to test main and interaction effects. RESULTS: Perceived emotional support moderated the relationship between SNAP eligibility and health outcomes. Lacking an emotional support network has greater detrimental effects on the overall health and psychological well-being of people with low income compared to similar persons with higher income. CONCLUSION: These findings suggest the need for health programs that enhance access to emotional support for adults with low income.

Social Media Campaign Effects: Moderating Role of Social Capital in an Anti-Smoking Campaign.

This study examined the effects of an anti-smoking campaign that employs a crowdsourcing method with a social networking service. Drawing upon social capital scholarship and the expression effect research paradigm in eHealth systems, the study also investigated the roles of social trust and community life satisfaction in the social media campaign that has a specific geographical boundary. To that end, we conducted an experiment using a two-group pretest-posttest design. We randomly assigned 201 participants to two conditions: "campaign message reception only" as a control group and "message reception and expression" as a treatment group in which participants fully engaged in the campaign process by sharing their own campaign ideas with other participants. Findings revealed that social trust and community life satisfaction interacted with the treatment condition to positively affect persuasive intentions, but in distinct ways. Social trust moderated the effect of the message reception and interaction condition on participants' willingness to encourage community members to stop smoking. In contrast, community life satisfaction moderated the effect of the treatment condition on encouraging others to comply with the community's anti-smoking policy. These results provide theoretical and practical implications related to the roles of social capital in geographically defined social media campaigns.

Communication, Reasoning, and Planned Behaviors: Unveiling the Effect of Interactive Communication in an Anti-Smoking Social Media Campaign.

This study examines direct and indirect effects of interactive communication in an antismoking social media campaign. To that end, we pose a multitheoretical framework that integrates communication mediation models and the Theory of Planned Behavior. To test the theorized model, we conducted an experiment using a two-group pretest-posttest design. Participants (N = 201) were randomly assigned into two experimental conditions: "campaign message reception only" as a control group and "message reception and social interaction" as a treatment group, in which the participants contributed to the antismoking campaign by posting their own campaign ideas and information they found through mediated and interpersonal communication. The findings show that interactive communication catalyzes the participants' information searching behaviors through diverse communication channels. In turn, increased media use plays a crucial role in changing their attitudes and perceived social norms about smoking behaviors, and eventually reducing smoking intention. This study affirms that the theory of planned behavior is effective in predicting behavioral intention and demonstrates the usefulness of a multitheoretical approach in interactive campaign research on social media.

Offline Social Relationships and Online Cancer Communication: Effects of Social and Family Support on Online Social Network Building.

This study investigates how social support and family relationship perceptions influence breast cancer patients' online communication networks in a computer-mediated social support (CMSS) group. To examine social interactions in the CMSS group, we identified two types of online social networks: open and targeted communication networks. The open communication network reflects group communication behaviors (i.e., one-to-many or "broadcast" communication) in which the intended audience is not specified; in contrast, the targeted communication network reflects interpersonal discourses (i.e., one-to-one or directed communication) in which the audience for the message is specified. The communication networks were constructed by tracking CMSS group usage data of 237 breast cancer patients who participated in one of two National Cancer Institute-funded randomized clinical trials. Eligible subjects were within 2 months of a diagnosis of primary breast cancer or recurrence at the time of recruitment. Findings reveal that breast cancer patients who perceived less availability of offline social support had a larger social network size in the open communication network. In contrast, those who perceived less family cohesion had a larger targeted communication network in the CMSS group, meaning they were inclined to use the CMSS group for developing interpersonal relationships.

Self-Determination Theory and Computer-Mediated Support: Modeling Effects on Breast Cancer Patient's Quality-of-Life.

A breast cancer diagnosis typically results in dramatic and negative effects on an individual's quality of life. Web-based interactive support systems such as the Comprehensive Health Enhancement Support System (CHESS) offer one avenue for mitigating these negative effects. While evidence supports the efficacy of such systems, evaluations typically fail to provide a true test of the theorized model of effects, treating self-determination theory's constructs of competence, relatedness, and autonomy as outcomes rather than mediators. Using path analysis, this study tests the nature of the proposed mediated relationship between system engagement and quality-of-life indicators utilizing data collected from women (N = 90) who participated in the treatment condition of a CHESS randomized controlled trial. Findings support a latent model, indicating that system effects are mediated through an intertwined measure of autonomy, competence, and relatedness.

The Potential of AI and ChatGPT in Improving Agricultural Injury and Illness Surveillance Programming and Dissemination.

Generative Artificial Intelligence (AI) provides unprecedented opportunities to improve injury surveillance systems in many ways, including the curation and publication of information related to agricultural injuries and illnesses. This editorial explores the feasibility and implication of ChatGPT integration in an international sentinel agricultural injury surveillance system, AgInjuryNews, highlighting that AI integration may enhance workflows by reducing human and financial resources and increasing outputs. In the coming years, text intensive natural language reports in AgInjuryNews and similar systems could be a rich source for data for ChatGPT or other more customized and fine-tuned LLMs. By harnessing the capabilities of AI and NLP, teams could potentially streamline the process of data analysis, report generation, and public dissemination, ultimately contributing to improved agricultural injury prevention efforts, well beyond any manually driven efforts.

An eHealth system supporting palliative care for patients with non-small cell lung cancer: a randomized trial.

BACKGROUND: In this study, the authors examined the effectiveness of an online support system (Comprehensive Health Enhancement Support System [CHESS]) versus the Internet in relieving physical symptom distress in patients with non-small cell lung cancer (NSCLC). METHODS: In total, 285 informal caregiver-patient dyads were assigned randomly to receive, for up to 25 months, standard care plus training on and access to either use of the Internet and a list of Internet sites about lung cancer (the Internet arm) or CHESS (the CHESS arm). Caregivers agreed to use CHESS or the Internet and to complete bimonthly surveys; for patients, these tasks were optional. The primary endpoint-patient symptom distress-was measured by caregiver reports using a modified Edmonton Symptom Assessment Scale. RESULTS: Caregivers in the CHESS arm consistently reported lower patient physical symptom distress than caregivers in the Internet arm. Significant differences were observed at 4 months (P = .031; Cohen d = .42) and at 6 months (P = .004; d = .61). Similar but marginally significant effects were observed at 2 months (P = .051; d = .39) and at 8 months (P = .061; d = .43). Exploratory analyses indicated that survival curves did not differ significantly between the arms (log-rank P = .172), although a survival difference in an exploratory subgroup analysis suggested an avenue for further study. CONCLUSIONS: The current results indicated that an online support system may reduce patient symptom distress. The effect on survival bears further investigation.

Predictors of Online Health Information Seeking Among Women with Breast Cancer: The Role of Social Support Perception and Emotional Well-Being.

This study attempts to examine the role of social support perception and emotional well-being on online information seeking among cancer patients within the context of CHESS, a well-established Interactive Cancer Communication System (ICCS). Factor and regression analyses conducted among 231 breast cancer patients revealed that social support perception and emotional well-being interacted with each other to influence online health information seeking. Patients with low social support perception and high emotional well-being were most likely to seek health information, whereas patients with high social support perception and high emotional well-being sought out the same information least. Practical implications of the study findings were further discussed.

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.

A feasibility study of Augmented Reality Intervention for Safety Education for farm parents and children.

Agriculture is one of the most dangerous U.S. occupations with high rates of injuries and fatalities, and especially more dangerous for children, having more young worker deaths than any other industry. Thus, safety education is essential in promoting safe and healthy working habits in agriculture. Augmented reality (AR) technology has great potential to enhance the effectiveness of safety education due to its high levels of system-user interactivity and media enjoyment. This study aims to: (1) develop Augmented Reality Intervention for Safety Education (ARISE), an AR 3D simulator that presents farm accident situations with immersive media technology, (2) examine the feasibility of ARISE, and (3) evaluate the potential of ARISE as an effective agricultural safety education program for farm parents and children. To test the feasibility of ARISE, we conducted semi-structured in-depth interviews with ten parent-child dyads at an extension office located in Maryland. Participants were farmers who owned and operated a family farm(s) with their child or children ages 5-13. The interviews included asking participants questions about their perceptions of farm risks, sources of risk education, and protection methods. In the next step, participants used ARISE with researcher guidance. After using the application, participants were asked questions about their experience using ARISE and suggestions for improvement. The interviews were then transcribed and analyzed following the conventional content analysis method. Three main themes emerged-demand (e.g., perceived risk and need for education; lack of farm safety education from school), acceptability (e.g., attitude toward AR technology; perceived realism; perceived ease of use; perceived usefulness), and implementation. These findings help us understand how an immersive experience can play an impactful role in enhancing agricultural safety. The feasibility of ARISE sheds light on the potential of AR technology for an innovative safety education program.

Media, social proximity, and risk: a comparative analysis of newspaper coverage of Avian Flu in Hong Kong and in the United States.

This study uses the psychometric paradigm (Renn & Rohrmann, 2000; Slovic, 1992) as an analytic framework to analyze the risk dimensions being conveyed in media coverage of Avian flu in Hong Kong and in the United States between 2003 and 2007. A quantitative content analysis of The New York Times and South China Morning Post stories showed different patterns of avian flu related risk content coverage. The differences revealed that dimensions related to dreadfulness, catastrophic potential, uncertainty, and unfamiliarity were more emphasized in The New York Times than in South China Morning Post. The authors discuss the implications.

Empathic exchanges in online cancer support groups: distinguishing message expression and reception effects.

Past studies on the efficacy of participation in online cancer support groups have primarily focused on the role of expression in the accrual of health benefits for participants. Unfortunately, few steps have been taken to determine whether this observed effect arises solely from the internal mental processes underlying the act of expressing or, perhaps, owes something to a nuanced, multidimensional understanding of expression that includes reception of responses to what is expressed. To test for the multilayered effect, we attend to one of the key concepts in the online support community scholarship: empathy. Our findings suggest that it is a combination of empathy expression and reception that is crucial to attaining optimal benefits for cancer patients. Further, our finding supports the buffering hypothesis that empathic expression provides a salutary effect for patients who experienced a higher degree of concern associated with their cancer diagnosis and follow-up treatments.

Facebook Ads Manager as a Recruitment Tool for a Health and Safety Survey of Farm Mothers: Pilot Study.

BACKGROUND: Social media platforms have experienced unprecedented levels of growth and usage over the past decade, with Facebook hosting 2.7 billion active users worldwide, including over 200 million users in the United States. Facebook users have been underutilized and understudied by the academic community as a resource for participant recruitment. OBJECTIVE: We performed a pilot study to explore the efficacy and cost-effectiveness of Facebook advertisements for the recruitment of an online agricultural health and safety survey. METHODS: We undertook a 1-week advertising campaign utilizing the integrated, targeted advertising platform of Facebook Ads Manager with a target-spending limit of US $294. We created and posted three advertisements depicting varying levels of agricultural safety adoption leading to a brief survey on farm demographics and safety attitudes. We targeted our advertisements toward farm mothers aged 21-50 years in the United States and determined cost-effectiveness and potential biases. No participant incentive was offered. RESULTS: We reached 40,024 users and gathered 318 advertisement clicks. Twenty-nine participants consented to the survey with 24 completions. Including personnel costs, the cost per completed survey was US $17.42. Compared to the distribution of female producers in the United States, our advertisements were unexpectedly overrepresented in the eastern United States and were underrepresented in the western United States. CONCLUSIONS: Facebook Ads Manager represents a potentially cost-effective and timely method to recruit participants for online health and safety research when targeting a specific population. However, social media recruitment mirrors traditional recruitment methods in its limitations, exhibiting geographic, response, and self-selection biases that need to be addressed.

Occupational Exposure Risk for Swine Workers in Confined Housing Facilities.

In an effort to change unsafe tractor operating behaviors among Appalachian youth resulting from practices and habits learned through a socialization process (termed an "apprenticeship of observation"), this study implemented a four-part intervention in high school agricultural education classes that included implementation of a cost-effective rollover protective structure (CROPS) curriculum. The curriculum included farm safety information, specific NIOSH plans for CROPS construction, and procedures for CROPS installation on unprotected tractors. In this exploratory study, pre- and post-assessments were conducted using theory of planned behavior (TPB) constructs to measure changes in four factors that influence changes in learner behavior: learner attitude, perceived social norms, behavioral control, and perceived behavioral intention. Students' perceived knowledge and skills gained through the intervention were also measured because they are integral components in assessing the effectiveness of a curriculum intervention. Participants (N = 83) were high school students from seven schools in three states in the Appalachian region. Findings revealed statistically significant differences in student attitudes toward the use of life-saving CROPS and in perceived knowledge and skills gained through the curriculum implementation. The CROPS curriculum can be an effective intervention effort for addressing the social and behavioral effects of farm youths' apprenticeships of observation by creating more positive attitudes and learning outcomes among youth at risk for tractor rollover fatalities. Recommendations are provided for expanding the applications of the curriculum intervention and the TPB constructs.

Redesigning a Sentinel Surveillance System for Collecting and Disseminating Near Real-Time Agricultural Injury Reports: System Usability Study.

BACKGROUND: Injury data and reports provide valuable information for both public and private organizations to guide programming, policy, and prevention, but in the increasingly complex and dangerous industry of US agriculture, the injury surveillance needed to produce this data is lacking. To address the gap, AgInjuryNews was established in 2015. The system includes fatal and nonfatal injury cases derived from publicly available reports, including occupational and nonoccupational injuries, occurring in the agricultural, forestry, and fishing (AFF) industry. OBJECTIVE: The study aimed to develop a stakeholder-engaged redesign of the interactive, up-to-date, and publicly available dataset of US AFF injury and fatality reports. METHODS: Instructor-led heuristic evaluations within a 15-student undergraduate course, data from 8 student participants of laboratory-based usability testing and 2016 and 2017 AgInjuryNews-registered user surveys, coupled with input from the National Steering Committee informed the development priorities for 2018. An interdisciplinary team employed an agile methodology of 2-week sprints developing in ASP.NET and Structured Query Language to deliver an intuitive frontend and a flexible, yet structured, backend, including a case report input form for capturing more than 50 data points on each injury report. RESULTS: AgInjuryNews produced 17,714 page views from 43 countries in 2018 captured via Google Analytics, whereas 623 injury reports were coded and loaded, totaling more than 31,000 data points. Newly designed features include customizable email alerts, an interactive map, and expanded search and filter options. User groups such as the Bureau of Labor Statistics and the Agricultural Safety and Health Council of America have endorsed the system within their networks. News media have cited or referenced the system in national outlets such as the New York Times, Politico, and the Washington Post. CONCLUSIONS: The new system's features, functions, and improved data granularity have sparked innovative lines of research and increased collaborative interest domestically and abroad. It is anticipated that this nontraditional sentinel surveillance system and its dataset will continue to serve many purposes for public and private agricultural safety and health stakeholders in the years to come. .

Expression and Reception: An Analytic Method for Assessing Message Production and Consumption in CMC.

This article presents an innovative methodology to study computer-mediated communication (CMC), which allows analysis of the multi-layered effects of online expression and reception. The methodology is demonstrated by combining the following three data sets collected from a widely tested eHealth system, the Comprehensive Health Enhancement Support System (CHESS): 1) a flexible and precise computer-aided content analysis; 2) a record of individual message posting and reading; and 3) longitudinal survey data. Further, this article discusses how the resulting data can be applied to online social network analysis and demonstrates how to construct two distinct types of online social networks - open and targeted communication networks - for different types of content embedded in social networks.

Giving and Receiving Emotional Support Online: Communication Competence as a Moderator of Psychosocial Benefits for Women with Breast Cancer.

This study examines the moderating role of emotional communication competence in the relationship between computer-mediated social support (CMSS) group participation, specifically giving and receiving emotional support, and psychological health outcomes. Data were collected as part of randomized clinical trials for women diagnosed with breast cancer within the last 2 months. Expression and reception of emotional support was assessed by tracking and coding the 18,064 messages that 236 patients posted and read in CMSS groups. The final data used in the analysis was created by merging (a) computer-aided content analysis of discussion posts, (b) action log data analysis of system usage, and (c) baseline and six-month surveys collected to assess change. Results of this study demonstrate that emotional communication competence moderates the effects of expression and reception of emotional support on psychological quality of life and breast cancer-related concerns in both desired and undesired ways. Giving and receiving emotional support in CMSS groups has positive effects on emotional well-being for breast cancer patients with higher emotional communication, while the same exchanges have detrimental impacts on emotional well-being for those with lower emotional communication competence. The theoretical and practical implications for future research are discussed.