Specifying Future Behavior When Assessing Risk Perceptions: Implications for Measurement and Theory.

Background. Many theories assert that high perceived risk motivates health behavior change; the empirical literature shows mixed findings. Purpose. To determine whether, for whom, and under what circumstances specifying a future behavior when assessing perceived risk (i.e., "conditioning" risk perception items on behavior) improves data quality and strengthens the perceived risk-intentions/behavior relationship. Methods. Internet panel participants (N = 787, 58.8% no college experience, 44.4% racial/ethnic minority, 43.7% men, 67.3% aged 18-49 years, 59.0% nonadherent to physical activity guidelines) answered 8 colon cancer perceived risk items in a within-subjects design. Participants answered 4 types of risk perception items: absolute and comparative perceived likelihood and absolute and comparative feelings of risk. Participants answered each type of item twice: once conditioned on not engaging in physical activity and once unconditioned. Results. Compared to unconditioned items, conditioned items elicited fewer "don't know" (DK) responses (OR = 0.80; 95% CI, 0.68-0.93), higher risk perceptions (b = 0.55; 95% CI, 0.49-0.61) and stronger positive correlations with intentions (zSteiger = 5.46, P < 0.001) and behavior (zSteiger = 5.10, P < 0.001). The effect of conditioning was more pronounced for perceived likelihood than feelings of risk items (OR = 2.21; 95% CI, 1.63-3.01 and b = 0.14; 95% CI, 0.08-0.20 for DK responding and risk perception magnitude, respectively). The effect on risk perception magnitude (except absolute feelings of risk) was higher among people with higher health literacy (χ2(3) = 8.11, P = 0.04). Conclusions. Researchers who examine whether perceived risk motivates precautionary behavior should consider conditioning risk perception items on behavior to increase the validity of the statistical conclusions they draw and to gain insight into the nature of perceived risk and its relation to behavior.

Cognitive and Affective Responses to Mass-media Based Genetic Risk Information in a Socio-demographically Diverse Sample of Smokers.

Many individuals receive information about genomics from the mass media. When media reports are about conditions that are considered behavioral, such as smoking, they may negatively affect some health-promoting cognitions. We examined how informing adult smokers about the genetic basis for nicotine addiction influenced smoking-related health cognitions and affect and whether responses varied by socio-demographics or genetics beliefs. We recruited 392 smokers (Mage = 44.5, 52.8% African American, 51.3% no college experience, 66.2% women) from public locations in a mid-sized Midwestern city. They were randomly assigned to read a news article describing either a pharmacy's decision to stop selling tobacco (n = 78) or the discovery of a gene associated with increased risk of nicotine addiction and lung cancer (n = 314). Participants also completed a survey assessing socio-demographics, health cognitions (quit intentions, self-efficacy, response efficacy, perceived risk), affect (worry, anticipated regret), genetic determinism, and other genetics beliefs. ANOVAs revealed no statistically significant main effects of genetic information on any health cognitions or affects. Linear regressions revealed that socio-demographics and genetics beliefs moderated very few effects. This suggests that concerns that mass media-based dissemination of genetic discoveries may have detrimental effects on smoking-related cognitions and affects are likely unwarranted.

A Theoretically-Grounded Investigation of Perceptions About Healthy Eating and mHealth Support Among African American Men and Women in New Orleans, Louisiana.

There has been a surge in diet-related mobile health (mHealth) interventions. However, diet-related mHealth research targeted toward racial/ethnic populations has been relatively limited. Focus groups with African American men and women from New Orleans, Louisiana, were conducted to (1) describe perceptions about healthy eating, (2) determine the acceptability of mHealth interventions, and (3) identify preferred mHealth intervention features. Descriptive statistics and thematic content analyses were performed. Qualitative data were organized within the context of the Theory of Planned Behavior and Social Cognitive Theory's theoretical components. Results may inform the development of mHealth research to improve eating behaviors among the target population.

Louisiana Physicians Are Increasing HPV Vaccination Rates.

Human papilloma virus (HPV) is a common virus that can cause genital warts and certain cancers. The HPV vaccine is effective in preventing many HPV-associated diseases, however, vaccination rates suggest many remain unprotected. This study examined successful strategies used by physicians to improve HPV vaccination rates. Providers with above average vaccination rates were identified. A representative from each provider participated in an interview to identify strategies used to boost HPV vaccination. Key strategies in ensuring vaccine completion were reminders, education, standing orders, and scheduling future vaccine appointments at time of first dose. Other successful strategies included coupling the HPV vaccine with adolescent vaccines, administering during well-visits, and recommending the vaccine as protection against cancer and genital warts. Findings suggest successful and widely used methods among high performing providers in Louisiana, the majority of which should be easily reproducible with minimal resources to improve HPV vaccination rates.