Promoting support for community water fluoridation: Testing message effects and the role of normative beliefs.

BACKGROUND: Despite evidence that community water fluoridation (CWF) protects oral health, improves health equity, is safe and cost-effective, and contributes to social well-being, little is known regarding which of these benefits should be highlighted to effectively influence support for CWF. METHODS: This within-participants study examines differences in CWF support in response to pro-CWF messages reflecting themes of oral health, health equity, CWF safety, cost-effectiveness, or social well-being among a sample of parents. Prior belief that CWF has health benefits, worry about potential health risks, and normative beliefs were also examined as independent predictors of support for each theme. RESULTS: Oral health, health equity, and safety messages significantly increased support in comparison with social well-being messages (P < .05). Oral health messages also produced greater support than cost-savings messages. Belief that CWF has health benefits positively predicted support, as did normative beliefs that one's family and physician approve of CWF. Worry about health risks and community and dentist norms were not significant predictors of support. There were no interaction effects of message themes and prior beliefs. CONCLUSIONS: Messaging focused on oral health, health equity, and the safety of CWF may be the most effective at influencing support for CWF. Preexisting personal beliefs about CWF benefits significantly predict support, but so do normative beliefs-family and physician norms in particular. PRACTICAL IMPLICATIONS: Findings suggest dental health educators should emphasize CWF's oral health benefits, such as preventing caries, over cost-saving and social well-being outcomes. They should also consider collaborating with family physicians to promote CWF and referencing other groups that may positively influence beliefs that CWF is beneficial.

An analysis of nanoscientists as public communicators.

The American public remains unfamiliar with nanotechnology despite more than a decade of investment and development. Nanoscientists have an opportunity to contribute to public conversations about their work, and its potential implications, through their engagement with lay audiences and media professionals. Indeed, the leaderships of many professional scientific organizations have placed a renewed focus on the public communication of science, particularly in the light of drastic changes in the information landscape and the increasing politicization of many technological and scientific issues. However, we have a limited understanding of nanoscientists' perceptions and behaviours regarding their participation in public communication. Here, we report survey results that provide an examination of the public communication behaviours of nanoscientists affiliated with the National Science Foundation's (NSF) National Nanotechnology Infrastructure Network (NNIN), an integrated partnership of US research institutions designed to facilitate nanoscale research and development. Our results suggest that nanoscientists are relatively frequent public communicators who commonly associate their communication efforts with positive impacts on their professional success. We also identify a handful of characteristics that drive nanoscientists' intentions to communicate with the public about nanotechnology.

Personal cancer knowledge and information seeking through PRISM: the planned risk information seeking model.

This study retested PRISM, a model of risk information seeking, and found that it is applicable to the context of cancer risk communication. The study, which used an online sample of 928 U.S. adults, also tested the effect of additional variables on that model and found that the original model better fit the data. Among the strongest predictors of cancer information seeking were seeking-related subjective norms, attitude toward seeking, perceived knowledge insufficiency, and affective risk response. Furthermore, risk perception was a strong predictor of an affective risk response. The authors suggest that, given the robustness across studies, the path between seeking-related subjective norms and seeking intention is ready to be implemented in communication practice.

Predicting cancer risk knowledge and information seeking: the role of social and cognitive factors.

This study tests an expanded Structural Influence Model (SIM) to gain a greater understanding of the social and cognitive factors that contribute to disparities in cancer risk knowledge and information seeking. At the core of this expansion is the planned risk information seeking model (PRISM). This study employed an online sample (N = 1,007) of African American, Hispanic, and non-Hispanic White adults. The addition of four cognitive predictors to the SIM substantially increased variance explained in cancer risk knowledge (R(2) = .29) and information seeking (R(2) = .56). Health literacy mediated the effects of social determinants (socioeconomic status [SES] and race/ethnicity) on cancer risk knowledge, while subjective norms mediated their effects on cancer risk information seeking. Social capital and perceived seeking control were also shown to be important mediators of the relationships between SES and cancer communication outcomes. Our results illustrate the social and cognitive mechanisms by which social determinants impact cancer communication outcomes, as well as several points of intervention to reduce communication disparities.

Ensuring children eat a healthy diet: a theory-driven focus group study to inform communication aimed at parents.

The Theory of Planned Behavior (TPB) served as a framework for analyzing focus group transcripts (N = 43) focused on parents' perceptions of the challenges of ensuring their children eat a healthy diet. The results suggest that parents consider their beliefs and behaviors as individuals within a society, within families, within cultures, as inheritors of family traditions, and as parents who influence or fail to influence the attitudes and behaviors of their children. The results showed the particular salience of factors related to the TPB concepts of perceived norms and control. Approaches to building theory-driven nursing interventions are suggested.

Promoting folic acid to Spanish-speaking Hispanic women: evaluating existing campaigns to guide new development.

Hispanic women are 1.5-3 times as likely as non-Hispanic white women to have a child affected by neural tube defects. This disparity exists in spite of varied interventions designed to address the problem. The purpose of this research was to investigate Hispanic women's knowledge of folic acid, perceptions of existing education campaigns, and provide guidance for future promotion efforts. Three focus groups with Hispanic mothers (N = 18) were conducted to garner insights on these issues. Results suggested that these women understood the benefits of folic acid, did not see major cultural barriers to consuming folic acid-rich foods, and did not perceive insurmountable challenges to consuming a multivitamin with folic acid. For many women, an initial pregnancy served as their initial cue to action, suggesting a need for the continued development of education strategies that communicate the benefits of folic acid supplementation prior to pregnancy. Such strategies may necessitate targeting younger audiences, including teenagers.

PRISM: a planned risk information seeking model.

Recent attention on health-related information seeking has focused primarily on information seeking within specific health and health risk contexts. This study attempts to shift some of that focus to individual-level variables that may impact health risk information seeking across contexts. To locate these variables, the researcher posits an integrated model, the Planned Risk Information Seeking Model (PRISM). The model, which treats risk information seeking as a deliberate (planned) behavior, maps variables found in the Theory of Planned Behavior (TPB; Ajzen, 1991) and the Risk Information Seeking and Processing Model (RISP; Griffin, Dunwoody, & Neuwirth, 1999), and posits linkages among those variables. This effort is further informed by Kahlor's (2007) Augmented RISP, the Theory of Motivated Information Management (Afifi & Weiner, 2004), the Comprehensive Model of Information Seeking (Johnson & Meischke, 1993), the Health Information Acquisition Model (Freimuth, Stein, & Kean, 1989), and the Extended Parallel Processing Model (Witte, 1998). The resulting integrated model accounted for 59% of the variance in health risk information-seeking intent and performed better than the TPB or the RISP alone.

Designing e-health interventions for low-health-literate culturally diverse parents: addressing the obesity epidemic.

Child and adolescent obesity is a significant problem contributing to long-term trends in adult obesity. Educating parents about strategies for raising healthy children is complicated by the problem of low health literacy. E-health provides new opportunities to educate lowhealth-literate audiences, and this project was intended as formative research to guide design of interventions for low-health-literate parents. Focus groups were conducted with African American, Hispanic, and white parents (n = 43), 18 years of age or older, and at or below median income for the region. Each focus group included the following: a discussion of parents' general use of the Internet for health information, the demonstration of a Web site designed specifically for low-health-literate users, and asking participants about ideas under consideration for future interventions. Participants use search engines to look for health information and use heuristics, such as position in search results, to evaluate Web site quality. Some participants avoid information from .edu and .gov domains due to perceived complexity, and there was an almost-universal lack of trust in the government for health information. University researchers, by contrast, were trusted sources as information providers. Content and usability that meet the needs of extremely low-literate audiences may be perceived as slow and lacking depth by more literate and Internet-savvy users. E-health can be used to educate low-health-literate audiences, but interventions designed for these users must be layered in terms of content and usability to meet varying levels of functional and media literacy.

Perceptions of infertility information and support sources among female patients who access the Internet.

OBJECTIVE: To evaluate perceived helpfulness of and reliance on infertility information and support sources and correlates of online information and support seeking among infertile women. DESIGN: Cross-sectional survey. SETTING: Web site of RESOLVE: The National Infertility Association. PATIENT(S): A total of 567 infertile women responded to an invitation. INTERVENTION(S): Self-administered online questionnaire. MAIN OUTCOME MEASURE(S): Sense of being informed, perceived helpfulness of online information, perceived helpfulness of online support, perceived helpfulness of infertility specialist for information, perceived helpfulness of infertility specialist for support. RESULT(S): The Internet is the most heavily relied-upon source, followed by books and infertility specialists. Sense of being informed was related to patient history, comfort level with doctor, doctor's encouragement of Internet use, and reliance on infertility specialists, but not related to Internet use. Perceived helpfulness of online information was negatively related to reliance on infertility specialists for information and support. CONCLUSION(S): Providers should consider patients' perceptions of the Internet as an information and support source. Encouraging Internet use may help women feel comfortable talking with providers and asking questions, two major factors that contributed significantly to ratings of specialists and to these women's sense of being informed about their infertility.

Studying heuristic-systematic processing of risk communication.

Using a model of risk information seeking and processing developed by Griffin, Dunwoody, and Neuwirth (1999), this study looks at predictors of the processing strategies that people apply to health risk information. Specifically, this article focuses on one relationship within the model--the relationship between perceived amount of information needed to deal with a risk and heuristic-systematic processing. Perceived amount of information needed refers to the gap between one's understanding of a risk and the level of understanding that one needs in order to make a decision about that risk. Building on the work of Chaiken (cf. 1980), the Griffin et al. model predicts--and finds--that the larger the gap, the more likely one will process information systematically. The study employs a novel measure of information processing in a survey setting by sending actual information to participants and then asking them how they attended to it; the researchers evaluate this strategy. Finally, the researchers discuss how these findings might help agencies and practitioners create more effective risk messages.

Attributions in explanations of risk estimates.

In the spring of 1993, nearly 40 percent of Milwaukee-area residents experienced a nationally publicized outbreak of cryptosporidium, a parasite that infested the metropolitan drinking water supply. Using open-ended survey data gathered from 610 adult residents in the wake of that outbreak, this study looks at factors related to the ways in which people make sense of their quantitative personal risk estimates. The concepts of informal reasoning and attribution aided this endeavor. Analysis of open-ended comments about the risk of getting ill from a waterborne parasite indicated that explanations of personal risk were consistent with predictions made by attribution theory. Good outcomes, which included having remained healthy during the outbreak, were associated with a greater likelihood that respondents would attribute causation to themselves, while one specific bad outcome, having experienced the illness, was associated with a greater likelihood that respondents would attribute causation externally. This study also examined predictors of whether respondents employed probabilistic language in those attributions. Analysis indicated that income was positively related to the use of probability-oriented language, while age and race were negatively related to the use of such language (i.e., persons of color and older individuals were less likely to use such language).