The Effects of Alcohol-Related Social Media Content on Adolescents' Momentary Perceived Norms, Attitudes, and Drinking Intentions.

Research has shown that exposure to alcohol posts on social media can shape adolescents' alcohol-related normative perceptions and attitudes, which in turn play a role in their drinking intentions. However, these studies focused on content in general, neglecting the variety of alcohol posts on social media. Furthermore, they were mostly cross-sectional and studied behaviors at one-time point, thus not considering within-person/daily (co-)fluctuations in exposure to alcohol posts and drinking cognitions. Therefore, this daily diary study among 275 Belgian adolescents (Mage = 15.83, SD = .88, 56.2% girls, 43% boys, 1 X) adds to the literature by examining how two types of alcohol posts (i.e. alcohol-focused vs. friend-focused) differently predict adolescents' normative perceptions (i.e. descriptive and injunctive), alcohol-related attitudes and intentions to drink, both on the between- and daily within-levels. The results showed that alcohol-focused posts but not friend-focused posts predicted adolescents' drinking cognitions (i.e. injunctive norms, descriptive norms, and attitudes) on the daily within-level. Descriptive norms and attitudes also predicted the intention to drink, on the between and daily within-level for attitudes but only on the daily within-level for norms. Overall, the results highlight that specific types of alcohol posts differently shape adolescents' daily drinking cognitions, thereby informing future interventions.

I spy with my little eye: An eye-tracking study examining adolescents' attention to alcoholic and non-alcoholic beverages in Instagram stories.

Social media users are frequently exposed to alcohol images on Instagram, which in turn influences their own alcohol behaviors. Yet, it is unclear what factors drive attention to alcohol cues. In an eye-tracking study (N = 108; Mage = 16.54), we examined adolescents' attention to Instagram Stories depending on: (a) the type of beverage depicted (beer vs water), (b) the character-product interaction portrayed (CPI: peers in images shown consuming [high CPI] vs holding beverages [low CPI]) and, (c) participant's own susceptibility (high vs low-risk alcohol drinker). Our results illustrated that adolescents allocated an equal amount of attention to beer and water depicted in Instagram images. Furthermore, they devoted more attention to Instagram images wherein peers were shown consuming water and beer (high CPI) compared to those wherein peers were holding these beverages (low CPI). Surprisingly, high-risk alcohol drinkers were more responsive to both beer and water cues than low-risk drinkers. This was particularly the case for Instagram images with high CPI. These findings have implications for how health cues on Instagram are attended to and processed.

I See, Therefore I am: Exposure to Alcohol References on Social Media, but Not on Traditional Media, Is Related to Alcohol Consumption via Drinking and Non-Drinking Identity.

In recent years, the role of media in individuals' alcohol consumption has been touched upon by several researchers. Nevertheless, the underlying processes explaining the relationship between media use and alcohol consumption, as well as the differences in strength of the associations between social and traditional media use and alcohol consumption remain understudied. The present exploratory cross-sectional study (N = 381) among emerging adults (M = 21.83, SD = 2.04, 75.3% females, 67.7% college students) examined drinking identity and non-drinking identity as underlying mechanisms of the relationship between alcohol-related media use and alcohol consumption, while comparing the role of social and traditional media in these processes. We found no associations between traditional media use and drinking identity, non-drinking identity or alcohol consumption. In contrast, social media use was both directly and indirectly related to alcohol consumption via drinking identity and non-drinking identity. This demonstrates that social media can play a socializing role in emerging adults' alcohol consumption.

Self-Reported versus Actual Alcohol-Related Communication on Instagram: Exploring the Gap.

Numerous studies have highlighted the relation between drinking behavior and alcohol references on social media. However, most studies on substance-use-related social media effects rely on self-report data, and it remains unclear whether individuals can accurately report their online alcohol-related communication. This study contributes to this line of research by examining whether individuals accurately report their alcohol-related self-sharing behavior on social media and what factors contribute to a misestimation of this behavior. A sample of 149 Belgian college students (64.3% females, Mage = 21.33, SD = 1.49) participated in this study, who were asked survey questions on their general and alcohol-related social media use. In addition, all posts they shared on their Instagram profiles between April 1st, 2019, and March 31st, 2020, were captured and coded. The results indicated a positive association between the counted and self-reported frequencies of sharing alcohol posts on Instagram. However, most participants overestimated how often they shared this content. The perceived injunctive norms and sharing alcohol posts for entertainment motives were the only significant predictors of this overestimation. We conclude that this overestimation may be a result of subtle social desirability processes and a misremembrance of what has been shared.

Drinking Buddies: The Importance of Proximal Norms in Emerging Adults' Alcohol-Related Private and Public Social Media Use.

Exposure to alcohol posts on social media has been found to be associated with emerging adults' alcohol use. An important mechanism through which this association seems to occur are social norms. Thus far, however, research has not differentiated between proximal and distal norms and has not accounted for the private (e.g. Instagram private features, Snapchat) and public media outlets (e.g. Instagram public features) through which these norms might have been constructed. The results of our online survey among emerging adults (N = 789, Mage = 21.46, SDage = 1.88, 56.4% female), therefore, showed that exposure to alcohol posts on private SNS features in combination with descriptive proximal norms, instead of more public SNS features and distal norms, played an important role in emerging adults' alcohol use. As such, future research should focus more thoroughly on the interrelations between SNS private features and proximal normative perceptions and try to better understand on which social cues normative perceptions of proximal other's alcohol consumption are based.

Stay Home, Drink at Home? A Daily Diary Study on College Students' Alcohol and Social Media Use during the COVID-19 Pandemic.

BACKGROUND: COVID-19 and measures to contain it may have impacted college students' behavior, including their drinking behavior. Students' drinking may have decreased-for example, due to the closure of bars-but problematic drinking may have increased-for example, due to (solitary) drinking at home. Another behavior that has increased due to COVID-19 and the accompanying social isolation is students' social networking site (SNS) use. This is worrisome because students' SNS use has been shown to increase their alcohol use. Nevertheless, little research has investigated these behaviors and the possible link between them during a lockdown. Therefore, this study aimed to examine (1) whether students engaged in drinking during a lockdown, (2) whether they displayed their drinking behavior on SNSs, and (3) whether exposure to and posting of alcohol-related content was linked to their daily alcohol use. METHODS: 337 college students (Mage = 20.63 years, SDage = 1.55 years; 50.3% male) participated in a two-week daily diary study. Descriptive statistical analyses and generalized linear mixed modeling (GLMM) were deployed. RESULTS: Descriptive analysis results showed that during the week, students' drinking occurred with friends in dormitories, while in the weekend, this behavior shifted to drinking with friends and parents at home. Moreover, students mostly saw visual and posted textual posts of this drinking on SNSs. Furthermore, GLMM revealed associations between exposure to alcohol postings, sharing of alcohol postings, and students' probability of drinking on the same day. CONCLUSION: This study provides important insights into students' alcohol use and its underlying mechanisms during health crises.

Mothers Matter: Using Regression Tree Algorithms to Predict Adolescents' Sharing of Drunk References on Social Media.

Exposure to online drinking on social media is associated with real-life alcohol consumption. Building on the Theory of planned behavior, the current study substantially adds to this line of research by identifying the predictors of sharing drunk references on social media. Based on a cross-sectional survey among 1639 adolescents with a mean age of 15 (59% female), this study compares and discusses multiple regression tree algorithms predicting the sharing of drunk references. More specifically, this paper compares the accuracy of classification and regression tree, bagging, random forest and extreme gradient boosting algorithms. The analysis indicates that four concepts are central to predicting adolescents' sharing of drunk references: (1) exposure to them on social media; (2) the perceived injunctive norms of the mother towards alcohol consumption; (3) the perceived descriptive norms of best friends towards alcohol consumption; and (4) willingness to drink alcohol. The most accurate results were obtained using extreme gradient boosting. This study provides theoretical, practical, and methodological conclusions. It shows that maternal norms toward alcohol consumption are a central predictor for sharing drunk references. Therefore, future media literacy interventions should take an ecological perspective. In addition, this analysis indicates that regression trees are an advantageous method in youth research, combining accurate predictions with straightforward interpretations.

Perceptions surpass reality: Self-reported alcohol-related communication on Instagram is more strongly related with frequency of alcohol consumption and binge drinking than actual alcohol-related communication.

Mounting research finds that sharing alcohol references on social media is related to higher levels of alcohol consumption. The present study aims to improve our understanding of potential biases when using self-report measures, to provide more insight in the differences between background and foreground alcohol references, and to examine different drinking patterns. We examined the Instagram profiles of 128 Belgian college students (Mage = 21.31, SD = 1.50; 64.8 % women) and compared how the observed number of pictures depicting alcohol in the background or in the foreground as well as self-reports on their frequency of sharing alcohol-related content was associated with frequency of alcohol consumption, typical quantity consumed and frequency of binge drinking. Results demonstrated that self-reported frequency of sharing alcohol references and observed number of alcohol-in-the-foreground references were positively related to participants' alcohol consumption. However, self-reports were a stronger predictor of alcohol consumption than alcohol-in-the-foreground references, and were most strongly related to binge drinking. Alcohol-in-the-background references were not significant. This means that the relationship between sharing alcohol posts and drinking behavior is overinflated in studies relying solely on self-report data.

#Coronavirus: Monitoring the Belgian Twitter Discourse on the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic.

In this study, a social media analysis is conducted to examine the public discourse about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on Twitter. In particular, this study aims to examine (a) how the number of tweets varies as a function of the timeline of the pandemic and associated measures and (b) how the content of these tweets, including displayed emotions, changes. Therefore, 373,908 tweets and retweets from Belgium were collected from February 25, 2020 to the March 30. Time series analysis, network bigrams, topic models, and emotional lexica were deployed for analysis. The results showed that significant events related to the virus correlated with an immediate increase in the number of tweets addressing them. Furthermore, the Belgian Twitter discourse was characterized by positively connoted words, which also refer to European solidarity. These findings do not only stress the relevance of Twitter as a medium for public discourse during lockdowns, but also seem to indicate that the Belgian public supports policy measures that respect solidarity in Europe.

Disposition-Content Congruency in Adolescents' Alcohol-Related Social Media (Self-) Effects: The Role of the Five-Factor Model.

OBJECTIVE: Accumulating evidence indicates that social networking sites play an increasingly important role in young people's drinking behavior. The present study adds to this research by assessing the conditionality of the relationships between exposure to and self-sharing of alcohol-related content on social media and adolescents' drinking behavior. Specifically, the moderating role of the five-factor model of personality is determined. METHOD: A cross-sectional survey study was conducted among 866 mid-adolescents (Msubsample = 14.85 years, SD = 0.71, 57.5% girls). Polynomial regression analysis with response surface modeling was used to test the interactions. RESULTS: Exposure, but not self-sharing, was directly associated with more alcohol consumption. However, it appeared that the act of sharing was more important than the frequency of sharing. Next, the relationship between exposure and consumption was not found to be moderated by personality. In contrast, there were significant linear and nonlinear interactions between self-sharing and all five personality traits. Individuals who are predisposed to engage in more alcohol consumption experience a stronger association between self-sharing and their drinking behavior. CONCLUSIONS: Social media can play a role in adolescents' drinking behavior, but this role is partially dependent on temperamental predispositions.

Feasibility and impact study of a reward-based mobile application to improve adolescents' snacking habits.

OBJECTIVE: Adolescents' snacking habits are driven by both explicit reflective and implicit hedonic processes. Hedonic pathways and differences in sensitivity to food rewards in addition to reflective determinants should be considered. The present study evaluated the feasibility and impact of a mobile phone-delivered intervention, incorporating explicit reflective and implicit rewarding strategies, on adolescents' snack intake. DESIGN: Adolescents (n 988; mean age 14·9 (sd 0·70) years, 59·4 % boys) completed a non-randomized clustered controlled trial. Adolescents (n 416) in the intervention schools (n 3) were provided with the intervention application for four weeks, while adolescents (n 572) in the control schools (n 3) followed the regular curriculum. Outcomes were differences in healthy snacking ratio and key determinants (awareness, intention, attitude, self-efficacy, habits and knowledge). Process evaluation data were collected via questionnaires and through log data of the app. RESULTS: No significant positive intervention effects on the healthy snack ratio (b=-3·52 (se 1·82), P>0·05) or targeted determinants were observed. Only 268 adolescents started using the app, of whom only fifty-five (20·5 %) still logged in after four weeks. Within the group of users, higher exposure to the app was not significantly associated with positive intervention effects. App satisfaction ratings were low in both high and low user groups. Moderation analyses revealed small positive intervention effects on the healthy snack ratio in high compared with low reward-sensitive boys (b=1·38 (se 0·59), P<0·05). CONCLUSIONS: The intervention was not able to improve adolescents' snack choices, due to low reach and exposure. Future interventions should consider multicomponent interventions, teacher engagement, exhaustive participatory app content development and tailoring.

Cancer-Diagnosed Individuals' Use of Television and the Internet as a Source for Peer Stories and Associated Emotional Responses.

When people are confronted with a potentially life-threatening disease such as cancer, they are likely to feel an urgent need for information about the disease and support from peers. Studies have shown that the mass media contain a lot of experiential information (i.e., peer stories) about cancer, either from real individuals or from fictional characters. To date, most studies have focused on using the Internet for peer support. This study aimed to extend this line of research by investigating (1) whether cancer-diagnosed individuals use both television and the Internet to access peer stories, (2) whether exposure to these stories results in different emotional outcomes, and (3) whether this differs depending on gender. A cross-sectional survey among 621 cancer-diagnosed individuals in Flanders (Belgium) showed that both television and the Internet were used as a source for following peer stories. Respondents indicated feeling fearful and concerned when following peer stories on entertainment television, but following peer stories on online forums was associated with feeling supported. These different emotional responses could be the result of the differences between these two content categories (i.e., fictional versus non-fictional peer stories). Future research should further examine these relationships by investigating the role of mass media content and how different psychological coping styles and personality traits moderate these associations.

Use of Fitness and Nutrition Apps: Associations With Body Mass Index, Snacking, and Drinking Habits in Adolescents.

BACKGROUND: Efforts to improve snacking and drinking habits are needed to promote a healthy body mass index (BMI) in adolescents. Although commercial fitness and nutrition mobile phone apps are widely used, little is known regarding their potential to improve health behaviors, especially in adolescents. In addition, evidence on the mechanisms through which such fitness and nutrition apps influence behavior is lacking. OBJECTIVES: This study assessed whether the use of commercial fitness or nutrition apps was associated with a lower BMI and healthier snacking and drinking habits in adolescents. Additionally, it explored if perceived behavioral control to eat healthy; attitudes to eat healthy for the good taste of healthy foods, for overall health or for appearance; social norm on healthy eating and social support to eat healthy mediated the associations between the frequency of use of fitness or nutrition apps and BMI, the healthy snack, and beverage ratio. METHODS: Cross-sectional self-reported data on snack and beverage consumption, healthy eating determinants, and fitness and nutrition app use of adolescents (N=889; mean age 14.7 years, SD 0.8; 54.8% [481/878] boys; 18.1% [145/803] overweight) were collected in a representative sample of 20 schools in Flanders, Belgium. Height and weight were measured by the researchers. The healthy snack ratio and the healthy beverage ratio were calculated as follows: gram healthy snacks or beverages/(gram healthy snacks or beverages+gram unhealthy snacks or beverages)×100. Multilevel regression and structural equation modeling were used to analyze the proposed associations and to explore multiple mediation. RESULTS: A total of 27.6% (245/889) of the adolescents used fitness, nutrition apps or both. Frequency of using nutrition apps was positively associated with a higher healthy beverage ratio (b=2.96 [1.11], P=.008) and a higher body mass index z-scores (zBMI; b=0.13 [0.05], P=.008. A significant interaction was found between the frequency of using nutrition and for the zBMI (b=-0.03 [0.02], P=.04) and the healthy snack ratio (b=-0.84 [0.37], P=.03). Attitude to eat healthy for appearance mediated both the fitness app use frequency-zBMI (a × b=0.02 [0.01], P=.02) and the nutrition app use frequency-zBMI (a × b=0.04 [0.01], P=.001) associations. No mediation was observed for the associations between the frequency of use of fitness or nutrition apps and the healthy snack or beverage ratio. CONCLUSIONS: Commercial fitness and nutrition apps show some association with healthier eating behaviors and BMI in adolescents. However, effective behavior change techniques should be included to affect key determinants of healthy eating.

Adding a reward increases the reinforcing value of fruit.

Adolescents' snack choices could be altered by increasing the reinforcing value (RV) of healthy snacks compared with unhealthy snacks. This study assessed whether the RV of fruit increased by linking it to a reward and if this increased RV was comparable with the RV of unhealthy snacks alone. Moderation effects of sex, hunger, BMI z-scores and sensitivity to reward were also explored. The RV of snacks was assessed in a sample of 165 adolescents (15·1 (sd 1·5) years, 39·4 % boys and 17·4 % overweight) using a computerised food reinforcement task. Adolescents obtained points for snacks through mouse clicks (responses) following progressive ratio schedules of increasing response requirements. Participants were (computer) randomised to three experimental groups (1:1:1): fruit (n 53), fruit+reward (n 60) or unhealthy snacks (n 69). The RV was evaluated as total number of responses and breakpoint (schedule of terminating food reinforcement task). Multilevel regression analyses (total number of responses) and Cox's proportional hazard regression models (breakpoint) were used. The total number of responses made were not different between fruit+reward and fruit (b -473; 95 % CI -1152, 205, P=0·17) or unhealthy snacks (b410; 95 % CI -222, 1043, P=0·20). The breakpoint was slightly higher for fruit than fruit+reward (HR 1·34; 95 % CI 1·00, 1·79, P=0·050), whereas no difference between unhealthy snacks and fruit+reward (HR 0·86; 95 % CI 0·62, 1·18, P=0·34) was observed. No indication of moderation was found. Offering rewards slightly increases the RV of fruit and may be a promising strategy to increase healthy food choices. Future studies should however, explore if other rewards, could reach larger effect sizes.

Strategic Self-Presentation or Authentic Communication? Predicting Adolescents' Alcohol References on Social Media.

OBJECTIVE: The current study is one of the first to examine how self-reported alcohol consumption, friends' perceived alcohol consumption, and the perceived number of friends sharing alcohol references on social networking sites (SNS) is associated with adolescents' sharing of alcohol references on SNS. METHOD: A cross-sectional paper-and-pencil survey was administered among 3,172 adolescents (n = 3,133 used for analyses, mean age = 17.16 years, SD = 0.93; 50.7% male). Structural equation modeling was used to test the hypotheses. RESULTS: First, the results indicated that both self-reported drinking behavior and the perceived number of friends sharing alcohol references were related to sharing alcohol references on SNS, but the perceived number of friends sharing alcohol references was a stronger predictor than self-reported drinking behavior. Friends' perceived drinking behavior was not a significant predictor. In the second place, self-reported drinking behavior was a stronger predictor for girls than for boys, whereas the perceived number of friends sharing alcohol references was a stronger predictor for boys than for girls. CONCLUSIONS: Adolescents' alcohol-related self-representation is in line with their alcohol consumption and is also strongly related to what their friends are sharing. Thus, adolescents appear to communicate authentically about their drinking experiences, but the decision to do so is heavily influenced by the prevailing social norm regarding alcohol-related communication.

Stem cell research: the role of information seeking and scanning.

BACKGROUND: The mass media have held an ongoing debate about stem cell research. However, few studies have investigated how individuals obtain information on stem cell research and whether this affects their knowledge and perspectives on stem cell research. OBJECTIVE: This study aims to investigate whether (i) cancer-diagnosed and non-diagnosed individuals differ in terms of their acquisition of stem cell research information, (ii) whether this information acquisition is associated with stem cell research knowledge and perspectives and (iii) whether having had a cancer diagnosis moderates these associations. METHOD: A standardised, cross-sectional survey was conducted among a convenience sample of 621 cancer-diagnosed and 1387 non-diagnosed individuals in Flanders (Belgium). RESULTS: The results indicate that stem cell research information acquisition explains a significant part of the variance of stem cell research knowledge (8.9%) and of the societal benefits of stem cell research (6.7%) and of embryonic stem cell research evaluation (3.9%) and morality (2%). These associations did not differ between cancer-diagnosed and non-diagnosed individuals but cancer-diagnosed individuals did seek more stem cell research information. CONCLUSION: Acquiring stem cell research information, both intentionally and unintentionally, is positively related to stem cell research knowledge and perspectives. Future research should further identify ways to promote health information acquisition behaviour because it is associated with better knowledge and more positive opinion formation.

Sensitivity to reward and adolescents' unhealthy snacking and drinking behavior: the role of hedonic eating styles and availability.

BACKGROUND: Although previous research found a positive association between sensitivity to reward (SR) and adolescents' unhealthy snacking and drinking behavior, mechanisms explaining these associations remain to be explored. The present study will therefore examine whether the associations between SR and unhealthy snack and/or sugar-sweetened beverage (SSB) intake are mediated by external and/or emotional eating and if this mediation is moderated by availability at home or at school. METHODS: Cross-sectional data on snacking, availability of snacks at home and at school, SR (BAS drive scale) and external and emotional eating (Dutch eating behavior questionnaire) of Flemish adolescents (n = 1104, mean age = 14.7 ± 0.8 years; 51 % boys; 18.0% overweight) in 20 schools spread across Flanders were collected. Moderated mediation analyses were conducted using generalized structural equation modeling in three steps: (1) direct association between SR and unhealthy snack or SSB intake, (2) mediation of either external or emotional eating and (3) interaction of home or school availability and emotional or external eating. RESULTS: Partial mediation of external eating (a*b = 0.69, p < 0.05) and of emotional eating (a*b = 0.92, p < 0.01) in the relation between SR and intake of unhealthy snacks was found (step 2). The relation between SR and SSB intake was not mediated by external or emotional eating (step 2). No moderation effects of home or school availability were found (step 3). CONCLUSION: Our findings indicate that the association between SR and the consumption of unhealthy snacks is partially explained by external and emotional eating in a population-based sample of adolescents irrespective of the home or school availability of these foods.

Sensitivity to reward is associated with snack and sugar-sweetened beverage consumption in adolescents.

PURPOSE: High intake of palatable foods, such as energy-dense snacks and sugar-sweetened beverages (SSBs), is common among adolescents. An individual's sensitivity to reward (SR) may influence these intakes. The main objective of this study was to investigate the association between SR and both snack and SSB intake among adolescents. METHODS: A representative cross-sectional survey was conducted among 1104 14- to 16-year-olds (mean age = 14.7 ± 0.8 years; 50.9 % boys; 18.0 % overweight) in Flanders. Daily intakes were measured by a food frequency questionnaire. SR was assessed using the behavioral activation system (BAS) scales. Multilevel regression analyses (two level: adolescent school) were conducted using STATA version 13. RESULTS: BAS drive was positively associated with daily intakes of SSBs (13.79 %, p < 0.01), unhealthy snacks (5.42 %, p < 0.001), and energy and nutrients derived from SSBs (p < 0.001) and snacks (p < 0.01). BAS reward responsiveness (RR) was only positively associated with intake of unhealthy snacks (3.85 %, p < 0.05), healthy snacks (6.41 %, p < 0.05), and fat (4.05 %, p < 0.01) and Na (3.89 %, p < 0.05) from snacks. Interaction effects of gender and BAS RR (p < 0.05) were found. Significant positive associations between BAS RR and daily intakes of energy from snacks (6.48 %, p < 0.01) and fat from snacks (7.22 %, p < 0.001) were found only for girls. CONCLUSION: SR was associated with snack and SSB consumption in adolescents, especially in girls. These findings suggest that SR should be taken into account when designing interventions to improve the snack and SSB intake of adolescents.

Fear of cancer is associated with cancer information seeking, scanning and avoiding: a cross-sectional study among cancer diagnosed and non-diagnosed individuals.

BACKGROUND: Nowadays, there is an abundance of health and cancer information in the mass media. Because of this high amount of information, it is possible for individuals to find or incidentally encounter cancer information, but it is also possible to be overloaded by this information and, consequently, to avoid it. Previous studies have indicated that fear of cancer could be both positively and negatively related to behaviours such as screening, help-seeking and information avoidance. OBJECTIVE: The aims of this study were (1) to assess the relationship between fear of cancer and cancer information acquisition and avoiding behaviour, (2) to examine whether this relationship was curvilinear, and (3) to determine whether this relationship was moderated by being diagnosed with cancer or not. METHOD: Six hundred and twenty-one cancer diagnosed and 1387 non-diagnosed individuals were recruited through a convenience sample in Flanders (Belgium) and filled in a standardised survey questionnaire. RESULTS: The results showed a positive linear association between fear of cancer and information seeking, scanning and avoiding. Being diagnosed with cancer or not did not moderate this relationship. CONCLUSION: Fear of cancer is positively associated with cancer information acquisition and avoiding behaviour. This suggests that fear of cancer predicts different behaviours in different individuals.

Media use, cancer knowledge and lifestyle choices: a cross-sectional analysis.

BACKGROUND: Both media use and cancer knowledge have been identified as important predictors of a healthy lifestyle. However, little is known about the interplay between these two variables, and about differences between cancer diagnosed and non-diagnosed consumers of media and knowledge. This study investigated the relationship between media use (television and internet exposure) and lifestyle choices of cancer diagnosed and non-diagnosed individuals, and looked at the influence of cancer knowledge on this relationship. METHODS: A cross-sectional, quantitative survey (the Leuven Cancer Information Survey) was administered to 621 cancer diagnosed and 1387 non-diagnosed individuals, aged 16-88 years old in Flanders (Belgium). Bivariate analyses, hierarchical linear regression analyses and advanced moderation and mediation analyses were conducted. RESULTS: Internet exposure was not a predictor of lifestyle choices. Television exposure, however, was a negative predictor of healthy lifestyle choices. Moreover, television exposure was a direct negative predictor of cancer knowledge, which in turn positively predicted lifestyle choices. However, no differences were found in the investigated relationships between the two subsamples. CONCLUSION: These results indicate that higher levels of television exposure coincide with less cancer knowledge and with less healthy lifestyle choices. It offers a pathway for intervention by suggesting that improving cancer knowledge through television might positively affect lifestyle choices.