Creativity in Health Communication to Promote Blood Lead Testing in Children.

Low rates of blood lead level screening among young children persist as a public health issue in the United States, including in Texas where levels remain below the national average. This article describes a multiyear, multipartner initiative aimed at increasing screening rates through a creative, community-informed social media campaign. Interviews with parents, providers, and state health department staff revealed a common perception that lead poisoning was a relic of the past. Using these insights, the team developed humorous social media messaging comparing extinct animals to lead poisoning to capture attention and change attitudes about lead's current relevance. The "#GetLeadCheckedTexas" campaign ran on state health department channels during National Lead Poisoning Prevention Week in October 2020. Colorful graphics depicted extinct creatures like dinosaurs along with their babies, playing on childhood enthusiasm for such animals while evoking protective feelings in parents. Messaging highlighted lead's dangers for young children and encouraged viewers to discuss testing with providers. Website analytics showed the campaign drove substantial increases in page views for lead screening resources, particularly among providers. While originally designed with a parent audience in mind, the campaign seemed to resonate more with providers, likely due to timing during an awareness week and use of official health department channels. The initiative demonstrates the value of creative communications approaches employed in traditional advertising to raise awareness and promote public health priorities. Audience research, thoughtful use of humor, and designing human-focused messaging helped cut through information clutter and drive engagement with an important childhood health issue.

Be Well™ Acres Homes: a community-driven, evidence-based approach to reduce health inequities through sustained cross-sector partnership.

PURPOSE: Be Well Communities™ is MD Anderson's signature place-based approach for cancer prevention and control, working with communities to promote wellness and address modifiable risk factors for cancer. The purpose of this paper is to describe implementation of the planning phase of the Be Well Communities model in Acres Homes which began in 2019. METHODS: A community advisory group (Steering Committee) including residents, non-profit organizations, health care partners, city and county agencies, plus other stakeholders, was convened and aligned through a structured process to develop shared goals, foster multisector collaboration, as measured by a stakeholder survey administered twice, and enhance community capacity to improve health outcomes through development of a Community Action Plan. RESULTS: Clear, achievable goals were developed, multisector collaboration was enhanced, and more than 400 h of capacity building support led to a Community Action Plan initially focused on healthy eating and active living, including 15 evidence-based interventions led by 18 organizations. The majority (93%) of the Steering Committee reports that this plan reflects community priorities and will reach the residents most in need. CONCLUSION: By listening and developing trust, the Be Well Communities team successfully worked with Acres Homes residents and organizations to enhance community capacity to address health inequities in one of Houston's most diverse and historic communities.

Social Media Use for Cancer Support Among Young Adults with Cancer.

Purpose: Social media can facilitate peer support among young adults with cancer; however, information is needed about what social media are used, by whom, and how to inform resource and intervention recommendations. Methods: In December 2021, we conducted an online survey with 396 young adults with cancer, ages 18-39, with any diagnosis ages 15-39. Participants reported their social media use to connect with other young adults with cancer, including frequency of use, type of support, and affect (positive to negative) when using to connect with cancer peers. Results: Participants were on average 31 years old (SD = 5.2), with an average age of 27 at diagnosis (63.4% male, 62.1% non-Hispanic White). Almost all (97.5%) reported using social media to connect with other young adults with cancer. Many (48.0%) used three or more social media platforms for cancer support, including Facebook (44.4%), YouTube (43.6%), Instagram (43.4%), Snapchat (36.9%), and Twitter (36.9%). Daily use for cancer support was common (32.9%-60.9%) among those who used social media, particularly among those who were younger; are not transgender; live in urban areas; or had brain, gynecologic, or testicular cancers. Across social media platforms, young adults with cancer reported seeking and sharing emotional support (88.9%), informational support (84.1%), and making connections (81.3%). Conclusion: Young adults with cancer use social media to connect with cancer peers for support. Commonly used existing social media (e.g., Facebook, YouTube, Instagram) should be prioritized in interventions to reach young adults who desire more age-appropriate resources to improve their psychosocial health.

Results of the George Washington University cancer center's comprehensive cancer control cancer communication mentorship program and implications for future practice.

PURPOSE: The Comprehensive Cancer Control Cancer Communication Mentorship Program ("Mentorship Program") was created by the George Washington University Cancer Center (GWCC) to provide technical assistance (TA) in implementing evidence-based cancer screening communication interventions and support networking for comprehensive cancer control (CCC) professionals. The Mentorship Program matched entry-to mid-level CCC professionals with health communication and/or CCC experts and offered monthly web-based discussions with academic researchers and practitioners who shared their knowledge and provided applied learning opportunities throughout mentees' project planning, implementation and evaluation. The program objective was for mentees to improve health communication skills and apply evidence-based knowledge to reduce the burden of cancer. METHODS: A mixed methods evaluation was conducted, including a qualitative description of each project and its outcomes as well as quantitative measures of satisfaction with the program and self-rated changes in competence. RESULTS: Mentees represented the following locations: New Jersey, Arkansas, Michigan, West Virginia, and Republic of Palau. Project topics ranged from increasing Human papillomavirus (HPV) vaccinations to increasing screening uptake for colorectal cancer, lung cancer, cervical cancer, and breast cancer. Evaluation results from pre- and post-program communication competency self-assessments and mid- and post-program surveys revealed that the Mentorship Program advanced personal and professional goals and improved public health communication skills. CONCLUSION: The Mentorship Program achieved its objectives for peer networking and offering expert TA in cancer prevention and control communication, offering a promising model for others involved in supporting implementation of evidence in practice.

Using Social Media for Peer-to-Peer Cancer Support: Interviews With Young Adults With Cancer.

BACKGROUND: Web-based social support can address social isolation and unmet support needs among young adults with cancer (aged 18-39 years). Given that 94% of young adults own and use smartphones, social media can offer personalized, accessible social support among peers with cancer. OBJECTIVE: This study aims to examine the specific benefits, downsides, and topics of social support via social media among young adults with cancer. METHODS: We conducted semistructured interviews with young adults with cancer, aged between 18 and 39 years, who were receiving treatment or had completed treatment for cancer. RESULTS: Most participants (N=45) used general audience platforms (eg, Facebook groups), and some cancer-specific social media (eg, Caring Bridge), to discuss relevant lived experiences for medical information (managing side effects and treatment uncertainty) and navigating life with cancer (parenting and financial issues). Participants valued socializing with other young adults with cancer, making connections outside their personal networks, and being able to validate their emotional and mental health experiences without time and physical constraints. However, using social media for peer support can be an emotional burden, especially when others post disheartening or harassing content, and can heighten privacy concerns, especially when navigating cancer-related stigma. CONCLUSIONS: Social media allows young adults to connect with peers to share and feel validated about their treatment and life concerns. However, barriers exist for receiving support from social media; these could be reduced through content moderation and developing more customizable, potentially cancer-specific social media apps and platforms to enhance one's ability to find peers and manage groups.

Initiation and changes in use of social media for peer support among young adult cancer patients and survivors.

PURPOSE: Social isolation is a prominent challenge for many young adults with cancer. Despite desires for peer-to-peer connections through technology, little is known about how young adults initiate or use social media for support over time. METHODS: We interviewed young adults with cancer (n = 45; age 18-39, in or post cancer treatment) to explore their initiation of social media for support, changes in use over time, and types of connections sought. RESULTS: Young adults with cancer learn about online support through individual personal recommendations, advocacy organizations, or searching on Google or social media. Most were reluctant to use social media support initially because of feeling overwhelmed-from diagnoses, abundance of online information, or demands of participation-and joined when informational and emotional needs arose. Many wished they had joined earlier. Some participants use social media to make close connections while others simply want to "see" others' shared experiences or crowdsource information. CONCLUSION: Young adults with cancer often haphazardly find online support from personal recommendations or Internet searches. Desires for social media connections are not one-size-fits-all; there are important audience segmentations for the degree and type of peer support. IMPLICATIONS FOR CANCER SURVIVORS: Better promotion of online social support options and benefits-early in one's cancer timeline and systematically through healthcare providers, cancer organizations, or family and friends-could improve access to helpful peer-to-peer support.

Cues for Increasing Social Presence for Mobile Health App Adoption.

As mobile health apps become increasingly influential in daily life, they present an important opportunity for health communication for disease prevention. User impressions of app designs are influential for adoption. Using cues to increase feelings of being with others (social presence) is one way to encourage favorable impressions and health app adoption. To examine the impact of social context cues (conversation cues vs. community cues vs. no cue control) on two forms of social presence (emergent and transcendent social presence), we conducted an online experiment (n = 587) with US adults. We also examined the indirect effects of conversation and community cues through social presence on app trust, perceived ease of use, perceived usefulness, and intentions to use the app. We found that conversational cues elicited intended feelings for new, emergent interactions and that community cues increased perceptions of ongoing or established social formations for transcendent interactions. These cues also had positive indirect effects for increased trust, perceived usefulness, and intentions to use the health apps and should be considered when developing mHealth to improve uptake and delivery of health promotion online.

Peer-to-peer connections: Perceptions of a social support app designed for young adults with cancer.

OBJECTIVE: Social support is a critical, yet frequently unmet, need among young adults (YAs) with cancer. YAs desire age-appropriate resources to connect with peers. Peer-to-peer mobile apps are promising interventions to provide social support. Peer-to-peer apps will be more effective if development incorporates users' input for whether app designs (look and function) afford meaningful connections. METHODS: We interviewed 22 YAs to assess perceptions of a peer-to-peer app at a YA cancer convention in April 2017. RESULTS: Participants were an average age of 29, mostly female (77%), white (73%), and well educated (68% with 4-year college degree or higher). Most participants expressed interested in using an app to connect with YAs, but preferences varied by prevalence or rarity of one's cancer diagnosis. YAs shared trade-offs for profile anonymity versus profiles with more personal information, requests for filter options to connect for varying support needs, and desires for tailored messaging and chat room features (eg, topic-specific and search capabilities). CONCLUSION: Findings demonstrate the promise of apps to fulfill YA cancer survivors' unmet peer support needs and provide guidance for app optimization. CLINICAL IMPLICATIONS: Peer-to-peer support apps should be designed so users can control their identity and customize features for meaningful connections.

Communication and comprehensive cancer control coalitions: lessons from two decades of campaigns, outreach, and training.

PURPOSE: Comprehensive cancer control (CCC) coalitions and programs have delivered effective models and approaches to reducing cancer burden across the United States over the last two decades. Communication plays an essential role in diverse coalition activities from prevention to survivorship, including organizational and community capacity-building and as cancer control intervention strategies. METHODS: Based upon a review of published CCC research as well as public health communication best practices, this article describes lessons learned to assist CCC coalitions and programs with systematic implementation of communication efforts as key strategies in cancer control. RESULTS: Communication-oriented lessons include (1) effective communication work requires listening and ongoing engagement with key stakeholders, (2) communication interventions should target multiple levels from interpersonal to mediated channels, (3) educational outreach can be a valuable opportunity to bolster coalition effectiveness and cancer control outcomes, and (4) dedicated support is necessary to ensure consistent communication efforts. CONCLUSIONS: External and internal communication strategies can optimize coalition efforts and resources to ultimately help produce meaningful improvement in cancer control outcomes.

The Audacity of Engagement: Hearing Directly from Young Adults with Cancer on Their Attitudes and Perceptions of Cancer Survivorship and Cancer Survivorship Research.

BACKGROUND: Young adult (YA) cancer survivors have been historically under-represented in cancer survivorship research, which has contributed to more disparate health outcomes compared with young and older cancer survivors. Using qualitative methods, this study explored YAs' perceptions of cancer survivorship and identified YA-specific barriers and preferences for participation in cancer survivorship research. METHODS: Individual interviews and focus groups were conducted with YA cancer survivors (N = 19) attending a patient-focused oncology conference. Grounded theory methodology guided analyses by using an inductive data-driven approach to thematic content analysis. RESULTS: Participants averaged 33 years old (standard deviation [SD] = 5.5), were 10 years postdiagnosis (SD = 2.3), and were primarily female (79%). Key cancer survivorship topics included adjusting to a "new normal," staying connected with cancer peers, and dealing with post-treatment medical care. Perceptions of YA survivorship research were mixed. YAs appreciated and were optimistic about the potential for benefit from research. Specific barriers for participation included perceptions of research being inaccessible, overwhelming, and frustrating; participation as inconvenient and burdensome; and researchers being viewed with skepticism and mistrust. They recommended: (1) making age-appropriate, patient-focused changes (e.g., language and design of study materials); (2) increasing participants' control, flexibility, and convenience of procedures; and (3) creating a back-and-forth dialogue between YAs and researchers. CONCLUSION: We assessed YA survivors' perceptions of YA cancer survivorship and research. Communication strategies are needed to address negative perceptions and perceived barriers to research participation. This includes tailoring of dissemination efforts and developmentally targeted implementation of YA priorities into the research process. Age-specific, patient-focused research practices may foster trust within the YA cancer survivor community and improve research participation.

Patterns of unmet needs in adolescent and young adult (AYA) cancer survivors: in their own words.

PURPOSE: Categorization of the needs of AYA cancer survivors is primarily based on quantitative analyses of epidemiological and observational research. The present study classified the phenomenological experiences of AYA survivors based on their own language. METHODS: A systematic approach for selecting qualitative studies of unmet needs in AYA cancer survivors was used. Following selection based on quality, survivor statements were entered verbatim and thematic analysis was conducted using NVivo qualitative research software. RESULTS: A total of 1993 AYA cancer survivors (post-treatment) were included in 58 studies (78% individual interviews). Mean age was 27.6 with an average of 8.6 years post-primary treatment. The organizational framework reported in this study was based on a heterogeneous group of cancer types. Thirteen themes including symptoms, function, reproductive health, emotional well-being, health management, health care system, social interaction, romantic relationships, cancer disclosure, normalcy, career development and employment, and school and fiscal concerns were identified. Forty-eight subthemes were also identified covering such areas as fertility, integrative health services, advice for cancer disclosure, family interaction, and insurance challenges. CONCLUSION: Direct analysis of text identified many common unmet needs similarly reported in the quantitative literature. The phenomenological data also provided a breakdown of unmet needs into subthemes or elements of unmet needs. IMPLICATIONS FOR CANCER SURVIVORS: This information can help form the basis for a personalized, valid, and reliable evaluation tool of the range of unmet needs in AYA survivors.

Exploring gender and identity issues among female adolescent and young adults who connect in an anonymous platform.

There has been an increased usage of online cancer support groups as a resource for health-related information and social support. This work analyzes message blog posts from an anonymous online support community to better understand issues related to gender and identity among female adolescent and young adults. This work sheds further light into the nuances of gender and identity issues including motherhood and reproductive issues, physical appearance, and romantic relationships. Specifically, findings reveal that female adolescent and young adults experience issues pertaining to infertility, feeling like a bad mom, hair loss, scarring, dating, and intimacy. These findings of this work offer further guidance about how healthcare providers and caregivers can attempt to meet the needs of female adolescent and young adults.

Making a Visual Impression (or Not): Current Design Practices of Nutritional Websites.

Understanding the influence of visual design, as the access point for online health communication, is key as Americans are increasingly sickened by an obesity epidemic. Nutritional websites that deliver critical health information should be considered as a potential strategy to fight against the grave consequences of obesity, as research indicates that consumers are consistently turning to the Internet as a resource for health information. Focusing on nutritional websites, this study analyzes the use of visual design principles that are known to greatly influence first impressions and appeal of the information from the user's perspective. The results suggest there are opportunities for improvement to the online communication of nutritional information to increase the likelihood of users' favorable first impressions, the critical first steps for nutritional information delivery goals.

Examining the Light and Dark of an Online Young Adult Cancer Support Community.

The young adult (YA) cancer community represents an understudied population in interpersonal and health communication scholarship. Through qualitative analysis, this study sought to advance a dark side perspective by exploring the content of messages shared in an online support forum for YAs with cancer. Our findings highlight a variety of complexities YAs face in an online cancer support community, including the light and dark of soliciting support, disclosing to a community, advocacy online, negative sentiment evaluating health care services, and asynchronous communication. Understanding the light and dark nuances involved with participating in an online YA support forum advances a dark side perspective on the scholarly research in health communication that can ultimately help care providers recommend resources and coach YAs to optimally and effectively use and navigate online support groups.

Hanging by a thread: exploring the features of nonresponse in an online young adult cancer survivorship support community.

PURPOSE: Finding helpful information can be challenging for young adult (YA) cancer survivors; thus, it is critical to examine features of online posts that successfully solicit responses and assess how these differ from posts that do not solicit responses. METHODS: Using posts from an online YA cancer support community, we analyzed initial posts that did and did not receive replies utilizing Linguistic Inquiry Word Count (LIWC). RESULTS: Independent t tests revealed significant differences between the sets of posts regarding content, emotions, cognitive processes, pronoun use, and linguistic complexity. More specifically, posts with replies contained fewer words per sentence, had more first-person pronouns, had more expressions of negative emotions, and contained more present tense and past tense verbs. CONCLUSIONS: The findings of this study can help improve peer-exchanged support in online communities so that YA cancer survivors can more effectively receive digital support. This research also provides communication researchers, health educators, and care providers a lens for understanding the YA cancer survivorship experience. IMPLICATIONS FOR CANCER SURVIVORS: This research helps survivors be strategic in how they use online forums to seek advice and support. More complete understanding of what kinds of prompts produce responses allows those in need to craft messages in ways that are most likely to elicit support from fellow cancer survivors. These implications for message design extend beyond blogging and can be applicable for text message and email exchanges between cancer patients and their care providers.

Understanding how adolescents and young adults with cancer talk about needs in online and face-to-face support groups.

We compared adolescent and young adult cancer patient and survivor language between mediated and face-to-face support communities in order to understand how the use of certain words frame conversations about family, friends, health, work, achievement, and leisure. We analyzed transcripts from an online discussion board ( N = 360) and face-to-face support group ( N = 569) for adolescent and young adults using Linguistic Inquiry and Word Count, a word-based computerized text analysis software that counts the frequency of words and word stems. There were significant differences between the online and face-to-face support groups in terms of content (e.g. friends, health) and style words (e.g. verb tense, negative emotion, and cognitive process).