The Impact of Celebrity and Influencer Illness Disclosures.

When celebrities, political figures, influencers, or anyone with a large following publicly disclose an illness or die, the news becomes a de facto public health campaign. Until health communicators began studying such disclosures and the effects of the following waves of media coverage, however, it was not known to what extent these events impacted the public. A growing body of research has empirically documented these events and examined the factors that predict which types of audiences are most affected and why. Beyond motivating research opportunities, celebrity and influencer health disclosures or deaths can impact calls to hotlines, views on health-related websites, discussions of related topics on social media, behavioral changes relevant to the disclosure, increased news coverage of celebrity health research, integration of celebrity health narratives into strategic health campaigns, and even policy changes. We provide an overview of research conducted in this area and detail examples of the impact that celebrity health disclosures and studies about those disclosures have had on public discourse and public health.

Exposure to Pro and Anti-Cannabis Social Media Messages and Teens' and College Students' Intentions to Use Cannabis.

Content analyses have documented that posts about cannabis are increasingly common on social media. The relationship between the cannabis-related content to which teens and college students are exposed on social media and how such content may be associated with intentions to use and use of cannabis is less known, however. We conducted an online survey with teens (N = 350) who lived in Washington state using online survey panel participants in June 2018 and with college students (N = 966) in a Washington state-wide university system in February and March 2019. Participants in both samples reported seeing both pro-cannabis and anti-cannabis messages on social media platforms. Exposure to pro-cannabis messages on social media was associated with an increased intention to use cannabis. Exposure to anti-cannabis messages on social media was indirectly associated with decreased intentions to use cannabis through negative outcome beliefs of cannabis use and, among college students, through perceived norms. Among college students specifically, exposure to pro-cannabis messages on social media was also associated with more frequent cannabis use. Health communicators could focus anti-cannabis messaging on negative outcome beliefs among teens and college students as well as norms among college students to potentially influence constructs associated with intentions and use.

An Exploratory Content Analysis of the Use of Health Communication Strategies and Presence of Objectification in Fitness Influencer Social Media Posts.

Health and fitness content intended to inspire people to live healthy lives (e.g. "fitspiration") has been linked to negative body image among girls and young women. Fitness influencers purport wanting to motivate healthy behaviors. This study seeks to examine the presence of strategies known to positively influence health behaviors (e.g. attitudes, self-efficacy) as well as of content known to have a negative influence (e.g. objectification) among fitness influencers. We conducted a content analysis (N = 441) of a random sample of one year of posts from four Instagram fitness influencers popular with girls and young women in the United States. The main analysis consisted of codes related to objectification, health promotion strategies, health-related content, and social engagement (i.e., likes). We found that fitness influencers included content that conveyed constructs previously found to positively influence health behaviors (e.g., attitudes and self-efficacy), but objectification was frequently present, in more than half of the posts. Additionally, we found that the presence of objectification in posts was negatively associated with likes, a form of social endorsement. We suggest health communicators aim to work in tandem with fitness influencers to include content that may motivate positive health behaviors and improve media literacy and that influencers aim to reduce the amount of objectifying content included in their posts. Our findings shed light on content being conveyed and possible insights into the negative effects associated with viewing such content.

The impact of sexual scripts in brand-generated cannabis social media posts on sex-related cannabis expectancies: Does body appreciation moderate effects?

INTRODUCTION: Cannabis messaging on digital media may include sexualised portrayals. We examined whether exposure to and perceptions of cannabis posts that included sexual objectification impacted two types of sex-related cannabis expectancies-sexual risk and sexual enhancement-and whether body appreciation moderated these relationships. METHODS: We conducted an online experiment with college students in Washington state. Participants viewed three brand-generated cannabis Instagram posts that either included sexually objectified women or recreational appeals (e.g., sitting by a firepit). We conducted regressions, using the PROCESS macro, to examine the hypothesized model and potential mediation and moderation. RESULTS: Exposure to sexualised advertisements was associated with increased perceptions of cannabis sex enhancement scripts (b = 0.34, p < 0.01), which was associated with increased cannabis sex enhancement expectancies (b = 0.34, p < 0.001) and decreased cannabis sexual risk expectancies (b = -0.16, p < 0.001); exposure to such advertisements were also associated with increased perceptions of cannabis sexual risk scripts (b = 0.61, p < 0.001), which was associated with increased cannabis sexual risk expectancies (b = 0.53, p < 0.001). Body appreciation was associated with increased cannabis sex enhancement expectancies (b = 0.13, p < 0.01) and moderated the relationship between exposure to sexualised ads and cannabis sex enhancement expectancies (b = -0.21, p < 0.01). DISCUSSION AND CONCLUSIONS: Practitioners may want to consider how to increase critical consumption of cannabis content on digital media. Researchers should consider the possible role of body appreciation as it relates to cannabis and sex enhancement expectancies.

#LoveYourBody: An Experimental Test of the Effects of Objectification and Body Appreciation Content on Instagram Fitness and Health Posts Among Young Women.

Fitspiration content on Instagram often includes images in which women are objectified but may also include captions that aim to positively motivate viewers, such as through messaging about body appreciation. Viewing objectifying content in fitspiration posts may be problematic for young women's mental health, but it's unclear if positive messaging may help to alleviate some of these effects. In this study, we conducted a 2 × 2 online experiment assessing the effects of body appreciation and objectification content present in Instagram fitness posts by influencers on young women (N = 200). The outcome variables were state body appreciation, trait body appreciation, self-esteem, and self-compassion. We found an interaction between the presence and absence of objectification and presence and absence of body appreciation that significantly influenced self-compassion and body appreciation. The interaction suggests that self-compassion and state body appreciation are higher in the presence of body appreciation messaging, although there were not main effects for just viewing objectifying images or body appreciation captions. This means that just body appreciation or just objectification may not affect state body appreciation and self-compassion, but the two together have an effect. Our findings suggest that body appreciation captions may serve as a protective factor for self-compassion and state body appreciation when young women view Instagram fitspiration posts that include sexual objectification. Health communicators could encourage influencers to include body appreciation content in their fitspiration posts to help improve self-compassion among viewers, and interventions could work to promote body appreciation among young women to encourage self-compassion.

Examining science and media literacy health communication messages to reduce intentions to use cannabis while pregnant.

OBJECTIVE: Although use of cannabis during pregnancy can be detrimental to the fetus, use of cannabis during pregnancy has increased. Pregnant people are often exposed to incorrect information about cannabis use during pregnancy online and have expressed a desire for additional information about the effects of using cannabis while pregnant. We wanted to design and test a brief intervention promoting media literacy and science literacy and assess whether exposure would reduce intentions to use cannabis during pregnancy. METHOD: We created two sets of messages, one with a focus on increasing media literacy and another on increasing science literacy. Messages were either presented in a narrative/story or nonnarrative formats. Participants who identified as female, aged 18-40, were recruited online via a Qualtrics panel to participate in the online experiment. We used multigroup structural equation modeling (SEM) to model the relationships across message groups. RESULTS: Results suggested that increased awareness about potential harms of Tetrahydrocannabinol to the fetus was associated with intentions to reduce cannabis use while pregnant in the science literacy conditions for both message types (science narrative b = .389, p = .003; science nonnarrative b = .410, p ≤ .001). Increased media literacy for source was associated with intentions to reduce cannabis use during pregnancy in the media literacy nonnarrative group (b = .319, p = .021) but was not significant for the media literacy narrative condition. CONCLUSIONS: Messages focused on both media literacy and science literacy may be of value to pregnant people who use cannabis, with science literacy likely having a more direct effect. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Fifteen Years after a 10-year Retrospective: The State of Health Mass Mediated Campaigns.

In 2006, a 10-year retrospective of successful mass mediated health communication campaigns reviewed the field and highlighted strategies for successful campaigns. In the 15 years since the retrospective, there have been dramatic changes in the media environment and advances in health communication research. In this article, we describe changes in the health communication media landscape and in our understanding of mass mediated health communication campaigns in the 15 years since the retrospective. Although the media environment has shifted, we argue that effective principles of health communication have remained relatively constant. We note significant advances in technology since the previous retrospective that can further advance health communication campaigns, with new technologies offering promise as channels for health communication campaigns as well as for campaign planning. We also recommend that campaign researchers report in detail on their use of theory, audience segmentation, channel selection, and the role of formative research when describing campaign efforts; that communicators continue to develop frameworks that integrate principles of effective campaign design; and that additional research focus on understanding how technology can be effectively incorporated into campaign planning, distribution, and evaluation.

The Effects of Embedded Skin Cancer Interventions on Sun-Safety Attitudes and Attention Paid to Tan Women on Instagram.

Background and Objectives: Because of high skin cancer risks for young women, it is vital that effective interventions reach and influence this demographic. Visual social media platforms, like Instagram, are popular with young women and are an appropriate intervention site; yet, they also host competing images idealizing tan skin. The present study tested the ability of digital sun-safety interventions to affect self-control-related emotions and visual attention to subsequent tan-ideal images as well as sun-safety attitudes. Methods: Women were recruited from a large public Mid-Atlantic university in the United States. Participants (N = 120) were randomly assigned to view an appearance benefits intervention, a self-control emotions intervention, or a control message, each designed to look like an Instagram sponsored story. After self-reporting self-compassion and anticipated pride, participants then viewed seven pairs of Instagram posts featuring either tan or pale women while an eye tracker assessed visual attention. Finally, participants self-reported their responses to questions assessing sun-safety-related norms, efficacy, and attitudes. Results: A mixed design analysis of covariance revealed that women who first viewed the appearance benefits intervention story spent less time visually fixated on Instagram images of tan women than did those who viewed the self-control emotions intervention or control message (p = 0.005, η p 2 = 0.087). Regressions also revealed interactions between the intervention conditions and feelings of anticipated pride on both visual attention and sun-safety attitudes. Conclusion: Sponsored stories on Instagram can promote sun-safety attitudes, depending on the emotional responses they generate. Additionally, sponsored interventions can affect subsequent visual attention.

Development of an mHealth text message intervention to promote adherence to COVID-19 isolation recommendations for college students.

Background: Important tools in preventing the spread of COVID-19 include contract tracing and adherence to isolation guidelines after a positive diagnosis of COVID-19. This is especially relevant among college students who are often away from support systems at home, living in high-density housing, and may not experience serious symptoms from COVID-19 while still contagious. Objective: As text message-based interventions have been found effective in addressing health behaviors among young adults, we conducted formative research to explore how text messaging could support students in adhering to isolation guidelines. Participants: A convenience sample of college students (n = 104) at one university. Methods: An online survey gathered students' perceptions of helpful components to include in a text message-based intervention. Results: Students expressed interest in receiving text messages with support, encouragement, and resources during their time in isolation following a COVID-19 diagnosis. Conclusions: Based on the results, we developed a text message-based intervention designed to provide motivation, support, distraction, and information on resources.

Social Media, Marijuana and Sex: An Exploratory Study of Adolescents' Intentions to Use and College Students' Use of Marijuana.

Recreational marijuana continues to be legalized in U.S. states, with popular media discussing connections between cannabis and the facilitation of sexual activity. We conducted two surveys with adolescents and college students in Washington state to examine the role of viewing social media and pro-marijuana content on sex-related marijuana expectancies and intentions to use. In Study 1, among adolescents (N = 350), we found connections between social media use, exposure to pro-marijuana content, and sex-related marijuana expectancies, with boys' sex-related marijuana expectancies predicting intentions to use marijuana. In Study 2, we expanded this research to college students (N = 966), with the addition of frequency of marijuana use as an outcome. For men, sex-related marijuana expectancies were negatively associated with marijuana use. Sex-related marijuana expectancies were not associated with intentions to use or use of marijuana among adolescent girls and college women. Our findings highlight how social media use is associated with increased exposure to pro-marijuana content for adolescents and college students, and how such content is associated with sex-related marijuana expectancies. The mixed relationships in our data between sex-related marijuana expectancies and intentions and use highlight potential gender and developmental differences.

A Mixed Methods Inquiry into the Role of Tom Hanks' COVID-19 Social Media Disclosure in Shaping Willingness to Engage in Prevention Behaviors.

Given the vast amounts of COVID-19-related messages flooding mediated and interpersonal communication channels during the global pandemic, celebrity COVID-19 disclosures offer rare opportunities to cut through message fatigue and apathy and garner the attention of wide swaths of the public. We conducted a convergent mixed method analysis of audience responses to actor Tom Hanks' March 11, 2020 disclosure of his COVID-19 diagnosis via social media. We collected our data within 24 hours of his announcement, allowing us to quickly capture emotional and cognitive responses to the announcement and to assess both demographic and psychosocial differences in types of people who heard the news in this time frame and those who had not. In our study, 587 participants had heard the news of Hanks' disclosure while 95 had not. Participants who had heard responded to an open-ended prompt asking if the disclosure affected them at all. Those who had not heard were funneled into a field intervention to test how random assignment to seeing Hanks' disclosure post or not would affect audiences' COVID-19-related emotions, cognitions, and willingness to enact prevention behaviors. The results of this mixed methods study revealed differences in responses to Hanks' disclosure based on health information source trust and involvement with Hanks as well as effects of the intervention on efficacy for dealing with COVID-19. We discuss implications for health communication theory and crafting messages that can effectively build off the attentional inertia generated by celebrity illness disclosures to encourage prevention efforts.

Measurement Invariance of the Sex-Related Cannabis Expectancies Scale across Age and Gender.

Sex-related cannabis expectancies have been found to be associated with intentions to use cannabis, cannabis use, and sexual behavior. However, the construct of sex-related cannabis expectancies has been adapted from research with limited examination of the scales themselves. We tested (N = 350 adolescents age 13-17; N = 929 young adults age 18-29) measurement invariance of a sex-related cannabis expectancies scale and found the scale invariant between adolescents and emerging adults as well as between genders. But the partial invariance across age groups suggested that one item from the scale contained systematic errors in assessing the age group differences and warrants additional examination. Latent mean difference tests revealed that young people's sex-related cannabis expectancies differ between age groups and genders.

The "celebrity canary in the coal mine for the coronavirus": An examination of a theoretical model of celebrity illness disclosure effects.

RATIONALE: On March 11, 2020, actor Tom Hanks announced via social media that he had been diagnosed with COVID-19. Previous research has found celebrity illness disclosures to influence behavior, but during the uncertainty of a pandemic, the effects of such a disclosure were unclear. OBJECTIVE: To test the proposed Celebrity Illness Disclosure Effects (CIDE) model, demonstrating how an illness disclosure, communicated through mediated and interpersonal channels, may shape willingness to engage in prevention behaviors. METHODS: We conducted an online survey (N = 587) 24 hours after Hanks' COVID-19 disclosure. RESULTS: Findings revealed that celebrity-related perception variables predicted illness-related cognitions and emotions\, which were associated with willingness to enact prevention behaviors. Greater willingness to seek information, stronger perceptions of COVID as a threat, and stronger perceptions of efficacy for dealing with COVID after learning of Hanks' diagnosis predicted stronger willingness to enact prevention behaviors. However, anxiety about COVID predicted lower willingness to enact prevention behaviors. CONCLUSIONS: The CIDE model can serve as a guide for future research in this area. The results can help scholars who aim to better understand the phenomena around celebrities and health communication as well as policymakers who hope to ride the wave of star power to improved public health outcomes.

How Media Literacy and Science Media Literacy Predicted the Adoption of Protective Behaviors Amidst the COVID-19 Pandemic.

Individuals must navigate complex media environments filled with frequently changing and varyingly credible information to acquire and apply health information during times of uncertainty and danger. A process model tested in two U.S. national surveys in spring (N = 1220) and summer (N = 1264) of 2020 tested how three media literacy constructs (about sources, content, and science information) predicted the adoption of behaviors protective for COVID-19. Results showed that the three media literacy constructs were mediated by knowledge of COVID-19 (wave 1 TE = 0.190; wave 2 TE = 0.190) and expectancies (wave 1 TE = 0.496; wave 2 TE = 0.613). The model was confirmed as largely consistent across the two waves of data collection with independent samples. Results show the importance of expectancies for mediating the effects of media literacy, efficacy, and knowledge on behavior. The study suggests that media literacy and science media literacy skills aid health behavior adoption by contributing to knowledge gain and expectancies.

Appearance, Friends, and Feelings: A Two-Study Exploration of Young Women's Emotional Associations and Indoor Tanning Frequency.

BACKGROUND: Knowledge of its potential cancer risk is often not enough to motivate individuals to avoid indoor tanning. Previous research has found that emotions toward indoor tanning and appearance motivations may prompt people to continue despite the risks. METHODS: We conducted two online surveys of US young adult women. Study one included a convenience sample of female undergraduates (N = 502) at a university in the northwestern USA. Study two included young women from a nationwide US online panel (N = 270). RESULTS: Results suggest that emotional associations, both positive and negative, with indoor tanning explain greater variances in indoor tanning behavior than demographics and previously established psychosocial predictors of tanning alone. Appearance motivations were also positively associated with indoor tanning in both samples. CONCLUSIONS: This research has implications for health care providers and health communicators, as indoor tanning prevention messages and campaigns should consider the association between both positive and negative emotions on tanning behaviors as well as appearance motivations.

Effects of Website Interactivity on Skin Cancer-Related Intentions and User Experience: Factorial Randomized Experiment.

BACKGROUND: Digital media technologies provide users with the ability to interact with content and to receive information based on their preferences and engagement. OBJECTIVE: We used skin cancer and sun protection as a health topic to explore how modality interactivity, interface tools that afford users greater activity, resulting in greater depth and breadth of mentally representing and experiencing mediated content, and message interactivity, the extent to which the system allows users to exchange messages back and forth on health websites, influenced users' attitudes, knowledge, behavioral intentions, and experience. METHODS: We employed a 2×2 (modality interactivity: high vs low; message interactivity: high vs low) between-subject online experiment for which 4 websites were created. Participants (n=293) were recruited using Amazon Mechanical Turk and randomly assigned into to 1 of 4 conditions. After browsing the website, participants completed an online survey regarding their experience and cognitive perceptions. General linear models and path analysis were used to analyze the data. RESULTS: Both modality interactivity (P=.001) and message interactivity (P<.001) had an impact on intention to use sun protection. Attitudes toward health websites and perceived knowledge mediated the effects of modality interactivity and message interactivity on sun protection use intention, individually. Participants in the high modality interactivity and high message interactivity condition felt more satisfied (P=.02). Participants in the low message interactivity condition had more interest in the experience with health websites than participants in the high message interactivity condition (P=.044). CONCLUSIONS: Findings suggested that modality interactivity influenced intention to use sun protection directly as well as via attitudes toward the websites. Message interactivity impacted intention to use sunscreen directly and also through perceived knowledge. Implications for designing health websites and health intervention content are discussed.

Friends over Doctors? The Influences of Source and Perceived Customization on College Drinking.

College drinking, often associated with college binge drinking, is a critical issue in the United States and may lead to harmful consequences such as academic failure, injury, sexual assault, and even death. Health interventions targeted at reducing problematic drinking are needed to help prevent these harmful behaviors among college students. The current work explores the intersection of different types of information sources (e.g., authority and peer) and perceived customization on various health-related outcomes related to college drinking (e.g., trust, attitudes, and behavioral intentions). Undergraduate students (N = 448) were presented with health information regarding college drinking in a 2 (perceived customization or non-customization) × 3 (authority, peer, or technology source) between-subjects experimental design. We found a strong effect of peer source of health information, somewhat surprisingly more effective than information from a professional source (i.e., a medical physician). Moreover, the results underscore the importance of not only promoting perceived customization but also fostering a sense of agency with such interface features. Theoretical and practical implications for health-related outcomes are discussed.

Adding to the Message Testing Tool Belt: Assessing the Feasibility and Acceptability of an EMA-Style, Mobile Approach to Pretesting mHealth Interventions.

Effective health message design requires strong pretesting to ensure that potential audiences see communication efforts as acceptable. Previous research has often used long-form surveys to test messaging, even when the potential communication efforts are going to take place in a non-traditional format, such as on a text message platform. This study asks whether real-time sampling on a mobile phone could serve as a message-testing alternative to traditional surveys. Participants evaluated health messages over a week using mobile phones in a style similar to ecological momentary assessment. More than 90 percent of messages were evaluated, and a majority of participants preferred this methodology to other pretesting methods. This approach, while not without limitations, is a viable tool for diversifying message testing efforts.