Pandemic lifeworlds: A segmentation analysis of public responsiveness to official communication about Covid-19 in England.

Pandemics such as Covid-19 pose tremendous public health communication challenges in promoting protective behaviours, vaccination, and educating the public about risks. Segmenting audiences based on attitudes and behaviours is a means to increase the precision and potential effectiveness of such communication. The present study reports on such an audience segmentation effort for the population of England, sponsored by the United Kingdom Health Security Agency (UKHSA) and involving a collaboration of market research and academic experts. A cross-sectional online survey was conducted between 4 and 24 January 2022 with 5525 respondents (5178 used in our analyses) in England using market research opt-in panel. An additional 105 telephone interviews were conducted to sample persons without online or smartphone access. Respondents were quota sampled to be demographically representative. The primary analytic technique was k means cluster analysis, supplemented with other techniques including multi-dimensional scaling and use of respondent - as well as sample-standardized data when necessary to address differences in response set for some groups of respondents. Identified segments were profiled against demographic, behavioural self-report, attitudinal, and communication channel variables, with differences by segment tested for statistical significance. Seven segments were identified, including distinctly different groups of persons who tended toward a high level of compliance and several that were relatively low in compliance. The segments were characterized by distinctive patterns of demographics, attitudes, behaviours, trust in information sources, and communication channels preferred. Segments were further validated by comparing the segmentation variable versus a set of demographic variables as predictors of reported protective behaviours in the past two weeks and of vaccine refusal; the demographics together had about one-quarter the effect size of the single seven-level segment variable. With respect to managerial implications, different communication strategies for each segment are suggested for each segment, illustrating advantages of rich segmentation descriptions for understanding public health communication audiences. Strengths and weaknesses of the methods used are discussed, to help guide future efforts.

Lessons Learned from Developing Tailored Community Communication Campaigns in the HEALing Communities Study.

This paper outlines lessons learned from tailoring communication campaigns to increase demand for, and reduce stigma toward, evidence-based practices to reduce opioid overdose deaths in 66 communities participating in the HEALing (Helping to End Addiction Long-termSM) Communities Study (HCS). We present nine lessons gathered about how to engage local communities in both virtual and in-person opioid messaging and distribution between February 2019 and June 2022. The research team created four communication campaigns and did extensive, tailored marketing and promotion to assist communities in implementing evidence-based clinical activities to reduce opioid overdose mortality. Various strategies and venues were used to amplify HCS messages, using free and paid outlets for message distribution, focusing primarily on social media due to the COVID-19 pandemic. Increasing the availability of medications for opioid use disorder and naloxone, as HCS attempted, is not enough; getting people to accept and use them depends on communication efforts. This paper focuses on the process of preparing communities for communication campaign activities, which we hope can help guide other communities preparing for opioid or substance-related campaigns in the future.

Simultaneous inhibition of DNA-PK and PolÏ´ improves integration efficiency and precision of genome editing.

Genome editing, specifically CRISPR/Cas9 technology, has revolutionized biomedical research and offers potential cures for genetic diseases. Despite rapid progress, low efficiency of targeted DNA integration and generation of unintended mutations represent major limitations for genome editing applications caused by the interplay with DNA double-strand break repair pathways. To address this, we conduct a large-scale compound library screen to identify targets for enhancing targeted genome insertions. Our study reveals DNA-dependent protein kinase (DNA-PK) as the most effective target to improve CRISPR/Cas9-mediated insertions, confirming previous findings. We extensively characterize AZD7648, a selective DNA-PK inhibitor, and find it to significantly enhance precise gene editing. We further improve integration efficiency and precision by inhibiting DNA polymerase theta (PolÏ´). The combined treatment, named 2iHDR, boosts templated insertions to 80% efficiency with minimal unintended insertions and deletions. Notably, 2iHDR also reduces off-target effects of Cas9, greatly enhancing the fidelity and performance of CRISPR/Cas9 gene editing.

A Novel Cell-based Luciferase Reporter Platform for the Development and Characterization of T-Cell Redirecting Therapies and Vaccine Development.

T-cell immunotherapies are promising strategies to generate T-cell responses towards tumor-derived or pathogen-derived antigens. Adoptive transfer of T cells genetically modified to express antigen receptor transgenes has shown promise for the treatment of cancer. However, the development of T-cell redirecting therapies relies on the use of primary immune cells and is hampered by the lack of easy-to-use model systems and sensitive readouts to facilitate candidate screening and development. Particularly, testing T-cell receptor (TCR)-specific responses in primary T cells and immortalized T cells is confounded by the presence of endogenous TCR expression which results in mixed alpha/beta TCR pairings and compresses assay readouts. Herein, we describe the development of a novel cell-based TCR knockout (TCR-KO) reporter assay platform for the development and characterization of T-cell redirecting therapies. CRISPR/Cas9 was used to knockout the endogenous TCR chains in Jurkat cells stably expressing a human interleukin-2 promoter-driven luciferase reporter gene to measure TCR signaling. Reintroduction of a transgenic TCR into the TCR-KO reporter cells results in robust antigen-specific reporter activation compared with parental reporter cells. The further development of CD4/CD8 double-positive and double-negative versions enabled low-avidity and high-avidity TCR screening with or without major histocompatibility complex bias. Furthermore, stable TCR-expressing reporter cells generated from TCR-KO reporter cells exhibit sufficient sensitivity to probe in vitro T-cell immunogenicity of protein and nucleic acid-based vaccines. Therefore, our data demonstrated that TCR-KO reporter cells can be a useful tool for the discovery, characterization, and deployment of T-cell immunotherapy.

Testing the effectiveness of alcohol health warning label formats: An online experimental study with Australian adult drinkers.

Health warning labels (HWLs) on alcohol containers may help reduce population-level alcohol consumption. However, few studies have examined the most effective formats for alcohol HWLs. This study tested the effects of three different types of alcohol HWLs. In an online experiment, N = 1,755 Australian adult drinkers were randomly assigned to one of five conditions: (a) No HWL control; (b) DrinkWise control (industry-developed labels currently on some containers); (c) Text-Only HWLs; (d) Text + Pictogram HWLs; or (e) Text + Photograph HWLs. In the three intervention conditions, participants were exposed to eight HWLs, each depicting a different long-term harm. Exposure occurred during an initial session, and repeatedly over the subsequent eight days. Differences between conditions were assessed immediately following initial exposure and at nine-day follow-up. Compared to participants in the No HWL control, participants exposed to Text + Pictogram HWLs were more likely to have intentions to avoid drinking alcohol completely in the next month (post-exposure) and intentions to drink less alcohol in the next week (follow-up), and participants in all three intervention conditions reported stronger negative emotional arousal (follow-up) and weaker positive emotional arousal (follow-up). Compared to participants in the DrinkWise control, those exposed to Text + Pictogram HWLs had stronger intentions to drink less alcohol in the next week and intentions to avoid drinking alcohol completely in the next month (follow-up), participants in the Text + Photograph condition reported significantly weaker positive emotional arousal, and all three intervention conditions resulted in stronger negative emotional arousal. There would likely be benefits to public health if any of the three types of intervention HWLs were implemented. However, there is some evidence that Text + Pictogram HWLs should be recommended over Text-Only or Text + Photograph HWLs, given they were the only HWLs to increase intentions to drink less.

Prospective associations between attitudes toward alcohol advertisements and alcohol use behaviors among adolescent boys.

Objectives: Earlier initiation of alcohol use and problematic drinking among adolescents are linked with adverse health outcomes. Exposure to alcohol advertisements is associated with drinking among adolescents, but the association between the attitudes toward alcohol advertisements and drinking behaviors is understudied. We evaluated the association between attitudes towards alcohol advertisements and initiation of alcohol use among adolescent boys. Methods: Adolescent boys from urban and Appalachian Ohio enrolled in a prospective study and reported whether they had ever consumed alcohol or been drunk at baseline (N = 1220; ages 11-16 years) and at the 24-month follow up (N = 891). Attitudes toward alcohol advertisements were measured at baseline following a brief advertisement viewing activity. Adjusted logistic regression models were used to estimate associations between attitudes toward advertisements and initiating alcohol use or drunkenness at the 24-month follow-up. Results: Adolescent boys reporting any positive attitudes toward alcohol advertisements had higher odds of initiating alcohol use (aOR = 2.00, 95% CI [1.16, 3.44]), and attitudes were marginally associated with incident drunkenness (aOR = 2.20, 95% CI [0.94, 5.12]). Increasing age, higher household income, ever use of tobacco, and frequency of visiting alcohol retailers were also associated with greater odds of incident alcohol use and/or drunkenness. Conclusions: Attitudes toward alcohol advertisements at baseline were associated with alcohol drinking behaviors 24-months later among adolescent boys. Results highlight the importance of media literacy interventions targeted to adolescents.

Correlates of U.S. Young adults' awareness of alcohol use as a behavioral risk factor for cancer.

Although alcohol increases the risk of cancer, awareness of alcohol-related cancer risks is low. Alcohol use is prevalent among young adults, and understanding factors associated with awareness and perceptions of alcohol-related cancer risks in this group is critical for cancer prevention efforts. We examined the demographic, tobacco, and alcohol related correlates of young adults' awareness and perceptions of alcohol as a behavioral risk factor for cancer. We completed a secondary analysis of data collected in February 2020 in the U.S. from 1,328 young adults (ages 18-30) who completed a cross-sectional online survey. Participants reported (1) awareness of alcohol as a risk factor for cancer and (2) perceived risks of serious disease such as cancer. We analyzed demographic characteristics, alcohol use, and tobacco use associated with these outcome variables using multivariable regression. Overall, 18.5% of participants believed that alcohol does not increase cancer risk. Perceived cancer risk associated with alcohol use was moderate (M 3.2, SD 1.6, 1-7 scale). In multivariable analysis, awareness of risk was significantly higher among those with higher socioeconomic status. Perceived risk was significantly greater among those with higher socioeconomic status, higher alcohol consumption, and a history of tobacco use. These findings indicate research is warranted to better understand awareness of alcohol as a behavioral risk factor for cancer and associated beliefs in subgroups of young adults to help guide the development of interventions to raise awareness of the risks of cancer associated with alcohol use.

Associations between Cognitive and Affective Responses to Tobacco Advertisements and Tobacco Use Incidence: A Four-Year Prospective Study among Adolescent Boys.

Exposure to tobacco advertisements is associated with initiation of tobacco use among youth. The mechanisms underlying this association are less clear. We estimated longitudinal associations between youths' cognitive and affective responses to advertisements for cigarettes, e-cigarettes, and smokeless tobacco (SLT) and initiation of these products. N = 1220 Ohio-residing boys of ages 11-16 were recruited into a cohort in 2015 and 2016. Participants completed surveys every six months for four years. Surveys assessed cognitive and affective responses to tobacco advertisements (which included health warnings) and tobacco use after an advertisement viewing activity. We used mixed-effects Poisson regression models with robust standard errors to estimate risk of initiating use of each tobacco product according to participants' cognitive (i.e., memorability of health risks) and affective (i.e., likability of advertisement) responses to advertisements for that product. No associations between affective responses to advertisements and tobacco use outcomes were detected in adjusted models. However, finding health risks memorable was associated with reduced risk of ever smoking initiation (aRR = 0.57; 95% CI: 0.34, 0.95) and a reduced risk of ever SLT initiation that approached statistical significance (aRR = 0.61; 95% CI: 0.36, 1.05). Measures to increase saliency of health risks on cigarette and SLT advertisements might reduce use among youth.

Increasing Alcohol Control Policy Support: The Mediating Role of Empathy and Emotions.

Background: Mass media messages have the potential to reduce alcohol-related harm through increasing support for alcohol-control policies. Objectives: In Study 1, we experimentally examined the incidental effects of alcohol mention in news articles about accidents and crime and found evidence that messages mentioning alcohol as a causal factor in the accident or crime can activate empathic and emotional responses, which in turn increase support for alcohol control policy. In Study 2, anti-drinking and driving public service announcements (PSAs) were edited to either portray consequences of drinking and driving for the driver only or for both the driver and innocent others. Results: The versions of the PSAs that showed consequences to others were more successful at eliciting alcohol-control policy support than the versions showing only consequences to the self. As hypothesized, empathy that was directed toward victims (but not drivers under the influence) and negative emotions were supported as mediators of this relationship. Although negative affect and feelings of empathy for the victims of drunk driving are not pleasant emotions to experience, they appear to play an important role in increasing support for public policies to increase safety without having a negative impact on viewer's evaluations of the PSA. Conclusions: Results from the two studies provide evidence that empathy and emotions can play a mediating role between message characteristics (either intentional or incidental) and alcohol control policy support.

Eudaimonic Testimonial Vs. Didactic Presentation Impact on Willingness to Engage in Conversations about End-of-Life Care: The Moderating Role of Modeling.

Using the mediated wisdom of experience (MWOE) theoretical framework, this study examines how eudaimonic testimonials versus comparable didactic presentations, and the presence or absence of modeling target behavior, influence death acceptance and intentions to converse about end-of-life care preferences. Effects for testimonials on attitudes and behaviors proved contingent on modeling. When testimonials incorporated modeled behavior, individuals were more likely to intend to carry out conversations about end-of-life conversations. However, when the testimonials did not provide modeled examples of conversations about death, individuals were more likely to experience anxiety and less likely to intend to engage in such conversations. Mediation analyses found that testimonials indirectly increased attitudes and intentions to have end-of-life conversations through emotional range and death acceptance. Mediation analyses also indicated modeling such conversations increased attitudes and intentions toward having end-of-life conversations via identification and self-efficacy.

Understanding the effectiveness of advertisements about the long-term harms of alcohol and low-risk drinking guidelines: A mediation analysis.

RATIONALE: Many people overestimate the amount of alcohol that increases their risk of harm and so may not perceive any need to change their drinking behaviour. Several countries have developed low-risk drinking guidelines, yet awareness of these guidelines remains low. Furthermore, mass media campaigns about alcohol-related harms may have limited impact if people do not perceive their current consumption as potentially harmful. Integrating drinking guidelines into media campaigns about alcohol's harms can concurrently provide drinkers with information about low-risk drinking levels and compelling reasons to comply. OBJECTIVE: Our aim was to build understanding of the effectiveness of messages about the long-term harms of drinking and low-risk drinking guidelines, by testing the mediating effects of estimates of harmful drinking levels and attitudes towards drinking alcohol on subsequent intentions and behaviours. METHOD: In an online experiment conducted in 2016, n = 1156 Australian adult monthly drinkers were randomly assigned to view advertisements for non-alcohol products (NON-ALC; control), advertisements featuring long-term harms of alcohol (LTH), or LTH advertisements plus a guideline message (LTH + G). Immediately following exposure, we measured estimates of harmful drinking levels and attitudes towards drinking alcohol. One week later, we measured intentions to drink less and behavioural compliance with the guideline. RESULTS: Compared to NON-ALC advertisements, exposure to LTH + G advertisements increased (i) the proportion of respondents who correctly estimated harmful drinking levels, which in turn, strengthened intentions to drink less (42% of the total effect was mediated), and (ii) negative attitudes, which in turn, also increased intentions to drink less (35% mediated) and behavioural compliance (24% mediated). Compared to NON-ALC, LTH advertisements increased negative attitudes, which in turn strengthened intentions to drink less (53% mediated). CONCLUSIONS: When paired with effective alcohol harm reduction television advertisements, messages promoting low-risk drinking guidelines can increase drinkers' intentions to reduce their alcohol consumption and compliance with low-risk drinking guidelines.

Health communication campaigns to drive demand for evidence-based practices and reduce stigma in the HEALing communities study.

BACKGROUND: The HEALing Communities Study (HCS) is testing whether the Communities that Heal (CTH) intervention can decrease opioid overdose deaths through the implementation of evidence-based practices (EBPs) in highly impacted communities. One of the CTH intervention components is a series of communications campaigns to promote the implementation of EBPs, increase demand for naloxone and medications for opioid use disorder (MOUD), and decrease stigma toward people with opioid use disorder and the use of EBPs, especially MOUD. This paper describes the approach to developing and executing these campaigns. METHODS: The HCS communication campaigns are developed and implemented through a collaboration between communication experts, research site staff, and community coalitions using a three-stage process. The Prepare phase identifies priority groups to receive campaign messages, develops content for those messages, and identifies a "call to action" that asks people to engage in a specific behavior. In the Plan phase, campaign resources are produced, and community coalitions develop plans to distribute campaign materials. During the Implement stage, these distribution plans guide delivery of content to priority groups. Fidelity measures assess how community coalitions follow their distribution plan as well as barriers and facilitators to implementation. An evaluation of the communication campaigns is planned. CONCLUSIONS: If successful, the Prepare-Plan-Implement process, and the campaign materials, could be adapted and used by other communities to address the opioid crisis. The campaign evaluation will extend the evidence base for how communication campaigns can be developed and implemented through a community-engaged process to effectively address public health crises.

Comparing responses to public health and industry-funded alcohol harm reduction advertisements: an experimental study.

OBJECTIVES: Conduct a head-to-head experimental test of responses to alcohol harm reduction advertisements developed by alcohol industry Social Aspects/Public Relations Organisations (SAPROs) versus those developed by public health (PH) agencies. We hypothesised that, on average, SAPRO advertisements would be less effective at generating motivation (H1) and intentions to reduce alcohol consumption (H2) but more effective at generating positive perceptions of people who drink (H3). DESIGN: Online experiment with random assignment to condition. PARTICIPANTS: 2923 Australian adult weekly drinkers (49% high-risk drinkers) recruited from an opt-in online panel. INTERVENTIONS: Participants viewed 3 of 83 advertisements developed by PH agencies (n=2174) or 3 of 28 advertisements developed by SAPROs (n=749). PRIMARY OUTCOME MEASURES: Participants reported their motivation to reduce the amount of alcohol consumed; behave responsibly and/or not get drunk; and limit their drinking around/never supply to minors, as well as intentions to avoid drinking alcohol completely; reduce the number of drinking occasions; and reduce the amount of alcohol consumed per occasion. Participants also reported their perceptions of people who drink alcohol on six success-related items and four fun-related items. RESULTS: Compared with drinkers exposed to PH advertisements, those exposed to SAPRO advertisements reported lower motivation to reduce the amount of alcohol consumed (ß=-0.091, 95% CI -0.171 to -0.010), and lower odds of intending to avoid alcohol completely (OR=0.77, 0.63 to 0.94) and to reduce the amount of alcohol consumed per occasion (OR=0.82, 0.69 to 0.97). SAPRO advertisements generated more favourable fun-related perceptions of drinkers (ß=0.095, 0.013 to 0.177). CONCLUSIONS: The alcohol harm reduction advertisements produced by alcohol industry SAPROs that were tested in this study were not as effective at generating motivation and intentions to reduce alcohol consumption as those developed by PH organisations. These findings raise questions as to whether SAPROs should play a role in alcohol harm reduction efforts.

Adolescent males' responses to blu's fake warnings.

OBJECTIVE: Blu's 'Something Better' advertising campaign ran in popular print magazines in 2017. The campaign included advertisements with fake warnings conveying positive messages, which mimicked the Food and Drug Administration (FDA)'s warning requirements for electronic cigarette (e-cigarette) advertisements that took effect in 2018. We report adolescent males' recall of these fake warnings and how exposure to fake warnings affected recall of other advertisement components, including the actual warning or health risks, brand and product. METHODS: Ohio males ages 12-19 years (N = 775; 73.8 % white non-Hispanic) were randomly assigned to view an e-cigarette advertisement with or without a fake warning. Afterward, they were asked what they remembered most about the advertisement. Responses were qualitatively coded. Statistical analyses included survey-weighted descriptive statistics and logistic regression. RESULTS: Of participants who viewed an e-cigarette advertisement with a fake warning, 27.0 % reported the fake warning was what they remembered most, and 18.8 % repeated the fake warning message. Participants viewing advertisements with a fake warning had lower odds of recalling the actual warning or health risks (OR = 0.29; 95% CI: 0.11 to 0.77) or brand (OR = 0.43; 95% CI: 0.22 to 0.85), compared with participants viewing other e-cigarette advertisements. CONCLUSIONS: Adolescents viewing an advertisement with a fake warning were less likely to recall the advertisement's actual warning or health risks. Although e-cigarette advertisements now carry large FDA-mandated warnings, this tactic could be used for cigarette advertisements that continue to carry small warnings in the USA. Findings underscore the necessity of tobacco advertisement surveillance and study of advertisements' effects on adolescents.

The magnitude and impact of tobacco marketing exposure in adolescents' day-to-day lives: An ecological momentary assessment (EMA) study.

PURPOSE: Research indicates that tobacco marketing contributes to higher pro-tobacco attitudes and behaviors among adolescents, but no studies have been able to assess the impact of real-world tobacco marketing exposures in real-time. The purpose of this study was to examine the magnitude and impact of tobacco marketing exposure on adolescents using ecological momentary assessment (EMA). Our primary hypotheses were that (1) youth would most frequently report tobacco marketing at the retail points-of-sale and (2) greater exposures to tobacco marketing would be associated with more favorable tobacco-related attitudes, use, and expectancies. METHODS: Participants were adolescent males from rural and urban Ohio (N = 176, ages 11-16). For ten days, these adolescents were prompted at two-three random times/day to complete a brief smartphone-based survey about their exposures and responses to tobacco-related advertising. RESULTS: Adolescents reported exposures to tobacco marketing an average of 1.9 times over the 10-day EMA period, with over 10% seeing a tobacco advertisement 5 or more times. Reports of marketing exposures occurred most frequently at the point-of-sale; exposures were higher among tobacco users and rural adolescents. Consistent with hypotheses, marketing exposure was related to more positive attitudes to the tobacco advertisements, more tobacco use, and higher expectancies to use in the future. CONCLUSIONS: Overall, these findings signal the magnitude of tobacco marketing exposures and their pernicious impact on youth. Findings underscore the importance of federal, state, and local-level tobacco regulatory policies to protect youth from the marketing that puts them at risk for a lifetime of nicotine addiction and tobacco-related diseases.

Memorability of Cigarette Advertisements Making "Natural" Claims Among Adolescents.

OBJECTIVES: The tobacco industry has a history of making "natural" claims in advertisements. We report how viewing advertisements with such claims affected what adolescents found memorable. METHODS: Adolescent boys (N = 1220; 11-16 years old) were randomly assigned to view a Natural American Spirit (NAS) or other brand cigarette advertisement, and were asked what they remembered about the advertisement. Survey-weighted logistic regression models assessed whether memorability of advertisement components differed by NAS advertisement exposure. RESULTS: Adolescents viewing a NAS advertisement (vs another brand) had lower odds of finding memorable the advertisement's warning (OR = 0.58; 95% CI: [0.34, 0.98]) or brand (OR = 0.25; 95% CI: [0.11, 0.54]). They had higher odds of mentioning tobacco (OR = 2.33; 95% CI: [1.49, 3.63]) and packaging (OR = 2.57; 95% CI: [1.51, 4.37]). An estimated 6.7% of those viewing an NAS advertisement said the product was not addictive. CONCLUSIONS: Reduced-harm claims on cigarette advertisements may affect what adolescents find salient about the advertisement. As the FDA's agreement with Santa Fe Natural Tobacco Company to remove these claims is not inclusive of all reduced-harm claims and does not apply to other companies, findings underscore the need for prohibiting all reduced-harm claims from cigarette advertisements.

Tobacco and Alcohol on Television: A Content Analysis of Male Adolescents' Favorite Shows.

INTRODUCTION: Media tobacco and alcohol portrayals encourage adolescent substance use. Preventing adolescent initiation with these substances is critical, as they contribute to leading causes of morbidity and mortality in the United States. Television tobacco and alcohol portrayals have not been examined for more than 7 years. This study analyzed tobacco and alcohol portrayals on adolescents' favorite television shows and evaluated the rate of portrayals by parental rating. METHODS: Adolescent males (N = 1,220) from Ohio reported 3 favorite television shows and how frequently they watch them. For each of the 20 most-watched shows in the sample, 9 episodes were randomly selected and coded for visual and verbal tobacco and alcohol incidents. Demographics of characters who used or interacted with the substances were recorded. Negative binomial regression modeled rates of tobacco and alcohol incidents per hour by parental rating. RESULTS: There were 49 tobacco and 756 alcohol portrayals across 180 episodes. Characters using the products were mostly white, male, and adult. The rate of tobacco incidents per hour was 1.2 for shows rated TV-14 (95% CI, 0.4-3.6) and 1.1 for shows rated TV-MA (95% CI, 0.3-4.5). The estimated rate of alcohol incidents per hour was 20.9 for shows rated TV-14 (95% CI, 6.3-69.2) and 7.2 for shows rated TV-MA (95% CI, 1.5-34.1). CONCLUSIONS: Adolescent males' favorite television shows rated TV-14 expose them to approximately 1 tobacco incident and 21 alcohol incidents per hour on average. Limiting tobacco and alcohol incidents on television could reduce adolescents' risk of substance use.

Rumor Acceptance during Public Health Crises: Testing the Emotional Congruence Hypothesis.

Rumors pose a significant challenge to officials combatting a public health crisis. The flow of unsubstantiated and often inaccurate information can dilute the effects of more accurate messaging. Understanding why rumors thrive in this context is a crucial first step to constraining them. We propose a novel mechanism for explaining rumor acceptance during a health crisis, arguing that the congruence between one's emotional state and the emotion induced by a rumor leads people to believe the rumor. Data collected using a novel experimental design provide preliminary evidence for our emotional congruence hypothesis. Participants who felt angry were more likely to accept anger-inducing rumors than those who were not angry. We discuss the implications of this insight for public health officials combatting rumors during a health crisis.

Randomized Trial Evaluating Targeted Photographic Health Communication Messages in Three Stigmatized Populations: Physically-Disabled, Senior, and Overweight/Obese Individuals.

The homophily principle that perceived similarities among people produce positive reactions is a cross-cultural, global phenomenon. The prediction that photographs depicting models similar to the target population improve health communication was tested. Three nationally-representative samples (n = 1,796) of adults who are disabled, seniors, or considered overweight/obese were selected from GfK's Knowledge Panel®. Participants read a message promoting physical activity and improved diets and responded to assessments of behavioral intentions, outcome and self-efficacy expectations, and identification. Photographs from a stock photograph service versus photographs created for the research project to match the three populations, Real Health Photos (RHP), were included in the message. Structural equation modeling confirmed that RHP which matched the population increased behavioral intentions mediated by identification (p < 0.05) in the physically-disabled and overweight/obese samples. Messages with only half of the matched RHP images had these same positive indirect effects (p < 0.05). Matched visual images in health messages improved effectiveness by capitalizing on the homophily and identification processes. Health educators should leverage these hardwired, evolutionary, biological phenomena that extend to health status as well as race and ethnicity. For optimal effects, not all persons shown need to be homophilous to the target audience, reducing logistical difficulties in showing diverse persons of various types.

Warning Size Affects What Adolescents Recall From Tobacco Advertisements.

OBJECTIVES: In the U.S., print advertisements for smokeless tobacco (SLT) feature a large black-and-white text warning covering 20% of the advertisement space. Cigarette and e-cigarette advertisements feature a small warning covering approximately 4% of advertisement space. We explored how warning size affects adolescent boys' spontaneous recollection of the warning, brand-relevant advertisement features, and product risks. METHODS: 1,220 adolescent males (ages 11-16) viewed SLT, cigarette, and e-cigarette advertisements. After each advertisement, boys were asked to recall what they remembered most. Coders identified recalls of the warning label, brand-relevant advertisement features, and risks associated with the product in responses. RESULTS: Participants were less likely to recall warnings in the cigarette vs. SLT (OR=0.30, p<0.001) and e-cigarette vs. SLT (OR=0.15, p<0.001) ads. Separate GEEs revealed that boys who recalled warnings were less likely to mention brand-relevant advertisement features (OR's<0.32, p's<0.001). Logistic regressions revealed that boys who recalled the warnings were more likely to mention risks associated with the products (OR's>3.50, p's<0.001). CONCLUSIONS: Youth are more likely to recall large SLT warnings than small cigarette and e-cigarette warnings. Warning recall is associated with lower likelihood of recalling brand-relevant advertisement features and greater likelihood of mentioning product risks.