Showing papers in "Journal of Health Communication in 2016"
TL;DR: It is found that individuals with low health literacy were significantly more likely than individuals with adequate health literacy to delay or forgo needed care or to report difficulty finding a provider, even after other factors, including health insurance coverage, employment, race/ethnicity, poverty, and general cognitive function.
Abstract: Despite well-documented links between low health literacy, low rates of health insurance coverage, and poor health outcomes, there has been almost no research on the relationship between low health literacy and self-reported access to care. This study analyzed a large, nationally representative sample of community-dwelling adults ages 50 and older to estimate the relationship between low health literacy and self-reported difficulty obtaining care. We found that individuals with low health literacy were significantly more likely than individuals with adequate health literacy to delay or forgo needed care or to report difficulty finding a provider, even after we controlled for other factors, including health insurance coverage, employment, race/ethnicity, poverty, and general cognitive function. They were also more likely to lack a usual source of care, although this result was only marginally significant after we controlled for other factors. The results show that in addition to any obstacles that low heal...
175 citations
TL;DR: Examination of how major health organizations use Twitter for disseminating health information, building relationships, and encouraging actions to improve health revealed that all of the organizations posted original tweets most, but they differed in the degree to which they used the retweet and reply functions.
Abstract: This study examined how major health organizations use Twitter for disseminating health information, building relationships, and encouraging actions to improve health. The sampled organizations were the American Heart Association, American Cancer Society, and American Diabetes Association. A content analysis was conducted on 1,583 tweets to examine these organizations' use of Twitter's interactive features and to understand the message functions and topics of their tweets. The numbers of retweets and favorites were also measured as engagement indicators and compared by different message functions. The results revealed that all of the organizations posted original tweets most, but they differed in the degree to which they used the retweet and reply functions. Hashtags and hyperlinks were the most frequently used interactive tools. The majority of the tweets were about organization-related topics, whereas personal health-related tweets represented a relatively small portion of the sample. Followers were most likely to like and retweet personal health action-based messages.
165 citations
TL;DR: Health literacy, strongly influenced by income and years of education, may play a key role in determining self-assessed health, a proxy health outcome, beyond sociodemographic variables.
Abstract: There is a growing need to understand how health literacy influences health outcomes in diverse populations. The aim of this study was to examine the relationship between health literacy, health behavior, sociodemographic indicators, and self-assessed health in the adult population in Israel while identifying populations at risk for low health literacy. A cross-sectional national survey was conducted among 600 adults randomly selected from a national database. The Health Literacy Survey-Europe-Q16 (HLS-EU-Q16) research instrument, adapted for use in Israel, was the basis for home interviews in Hebrew, Russian, and Arabic. Three levels of health literacy were distinguished: More than 31% of the sample had inadequate or problematic health literacy, and 69% showed likely sufficient health literacy. Logistic regression analyses showed that after we controlled for other determinants, years of education (β = 1.8) and income (β = 2.2) were significantly associated with health literacy. Multinomial logistic regre...
121 citations
TL;DR: The study analyzed 25,598 tweets about the H7N9 virus that were produced in April 2013 and found that a large proportion of messages contained sensemaking information, however, few tweets contained efficacy information that would help individuals respond to the crisis appropriately.
Abstract: Limited research has examined the messages produced about health-related crises on social media platforms and whether these messages contain content that would allow individuals to make sense of a crisis and respond effectively. This study uses the crisis and emergency risk communication (CERC) framework to evaluate the content of messages sent via Twitter during an emerging crisis. Using manual and computer-driven content analysis methods, the study analyzed 25,598 tweets about the H7N9 virus that were produced in April 2013. The study found that a large proportion of messages contained sensemaking information. However, few tweets contained efficacy information that would help individuals respond to the crisis appropriately. Implications and recommendations for practice and future study are discussed.
110 citations
TL;DR: The study showed that health literacy in general and the ability to understand health information in particular mediated the relationship between educational attainment and health behavior, especially in relation to being physically inactive, having a poor diet, and being obese.
Abstract: Individuals with a lower education level frequently have unhealthier behaviors than individuals with a higher education level, but the pathway is not fully understood. The aim of this study was to investigate whether health literacy mediates the association between educational attainment and health behavior (smoking, physical inactivity, poor diet) and obesity. The study included respondents ages 25 years or older drawn from a large population-based survey conducted in 2013 (N = 29,473). Two scales from the Health Literacy Questionnaire were used: (a) Understanding health information well enough to know what to do and (b) Ability to actively engage with health care providers. Multiple mediation analyses were conducted using the Karlson-Holm-Breen method. The study showed that health literacy in general and the ability to understand health information in particular mediated the relationship between educational attainment and health behavior, especially in relation to being physically inactive (accounting for 20% of the variance), having a poor diet (accounting for 13% of the variance), and being obese (accounting for 16% of the variance). These findings suggest that strategies for improving health behavior and reducing health inequalities may benefit from adopting a stronger focus on health literacy within prevention, patient education, and other public health interventions.
108 citations
TL;DR: Low health literacy is negatively associated with health behaviors and social factors in older adults, but social factors seldom moderate the associations between health literacy and health behaviors.
Abstract: This study assesses the associations between health literacy and various health behaviors and social factors among older adults, and whether social factors moderate the other associations. Data from 3,241 participants in the LifeLines Cohort Study were analyzed (mean baseline age = 68.9 years). Data on health literacy, health behaviors (physical activity, fruit and vegetable consumption, smoking, breakfast consumption, alcohol consumption, and body mass index (BMI), and social factors (loneliness, social support, social activities, social contacts, and living situation) were collected in three waves. Logistic regression analyses were used, adjusted for age and gender. Low health literacy was associated with insufficient physical activity, insufficient fruit and vegetable consumption, lack of regular breakfast consumption, obesity (odds ratios (ORs) > 1.31, p-values < .005) and low alcohol use (OR = 0.81, p = .013), but not with smoking. Low health literacy was also associated with greater loneliness, enga...
97 citations
TL;DR: A meta-analytic review was undertaken to examine the effects of mass communication campaigns on changes in behavior, knowledge, and self-efficacy in the general public, and it indicated that campaigns produced positive effects in behavior change and knowledge but failed to produce significant increases in self- efficacy.
Abstract: A meta-analytic review was undertaken to examine the effects of mass communication campaigns on changes in behavior, knowledge, and self-efficacy in the general public. A review of the academic literature was undertaken and identified 1,638 articles from 1966 through 2012. Using strict inclusion criteria, we included 63 studies for coding and analyses. Results from these efforts indicated that campaigns produced positive effects in behavior change (r = .05, k = 61) and knowledge (r = .10, k = 26) but failed to produce significant increases in self-efficacy (r = .02, k = 14). Several moderators (e.g., health topic, the theory underlying the campaign) were examined in relation to campaign principles that are prescribed to increase campaign effects. The major findings are reviewed, and the implications for future campaign design are discussed.
79 citations
TL;DR: The analysis revealed that messages written by users who had a higher number of followers, a higher level of personal influence over the interaction, and closer relationships and similarities with other users were retweeted.
Abstract: This study explored how social media, especially Twitter, serves as a viable place for communicating about cancer. Using a 2-step analytic method that combined social network analysis and computer-aided content analysis, this study investigated (a) how different types of network structures explain retweeting behavior and (b) which types of tweets are retweeted and why some messages generate more interaction among users. The analysis revealed that messages written by users who had a higher number of followers, a higher level of personal influence over the interaction, and closer relationships and similarities with other users were retweeted. In addition, a tweet with a higher level of positive emotion was more likely to be retweeted, whereas a tweet with a higher level of tentative words was less likely to be retweeted. These findings imply that Twitter can be an effective tool for the dissemination of health information. Theoretical and practical implications for psychosocial interventions for people with...
69 citations
TL;DR: The findings highlight the importance of considering domains of genomics-related health literacy (e.g., knowledge, oral literacy) in developing educational strategies for genomic information as genomic information reaches more patients.
Abstract: The increasing importance of genomic information in clinical care heightens the need to examine how individuals understand, value, and communicate about this information. Based on a conceptual framework of genomics-related health literacy, we examined whether health literacy was related to knowledge, self-efficacy, and perceived importance of genetics and family health history (FHH) and communication about FHH in a medically underserved population. The analytic sample was composed of 624 patients at a primary care clinic in a large urban hospital. About half of the participants (47%) had limited health literacy; 55% had no education beyond high school, and 58% were Black. In multivariable models, limited health literacy was associated with lower genetic knowledge (β = -0.55, SE = 0.10, p < .0001), lower awareness of FHH (odds ratio [OR] = 0.50, 95% confidence interval [CI; 0.28, 0.90], p = .020), and greater perceived importance of genetic information (OR = 1.95, 95% CI [1.27, 3.00], p = .0022) but lower perceived importance of FHH information (OR = 0.47, 95% CI [0.26, 0.86], p = .013) and more frequent communication with a doctor about FHH (OR = 2.02, 95% CI [1.27, 3.23], p = .0032). The findings highlight the importance of considering domains of genomics-related health literacy (e.g., knowledge, oral literacy) in developing educational strategies for genomic information. Health literacy research is essential to avoid increasing disparities in information and health outcomes as genomic information reaches more patients.
66 citations
TL;DR: Teenagers and young adults underestimate and discount the long-term risks associated with hookah and LCC use, and effective messages may be those that focus on the acute/immediate health and cosmetic effects.
Abstract: Use of hookah and little cigars/cigarillos (LCCs) is high among adolescents and young adults. Although these products have health effects similar to cigarettes, adolescents and young adults believe them to be safer. This study examined adolescent and young adult perceptions of hookah and LCCs to develop risk messages aimed at discouraging use among users and at-risk nonusers. Ten focus groups with 77 adolescents and young adults were conducted to explore their perceptions about the perceived risks and benefits of hookah and LCC use. Participants were users of other (non-cigarette) tobacco products (n = 47) and susceptible nonusers (n = 30). Transcripts were coded for emergent themes on participants’ perceptions of hookah and LCCs. Participants did not perceive health effects associated with hookah and LCC use to be serious or likely to happen given their infrequency of use and perceptions that they are less harmful than cigarettes. Participants generally had positive associations with smoking hookah and L...
63 citations
TL;DR: It is concluded that getting people to think and reflect can help persuade them, which suggests that narrative persuasion models and dual models of rhetorical persuasion can be compatible in certain contexts, such as when messages are designed in such a way that characters make explicit arguments that endorse a prosocial message through dialogues.
Abstract: The aim of this article is to further knowledge of the explanatory processes of narrative persuasion in the field of health communication, using data obtained in a research study of entertainment-education based on audiovisual fiction. Participating in the study were 208 young persons between the ages of 14 and 20, randomly distributed to three different groups. Each of the groups was exposed to a different episode of the Colombian television series Revelados, desde todas las posiciones. The results showed that greater identification with the main character of the episode transmitting a prevention message was associated with greater cognitive elaboration, which in turn led to more favorable attitudes toward the topics addressed. However, counterarguing was not observed to play a significant mediating role. The findings of this study allow us to conclude that getting people to think and reflect can help persuade them, which suggests that narrative persuasion models and dual models of rhetorical persuasion can be compatible in certain contexts, such as when messages are designed in such a way that characters make explicit arguments that endorse a prosocial message through dialogues.
TL;DR: A survey of 356 adults immediately after Angelina Jolie's announcement that she is a BRCA1 carrier and has had a prophylactic bilateral mastectomy provided preliminary evidence of an Angelina effect.
Abstract: Angelina Jolie's announcement that she is a BRCA1 carrier and has had a prophylactic bilateral mastectomy was met with widespread support as well as speculation about its possible impact on the public. These speculations were the subject of a Time magazine cover story titled “The Angelina Effect” (Kluger et al., 2013). Although there is anecdotal evidence to support this hypothesized Angelina effect, empirical tests are lacking. To explore possible links between Angelina's announcement and public health, we surveyed 356 adults immediately after the announcement. Guided by a model of celebrity influence, the survey assessed participants’ demographics and health history, identification and parasocial interaction with Jolie, and genetic testing intentions. Results supported the model's predictions and provided preliminary evidence of an Angelina effect.
TL;DR: It is posited that a 1st-person point of view (POV) narrative would have a greater effect than a 3rd-person POV on the mediators identification and self-referencing—an effect moderated by protagonist–reader similarity.
Abstract: Narratives are often used in messages about health threats. We posited that a 1st-person point of view (POV) narrative would have a greater effect than a 3rd-person POV on the mediators identification and self-referencing—an effect moderated by protagonist–reader similarity. Higher levels of identification and self-referencing were expected to elevate susceptibility and severity perceptions, leading to persuasion. Participants ages ≤30 years were recruited from a crowdsource website and randomly assigned to read one version of a faux magazine article about caffeine overdose. Article versions were defined by a 2 (1st- or 3rd-person POV) × 2 (similar or dissimilar protagonist) design. To manipulate similarity, we had respondents read an article in which the protagonist was also young (24 years of age) and of the same sex or much older (54 years of age) and of the opposite sex. Participants then completed a questionnaire measuring study variables. Contrary to expectations, POV did not affect identification o...
TL;DR: For both message types, videos had a more positive influence than infographics when communicating breast cancer information for this audience, and the didactic message delivered in video format had the most positive effect on awareness and knowledge, whereas the narrative video message had the largest effect on attitude and intention.
Abstract: Cancer is one of the leading causes of death around the world. Mortality from breast cancer can be reduced if the cancer is detected early enough. It is important to find effective communication that encourages early detection of breast cancer. This study aimed to measure differences between narrative and didactic communication on breast cancer awareness, knowledge of appropriate diagnostic exams, attitude toward breast self-exam, and intention to screen for breast cancer through a breast self-exam. It further aimed to test whether any differences in outcomes were associated with the format used to deliver the communication: video or infographic. The effects of the communication strategies were tested using an experimental design with a control group and four experimental groups: narrative video, didactic video, narrative infographic, or didactic infographic. A total of 194 Italian-speaking women ages 18-30 years completed questionnaires before and after exposure. Positive increases were found for all outcome variables after exposure to any communication strategy tested. The didactic message delivered in video format had the most positive effect on awareness and knowledge, whereas the narrative video message had the most positive effect on attitude and intention. For both message types, videos had a more positive influence than infographics when communicating breast cancer information for this audience. This was the first study of message effects of breast cancer communication with Italian-speaking young women. Further research is warranted to understand how to maximize communication strategies so that they are the most effective in influencing behaviors and if these results are consistent with other linguistic populations.
TL;DR: Older adults, minority populations, and individuals with low educational attainment represent a growing percentage of respondents who have looked for health information but have never used the Internet, highlighting trends in digital information disparities.
Abstract: With more people turning to the Internet for health information, a few questions remain: Which populations represent the remaining few who have never used the Internet, and where do they go for health information? The purpose of this study is to describe population characteristics and sources of health information among U.S. adults who do not use the Internet. Data from 3 iterations of the Health Information National Trends Survey (n = 1,722) are used to examine trends in health information sources. Weighted predicted probabilities demonstrate changes in information source over time. Older adults, minority populations, and individuals with low educational attainment represent a growing percentage of respondents who have looked for health information but have never used the Internet, highlighting trends in digital information disparities. However, 1 in 10 respondents who have never used the Internet also indicate that the Internet was their first source of health information, presumably through surrogates. Findings highlight digital disparities in information seeking and the complex nature of online information seeking. Future research should examine how individuals conceptualize information sources, measure skills related to evaluating information and sources, and investigate the social nature of information seeking. Health care organizations and public health agencies can leverage the multifaceted nature of information seeking to better develop information resources to increase information access by vulnerable populations.
TL;DR: Medical mistrust was associated with poorer communication with providers in this public health setting and providers should consider the impact of mistrust on communication with vulnerable diabetes populations and focus efforts on mitigating its influence.
Abstract: Patient–provider communication is modifiable and is linked to diabetes outcomes. The association of communication quality with medical mistrust is unknown. We examined these factors within the context of a low-literacy/numeracy-focused intervention to improve diabetes care, using baseline data from diverse patients enrolled in a randomized trial of a health communication intervention. Demographics, measures of health communication (Communication Assessment Tool [CAT], Interpersonal Processes of Care survey [IPC-18]), health literacy (Short Test of Functional Health Literacy in Adults), depression, medical mistrust, and glycemic control were ascertained. Adjusted proportional odds models were used to test the association of mistrust with patient-reported communication quality. The interaction effect of health literacy on mistrust and communication quality was also assessed. A total of 410 patients were analyzed. High levels of mistrust were observed. In multivariable modeling, patients with higher mistrust...
TL;DR: The findings suggest that news framing can be an effective venue for raising awareness of obesity as a societal issue and mobilizing collective efforts.
Abstract: Based on a public health model of obesity, this study set out to examine whether a news article reporting the obesity issue in a societal versus individual frame would increase perceptions of societal responsibilities for the obesity problem and motivate responsibility-taking behaviors. Responsibility-taking behaviors were examined at 3 levels: personal, interpersonal, and societal. Data from a Web-based experiment revealed significant framing effects on behaviors via causal and treatment responsibility attributions. The societal frame increased societal causal and treatment attribution, which led to greater likelihoods of interpersonal and social responsibility-taking behaviors as well as personal behaviors. Our findings suggest that news framing can be an effective venue for raising awareness of obesity as a societal issue and mobilizing collective efforts.
TL;DR: In a sample of 368 patients, it is found that higher health literacy scores were associated with decreased odds of developing minor complications and should serve as a potential indicator of the need for additional resources to improve postoperative outcomes.
Abstract: Health literacy is the ability to obtain, comprehend, and act on medical information and is an independent predictor of health outcomes in patients with chronic health conditions. However, little has been reported regarding the potential association of health literacy and surgical outcomes. We hypothesized that patient complications after radical cystectomy would be associated with health literacy. In a sample of 368 patients, we found that higher health literacy scores (as determined by the Brief Health Literacy Screen) were associated with decreased odds of developing minor complications (odds ratio = 0.90, 95% confidence interval [0.83, 0.97]). Health literacy should be considered when caring for patients undergoing radical cystectomy and should serve as a potential indicator of the need for additional resources to improve postoperative outcomes.
TL;DR: Survey of undergraduates at a large public southeastern university to examine health information seeking in two incongruent health contexts found that the planned risk information seeking model was statistically a good fit for the data.
Abstract: Research indicates that when people seek health information, they typically look for information about a specific symptom, preventive measure, disease, or treatment. It is unclear, however, whether general or disease-specific theoretical models best predict how people search for health information. We surveyed undergraduates (N = 963) at a large public southeastern university to examine health information seeking in two incongruent health contexts (sexual health and cancer) to test whether a general model would hold for specific topics that differed in their immediate personal relevance for the target population. We found that the planned risk information seeking model was statistically a good fit for the data. Yet multiple predicted paths were not supported in either data set. Certain variables, such as attitudes, norms, and affect, appear to be strong predictors of intentions to seek information across health contexts. Implications for theory building, research methodology, and applied work in health-related risk information seeking are discussed.
TL;DR: This article examines youth receptivity to potential campaign ads using data from 3 message pretesting studies featuring the same design and consistent instrumentation to find responses to campaign ads were largely consistent between experimenters and at-risk nonsmokers.
Abstract: In February 2014, the Food and Drug Administration launched The Real Cost, a national youth tobacco prevention campaign. This article examines youth receptivity to potential campaign ads using data from 3 message pretesting studies featuring the same design and consistent instrumentation. A total of 3,258 adolescents ages 13–17 were randomized to either an ad-viewing condition or a no-exposure control condition. Perceived ad effectiveness, smoking-related beliefs, and attitudes were measured as outcome variables. The sample consisted of both experimental smokers (58%) and current nonsmokers at risk for cigarette initiation (42%). A total of 14 ads were tested across the three studies. Participants who viewed the ads generally considered them to be effective (with a mean perceived ad effectiveness score of 3.66 on a scale from 1 to 5). Compared to those in the control condition, participants in the ad-viewing condition reported stronger beliefs about the health risks of smoking (p < .001), a greater likeli...
TL;DR: Analysis of tweets about the recent smoking cessation campaign by the Centers for Disease Control and Prevention investigated the dissemination of health campaign messages on Twitter and answered questions from the process evaluation of health campaigns: who tweeted about the campaign, who played central roles in disseminating healthcampaign messages, and how various features of Twitter were used for sharing of campaign messages.
Abstract: The current study examined the use of online social media for a health campaign. Collecting tweets (N = 1,790) about the recent smoking cessation campaign by the Centers for Disease Control and Prevention, the current study investigated the dissemination of health campaign messages on Twitter and answered questions from the process evaluation of health campaigns: who tweeted about the campaign, who played central roles in disseminating health campaign messages, and how various features of Twitter were used for sharing of campaign messages. Results showed that individuals and nonprofit organizations posted frequently about the campaign: Individuals and nonprofit organizations posted about 40% and 30% of campaign-related tweets, respectively. Although the campaign under investigation was steered by a government agency, nonprofit organizations played a vital role as mediators who disseminated campaign messages. The culture of retweeting demonstrated its particular usefulness for the dissemination of campaign...
TL;DR: Data from the National Cancer Institute's Health Information National Trends Survey was used to examine cancer information scanning using the comprehensive model of information seeking (CMIS), and health-related factors and trust were associated with attention to information sources.
Abstract: Information scanning, or attention to information via incidental or routine exposure or browsing, is relatively less understood than information seeking. To (a) provide a more theoretical understanding of information scanning and (b) extend existing information seeking theory to information scanning, the current study used data from the National Cancer Institute's Health Information National Trends Survey to examine cancer information scanning using the comprehensive model of information seeking (CMIS). Consistent with the CMIS, health-related factors were associated with the information-carrier factor of trust, and health-related factors and trust were associated with attention to information sources. Some of these associations differed between entertainment-oriented sources, information-oriented sources, and the Internet. The current findings provide a clearer picture of information scanning and suggest future avenues of research and practice using the CMIS.
TL;DR: Results indicated that messages communicating positive injunctive norms were most effective among men who were least likely to engage in bystander intervention, and descriptive norms played a significant role in behavioral intentions, such that those with stronger norms were more likely to report intentions to engageIn bystander behaviors in the future.
Abstract: The high prevalence of sexual assault on college campuses has led to the implementation of health communication programs to prevent sexual assault. A few novel programs focus on primary prevention ...
TL;DR: Trait anxiety at Wave 1 predicted CIO at Wave 2, which in turn increased CIA at Wave 3, suggesting that some people are inherently inclined to avoid cancer information due to their trait anxiety, which results in confusion about cancer information.
Abstract: Although cancer information avoidance (CIA) is detrimental to public health, predictors of CIA have not been fully investigated. Based on uncertainty management theory, this study viewed CIA as a response to uncertainty related to the distress associated with cancer information and illustrated the psychological process leading to CIA. Given the current information context, it was hypothesized that cancer information overload (CIO), accompanied by confusion and stress about cancer information, causes CIA. As trait anxiety is a strong predictor of CIO, it was also hypothesized that trait anxiety has an indirect effect on CIA through CIO. Study 1 tested this relationship in a U.S. sample (N = 384); the results showed that CIO was positively associated with CIA and that trait anxiety indirectly influenced CIA through CIO. Whereas Study 1 tested the relationship with cross-sectional data in the general cancer context, Study 2 replicated Study 1 with 3-wave longitudinal data in the context of a specific cancer ...
TL;DR: The results show that people receiving dialysis feel better supported and informed about their health than other health consumers but are less active in managing it.
Abstract: Health literacy (HL) refers to a person’s ability to engage effectively with health information and services. We aimed to describe the HL of people receiving dialysis and the factors associated with it. A cross-sectional design was used, with demographic and clinical data as predictors. Participants were people receiving dialysis at a metropolitan health service in Melbourne, Australia. Health consumers with conditions not requiring dialysis were included for comparison. The Health Literacy Questionnaire, Kidney Disease Quality of Life–36, and Depression Anxiety Stress Scales–21 were administered. Participants (M age = 68.2 ± 13.7 years; n = 57 males) were 76 people receiving hemodialysis within a dialysis unit, 16 people receiving home peritoneal dialysis, and 8 people receiving home hemodialysis. Participants scored higher on the HL domains social support for health and engagement with health care providers but lower on active management of health than the comparison group (n = 813). Hierarchical cluste...
TL;DR: An argument for Ecological Research and Intervention in Health Communication Meghan Bridgid Moran, Lauren B. Frank, Nan Zhao, Carmen Gonzalez, Prawit Thainiyom, Sheila T. Murphy & Sandra J. Ball-Rokeach.
Abstract: Ecological approaches to understanding and changing health behavior are becoming increasingly common (Gehlert et al., 2007; Mabry, Olster, Morgan, & Abrams, 2008). Such approaches account for the m...
TL;DR: To improve recall and attitudes among people with lower health literacy, online health communication should consist of information that is not cognitively demanding and that is easy to imagine.
Abstract: The usefulness of the Internet as a health information source largely depends on the receiver’s health literacy. This study investigates the mechanisms through which health literacy affects information recall and website attitudes. Using 2 independent surveys addressing different Dutch health websites (N = 423 and N = 395), we tested the mediating role of cognitive load, imagination ease, and website involvement. The results showed that the influence of health literacy on information recall and website attitudes was mediated by cognitive load and imagination ease but only marginally by website involvement. Thus, to improve recall and attitudes among people with lower health literacy, online health communication should consist of information that is not cognitively demanding and that is easy to imagine.
TL;DR: Integrating hidden phones, financial support, and safety management may improve homeless youth’s access to and engagement with mHealth strategies over time, and thought mHealth programs for this population should be designed.
Abstract: Few interventions for homeless youth have leveraged the potential of mHealth technologies, in part because of the limited data on phone behaviors, perceptions, and intervention preferences among youth experiencing homelessness We conducted 9 focus groups (n = 52 homeless youth) and 41 individual structured interviews also with homeless youth in underserved communities in Baltimore and Washington, DC, to ascertain how youth perceived their mobile phone, acquired and maintained mobile services over time, and thought mHealth programs for this population should be designed We also measured phone use, functionality, source, duration of ownership, and reasons for changing phones or numbers Results showed that mobile coverage was high, as most youth self-purchased phones or received gift payments from others Maintaining mobile connectivity was often challenging because of financial constraints and interpersonal conflict Youth valued phones to access social support but used several tactics to avoid perceived
TL;DR: Results from a Web survey of 410 undergraduate students in Singapore show that response efficacy to seek haze-related information mediates the association between perceived self-efficacy and intention to take protective measures during haze.
Abstract: The annual Southeast Asian haze pollution raises public health concerns in this region. Based on a modified extended parallel process model, this study examines efficacy (self-efficacy and response efficacy) and perceived threat (susceptibility and severity) and incorporates new constructs of media trust and affective attitude. Results from a Web survey of 410 undergraduate students in Singapore show that response efficacy to seek haze-related information mediates the association between perceived self-efficacy and intention to take protective measures during haze. Moreover, self-efficacy is negatively associated with affective attitude (e.g., fear and worry) toward haze-related health problems. Next, perceived severity and perceived susceptibility are positively associated with response efficacy and affective attitude. Affective attitude toward haze is a stronger predictor than response efficacy for behavioral intention. Finally, trust in new media is positively associated with young Singaporeans’ affect...
TL;DR: This study draws on health behavior theories and dialogic theory in public relations to analyze microblog campaign postings and their relationships with the outcome of online audience engagement, showing that the most common persuasive content characteristic was perceived risk, followed by subjective norms and self-efficacy.
Abstract: The China Tobacco Control Media Campaign on Sina Weibo is novel in the context of smoking prevention and cessation in China and has not to date been evaluated. This study draws on health behavior theories and dialogic theory in public relations to analyze microblog campaign postings and their relationships with the outcome of online audience engagement. Microblog postings from May 2011 to January 2015 were content analyzed, showing that the most common persuasive content characteristic was perceived risk, followed by subjective norms and self-efficacy. Perceived risk and self-efficacy postings positively influenced online audience engagement, whereas subjective norm postings was a nonsignificant predictor. Postings were more likely to share information than aim to interact with audience members. However, both information sharing and audience interaction postings were positive predictors of online audience engagement. There was also evidence of main and interactive effects of message originality on online audience engagement. The current study has, to the best of our knowledge, broken new ground in 2 regards: (a) using health behavior theories as a basis for analyzing the content of an anti-smoking social media campaign and (b) examining the content of an anti-smoking media campaign of any type in China.