Beth Sundstrom

Mothers “Google It Up:” Extending Communication Channel Behavior in Diffusion of Innovations Theory

This study employed qualitative methods, conducting 44 in-depth interviews with biological mothers of newborns to understand women’s perceptions and use of new media, mass media, and interpersonal communication channels in relation to health issues. Findings contribute to theoretical and practical understandings of the role of communication channels in diffusion of innovations theory. In particular, this study provides a foundation for the use of qualitative research to advance applications of diffusion of innovations theory. Results suggest that participants resisted mass media portrayals of women’s health. When faced with a health question, participants uniformly started with the Internet to “Google it up.” Findings suggest new media comprise a new communication channel with new rules, serving the functions of both personal and impersonal influence. In particular, pregnancy and the postpartum period emerged as a time when campaign planners can access women in new ways online. As a result, campaign planners could benefit from introducing new ideas online and capitalizing on the strength of weak ties favored in new media. Results expand the innovativeness/needs paradox in diffusion of innovations theory by elaborating on the role of new media to reach underserved populations. These findings provide an opportunity to better understand patient information seeking through the lens of diffusion of innovations theory.

A Technology-Mediated Behavioral Weight Gain Prevention Intervention for College Students: Controlled, Quasi-Experimental Study

Background Both men and women are vulnerable to weight gain during the college years, and this phenomenon is linked to an increased risk of several chronic diseases and mortality. Technology represents an attractive medium for the delivery of weight control interventions focused on college students, given its reach and appeal among this population. However, few technology-mediated weight gain prevention interventions have been evaluated for college students. Objective This study examined a new technology-based, social media-facilitated weight gain prevention intervention for college students. Methods Undergraduates (n =58) in two sections of a public university course were allocated to either a behavioral weight gain prevention intervention (Healthy Weight, HW; N=29) or a human papillomavirus (HPV) vaccination awareness intervention (control; N=29). All students were enrolled, regardless of initial body weight or expressed interest in weight management. The interventions delivered 8 lessons via electronic newsletters and Facebook postings over 9 weeks, which were designed to foster social support and introduce relevant educational content. The HW intervention targeted behavioral strategies to prevent weight gain and provided participants with a Wi-Fi-enabled scale and an electronic physical activity tracker to facilitate weight regulation. A repeated-measures analysis of variance was conducted to examine within- and between-group differences in measures of self-reported weight control practices and objectively measured weight. Use of each intervention medium and device was objectively tracked, and intervention satisfaction measures were obtained. Results Students remained weight stable (HW: −0.48+1.9 kg; control: −0.45+1.4 kg), with no significant difference between groups over 9 weeks (P =.94). However, HW students reported a significantly greater increase in the number of appropriate weight control strategies than did controls (2.1+4.5 vs −1.1+3.4, respectively; P =.003) and there was no increase in inappropriate weight control behaviors (P =.11). More than 90% of students in the HW arm opened the electronic newsletters each week, and the average number of Facebook interactions (comments and likes) per student each week was 3.3+1.4. Each self-monitoring device was initialized by 90% of HW students. On average, they used their physical activity tracker for 23.7+15.2 days and their Wi-Fi scale for 14.1+13.1 days over the 9 weeks. HW students rated the intervention favorably. Conclusions The short-term effect of this technology-based weight gain prevention intervention for college students is promising and merits evaluation over a longer duration to determine whether engagement and behavioral improvements positively affect weight outcomes and can be maintained.

The art of engagement: dialogic strategies on Twitter

Purpose The purpose of this paper is to explore how the dialogic theory of public relations can help strategic communication practitioners support and enhance the relationship between individuals and organizations. Design/methodology/approach This inquiry applied the dialogic theory of public relations by investigating leading media companies’ context-based strategic use of Twitter. Researchers conducted a qualitative content analysis of 1,800 tweets from 18 top-performing media organizations. Findings This study identified strategies, rooted in dialogic theoretical principles that media organizations used to engage stakeholders. Media companies employed strategies based on dialogic principles, including promoting organizations as industry and thought leaders, integrating social media, and using an interactive, synergistic organizational voice. Research limitations/implications These strategies support the need to expand theoretical conceptualizations and use of dialogic principles to study online communication. Practical implications Findings offer practical strategies for practitioners managing organizations’ Twitter communication to foster engagement. In particular, practitioners should consider organizational context and subsequent content advantages. Originality/value Findings offer practical and theoretical contributions to the debate of interactivity.

Integrating Pregnancy Ambivalence and Effectiveness in Contraceptive Choice

ABSTRACT Approximately 70% of pregnancies among young unmarried women living in the United States are unintended. Unintended pregnancy results in negative health and economic outcomes for infants, children, women, and families. Further research into the decision-making process of contraceptive selection is needed to meet young women’s contraceptive needs in the United States. Overall, 53 women ages 18–24 years completed in-depth qualitative interviews. Researchers used analytical techniques from grounded theory and HyperRESEARCH 3.5.2 qualitative data analysis software to identify emergent themes. Problematic integration theory provided a theoretical lens to identify young women’s probabilistic and evaluative orientations toward contraception. Researchers identified two profound values at stake to participants regarding their contraceptive decisions: avoiding pregnancy in the present, and protecting future fertility. Participants resisted long-acting reversible contraception (LARC) methods (e.g., the intrauterine device and the implant) due to concerns about safety and fears about infertility. Participants experienced ambivalence toward the idea of pregnancy, which complicated contraceptive decisions, especially regarding long-term methods. Uncertainty led participants to rationalize their use of less effective methods and reduced information seeking. Findings from this study offer practical suggestions for practitioners and health communication campaign planners. Contraceptive access campaigns should focus on the effectiveness, safety, and convenience of LARC methods. Messages should help young women make contraceptive choices that better fit their needs in order to reduce unintended pregnancy.

Perceptions and correlates of pubic hair removal and grooming among college-aged women: a mixed methods approach

UNLABELLED Background Although much is known about behavioural indicators of pubic hair removal, current research lacks deeper cognitive reasoning and understanding through utilising quantitative and qualitative methodologies. The purpose of this study was to: (1) describe and understand pubic hair removal behaviours using a quantitative survey; and (2) examine the relationship between pubic hair removal, sexual behaviours and genital self-image using in-depth interviews. METHODS Data were collected from women aged 18-24 years living in the United States. Overall, 663 participants completed an online survey and 53 completed in-depth interviews. Questions asked related to pubic hair removal and sexual history. RESULTS Participants removed hair for hygiene, comfort and sensation purposes, which was a personal decision influenced by family, friends and the media. Race, pubic hair removal initiation age, genital image and sexual behaviours were significantly related to pubic hair removal. CONCLUSIONS Data from this study prove that further education regarding safe pubic hair removal methods is needed, especially for those who initiate pubic hair removal and sexual behaviours concurrently.

Protecting the Next Generation Elaborating the Health Belief Model to Increase HPV Vaccination Among College-Age Women

This study guides social marketing campaigns to increase human papillomavirus (HPV) vaccination among young women by elaborating the health belief model (HBM). A self-administered, anonymous, web-based questionnaire was e-mailed to all entering female college students at a large, public university in the mid-Atlantic region of the United States. Findings elaborate the HBM constructs of perceived threat, benefits, barriers, and cues to action. Almost all participants had heard about the HPV vaccine and the majority of first-year students had received at least one shot in the vaccination series. Results expand understandings of perceived threat in relation to the HPV vaccine by explicating misinformation and knowledge gaps. Participants indicated that parents and physicians were their most trusted sources of vaccine information. Television and Internet cues to action were negatively associated with HPV vaccination among these women. Structural equation modeling results affirmed the HBM’s fit (comparative fit index = 0.935, normative fit index = 0.921, and root mean square error of approximation = 0.077). This finding suggests the importance of multimodal sources of information, expanding the dichotomous internal and external cues to action. Perceptions of vaccine safety remained a significant barrier to the uptake of HPV vaccination among participants. Racial disparities between White and non-White students could have a considerable impact on the established inequality in HPV vaccination rates in the United States. Results inform future social marketing campaign messages and strategies based on the HBM.

Expecting the unexpected: Non-profit women's organizations’ media responses to anti-abortion terrorism

Purpose – The purpose of this paper is to explore a postmodern approach to crisis management through the lens of complexity theory to understand six non-profit organizations’ communication responses to anti-abortion terrorism. Design/methodology/approach – Researchers conducted a qualitative content analysis of publicly available documents from six non-profit organizations, which included 62 news releases and statements on organization web sites, 152 tweets, and 63 articles in national and local newspapers. Findings – A history of violence and rituals of remembrance emerged as important pieces of organizational, personal, and social history surrounding anti-abortion terrorism. The process of self-organization facilitated calling publics to action and combating the “terrorism” naming problem. The non-profits’ dynamic environment exemplified the importance of coalition building to construct digital attractor basins, or networks extending beyond permeable boundaries, through a variety of strategies, includin...

Integrating Public Relations and Social Marketing A Case Study of Planned Parenthood

This study examined the relationship between public relations and social marketing in a nonprofit health organization. A case study was conducted, in which internal and external organizational documents, archival records, and artifacts were analyzed and four in-depth interviews were completed. Evidence showed that public relations and social marketing were integrated into the organization’s communication function. Findings provided evidence for a tactical paradigm of public relations, which emphasizes publicity and promotion, as well as a situational approach to messaging and communication functions. The organization engaged the new two-way model of symmetry through cultivating relationships and two-way dialogue. These findings suggest the importance of social marketing approaches to behavior change and relationship cultivation strategies. This case study highlights the success of social marketing initiatives, and the opportunity for social marketing and public relations to evolve together in a new media context.

Breaking Women’s Health Taboos: Integrating Diffusion of Innovations Theory With Social Marketing

This study explored diffusion of innovations theory as a particularly relevant and useful theory to the social marketing approach. In-depth interviews with 44 biological mothers of newborns were conducted to understand their communication behaviors, system norms, and social networks. A grounded theory approach was used to expand diffusion of innovations theory by investigating social network influences on women’s innovativeness. Findings suggest opportunities to apply diffusion of innovations theory to better understand women’s health and the health of their families. This study provides a basis for the use of qualitative research to diffuse behaviors where desired health behaviors emerge by listening to the target audience. According to participants, online networks offer reprieve from system norms that create a taboo around women’s health issues. These women engaged in complex research and decision-making processes about health that involved trusting themselves and their newborns. Additionally, findings contribute to theory development by revealing participants’ experiences of stigma and silence, which suggest that gender, as well as race and class, should be an integral component of the empty vessels fallacy in the diffusion of innovations theory.

Determining the Level of Interest in a Professional Association for Social Marketing in the United States: Results of a National Survey

Recent proposals about a professional organization for social marketing in public health led to a web-based survey of 430 anonymous respondents. The analysis explored the various characteristics of respondents (e.g., career status, experience, and work setting) in addition to the kind of organization they prefer, its benefits, and membership fees. The results indicate strong support for a professional organization and encourage further developmental efforts.