Jeffrey K. Springston

Effects of Mass and Interpersonal Communication on Breast Cancer Screening: Advancing Agenda-Setting Theory in Health Contexts This article is drawn from data gathered for the doctoral dissertation of Karyn Ogata Jones at the University of Georgia in 2003. An earlier version of this article was presented at the National Communication Association Annual Conference, Health Communication Division, November 2005.

Drawing on components of agenda-setting theory and the two-step flow of information from mass media to news audiences, this study examines the effects of mass and interpersonal communication on breast cancer screening practices among college- and middle-aged women (n = 284). We theorized that screening behaviors among younger women would be influenced more by interpersonal sources of information while screening among middle-aged women would be more influenced by exposure to mass-mediated information. Findings supported anticipated patterns, revealing important and varying roles for both mass and interpersonal communication in the health behaviors of women. Implications for health practitioners and campaign planners, as well as recommendations for future research, are discussed.

Promoting colorectal cancer screening discussion: A randomized controlled trial

BACKGROUND Provider recommendation is a predictor of colorectal cancer (CRC) screening. PURPOSE To compare the effects of two clinic-based interventions on patient-provider discussions about CRC screening. DESIGN Two-group RCT with data collected at baseline and 1 week post-intervention. SETTING/PARTICIPANTS African-American patients that were non-adherent to CRC screening recommendations (n=693) with a primary care visit between 2008 and 2010 in one of 11 urban primary care clinics. INTERVENTION Participants received either a computer-delivered tailored CRC screening intervention or a nontailored informational brochure about CRC screening immediately prior to their primary care visit. MAIN OUTCOME MEASURES Between-group differences in odds of having had a CRC screening discussion about a colon test, with and without adjusting for demographic, clinic, health literacy, health belief, and social support variables, were examined as predictors of a CRC screening discussion using logistic regression. Intervention effects on CRC screening test order by PCPs were examined using logistic regression. Analyses were conducted in 2011 and 2012. RESULTS Compared to the brochure group, greater proportions of those in the computer-delivered tailored intervention group reported having had a discussion with their provider about CRC screening (63% vs 48%, OR=1.81, p<0.001). Predictors of a discussion about CRC screening included computer group participation, younger age, reason for visit, being unmarried, colonoscopy self-efficacy, and family member/friend recommendation (all p-values <0.05). CONCLUSIONS The computer-delivered tailored intervention was more effective than a nontailored brochure at stimulating patient-provider discussions about CRC screening. Those who received the computer-delivered intervention also were more likely to have a CRC screening test (fecal occult blood test or colonoscopy) ordered by their PCP. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT00672828.

A tailored intervention for mammography among low-income African-American women

Abstract This report describes a tailored intervention to increase compliance regarding mammography and the stage of its adoption among low-income African-American women aged 45 to 64 years. Two randomly assigned groups received either an in-person tailored intervention or routine care. The intervention was targeted toward perceived risk of breast cancer and perceived benefits of and barriers to breast cancer screening. Participants accrued from a community service center were followed for one year to identify the effect of the intervention on adoption of mammography.

Differing Effects of Mass and Interpersonal Communication on Breast Cancer Risk Estimates: An Exploratory Study of College Students and Their Mothers

Research has demonstrated that women tend to overestimate the percentage of all breast cancers that result from genetic predispositions, and this article examines the knowledge of college students, as well as their mothers, on this subject, applying uncertainty management (Brashers, 2001) as the theoretical framework. The authors build on the literature by studying (a) the types of media outlets college students and their mothers use for securing information, and (b) the types of articles and programs within those outlets that may affect risk perceptions. The authors also address associations between these mass communication measures and interpersonal sources of information in the context of risk estimation. Respondents exposed to media reports about the role of genetics in breast cancer, in addition to study participants who had discussed this role within the family, tended to overestimate measures of genetic risk. Conversely, those who had attended to media reports about screening practices tended to offer lower risk estimates, indicating that such reports may have positioned genetics as just one factor in the overall equation of breast cancer risk. The authors discuss the implications of these and other findings for communication scholars and health practitioners.

How to Use Health and Nutrition–Related Claims Correctly on Food Advertising: Comparison of Benefit-Seeking, Risk-Avoidance, and Taste Appeals on Different Food Categories

This study applies the concepts of health halos and unhealthy = tasty intuition to examine how the different health and nutrition–related (HNR) appeal types interact with different food product types compared with taste claims. The experiment investigated the impact of benefit-seeking and risk-avoidance HNR appeals compared with that of taste appeals on different food types. The authors found that although respondents evaluated food ads with the two HNR appeals as less risky/more beneficial and healthier than food ads with a taste claim, the respondents showed better ad-related evaluations on the HNR appeals for perceivably healthy food and on taste appeal for perceivably unhealthy food. The findings provide several theoretical and practical implications for health food marketing and public health policy.

Predictors of stage of adoption for colorectal cancer screening among African American primary care patients.

Background: Compared with other racial groups, African Americans have the highest colorectal cancer (CRC) incidence and mortality rates coupled with lower screening rates. Objective: Our study examined the predictors of stage of adoption for fecal occult blood testing (FOBT) and colonoscopy among African American primary care patients who were nonadherent to published screening guidelines. Methods: Baseline data (N = 815) in a randomized clinical trial were analyzed. Participants were categorized into precontemplation, contemplation, and preparation stages for FOBT and colonoscopy. Predictor variables were demographics, clinical variables, CRC health beliefs and knowledge, and social support. Hierarchical modeling was to identify significant predictors of stage of adoption. Results: Older, male, Veterans Affairs participants and those with higher perceived self-efficacy, family/friend encouragement, and a provider recommendation had higher odds of being at a more advanced stage of adoption for FOBT. Patients with a history of cancer and higher perceived barriers had higher odds of being at an earlier stage of adoption for FOBT. Predictors of more advanced stage of adoption for colonoscopy included higher perceived benefits, higher perceived self-efficacy, family/friend encouragement, and a provider recommendation for colonoscopy. Higher income (>30 000 vs <15 000) was predictive of earlier stage of adoption for colonoscopy. Conclusions: Enhancing self-efficacy, encouragement from family and friends, and provider recommendations are important components of interventions to promote CRC screening. Implications for Practice: Nurses can use knowledge of the characteristics associated with stage of adoption to educate and motivate their African American primary care patients to complete CRC screening tests.

Process outcomes from a randomized controlled trial comparing tailored mammography interventions delivered via telephone vs. DVD

OBJECTIVE Tailored, interactive mammography-promotion interventions can increase adherence if women are exposed to and find them usable. We compare exposure to and usability of interventions delivered via telephone vs. DVD. METHODS Process evaluation measures from 926 women randomly assigned to telephone or DVD intervention and completing post-intervention surveys. RESULTS ∼83% of each group reported exposure to all content. Partial exposure was higher for DVD (9% vs. 0.4%; p<.01); no exposure was higher for phone (15% vs. 8%; p<.01). There were no differences in exposure by age or race. Full phone exposure was less likely for women who already made mammography appointments. Usability rating was higher for DVD (p<.05), driven by ratings of understandability and length. Usability of both interventions was correlated with lower baseline barriers, and higher fear, benefits, and self efficacy. Higher ratings for phone were associated with lower knowledge and contemplating mammography. Non-whites rated DVD better than whites. CONCLUSION Both tailored interactive interventions had wide reach and favorable ratings, but DVD recipients had greatest exposure to at least partial content and more favorable ratings, especially among non-white women. PRACTICE IMPLICATIONS This first evaluation of a tailored, interactive DVD provides promise for its use in mammography promotion.

Health crises and media relations: relationship management-by-fire.

SUMMARY Media relations is an important function in the operation of any health organization, yet it is often relegated as a simple task function. Such an orientation can be problematic, particularly in times of crisis. This article provides an overview of some of the inherent internal conflicts within health organizations that may mitigate against the best media relations practices in times of crises. The article surveys some of the predominant theoretical models used for crisis management, and suggests directions for the further development of media relations and crisis communication theory and practice.

Estimating development cost of an interactive website based cancer screening promotion program

OBJECTIVES The aim of this study was to estimate the initial development costs for an innovative talk show format tailored intervention delivered via the interactive web, for increasing cancer screening in women 50-75 who were non-adherent to screening guidelines for colorectal cancer and/or breast cancer. METHODS The cost of the intervention development was estimated from a societal perspective. Micro costing methods plus vendor contract costs were used to estimate cost. Staff logs were used to track personnel time. Non-personnel costs include all additional resources used to produce the intervention. RESULTS Development cost of the interactive web based intervention was

Abstract B65: Colorectal cancer screening in nonadherent black Americans

.39 million, of which 77% was direct cost. About 98% of the cost was incurred in personnel time cost, contract cost and overhead cost. CONCLUSIONS The new web-based disease prevention medium required substantial investment in health promotion and media specialist time. The development cost was primarily driven by the high level of human capital required. The cost of intervention development is important information for assessing and planning future public and private investments in web-based health promotion interventions.