Jessica Fitts Willoughby

eHealth interventions for HIV prevention

Abstract The rapidly changing media landscape and proliferation of new technologies creates vast new opportunities for HIV prevention. The fast growth of the relatively new eHealth field is a testament to the excitement and promise of these new technologies. eHealth interventions in HIV prevention tested to date include computer- and Internet-based interventions; chat room interventions; text messaging interventions; and social media. The current article provides a brief review of these types of interventions in HIV prevention, including their unique advantages and evidence of efficacy. Implications for future research in the eHealth HIV prevention field are discussed.

Public Figure Announcements About Cancer and Opportunities for Cancer Communication: A Review and Research Agenda

Announcements by public figures and celebrities about cancer diagnosis or death represent significant events in public life. But what are the substantive effects of such events, if any? The purpose of this article is to systematically review studies that examined the impact of public figure cancer announcements on cancer-oriented outcomes. Using comprehensive search procedures, we identified k = 19 studies that examined 11 distinct public figures. The most commonly studied public figures were Jade Goody, Kylie Minogue, Nancy Reagan, and Steve Jobs, with the most common cancers studied being breast (53%), cervical (21%), and pancreatic (21%) cancer. Most studies assessed multiple outcome variables, including behavioral outcomes (k = 15), media coverage (k = 10), information seeking (k = 8), cancer incidence (k = 3), and interpersonal communication (k = 2). Results fairly consistently indicated that cancer announcements from public figures had meaningful effects on many, if not most, of these outcome variables. While such events essentially act as naturally occurring interventions, the effects tend to be relatively short term. Gaps in this literature include few contemporary studies of high-profile public figures in the United States and a general lack of theory-based research. Directions for future research as well as implications for cancer communication and prevention are discussed.

Perceptions of News Media, External Efficacy, and Public Affairs Apathy in Political Decision Making and Disaffection

A telephone survey of 416 randomly selected registered voters examined the distinctive contributions of cynicism and skepticism to citizens’ media satisfaction, external political efficacy, and apathy. Results suggest that cynicism and skepticism reflect dissatisfaction with media coverage, but have opposite effects on external efficacy. Cynicism has no relationship with apathy, while skepticism decreases it. Satisfaction with news media increases efficacy and apathy. Although cynicism’s relationship to efficacy is of concern, these findings undercut the argument frequently made that dissatisfaction with media coverage is responsible for cynicism and political apathy.

Public Reaction to the Death of Steve Jobs: Implications for Cancer Communication

The present study aimed to examine the public reaction to the death of Steve Jobs, focusing on general and cancer-specific information seeking and interpersonal communication. Shortly after Jobss death, employees from a large university in the Southeastern United States (N = 1,398) completed a web-based survey. Every employee had heard about Steve Jobss death, and 97% correctly identified pancreatic cancer as the cause of his death. General (50%) and pancreatic cancer–specific (7%) information seeking, as well as general (74%) and pancreatic cancer–specific (17%) interpersonal communication, took place in response to Steve Jobss death. In multivariate logistic regression analyses controlling for demographics and several cancer-oriented variables, both identification with Steve Jobs and cancer worry in response to Steve Jobss death significantly (p < .05) predicted pancreatic cancer information seeking as well as interpersonal communication about pancreatic cancer. Additional analyses revealed that cancer worry partially mediated the effects of identification on these outcome variables. Implications of these results for future research as well as cancer prevention and communication efforts are discussed.

Reactions of Young Adults to the Death of Apple CEO Steve Jobs: Implications for Cancer Communication

On October 5, 2011, the Chief Executive Officer of Apple®, Inc., Steve Jobs, died from pancreatic cancer. Media outlets covered the event with fervor, and the public responded in kind. The purpose of this study was to examine public reaction to Jobss death from pancreatic cancer in relation to general and health-specific information-seeking, as well as interpersonal communication. Using a survey conducted within weeks of Jobss death (N = 401), high awareness of this event was found, as were significant amounts of information-seeking and interpersonal communication with regard to his death. Emotional responses to his death were found to be the best predictors of related health communication behaviors. Along with descriptive findings of who communicated, with whom, when, and about what, these findings provide guidance for health communicators, who may use celebrity cancer announcements or deaths to capitalize on increased attention to the disease.

Establishing and adhering to sexual consent: the association between reading magazines and college students' sexual consent negotiation.

Content analyses have cataloged the sexual scripts present in magazines largely because of their perceived value to readers and their potential role as sex educators. Although it is generally agreed that magazines have the potential to influence sexual attitudes and behavioral intentions, the effects of this medium are not as frequently researched as are other forms of media. The current study tested whether exposure to magazines was associated with intentions related to sexual consent negotiation. A survey of 313 college students indicated that exposure to mens magazines was significantly associated with lower intentions to seek sexual consent and lower intentions to adhere to decisions about sexual consent. In contrast, exposure to womens magazines was significantly associated with greater intentions to refuse unwanted sexual activity. Overall, the findings of this study further reinforce the critical need for responsible and realistic portrayals of sex in entertainment media, specifically magazines.

Can You Get Pregnant When U R in the Pool?: Young People's Information Seeking from a Sexual Health Text Line.

Young people have questions about sex and development but may have trouble getting answers to them. Text messaging services can serve as a resource. This study analysed 1351 text messages sent to a sexual health text message service designed for young people in North Carolina to determine the types of questions asked of a confidential, accurate source of information. The majority of texts sought information about sexual health topics (89%). A smaller proportion asked for advice (7%) or reassurance (4%) that the sender was developing normally. Questions mainly asked about sexual acts (33.9%), unplanned pregnancy (20.2%), contraception (13.7%), physical or sexual development (12.9%) and sexually transmitted diseases (10.8%). Findings suggest that a confidential and accurate sexual health text message service could be an important resource for young people, especially if they seek advice before engaging in risky sexual behaviour.

Underdeveloped or Underreported? Coverage of Pretesting Practices and Recommendations for Design of Text Message–Based Health Behavior Change Interventions

Text messaging interventions for health are becoming increasingly popular, but it is unclear how rigorously such interventions are developed and pretested before being implemented. Pretesting is important to the development of successful health communication interventions. This study reviewed the literature published on text messaging health behavior change interventions and examined pretesting practices. Results showed that pretesting is rarely mentioned in articles, although it is not clear as to why. Six articles mentioned pretesting practices conducted for their mobile intervention, and three articles were written specifically on the pretesting of an intervention. Most pretesting used qualitative methods. Recommendations are provided on pretesting best practices and pretesting reporting to help other researchers in the field of mobile health.

Incarceration and unstable housing interact to predict sexual risk behaviours among African American STD clinic patients

Given the dramatic racial disparities in the rates of HIV/sexually transmitted infections (STIs) among African Americans, understanding broader structural factors that increase the risk for HIV/STIs is crucial. This study investigated incarceration history and unstable housing as two structural predictors of HIV risk behaviour among 293 African Americans (159 men/134 women, mean age = 27). Participants were recruited from an urban sexually transmitted disease (STD) clinic in the southeastern U.S. Approximately half the sample had been incarcerated in their lifetime (54%), and 43% had been unstably housed in the past six months. Incarceration was independently associated with the number of sex partners and the frequency of unprotected sex. Unstable housing was independently associated with the frequency of unprotected sex. However, these main effects were qualified by significant interactions: individuals with a history of incarceration and more unstable housing had more sex partners and more unprotected sex in the past three months than individuals without these structural barriers. Implications for structural-level interventions are discussed.

Does Context Matter? Examining PRISM as a Guiding Framework for Context-Specific Health Risk Information Seeking Among Young Adults.

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.