Mary M. Step

Impact of Motivation, Attraction, and Parasocial Interaction on Talk Radio listening

We examined the impact of motivation, interpersonal attraction, and parasocial interaction (PSI) on listening to public affairs talk radio. Hierarchical regression identified several results. PSI and exciting entertainment motivation predicted intentional and frequent listening to a favorite host. PSI, task attraction, and information motivation predicted regarding a host as an important source of information. PSI, information motivation, task attraction, and pass time/habit motivation predicted feeling that a host influenced attitudes. PSI, information motivation, and pass time/habit motivation predicted following a hosts advice to act on societal concerns.

A communication model of shared decision making: accounting for cancer treatment decisions.

The authors present a communication model of shared decision making (CMSDM) that explicitly identifies the communication process as the vehicle for decision making in cancer treatment. In this view, decision making is necessarily a sociocommunicative process whereby people enter into a relationship, exchange information, establish preferences, and choose a course of action. The model derives from contemporary notions of behavioral decision making and ethical conceptions of the doctor-patient relationship. This article briefly reviews the theoretical approaches to decision making, notes deficiencies, and embeds a more socially based process into the dynamics of the physician-patient relationship, focusing on cancer treatment decisions. In the CMSDM, decisions depend on (a) antecedent factors that have potential to influence communication, (b) jointly constructed communication climate, and (c) treatment preferences established by the physician and the patient.

A teachable moment communication process for smoking cessation talk: description of a group randomized clinician-focused intervention

BackgroundEffective clinician-patient communication about health behavior change is one of the most important and most overlooked strategies to promote health and prevent disease. Existing guidelines for specific health behavior counseling have been created and promulgated, but not successfully adopted in primary care practice. Building on work focused on creating effective clinician strategies for prompting health behavior change in the primary care setting, we developed an intervention intended to enhance clinician communication skills to create and act on teachable moments for smoking cessation. In this manuscript, we describe the development and implementation of the Teachable Moment Communication Process (TMCP) intervention and the baseline characteristics of a group randomized trial designed to evaluate its effectiveness.Methods/DesignThis group randomized trial includes thirty-one community-based primary care clinicians practicing in Northeast Ohio and 840 of their adult patients. Clinicians were randomly assigned to receive either the Teachable Moments Communication Process (TMCP) intervention for smoking cessation, or the delayed intervention. The TMCP intervention consisted of two, 3-hour educational training sessions including didactic presentation, skill demonstration through video examples, skills practices with standardized patients, and feedback from peers and the trainers. For each clinician enrolled, 12 patients were recruited for two time points. Pre- and post-intervention data from the clinicians, patients and audio-recorded clinician‒patient interactions were collected. At baseline, the two groups of clinicians and their patients were similar with regard to all demographic and practice characteristics examined. Both physician and patient recruitment goals were met, and retention was 96% and 94% respectively.DiscussionFindings support the feasibility of training clinicians to use the Teachable Moments Communication Process. The next steps are to assess how well clinicians employ these skills within their practices and to assess the effect on patient outcomes.Trial RegistrationClinicalTrials.gov Identifier: NCT01575886

A Comprehensive Observational Coding Scheme for Analyzing Instrumental, Affective, and Relational Communication in Health Care Contexts

Many observational coding schemes have been offered to measure communication in health care settings. These schemes fall short of capturing multiple functions of communication among providers, patients, and other participants. After a brief review of observational communication coding, the authors present a comprehensive scheme for coding communication that is (a) grounded in communication theory, (b) accounts for instrumental and relational communication, and (c) captures important contextual features with tailored coding templates: the Siminoff Communication Content & Affect Program (SCCAP). To test SCCAP reliability and validity, the authors coded data from two communication studies. The SCCAP provided reliable measurement of communication variables including tailored content areas and observer ratings of speaker immediacy, affiliation, confirmation, and disconfirmation behaviors.

Interpersonal communication motives in everyday interactions

Everyday conversations are pivotal to unfolding human relationships. These routine conversations provide evidence of the structure and function of talk within relationships. Interpersonal communication motives were considered antecedents to climate and outcome variables as defined by the Iowa Communication Record. Participants completed three diary records for substantial interactions they engaged in over the course of one week. Analysis established communication for enjoyment to be associated with quality and positive change outcomes. Inclusion motivation was associated with high conversational value and positive social change. Results support a functional view of communication.

The Role of Primary Care Physicians in Advanced Cancer Care: Perspectives of Older Patients and Their Oncologists

OBJECTIVES: To examine data from advanced cancer patients and their oncologists regarding patient age‐related differences in patient and oncologist perspectives on involvement of primary care physicians (PCPs) in aspects of cancer management.

Viewing television talk shows

We examined how motivation, audience activity, and attitudes influenced the likelihood of watching societal‐issue and relational topics on television talk programs. Path analysis supported differences in ritualized and instrumental motives for watching talk shows. Information and exciting‐entertainment motivation predicted greater’ realism of, affinity with, involvement with, and intent to watch talk television. Pass‐time motivation predicted reduced affinity with and intent to watch talk television, and reduced likelihood of watching relational topics. Information motivation predicted greater likelihood of watching relational topics. We discussed these findings in light of the concept of audience activity.

User and Content Characteristics of Public Tweets Referencing Little Cigars

OBJECTIVES Compared to cigarettes, little cigars and cigarillos (LCC) are minimally regulated, affordable, and widely available to young people. Because Twitter is a preferred mode of communication among younger people, product portrayals may be useful for informing both interventions and public health or tobacco policy. METHODS A mixed-methods study was implemented to analyze the content of public tweets (N = 288) and profile photos sampled from a search of 2 LCC brands (Black & Mild and Swisher Sweets). Metadata and manifest attributes of profile photo demographic features and tweet message features were coded and analyzed. Thematic analysis of the tweets was conducted using an iterative immersion/ crystallization method. RESULTS Tweeters were most often boys or men (63%) and appeared young (76%). Prevalent content themes included expressing affiliation for the LCC product and reporting smoking activity. Although men and women tweeted affiliation for LCC products and reported smoking activity in similar numbers, women were significantly less likely to tweet about blunting than men. CONCLUSIONS Twitter provides a potentially potent source of nuanced information about how young people are using little cigars. These observed characteristics may be useful to inform counter-messaging strategies and interventions.

An exploration of the relative influence of patient's age and cancer recurrence status on symptom distress, anxiety, and depression over time

Past research suggests that psychosocial responses to advanced or recurrent cancer vary by age. This study compares the relative influences of patients’ age and recurrence status on indicators of symptom distress, anxiety, and depression following a diagnosis of advanced cancer. A prospective study of advanced cancer support provided patient outcome data reported at baseline, 3-, and 6-month intervals. Cohorts were defined by age group and recurrence status and latent growth curves fit to anxiety, depression, and symptom distress outcomes. Middle-age recurrent patients reported the highest symptom distress, depression, and anxiety across time points. Older recurrent patients fared worse at baseline than older nonrecurrent patients, but outcome scores converged across time points. Recurrent cancer presents a distinct challenge that, for middle-age patients, persists across time. It may be beneficial to develop targeted educational and support resources for middle-age patients with recurrent disease.

Facilitating enrollment in a Cancer Registry through modified consent procedures: a pilot study.

Research registries are increasingly important in medical research and are essential to the mission of cancer centers. However, designing enrollment and data collection procedures that are consistent with ethical norms and regulatory requirements yet are efficient and cost effective is a major challenge. Current standard consent forms can be a barrier to enrollment because of their length, multiple components, and technical language. We pilot tested an IRB-approved registry booklet and simplified one-page, tiered consent form, allowing for choice of extent of participation. The booklet was mailed to patients with breast cancer as part of their routine information packet prior to the first clinic appointment. A research nurse met with 27 patients at initial treatment to review the booklet, answer questions, obtain informed consent, and collect quality of life data. The consent rate was 78% with 21 patients enrolling in the study. Twelve of the 21 patients (57%) did not read the booklet prior to the visit. The 9 patients (43%) who had read the booklet prior to arrival found it easy to understand. The multistage, simplified consent process and data collection were acceptable to these patients and readily integrated into clinical operations. An easy-to-read registry booklet may be an effective guide for discussion, but in-person consent procedures and further testing of the approach are required.