Nancy Grant Harrington

Psychobiology of novelty seeking and drug seeking behavior.

There is considerable evidence that high novelty seekers are at increased risk for using drugs of abuse relative to low novelty seekers. This review examines the potential biological mechanism that may help explain the relationship between novelty seeking and drug seeking behavior. Evidence is summarized to suggest that exposure to novelty activates, at least in part, the same neural substrate that mediates the rewarding effects of drugs of abuse. It is argued that individual differences in response to novelty and drugs may relate to individual differences in the mesolimbic dopamine (DA) system of the brain. Individual differences in both novelty seeking and drug seeking behavior, while under some degree of genetic control, appear to be modifiable by early development experiences and this modification may relate to alterations in activity of the mesolimbic DA system. Within the context of this biological formulation, implications for the prevention and treatment of drug abuse are discussed.

Efficacy of text messaging-based interventions for health promotion: A meta-analysis

This meta-analysis investigated the efficacy of text messaging-based health promotion interventions. Nineteen randomized controlled trials conducted in 13 countries met inclusion criteria and were coded on a variety of participant, intervention, and methodological moderators. Meta-analytic procedures were used to compute and aggregate effect sizes. The overall weighted mean effect size representing the impact of these interventions on health outcomes was d = .329 (95% CI = .274, .385; p < .001). This effect size was statistically heterogeneous (Q18 = 55.60, p < .001, I(2) = 67.62), and several variables significantly moderated the effects of interventions. Smoking cessation and physical activity interventions were more successful than interventions targeting other health outcomes. Message tailoring and personalization were significantly associated with greater intervention efficacy. No significant differences were found between text-only interventions and interventions that included texting plus other components. Interventions that used an individualized or decreasing frequency of messages over the course of the intervention were more successful than interventions that used a fixed message frequency. We discuss implications of these results for health promotion interventions that use text messaging.

How all Stars Works: An Examination of Program Effects on Mediating Variables:

Prevention research continues to focus on school-based substance use programs aimed at adolescents. These programs are designed to reduce substance use and risk behavior by targeting key mediators, such as normative beliefs, which in turn reduce substance use. All Stars is a newly developed program that was recently evaluated in a randomized field trial in 14 middle schools in Lexington and Louisville, Kentucky. The authors examined targeted and nontargeted variables as possible mediators of program effectiveness. Findings indicate that All Stars achieved reductions in substance use and postponed sexual activity when teachers were successful at altering targeted mediators: normative beliefs, lifestyle incongruence, and manifest commitment to not use drugs. The program was not successful when it was delivered by specialists. At least in part, this failure is attributable to specialists’ inability to change mediators as intended by the program.

Evaluation of the All Stars Character Education and Problem Behavior Prevention Program: Effects on Mediator and Outcome Variables for Middle School Students

The effects of All Stars, a character education and problem behavior prevention program, on variables theorized to mediate problem behaviors and on the problem behavior variables of substance use, sexual behavior, and violence among middle school students are reported. In an independent, randomized, single-cohort, longitudinal evaluation of the program, 1,655 students completed pretest, posttest, and 1-year follow-up surveys measuring demographics, mediating variables, and behavioral outcome variables. Results indicate that the All Stars program, when administered by teachers, had an immediate effect on mediating variables that did not persist over time. Inclusion of ethnicity in the design showed that the program, when administered by specialists, had delayed effects on mediating variables for African American and Hispanic students. However, no consistent effects were found for student problem behaviors in either condition. Implications for prevention practice and directions for future research are discussed.

The Role of Message Tailoring in the Development of Persuasive Health Communication Messages

This chapter provides an overview of the literature on tailored health communication messages, an innovative area of health communication research that has broad applicability to other areas of communication. Unlike traditional message targeting practices, which operate at the group level, tailored interventions involve the development of persuasive health communications designed for (and based upon an assessment of) the individual. We introduce tailoring and discuss the historical context of message tailoring research. We then provide a broad review of seminal and more recent message tailoring studies. Next, we discuss the mechanisms through which tailored messages may exert their effects, reviewing theoretical perspectives as well as empirical data. Finally, we consider future directions for research on tailored health communication.

Tailored Health Communication to Change Lifestyle Behaviors

Tailored health communication research represents a very promising line of inquiry that has the potential to produce major impacts on lifestyle behaviors. This study defines tailoring and discusses how tailored interventions operate, including comparing/ contrasting different tailoring channels. Next, the authors review the literature on tailored interventions to change lifestyle behaviors, with a focus on smoking cessation, dietary change, and physical activity, as well as interventions that address multiple lifestyle behaviors. Finally, future directions for tailoring research are discussed. To date, a large literature has amassed showing the promise of tailored programs delivered via print, Internet, local computer/kiosk, telephone, and interpersonal channels. Numerous studies demonstrate that these programs are capable of significant impacts on smoking cessation, dietary change, physical activity, and multiple behavior change. It is concluded that the potential of tailoring will be more fully realized as (a) the field builds a more cumulative science of tailoring and (b) greater dissemination of efficacious tailored programs takes place.

Reporting standards for studies of tailored interventions

Message tailoring is a promising innovative approach to persuasive communication that involves designing messages to meet a persons psychological, behavioral and/or demographic characteristics. Although the tailored intervention literature has many strengths, a weakness is inconsistency in reporting information related to intervention development, implementation and evaluation. The objective of this manuscript is to report recommendations for studies of tailored interventions. As part of ongoing original empirical and meta-analytical research, we reviewed the tailoring literature and identified inconsistencies in reporting. We compared these inconsistencies with existing reporting standards and developed recommendations specific to tailored interventions. An advisory board of preeminent tailoring researchers provided feedback on draft and final recommendations. This paper offers the resulting seven recommendations for reporting studies of tailored interventions. If we are to build a cumulative science of tailoring, both for theory development and research translation, then we should establish standards in the conduct and reporting of the science.

Narrative and Framing: A Test of an Integrated Message Strategy in the Exercise Context

Health communication interventions encouraging exercise may aid in mitigating the obesity crisis in the United States. Although much research has investigated behavioral predictors of exercise, little work has explored message characteristics most persuasive in the exercise context. The purpose of this study, therefore, was to test a message strategy drawing on previous work in health behavior theory combined with persuasion theories (exemplification theory and prospect theory) to encourage positive exercise attitudes, control beliefs, and intentions. The authors report the results of a controlled experiment testing messages using gain or loss frames and narrative or statistical evidence. Results indicate that gain-framed messages are significantly more successful in promoting positive exercise variables and are perceived as more effective than are loss-framed or control messages. The authors discuss the implications of the results for future research.

DRUG USE PREVENTION FOR THE HIGH SENSATION SEEKER: THE ROLE OF ALTERNATIVE ACTIVITIES

Research demonstrating links between sensation-seeking and drug use, and sensation-seeking and participation in leisure activities suggests designing substance misuse prevention projects that encourage substituting alternative activities for drug use. The current study uses factor analysis and discriminant analysis to provide comprehensive information on the kinds of activities high-sensation seekers participate in. Factor analysis of activity participation indicates an eight factor solution. Discriminant analysis of factor scores indicates that high-sensation seekers can be discriminated from low- sensation seekers on the basis of two factors, active-adventure and conflict-combat. Implications for prevention program design are discussed.

An Extension of the Activation Model of Information Exposure: The Addition of a Cognitive Variable to a Model of Attention

The principal objective of this article is to offer an extended theoretical framework for further development of persuasive message design for media-based health campaigns. Drawing upon considerable convergent evidence that attention to and processing of persuasive messages is a function of both cognitive and biologically based processes, we consider implications for attention and processing from an extension of the activation model of information exposure through the addition of a cognitive variable associated with the elaboration likelihood model, need for cognition. The overall goal is to determine how target audiences are optimally influenced with persuasive health information that attracts and holds attention, triggers information processing, and eventually brings about behavior change.