Nick Carcioppolo

The cancer information overload (CIO) scale: Establishing predictive and discriminant validity

OBJECTIVE Survey data suggests that approximately three-fourths of adults are overwhelmed by cancer information - a construct we label cancer information overload (CIO). A significant limitation of existing research is that it relies on a single-item measure. The objective of the current study is to develop and validate a multi-item measure of CIO. METHODS Study 1 (N=209) surveyed healthcare and manufacturing employees at eight worksites. Colonoscopy insurance claims data were culled eighteen months later to evaluate the predictive validity of CIO. Study 2 (N=399) surveyed adults at seven shopping malls. CIO and cancer fatalism were measured to examine the properties of the two constructs. RESULTS Study 1 identified a reliable 8-item CIO scale that significantly predicted colonoscopy insurance claims 18 months after the initial survey. Study 2 confirmed the factor structure identified in Study 1, and demonstrated that CIO, cancer fatalism about prevention, and cancer fatalism about treatment are best modeled as three distinct constructs. CONCLUSION The perception that there are too many recommendations about cancer prevention to know which ones to follow is an indicator of CIO, a widespread disposition that predicts colon cancer screening and is related to, but distinct from, cancer fatalism. PRACTICE IMPLICATIONS Many adults exhibit high CIO, a disposition that undermines health efforts. Communication strategies that mitigate CIO are a priority. In the short-term, health care providers and public health professionals should monitor the amount of information provided to patients and the public.

Including Limitations in News Coverage of Cancer Research: Effects of News Hedging on Fatalism, Medical Skepticism, Patient Trust, and Backlash

Past research has demonstrated that news coverage of cancer research, and scientific research generally, rarely contains discourse-based hedging, including caveats, limitations, and uncertainties. In a multiple message experiment (k = 4 news stories, N = 1082), the authors examined whether hedging shaped the perceptions of news consumers. The results revealed that participants were significantly less fatalistic about cancer (p = .039) and marginally less prone to nutritional backlash (p = .056) after exposure to hedged articles. Participants exposed to articles mentioning a second researcher (unaffiliated with the present study) exhibited greater trust in medical professions (p = .001). The findings provide additional support for the inclusion of discourse-based hedging in cancer news coverage and suggest that news consumers will use scientific uncertainty in illness representations.

Examining HPV Threat-to-Efficacy Ratios in the Extended Parallel Process Model

The Extended Parallel Process Model (EPPM) posits that an effective fear appeal includes both threat and efficacy components; however, research has not addressed whether there is an optimal threat-to-efficacy ratio. It is possible that varying levels of threat and efficacy in a persuasive message could yield different effects on attitudes, beliefs, and behaviors. In a laboratory experiment, women (n = 442) were exposed to human papilloma virus (HPV) prevention messages containing one of six threat-to-efficacy ratios and one of two message frames (messages emphasizing the connection between HPV and cervical cancer or HPV and genital warts). Multiple mediation analysis revealed that a 1-to-1 ratio of threat to efficacy was most effective at increasing prevention intentions, primarily because it caused more fear and risk susceptibility than other message ratios. Response efficacy significantly mediated the relationship between message framing and intentions, such that participants exposed to a genital warts message reported significantly higher intentions, and this association can be explained in part through response efficacy. Implications for future theoretical research as well as campaigns and intervention research are discussed.

Perceived Historical Drinking Norms and Current Drinking Behavior: Using the Theory of Normative Social Behavior as a Framework for Assessment

Social norms are sustained and disseminated, both implicitly and explicitly, through the act of communication. As a result, communication researchers have sought to classify and target normative perceptions to enact social change. In line with this research, the current study investigated whether perceptions of past normative behavior, referred to here as historical norms, were significantly related to current behavior. Using the theory of normative behavior as a guiding framework, two studies were conducted to assess whether college student drinking behavior was related to one of two perceived historical drinking norms measures: historical consumption norms (i.e., the perceived percentage of students who drank over time) and historical tradition norms (i.e., the perception of drinking as a university tradition). Study 1 revealed that although historical consumption norms was not directly related to drinking behavior, it moderated the effect of descriptive norms on drinking behavior (p = .03). A full assessment of the theory of normative social behavior was conducted in study 2 to determine whether perceived historical drinking norms influenced behavior above and beyond both descriptive and injunctive norms. Findings demonstrated that historical tradition norms were significantly related to drinking behavior (p = .001), and marginally moderated the relationship between descriptive norms and drinking behavior (p = .09). These findings offer preliminary evidence in support of measuring perceived historical drinking norms in future campaigns and interventions designed to reduce drinking behavior.

Perceived Visual Informativeness (PVI): Construct and Scale Development to Assess Visual Information in Printed Materials

There is a paucity of research on the visual images used in health communication messages and campaign materials. Even though many studies suggest further investigation of these visual messages and their features, few studies provide specific constructs or assessment tools for evaluating the characteristics of visual messages in health communication contexts. The authors conducted 2 studies to validate a measure of perceived visual informativeness (PVI), a message construct assessing visual messages presenting statistical or indexical information. In Study 1, a 7-item scale was created that demonstrated good internal reliability (α = .91), as well as convergent and divergent validity with related message constructs such as perceived message quality, perceived informativeness, and perceived attractiveness. PVI also converged with a preference for visual learning but was unrelated to a persons actual vision ability. In addition, PVI exhibited concurrent validity with a number of important constructs including perceived message effectiveness, decisional satisfaction, and three key public health theory behavior predictors: perceived benefits, perceived barriers, and self-efficacy. Study 2 provided more evidence that PVI is an internally reliable measure and demonstrates that PVI is a modifiable message feature that can be tested in future experimental work. PVI provides an initial step to assist in the evaluation and testing of visual messages in campaign and intervention materials promoting informed decision making and behavior change.

Psychosocial Predictors of Human Papillomavirus Vaccination Intentions for Young Women 18 to 26: Religiosity, Morality, Promiscuity, and Cancer Worry

OBJECTIVES To determine whether five psychosocial variables, namely, religiosity, morality, perceived promiscuity, cancer worry frequency, and cancer worry severity, predict young womens intentions to receive the human papillomavirus (HPV) vaccination. METHODS Female undergraduate students (n=408) completed an online survey. Questions pertaining to hypothesized predictors were analyzed through bivariate correlations and hierarchical regression equations. Regressions examined whether the five psychosocial variables of interest predicted intentions to vaccinate above and beyond controls. Proposed interactions among predictor variables were also tested. RESULTS Study findings supported cancer worry as a direct predictor of HPV vaccination intention, and religiosity and sexual experience as moderators of the relationship between concerns of promiscuity reputation and intentions to vaccinate. One dimension of cancer worry (severity) emerged as a particularly robust predictor for this population. CONCLUSIONS This study provides support for several important, yet understudied, factors contributing to HPV vaccination intentions among college-aged women: cancer worry severity and religiosity. Future research should continue to assess the predictive contributions of these variables and evaluate how messages and campaigns to increase HPV vaccination uptake can utilize religious involvement and worry about cancer to promote more effectively HPV vaccination as a cancer prevention strategy.

How Do Perceived Descriptive Norms Influence Indoor Tanning Intentions? An Application of the Theory of Normative Social Behavior

ABSTRACT Indoor tanning bed use is highly influenced by perceived norms about a tanned appearance. The theory of normative social behavior (TNSB) details the many ways in which norms can impact intentions and behavior, but has never been assessed in the context of indoor tanning. Considering this, we conducted a survey among female university students (N = 274) to determine the extent to which the TNSB predicted intentions to use indoor tanning beds. Overall, the path model predicted about 46% of the variance in intentions, and the majority of significant indirect effects were witnessed through the outcome expectation variables included in the TNSB, suggesting that these may be the most salient mechanisms—as predicted by the TNSB—through which norms can impact tanning intentions. In light of these results, theoretical and practical implications are discussed, and specific recommendations are given to extend the predictive utility of the TNSB in the context of indoor tanning.

In-group rationalizations of risk and indoor tanning: A textual analysis of an online forum

Unlike other health behaviors, there does not appear to be a strong relationship between perceived skin cancer risk and reduction or cessation of indoor tanning bed use. This study seeks to address this inconsistency by determining how indoor tanning bed users rationalize skin cancer risk with their tanning behavior. Qualitative textual analysis of indoor tanning message board posts (N = 330) revealed varied perceptions of risk, including acknowledging the risk of indoor tanning; denying or downplaying risk, often citing perceived health benefits associated with tanning; blaming outside forces for cancer, such as lotion or genetics; and fatalistic beliefs about cancer. These results highlight the nuanced relationship between perceived skin cancer risk and indoor tanning bed use.

Health information seeking and scanning among US adults aged 50-75 years: Testing a key postulate of the information overload model

Past research has found that older US adults (aged 50–75 years) exhibit high levels of cancer information overload and cancer worry; however, no study to date has examined whether these perceptions are related to information seeking/scanning. To explore this relationship, older adults (N = 209, Mage = 55.56, SD = 4.24) were recruited to complete a survey measuring seeking, scanning, cancer information overload, and cancer worry. Most participants were high-scan/seekers (40.2%) followed by low-scan/seekers (21.1%), high-scan/no seekers (19.6%), and low-scan/no seekers (19.1%). Low-scan/no seekers had significantly higher cancer information overload compared to all other groups, consistent with the postulate that overload and seeking/scanning are negatively related. Low-scan/no seekers and high-scan/seekers both exhibited higher cancer worry severity, consistent with past research suggesting that cancer worry explains high levels of activity/inactivity.

When Does Perceived Susceptibility to Skin Cancer Influence Indoor Tanning? The Moderating Role of Two Risk Perception Beliefs

Previous research has demonstrated an inconsistent relationship between perceived susceptibility to skin cancer and indoor tanning. The current study explored potential moderators of this relationship to better understand how risk perceptions can impact indoor tanning intentions and behavior. A national online survey (N = 267) was administered in the United States to establish the relationship between perceived susceptibility to skin cancer, cancer fatalism, and external risk attribution beliefs on indoor tanning intentions and behavior. Results revealed significant 3-way interactions among these risk perceptions on both intentions and behavior that run contrary to much of the published research on perceived susceptibility and health behavior. These findings suggest that the relationship between perceived susceptibility to skin cancer and indoor tanning is conditional on other risk perceptions. These results are discussed in terms of their theoretical and practical implications.