Rachael A. Record

The Three Ts of Adopting Tobacco-free Policies on College Campuses

This article describes a 3-pronged compliance strategy to implement a tobacco-free campus policy at 1 large, land grant public university in the South, and evaluates its impact on outcomes and costs. Although there has been a recent wave of tobacco-free colleges, policy restrictiveness and implementation vary, and compliance remains a challenge. The 3 Ts strategy (Tell-Treat-Train) involves regular, consistent communications, access to tobacco treatment medications and counseling, and ongoing training of supervisors and student leaders. Administrative support, access to tobacco treatment, campus buy-in, sustained communications, and careful implementation planning are critical to instituting a tobacco-free university policy.

Using communication to manage uncertainty about cervical cancer screening guideline adherence among Appalachian women

ABSTRACT Changes to the United States Preventive Services Task Force (USPSTF) recommendations for cervical cancer preventive services have led to patient confusion, especially in medically underserved populations. We investigated how patient uncertainty concerning cervical cancer screening guidelines is appraised and managed through communication with healthcare providers by conducting in-depth, face-to-face interviews with 24 adult women between the ages of 24 and 65 (m = 41, SD = 14) living in Appalachia Kentucky. In general, participants expressed a high degree of uncertainty about the updated cervical cancer screening guidelines and appraised this uncertainty as both a danger and an opportunity. Communication with healthcare providers served both to exacerbate and to mitigate patient uncertainty. The study identifies how healthcare providers may use the change in USPSTF guidelines as a “teachable moment” to productively counsel patients on the importance of timely screening, the typical progression of certain types of high-risk HPV (human papillomavirus) infection to cervical cancer, and the importance of follow-up care.

An Evidence-Based Cessation Strategy Using Rural Smokers’ Experiences with Tobacco

Little is known about the most effective strategies to motivate rural smokers to quit. This article describes the personal narratives of current and former smokers living in an economically distressed, rural area of Appalachian Kentucky. Three categories emerged: personal motivators to quit smoking, external influences, pride of place. Capturing personal narratives represents an evidence-based, data-rich strategy for development of culturally sensitive, population-based interventions for rural smokers. Such strategies may be effective in reaching rural smokers and motivating them to quit, thereby reducing tobacco-related disease and premature death in rural, economically distressed communities.

Communication, Reasoning, and Planned Behaviors: Unveiling the Effect of Interactive Communication in an Anti-Smoking Social Media Campaign

Abstract This study examines direct and indirect effects of interactive communication in an antismoking social media campaign. To that end, we pose a multitheoretical framework that integrates communication mediation models and the Theory of Planned Behavior. To test the theorized model, we conducted an experiment using a two-group pretest–posttest design. Participants (N = 201) were randomly assigned into two experimental conditions: “campaign message reception only” as a control group and “message reception and social interaction” as a treatment group, in which the participants contributed to the antismoking campaign by posting their own campaign ideas and information they found through mediated and interpersonal communication. The findings show that interactive communication catalyzes the participants’ information searching behaviors through diverse communication channels. In turn, increased media use plays a crucial role in changing their attitudes and perceived social norms about smoking behaviors, and eventually reducing smoking intention. This study affirms that the theory of planned behavior is effective in predicting behavioral intention and demonstrates the usefulness of a multitheoretical approach in interactive campaign research on social media.

Outdoor tobacco smoke exposure at the perimeter of a tobacco-free university

There are few studies measuring exposure to outdoor tobacco smoke (OTS). Tobacco users often gather at the boundaries of tobacco-free campuses, resulting in unintended consequences. The objective of this study was to measure exposure levels from OTS on sidewalks bordering a tobacco-free university campus. Data were collected while walking along a sidewalk adjacent to a medium traffic road between May and August 2011. Monitoring occurred during “background,” “stop,” and “walk-through” conditions at and near hot spot area to measure fine particulate matter (<2.5 μm; PM2.5) from OTS using a portable aerosol monitor. The average PM2.5 levels during stop and walk-through conditions were significantly higher than during background conditions. PM2.5 peak occurrence rate and magnitude of peak concentration were significantly different depending on smoking occurrence. The peak occurrence rate during the stop condition was 10.4 times higher than during the background condition, and 3.1 times higher than during the walk-through condition. Average peak PM2.5 concentrations during the stop condition were 48.7% higher than during the background condition. In conclusion, individuals could be exposed to high levels of PM2.5 when stopping or even passing by smokers outdoors at the perimeter of tobacco-free campuses. The design and implementation of tobacco-free campus policies need to take into account the unintended consequences of OTS exposure at the boundaries. Implications: In this study, outdoor tobacco smoke (OTS) exposure was measured at the perimeter of tobacco-free campus. OTS exposure could be determined by peak analysis. Peak occurrence rate and peak concentration for OTS exposure were identified by using peak analysis. People could be exposed to high levels of PM2.5 when standing or even passing by smokers at the perimeter of tobacco-free campus. OTS exposure measurement in other outdoor locations with smokers is needed to support outdoor smoking regulation.

Let’s Clear the Air: a campaign that effectively increased compliance with a university’s tobacco-free policy

ABSTRACT The purpose of this study was to assess the effectiveness of the Let’s Clear the Air campaign, a print-based campaign guided by the theory of planned behavior, designed to increase compliance with a University’s tobacco-free policy among undergraduate student smokers. We hypothesized that individual-level compliance behaviors would increase with greater campaign exposure and that population-level compliance would improve post-intervention from baseline. To assess individual-level compliance, we collected survey data from 284 randomly selected undergraduate student smokers. To assess population-level compliance, we collected observational data by counting smokers in 10 violation locations for 10 weeks (three 30-minute periods per week). Data supported the hypotheses: Campaign exposure was related to an increase in individual-level compliance behaviors, and results from a negative binomial regression supported that population-level compliance improved from baseline to post-intervention. Implications regarding support for the campaign as an effective strategy for increasing tobacco-free policy compliance behaviors are discussed.

Navigating the thin-ideal in an athletic world: influence of coach communication on female athletes’ body image and health choices

Abstract This study sought to investigate how interpersonal communication between coaches and female athletes influences the female athletes’ perceptions of body image and health choices. Much of the current literature has focused on the fact that female athletes are at risk for disordered eating and a distorted body image due to susceptibility to the feminine “thin-ideal” while maintaining the fitness levels necessary to compete in their sport. However, very little research has examined how interpersonal interaction plays a role in female athletes’ body image perceptions and health behaviors. Utilizing the Communication Theory of Identity (CTI) as a lens to examine communication between female athletes and their coaches, the researchers analyzed transcripts from in-depth interviews with 28 female athletes and identified themes within the personal, relational, enacted, and communal layers of identity. Coach communication with their female athletes was found to be influential to the athletes’ body images and health choices.

Creating Effective Media Messaging for Rural Smoke‐free Policy

OBJECTIVES Objectives were to (1) explore perceived effectiveness of existing smoke-free print advertisements in rural communities and (2) generate message content, characteristics, and media delivery channels that resonate with residents. DESIGN AND SAMPLE Qualitative methods design. Thirty-nine rural adults recruited by community partners. MEASURES Content analysis of findings from individuals in four focus groups who participated in general discussion and reviewed eight print ads related to secondhand smoke (SHS) and smoke-free policy. RESULTS Six content themes were identified: smoking/SHS dangers, worker health, analogies, economic impact, rights, and nostalgia. Seven message characteristics were recognized: short/to the point, large enough to read, graphic images, poignant stories, statistics/charts/graphs, message sender, and messages targeting different groups. Four media delivery channels were considered most effective: local media, technology, billboard messages, and print materials. CONCLUSIONS Seeking input from key informants is essential to reaching rural residents. Use of analogies in media messaging is a distinct contribution to the literature on effective smoke-free campaigns. Other findings support previous studies of effective messaging and delivery channels. Further research is needed to examine effectiveness of themes related to message content in smoke-free ads and delivery strategies. Effective media messaging can lead to policy change in rural communities to reduce exposure to SHS.

Unveiling the Effects of Citizen Journalism Practice on College Students’ Social Capital

This study examined the effects of citizen journalism practices on social capital concerning nonprofit and voluntary organizations (i.e., satisfaction, trust, and engagement). Through a quasi-experimental design, the analyses revealed that students in the treatment group, in which participants engaged in citizen journalism practice, had greater positive changes in levels of satisfaction, trust, and engagement than students in the control group. This study offers unique contributions to the existing body of social capital scholarship and practical implications related to the use of citizen journalism as a civic education tool in school and community settings.

Social Media Campaign Effects: Moderating Role of Social Capital in an Anti-Smoking Campaign

ABSTRACT This study examined the effects of an anti-smoking campaign that employs a crowdsourcing method with a social networking service. Drawing upon social capital scholarship and the expression effect research paradigm in eHealth systems, the study also investigated the roles of social trust and community life satisfaction in the social media campaign that has a specific geographical boundary. To that end, we conducted an experiment using a two-group pretest–posttest design. We randomly assigned 201 participants to two conditions: “campaign message reception only” as a control group and “message reception and expression” as a treatment group in which participants fully engaged in the campaign process by sharing their own campaign ideas with other participants. Findings revealed that social trust and community life satisfaction interacted with the treatment condition to positively affect persuasive intentions, but in distinct ways. Social trust moderated the effect of the message reception and interaction condition on participants’ willingness to encourage community members to stop smoking. In contrast, community life satisfaction moderated the effect of the treatment condition on encouraging others to comply with the community’s anti-smoking policy. These results provide theoretical and practical implications related to the roles of social capital in geographically defined social media campaigns.