Rebecca Robbins

Using the Integrative Model of Behavioral Prediction to Identify Promising Message Strategies to Promote Healthy Sleep Behavior Among College Students

This research used the Integrative Model of Behavioral Prediction (IMBP) to examine cognitive predictors of intentions to engage in healthy sleep behavior among a population of college students. In doing so, we identify promising message strategies to increase healthy sleep behavior during college. In Phase 1, members of a small sample of undergraduates (n = 31) were asked to describe their beliefs about expected outcomes, norms, and perceived behavioral control associated with sleep on an open-ended questionnaire. We analyzed these qualitative responses to create a closed-ended survey about sleep-related attitudes, perceived norms, control beliefs, behavioral intentions, and behavior. In Phase 2, a larger sample of undergraduate students (n = 365) completed the survey. Attitudes and perceived behavioral control were the strongest predictors of both intentions to engage in sleep behavior and self-reported sleep behavior. Control beliefs associated with time management and stress also had substantial room to change, suggesting their potential as message strategies to better promote healthy sleep behavior in college. We conclude with a broader discussion of the study’s implications for message design and intervention.

Content and Effects of News Stories About Uncertain Cancer Causes and Preventive Behaviors

This article presents findings from two studies that describe news portrayals of cancer causes and prevention in local TV and test the effects of typical aspects of this coverage on cancer-related fatalism and overload. Study 1 analyzed the content of stories focused on cancer causes and prevention from an October 2002 national sample of local TV and newspaper cancer coverage (n = 122 television stations; n = 60 newspapers). Informed by results from the content analysis, Study 2 describes results from a randomized experiment testing effects of the volume and content of news stories about cancer causes and prevention (n = 601). Study 1 indicates that local TV news stories describe cancer causes and prevention as comparatively more certain than newspapers but include less information about how to reduce cancer risk. Study 2 reveals that the combination of stories conveying an emerging cancer cause and prevention behavior as moderately certain leads to an increased sense of overload, while a short summary of well-established preventive behaviors mitigates these potentially harmful beliefs. We conclude with a series of recommendations for health communication and health journalism practice.

Which Design Components of Nutrition Infographics Make Them Memorable and Compelling

OBJECTIVES Which design features of nutrition infographics make them memorable and compelling? METHODS First, we conducted 3 focus groups with a total of 28 participants to understand preferred infographic characteristics of adults who were mostly in their early 20s. Second, using between subject design, a slide show of single-image infographics was displayed to an independent sample of college students and young career university employees (N = 50). We assigned participants randomly to either active or passive processing conditions. We conducted correlation and regression analyses to examine differences in recall and intention by infographic characteristics and processing conditions. RESULTS Regardless of whether a person was actively or passively viewing the infographics, the most robust predictor of recall was an action-oriented title (p = .003). Surprisingly, infographics in color (vs black-and-white), humorous, or simply worded were no more memorable or effective than if they simply had actionable titles. CONCLUSIONS Action-oriented titles make infographics memorable and compelling. Regardless of how involved a person is in processing an infographic, cartoon, or illustration, time spent on perfecting an action-oriented title will be time better spent than on making the infographic colorful, humorous, or detailed. Whereas content and detail of the infographic are important, effectiveness might be improved by the command given in its title or subtitle.

Views of city, county, and state policy makers about childhood obesity in New York State, 2010-2011.

Introduction No single solution exists to reduce rates of childhood obesity in the United States, but public policy action is essential. A greater understanding of policy maker views on childhood obesity would provide insight into ways that public health advocates can overcome barriers to propose, enact, and implement obesity prevention policies. Methods We conducted 48 in-depth, qualitative interviews with town/city, county, and state policy makers in the state of New York from December 14, 2010, through June 10, 2011. We used a semistructured interview protocol to solicit policy maker views on the causes of, solutions to, and responsibility for addressing the issue of childhood obesity. Results Most policy makers considered the issue of childhood obesity to be of high importance. Respondents cited changes to family structures as a major cause of childhood obesity, followed by changes in the external environment and among children themselves. Respondents offered varied solutions for childhood obesity, with the most common type of solution being outside of the respondent’s sphere of policy influence. Policy makers cited the need for joint responsibility among parents, government, schools, and the food industry to address childhood obesity. Conclusion Beliefs of many policy makers about childhood obesity are similar to those of the general public. Findings highlight the need for future research to inform the development of communication strategies to promote policy action among those with authority to pass and implement it.

Examining Use of Mobile Phones for Sleep Tracking Among a National Sample in the USA

ABSTRACT Mobile technology has been designed to serve a number of functions relating to health, but we know little about individuals who use these tools to track sleep. This study utilized data from a cross-sectional, geographically diverse survey of adults in the USA (N = 934). Among the sample, 28.2% (n = 263) report current use of a mobile phone for sleep tracking. Income and gender were significant correlates of sleep tracking (p < 0.05). Compared to a poor diet, a reported “excellent” diet was associated with sleep tracking (p < 0.05). Interestingly, compared to individuals who never smoke, report of smoking “everyday” was associated with sleep tracking (p < 0.05). Finally, individuals who reported current use of their mobile device for other health functions (e.g., chat with their doctor or log symptoms) were more likely to report sleep tracking on their mobile device (p < 0.05). Results appear to suggest sleep tracking is common among individuals with good general health.

Social conversation and its relationship to sleep behavior among college students

Sleep health is compromised during the college years; college students have shortened sleep duration and often keep inconsistent sleep schedules. One strong predictor that has been identified in previous research on college student sleep is dysfunctional beliefs like worry and perceived lack of control. Less understood are the contributing factors to these dysfunctional beliefs. This paper draws on a social science perspective to examine how college students talk about sleep and how these conversations relate to beliefs and intentions to sleep. In a 2-step mixed-methods design, this study explores conversations among college students about sleep and how these conversations relate to sleep-related cognitions and behaviors (n=301). College students report frequently talking about sleep-damaging topics (staying up late, daytime sleepiness), and this discussion is associated with lower cognitive beliefs about behavioral control and lower intention to sleep. Regression results show a negative relationship between sleep behaviors and sleep-damaging conversations (β=-0.41; P<.001). Perceived control over sleep patterns was strongly associated with sleep behavior (β=0.46; P<.001), and evidence was found that this belief might partially mediate the relationship between sleep-damaging talk and behavior. Implications for sleep education and promotion efforts on college campuses are offered.

Employee Health Codes of Conduct: What Would They Look Like and Who Would Accept Them?

Purpose: Most workplace health promotion efforts have failed to consistently and sustainably encourage employees to take responsibility for their health. This paper explores a potentially high impact solution – Health Codes of Conduct – for engaging and motivating employees to assume responsibility for their health.Design: This mixed methods study draws on interview and survey methodology with a sample of 149 working adults to examine the feasibility of Health Codes of Conduct. Descriptive and inferential statistics are calculated to understand reactions, characteristics of the companies likely to support the idea, and components of a Health Code of Conduct.Findings: All employees offered moderate to high support for Health Codes of Conduct; this included overweight but not obese employees. Additionally, all demographic groups either moderately or strongly supported the policy when they included either monetary incentives (such as prescription discounts) or often overlooked nonmonetary incentives (such as employee recognition). Some of the more popular features of Health Codes of Conduct included annual physical exams, exercise routines, and simply encouraging employees to stay home when ill.Research implications: Health Codes of Conduct offer a surprisingly well-supported potential solution for engaging employees in wellness. Favorable reactions were observed across all examined segments of workers, including overweight (but not obese) employees. Using the specific features of Health Codes identified here, visionary companies can tailor their own company’s Health Code of Conduct with the appropriate monetary and nonmonetary incentives and disincentives.Social implications: What if the workplace could be a positive source of health and empowerment for valued employees? We show employee Health Codes of Conduct could be this empowering, engaging solution that has been missing.Originality: This paper is the first to propose the concept Health Codes of Conduct and solicit feedback from employees on this novel idea and show the specific features that are most attractive in such a code. Furthermore, we identify both the monetary and nonmonetary incentives and disincentives that employees believe would be most compelling.

National patterns of physician management of sleep apnea and treatment among patients with hypertension

Study objectives Sleep apnea is associated with hypertension, and treatment may improve outcomes. We examine national burden of sleep apnea, rates of sleep apnea treatment, and whether racial/ethnic disparities exist among patients with hypertension. Methods Data from the National Ambulatory Medical Care Survey/National Hospital Ambulatory Medical Care Survey (NAMCS/NHAMCS), 2005–2012, were analyzed (N = 417,950). We identified hypertension patient visits where sleep apnea diagnosis or complaint was recorded. Primary outcome measures were sleep study, medication, or behavioral therapy (diet, weight loss, or exercise counseling). We used multivariate logistic regression to examine treatment by demographic/clinical factors. Results Among patients with hypertension, sleep apnea was identified in 11.2-per-1,000 visits. Overall, patients with hypertension and a sleep disorder were referred for sleep study in 14.4% of visits, prescribed sleep medication in 11.2% of visits, and offered behavioral therapy in 34.8% of visits. Adjusted analyses show behavioral therapy more likely to be provided to obese patients than normal/overweight (OR = 4.96, 95%CI[2.93–8.38]), but less likely to be provided to smokers than nonsmokers (OR = 0.54, 95%CI[0.32–0.93]). Non-Hispanic blacks were less likely to receive medications than non-Hispanic whites (OR = 0.19, 95% CI[0.06–0.65]). Conclusions In the U.S., sleep apnea were observed in a small proportion of hypertension visits, a population at high-risk for the disorder. One explanation for the low prevalence of sleep apnea observed in this patient population at high risk for the disorder is under-diagnosis of sleep related breathing disorders. Behavioral therapy was underutilized, and non-Hispanic Blacks were less likely to receive medications than non-Hispanic Whites.

Developing a Tailored Website for Promoting Awareness about Obstructive Sleep Apnea (OSA) Among Blacks in Community-Based Settings

ABSTRACT Blacks are at greater risk for lower sleep quality and higher risk for obstructive sleep apnea (OSA) than other racial groups. In this study, we summarize the development of a tailored website including visuals, key messages, and video narratives, to promote awareness about sleep apnea among community-dwelling blacks. We utilized mixed methods, including in-depth interviews, usability-testing procedures, and brief surveys (n = 9, 55% female, 100% black, average age 38.5 years). Themes from the qualitative analysis illuminated varied knowledge regarding OSA symptoms and prevalent self-reported experience with sleep disturbance and OSA symptoms (e.g., snoring). On a scale from 1 (not at all) to 5 (very high), participants provided favorable ratings of website usefulness (mean = 4.9), user friendliness (mean = 4.9) and attractiveness (mean = 4.3). Our findings suggest although tailored health communication has potential for serving as a tool for advancing health equity, usability-testing of health materials is critical to ensure that culturally and linguistically tailored messages are acceptable and actionable in the intended population.

How Online Peer-to-Peer Conversation Shapes the Effects of a Message About Healthy Sleep.

Conversation about health messages and campaigns is common, and message-related conversations are increasingly recognized as a consequential factor in shaping message effects. The evidence base is limited, however, about the conditions under which conversation may help or hinder health communication efforts. In this study, college students (N = 301) first watched a short sleep video and were randomly assigned to either talk with a partner in an online chat conversation or proceed directly to a short survey. Unknown to participants, the chat partner was a confederate coached to say positive things about sleep and the message (‘positive’ chat condition), negative things (‘negative’ chat condition), or unrelated things (‘natural’ chat condition). All respondents completed a short survey on beliefs about sleep, reactions to the message, and intentions to get adequate sleep. Respondents had greater intentions to engage in healthy sleep when they engaged in positive conversation following message exposure than when they engaged in negative conversation after the message (p < 0.001). Positive emotion experienced in response to the message and positive chat perceptions were significant predictors (p < 0.05) of intentions to achieve healthy sleep. Health message designers may benefit from understanding how messages are exchanged in peer-to-peer conversation to better predict and explain their effects.