Shelly Campo

Cancer Patients' Desires for Communication of Prognosis Information

A mail survey was sent to cancer patients to determine how often they want, request, and receive a qualitative prognosis (i.e., will they die from the disease?) and a quantitative estimate (how long they will survive). The survey included measures of social and psychological characteristics that were hypothesized to be associated with their desire for and willingness to request prognosis information (N = 352). Major findings are as follows: (a) Whereas about 80% of patients wanted a qualitative prognosis, only about one half wanted a quantitative one; (b) over 90% of those who wanted a qualitative prognosis were given one, but only about one half of those who wanted a quantitative prognosis were given one; and (c) about 15% of those who wanted a qualitative prognosis failed to ask for it, and over one third of those who wanted a quantitative prognosis failed to ask for it. Multivariate analyses indicate that the effects of education on wanting, asking for, and receiving prognosis information are slight, and the effects of sex are essentially nil. Older people were significantly less likely to request and to be given prognosis information. Those who had greater anxiety and who needed to avoid thinking about death wanted, requested, and received significantly less information. Fear had significant nonlinear effects on desire, request, and receipt of quantitative information. Those whose prognosis was worse were less likely to want, ask for, and receive quantitative information. Those least likely to want, request, and be given qualitative information were those who combined a bad prognosis with a need to avoid thinking about death.

Placing the Burden on the Individual: Overweight and Obesity in African American and Mainstream Women's Magazines

One third of all U.S. adult women, and more than 75% of African American women, are overweight or obese. This study examined overweight and obesity editorial content (N = 406) in three mainstream and three African American womens magazines between 1984 and 2004. Content analysis was used to determine which strategies were suggested regarding diet, overweight, and obesity, which components of social cognitive theory were offered (behavior, person, or environment), and whether or not there were differences in the genres. The results suggest that although a wide range of strategies were being offered, the vast majority were behavioral changes with an individual solution focus. Although African American and mainstream magazines suggested many of the same strategies, nearly half more frequently appeared in one or the other genre. Mainstream magazines were twice as likely to offer the limiting or eliminating of fast food or junk food, eating more protein, eating lower-fat foods, and eating smaller portions. African American magazines were much more likely to cover fad diets and to suggest readers rely on God or faith in their diet plans. The average number of strategies offered per article was significantly higher in mainstream than in African American magazines.

Using the theory of planned behavior to predict mothers' intentions to vaccinate their daughters against HPV.

This study assessed mothers’ intentions to vaccinate their daughters against human papillomavirus (HPV) using the theory of planned behavior (TPB). Experience with sexually transmitted infections (STIs), beliefs about the vaccine encouraging sexual activity, and perception of daughters’ risk for HPV were also examined for a relationship with intention. A random sample of mothers in a rural, Midwestern state were mailed a survey with questions pertaining to the intention to vaccinate. Attitudes were the strongest predictor of mothers’ intentions to vaccinate, but intentions were not high. Subjective norms also influence intention. Mothers’ risk perceptions, experience with STIs, and beliefs about the vaccine encouraging sexual activity were not related to intention. Mothers’ perceptions of the daughters’ risks for HPV were surprisingly low. This research provides a foundation for designing interventions to increase HPV vaccination rates. Further research should explore ways to influence mothers’ attitudes and to uncover the referent groups mothers refer to for vaccination behavior.

Framing breastfeeding and formula-feeding messages in popular U.S. magazines.

ABSTRACT Media framing of infant feeding has the ability to influence knowledge and views of the barriers, benefits, and solutions inherent in breastfeeding or formula-feeding. This study examined how seven popular U.S. parenting, general womens, and African American magazines framed breastfeeding and formula-feeding messages to determine whether a sense-making approach was used and the extent to which visual images portrayed feeding practices. Analysis included 615 articles published from 1997 to 2003 that referred to infant feeding. Text and images were analyzed. The magazines provided more information on breastfeeding than formula feeding. Parenting magazines included more advice than barriers or benefits. African American magazines presented more breastfeeding benefits, and general womens magazines contained the least infant-feeding information. Messages were focused on individualized breastfeeding barriers and advice, seldom covered social and environmental issues, and placed much of the responsibility of infant feeding on the mother, while the role of social and partner support was diminished. Bottle-feeding images were nearly as common as breastfeeding images. Findings can be used by public health practitioners to increase the likelihood of reaching certain target audiences through popular magazines.

Online information exchanges for parents of children with a rare health condition: key findings from an online support community.

Background The Internet provides new opportunities for parents of children with difficult illnesses and disabilities to find information and support. The Internet is particularly important for caregivers of children with special needs due to numerous health-related decisions they face. For at-risk populations, online support communities can become key settings and channels for health promotion and communication. Objective This study is an initial exploration of the information-seeking and information-provision processes present in an online support community, which is an area of opportunity and interest for Internet-based medical research and practice. The aim of this study was to explore and describe information-related processes of uncertainty management in relationship to clubfoot. Specifically, the study explored interpersonal communication (information seeking and provision) in an online support community serving the needs of parents of children with clubfoot. Methods The study population consisted of messages posted to an online community by caregivers (parents) of children with clubfoot. The theoretical framework informing the study was the Uncertainty Management Theory (UMT). The study used content analysis to explore and categorize the content of 775 messages. Results Women authored 664 of 775 messages (86%) and men authored 47 messages (6%). Caregivers managed uncertainty through information seeking and provision behaviors that were dynamic and multilayered. The ratio of information-seeking messages to information-provision responses was 1 to 4. All five types of information-seeking behaviors proposed by Brashers’ schema were identified, most of them being correlated. Information seeking using direct questions was found to be positively correlated to self-disclosure (r=.538), offering of a candidate answer (r=.318), and passive information seeking (r=.253). Self-disclosure was found to be positively correlated to provision of a candidate answer (r=.324), second-guessing (r=.149), and passive information seeking (r=.366). Provision of a candidate answer was found to be positively correlated with second-guessing (r=.193) and passive information seeking (r=.223). Second-guessing was found to be positively correlated to passive information seeking (r=.311). All correlations reported above were statistically significant (P<0.01). Of the 775 messages analyzed, 255 (33%) identified a medical professional or institution by name. Detailed medical information was provided in 101 (13%) messages, with the main source of information identified being personal experience rather than medical sources. Conclusion Online communities can be an effective channel for caregivers, especially women, to seek and offer information required for managing clubfoot-related uncertainty. To enhance communication with parents, health care institutions may need to invest additional resources in user-friendly online information sources and online interactions with caregivers of children with special illnesses such as clubfoot. Furthermore, explorations of information-seeking and information-provision behaviors in online communities can provide valuable data for interdisciplinary health research and practice.

Comparing Normative, Anecdotal, and Statistical Risk Evidence to Discourage Tanning Bed Use

This study compared the efficacy of normative messages to other traditional persuasive messages using anecdotal or statistical risk evidence. Messages were compared regarding their impact on beliefs, attitudes, and normative perceptions regarding tanning bed use. Undergraduate students (N = 744) at a large Northeastern university were randomly assigned to 1 of 4 message conditions: normative, anecdotal, statistical risk, or no-message control. Results from this study indicate that, although evidence types do not directly influence behavioral intention, some do impact message perceptions, normative perceptions, severity, and health beliefs about the safety of tanning beds and their negative consequences. Normative evidence was superior to other evidence types in influencing normative perceptions of other college students’ and friends’ beliefs that tanning beds are safe, some messages ratings, and beliefs about health protection and consequences of tanning beds. Anecdotal messages were best at altering severity and amount of invested mental effort, but statistical messages overall performed the worst. Skin color effects and gender differences were also found.

Ambivalence, communication and past use: Understanding what influences women's intentions to use contraceptives

Unintended pregnancy among women in the 18–30 age group is a public health concern. The Extended Parallel Process Model (EPPM) provides a framework for exploring how womens perceptions of threat, efficacy, and fear influence intentions to use contraceptives. Past use and communication with best friends and partners were also considered. A telephone survey of 18–30-year-old women (N = 599) was completed. After univariate and bivariate analyses were conducted, the variables were entered into a hierarchal, multi-variate linear regression with three steps consistent with the EPPM to predict behavioral intention. The first step included the demographic variables of relationship status and income. The constructs for the EPPM were entered into step 2. Step 3 contained the fear measure. The model for the third step was significant, F(10,471) = 36.40, p < 0.001 and the variance explained by this complete model was 0.42. Results suggest that perceived severity of the consequences of an unintended pregnancy (p < 0.01), communication with friends (p < 0.01) and last sexual partner (p < 0.05), relationship status (p < 0.01), and past use (p < 0.001) were associated with womens intentions to use contraceptives. A womans perception of the severity was related to her intention to use contraceptives. Half of the women (50.3%) reported ambivalence about the severity of an unintended pregnancy. In our study, talking with their last sexual partner had a positive effect on intentions to use contraceptives, while talking with friends influenced intentions in a negative direction. These results reconfirm the need for public health practitioners and health care providers to consider level of ambivalence toward unintended pregnancy, communication with partner, and relationship status when trying to improve womens contraceptive behaviors. Implications for effective communication interventions are discussed.

Electronic word of mouth on Twitter about physical activity in the United States: exploratory infodemiology study

Background Twitter is a widely used social medium. However, its application in promoting health behaviors is understudied. Objective In order to provide insights into designing health marketing interventions to promote physical activity on Twitter, this exploratory infodemiology study applied both social cognitive theory and the path model of online word of mouth to examine the distribution of different electronic word of mouth (eWOM) characteristics among personal tweets about physical activity in the United States. Methods This study used 113 keywords to retrieve 1 million public tweets about physical activity in the United States posted between January 1 and March 31, 2011. A total of 30,000 tweets were randomly selected and sorted based on numbers generated by a random number generator. Two coders scanned the first 16,100 tweets and yielded 4672 (29.02%) tweets that they both agreed to be about physical activity and were from personal accounts. Finally, 1500 tweets were randomly selected from the 4672 tweets (32.11%) for further coding. After intercoder reliability scores reached satisfactory levels in the pilot coding (100 tweets separate from the final 1500 tweets), 2 coders coded 750 tweets each. Descriptive analyses, Mann-Whitney U tests, and Fisher exact tests were performed. Results Tweets about physical activity were dominated by neutral sentiments (1270/1500, 84.67%). Providing opinions or information regarding physical activity (1464/1500, 97.60%) and chatting about physical activity (1354/1500, 90.27%) were found to be popular on Twitter. Approximately 60% (905/1500, 60.33%) of the tweets demonstrated users’ past or current participation in physical activity or intentions to participate in physical activity. However, social support about physical activity was provided in less than 10% of the tweets (135/1500, 9.00%). Users with fewer people following their tweets (followers) (P=.02) and with fewer accounts that they followed (followings) (P=.04) were more likely to talk positively about physical activity on Twitter. People with more followers were more likely to post neutral tweets about physical activity (P=.04). People with more followings were more likely to forward tweets (P=.04). People with larger differences between number of followers and followings were more likely to mention companionship support for physical activity on Twitter (P=.04). Conclusions Future health marketing interventions promoting physical activity should segment Twitter users based on their number of followers, followings, and gaps between the number of followers and followings. The innovative application of both marketing and public health theory to examine tweets about physical activity could be extended to other infodemiology or infoveillance studies on other health behaviors (eg, vaccinations).

Preventing unintended pregnancies and improving contraceptive use among young adult women in a rural, midwestern state: health promotion implications.

Despite high rates of unintended pregnancy among women aged 18 to 30 years, little research has been conducted to understand the factors associated with their contraceptive use. Eighteen focus groups were conducted with young adult women (N = 106) who were mostly white, non-Hispanic. Results suggested that contraceptive use was negatively affected by low contraceptive knowledge; use of alcohol; a lack of planning for sex; a misperception of the likelihood of pregnancy; forgetting to use contraceptives; and concerns about side effects, cost, and confidentiality. Women liked the peace of mind that using contraceptives gave them and the benefits of regular periods from some hormonal methods. Implications for reducing unintended pregnancies through interventions are offered.

‘My friends love to tan’: examining sensation seeking and the mediating role of association with friends who use tanning beds on tanning bed use intentions

Abstract This paper explored how sensation seeking contributes to the likelihood of tanning bed use intentions both directly and indirectly through the way it shapes interaction with peers who use tanning beds and attitudes toward tanning bed. Eight hundred and ninety six (n = 896) male and female college students were recruited for the study. Measured variables included sensation seeking, association with friends who use tanning beds, attitudes toward tanning and tanning bed use intentions. Structural equation modeling was performed to test the hypotheses. In general, results supported the proposed hypotheses and documented that sensation seeking is indirectly associated with tanning bed use intentions through the mediation of association with peers who use tanning beds and attitudes toward tanning. The article discusses theoretical and methodological implications of the findings demonstrating the pathways of influence of sensation seeking on tanning bed use intentions.