Sonya Dal Cin

Narratives that address affective forecasting errors reduce perceived barriers to colorectal cancer screening

Narratives from similar others may be an effective way to increase important health behaviors. In this study, we used a narrative intervention to promote colorectal cancer screening. Researchers have suggested that people may overestimate barriers to colorectal cancer screening. We recruited participants from the US, ages 49-60 who had never previously been screened for colorectal cancer, to read an educational message about screening for the disease. One-half of participants were randomly assigned to also receive a narrative within the message (control participants did not receive a narrative). The narrative intervention was developed according to predictions of affective forecasting theory. Compared to participants who received only the educational message, participants who received the message along with a narrative reported that the barriers to screening would have less of an impact on a future screening experience. The narrative also increased risk perception for colorectal cancer and interest in screening in the next year.

Movie exposure to smoking cues and adolescent smoking onset: a test for mediation through peer affiliations.

OBJECTIVE To determine whether the effect of movie exposure to smoking on adolescent smoking onset is mediated through increased affiliation with peers who smoke. DESIGN A longitudinal study was conducted with a sample of 5th- 8th graders; persons who were nonsmokers at the baseline assessment (N = 2,614) were followed up 18 months later. Movie exposure to smoking cues was assessed at baseline with a rigorous coding procedure. MAIN OUTCOME MEASURE A school-based survey and follow-up telephone interview determined whether the participant smoked cigarettes. RESULTS Longitudinal structural modeling analysis indicated movie-smoking exposure was related to smoking onset both through an indirect effect involving increased affiliation with peer smokers and through a direct effect. The analysis controlled for demographics, parenting style, rebelliousness and sensation seeking, school performance, parental smoking, and sibling smoking; several of these variables also had mediated or direct effects to smoking onset. CONCLUSION The effect of movie exposure on adolescent smoking onset is attributable in part to a social mechanism. Implications of media effects for prevention are discussed.

Spontaneous Action Representation in Smokers when Watching Movie Characters Smoke

Do smokers simulate smoking when they see someone else smoke? For regular smokers, smoking is such a highly practiced motor skill that it often occurs automatically, without conscious awareness. Research on the brain basis of action observation has delineated a frontoparietal network that is commonly recruited when people observe, plan, or imitate actions. Here, we investigated whether this action observation network would be preferentially recruited in smokers when viewing complex smoking cues, such as those occurring in motion pictures. Seventeen right-handed smokers and 17 nonsmokers watched a popular movie while undergoing functional magnetic resonance imaging. Using a natural stimulus, such as a movie, allowed us to keep both smoking and nonsmoking participants naive to the goals of the experiment. Brain activity evoked by movie scenes of smoking was contrasted with nonsmoking control scenes that were matched for frequency and duration. Compared with nonsmokers, smokers showed greater activity in left anterior intraparietal sulcus and inferior frontal gyrus, regions involved in the simulation of contralateral hand-based gestures, when viewing smoking versus control scenes. These results demonstrate that smokers spontaneously represent the action of smoking when viewing others smoke, the consequence of which may make it more difficult to abstain from smoking.

Movie Character Smoking and Adolescent Smoking: Who Matters More, Good Guys or Bad Guys?

OBJECTIVE: To assess the association between smoking onset and exposure to movie smoking according to character type. METHODS: A longitudinal, random-digit-dial telephone survey of 6522 US adolescents was performed with movie exposure assessed at 4 time points over 24 months. Adolescents were asked whether they had seen a random subsample of recently released movies, for which we identified smoking by major characters and type of portrayal (divided into negative, positive, and mixed/neutral categories). Multivariate hazard regression analysis was used to assess the independent effects of these exposures on the odds of trying smoking. RESULTS: By the 24-month follow-up survey, 15.9% of baseline never-smokers had tried smoking. Within the sample of movies, 3848 major characters were identified, of whom 69% were male. Smokers represented 22.8% of 518 negative characters, 13.7% of 2486 positive characters, and 21.1% of 844 mixed/neutral characters. Analysis of the crude relationship showed that episodes of negative character smoking exposure had the strongest influence on smoking initiation. However, because most characters were portrayed as positive, exposure to this category was greatest. When the full population effect of each exposure was modeled, each type of character smoking independently affected smoking onset. There was an interaction between negative character smoking and sensation-seeking with stronger response for adolescents lower in sensation-seeking. CONCLUSIONS: Character smoking predicts adolescent smoking initiation regardless of character type, which demonstrates the importance of limiting exposure to all movie smoking. Negative character portrayals of smoking have stronger impact on low risk-taking adolescents, undercutting the argument that greater exposure is a marker for adolescent risk-taking behavior.

When Movies Matter: Exposure to Smoking in Movies and Changes in Smoking Behavior

The authors investigated the association between exposure to smoking in movies and the initiation and progression of adolescent smoking over time among 6,522 U.S. adolescents (between the ages of 10 and 14 years, at baseline) in a nationally representative, 4-wave random-digit-dial telephone survey. They conducted a hazard (survival) analysis testing whether exposure to movie smoking and demographic, personality, social, and structural factors predict (a) earlier smoking onset and (b) faster transition to experimental (1–99 cigarettes/lifetime) and established smoking (>100 cigarettes/lifetime). Results suggest that higher exposure to movie smoking is associated with less time to trying cigarettes for the first time (adjusted hazard ratio = 1.66; 95% CI [1.37, 2.01]) but not with faster escalation of smoking behavior following initiation (adjusted hazard ratio = 1.53; 95% CI [0.84, 2.79]). In contrast, age, peer smoking, parenting style, and availability of cigarettes in the home were predictors of earlier onset and faster transition to established smoking. Thus, the authors concluded that the effect of exposure to mass-mediated images of smoking in movies may decline once adolescents have started to smoke, whereas peers and access to tobacco remain influential.

Good self-control moderates the effect of mass media on adolescent tobacco and alcohol use: tests with studies of children and adolescents.

OBJECTIVE To investigate whether self-control moderates the effect of media influences on tobacco and alcohol use among youth and if so how this effect occurs. DESIGN In Study 1, a regional sample of 10-year olds (N = 290) was interviewed in households; attention to tobacco/alcohol advertising was assessed. In Study 2, a national sample of youth ages 10-14 years (N = 6,522) was surveyed by telephone; exposure to tobacco/alcohol use in movies was assessed. Good self-control was measured in both studies. MAIN OUTCOME MEASURES Willingness to use substances and affiliation with peer substance users (Study 1); involvement in smoking or drinking (Study 2). RESULTS In Study 1, the effect of tobacco/alcohol advertising on predisposition for substance use was lower among persons scoring higher on good self-control. In Study 2, the effect of movie smoking/alcohol exposure on adolescent tobacco/alcohol use was lower, concurrently and prospectively, among persons scoring higher on good self-control. Moderation occurred primarily through reducing the effect of movie exposure on positive smoking/alcohol expectancies and the effect of expectancies on adolescent use; some evidence for moderation of social processes was also noted. Covariates in the analyses included demographics, sensation seeking, and IQ. CONCLUSION Good self-control reduces the effect of adverse media influences on adolescent tobacco and alcohol use. Findings on the processes underlying this effect may be useful for media literacy and primary prevention programs.

Prevalence of smoking among major movie characters: 1996–2004

Background: Reports of a relationship between watching smoking in movies and smoking among adolescents have prompted greater scrutiny of smoking in movies by the public health community. Objective: To assess the smoking prevalence among adult and adolescent movie characters, examine trends in smoking in movies over time, and compare the data with actual smoking prevalence among US adults and adolescents. Design and methods: Smoking status of all major human adolescent and adult movie characters in the top 100 box office hits from 1996 to 2004 (900 movies) was assessed, and smoking prevalence was examined by Motion Picture Association of America (MPAA) rating and year of release. Results: The movies contained 5944 major characters, of whom 4911 were adults and 466 were adolescents. Among adult movie characters, the overall smoking prevalence was 20.6%; smoking was more common in men than in women (22.6% v 16.1%, respectively, p<0.001), and was related to MPAA rating category (26.9% for movies rated R (restricted, people aged <17 years require accompanying adult), 17.9% for PG-13 (parents strongly cautioned that some material might be inappropriate for children) and 10.4% for G/PG (general audiences, all ages; parental guidance suggested for children), p<0.001). In 1996, the smoking prevalence for major adult movie characters (25.7%) was similar to that in the actual US population (24.7%). Smoking prevalence among adult movie characters declined to 18.4% in 2004 (p for trend <0.001), slightly below that for the US population for that year (20.9%). Examination of trends by MPAA rating showed that the downward trend in smoking among adult movie characters was statistically significant in movies rated G/PG and R, but not in those rated PG-13. A downward trend over time was also found for smoking among adolescent movie characters. There was no smoking among adult characters in 43.3% of the movies; however, in 39% of the movies, smoking prevalence among adult characters was higher than that in the US adult population in the year of release. Conclusions: Smoking prevalence among major adolescent and adult movie characters is declining, with the downward trend among adult characters weakest for PG-13-rated movies. Although many movies depict no adult smoking, more than one third depict smoking as more prevalent than that among US adults at the time of release.

An examination of the association between seeing smoking in films and tobacco use in young adults in the west of Scotland: cross-sectional study

The objective is to examine the association between the amount of smoking seen in films and current smoking in young adults living in the west of Scotland in the UK. Cross-sectional analyses (using multivariable logistic regression) of data collected at age 19 (2002–04) from a longitudinal cohort originally surveyed at age 11 (1994–95) were conducted. The main outcome measure is smoking at age 19. No association was found between the number of occurrences of smoking estimated to have been seen in films (film smoking exposure) and current (or ever) smoking in young adults. This lack of association was unaffected by adjustment for predictors of smoking, including education, risk-taking orientation and smoking among peers. There was no association between film smoking exposure and smoking behaviour for any covariate-defined subgroup. Associations have been found between film smoking exposure and smoking initiation in younger adolescents in the United States. In this study, conducted in Scotland, no similar association was seen, suggesting that there may be age or cultural limitations on the effects of film smoking exposure on smoking. The lack of association could be due to methodological issues or greater sophistication of older adolescents and young adults in interpreting media images or the greater ubiquity of real-life smoking instances in Scotland. If the latter, film smoking exposure could become a more important risk factor for smoking uptake and maintenants in older adolescents following the recent ban on smoking in public places in Scotland.

Health Communications: Predicting Behavior Change from the Brain

Health communications are intended to motivate the public to engage in healthier lifestyle choices. Why some messages succeed while others fail, however, remains a difficult question to answer. Traditional methods used to predict behavior change rely heavily on participants’ self-reports. However, participants may be limited in their ability to discern which communications are likely to move them toward change. Neuroimaging offers a method to explore the underlying neural processes that occur during health message exposure, in real-time, without imposing additional cognitive tasks (e.g., assessing one’s evaluation of the message). This chapter explores the utility of using neuroimaging in tandem with other methodologies (e.g., self-report, behavioral observation) to enhance our understanding of conscious and unconscious mechanisms that promote the effectiveness of health communications. We begin examining how neuroscience contributes to current understanding of health communication, examine health-relevant studies in the emerging field of communication neuroscience, and then discuss future directions.

Effects of self-transcendence on neural responses to persuasive messages and health behavior change

Significance People often feel defensive when reminded of their unhealthy behavior. We propose that self-transcendence, encouraged by focusing on others’ well-being, can lessen subsequent focus on threatened aspects of the self and increase receptivity. We show that activating self-transcendent mindsets, either by reflecting on self-transcendent values or making positive wishes for others, increased activity in brain regions chosen for their role in positive valuation and reward. Furthermore, during subsequent health message exposure, self-transcendence increased activity in brain regions tracking message receptivity, which predicted later decreases in sedentary behavior. The current findings support the idea that having a positive, other-focused mindset can be a rewarding experience, and may allow people to see the personal value of potentially threatening yet beneficial health messages. Self-transcendence refers to a shift in mindset from focusing on self-interests to the well-being of others. We offer an integrative neural model of self-transcendence in the context of persuasive messaging by examining the mechanisms of self-transcendence in promoting receptivity to health messages and behavior change. Specifically, we posited that focusing on values and activities that transcend the self can allow people to see that their self-worth is not tied to a specific behavior in question, and in turn become more receptive to subsequent, otherwise threatening health information. To test whether inducing self-transcendent mindsets before message delivery would help overcome defensiveness and increase receptivity, we used two priming tasks, affirmation and compassion, to elicit a transcendent mindset among 220 sedentary adults. As preregistered, those who completed a self-transcendence task before health message exposure, compared with controls, showed greater increases in objectively logged levels of physical activity throughout the following month. In the brain, self-transcendence tasks up-regulated activity in a region of the ventromedial prefrontal cortex, chosen for its role in positive valuation and reward processing. During subsequent health message exposure, self-transcendence priming was associated with increased activity in subregions of the ventromedial prefrontal cortex, implicated in self-related processing and positive valuation, which predicted later decreases in sedentary behavior. The present findings suggest that having a positive self-transcendent mindset can increase behavior change, in part by increasing neural receptivity to health messaging.