Stephanie K. Van Stee

A Meta-Analysis of Web-Delivered Tailored Health Behavior Change Interventions

Web-based tailored intervention programs show considerable promise in effecting health-promoting behaviors and improving health outcomes across a variety of medical conditions and patient populations. This meta-analysis compares the effects of tailored versus nontailored web-based interventions on health behaviors and explores the influence of key moderators on treatment outcomes. Forty experimental and quasi-experimental studies (N =20,180) met criteria for inclusion and were analyzed using meta-analytic procedures. The findings indicated that web-based tailored interventions effected significantly greater improvement in health outcomes as compared with control conditions both at posttesting, d =.139 (95% CI = .111, .166, p <.001, k =40) and at follow-up, d =.158 (95% CI = .124, .192, p <.001, k =21). The authors found no evidence of publication bias. These results provided further support for the differential benefits of tailored web-based interventions over nontailored approaches. Analysis of participant/descriptive, intervention, and methodological moderators shed some light on factors that may be important to the success of tailored interventions. Implications of these findings and directions for future research are discussed.

Tailored Health Communication to Change Lifestyle Behaviors

Tailored health communication research represents a very promising line of inquiry that has the potential to produce major impacts on lifestyle behaviors. This study defines tailoring and discusses how tailored interventions operate, including comparing/ contrasting different tailoring channels. Next, the authors review the literature on tailored interventions to change lifestyle behaviors, with a focus on smoking cessation, dietary change, and physical activity, as well as interventions that address multiple lifestyle behaviors. Finally, future directions for tailoring research are discussed. To date, a large literature has amassed showing the promise of tailored programs delivered via print, Internet, local computer/kiosk, telephone, and interpersonal channels. Numerous studies demonstrate that these programs are capable of significant impacts on smoking cessation, dietary change, physical activity, and multiple behavior change. It is concluded that the potential of tailoring will be more fully realized as (a) the field builds a more cumulative science of tailoring and (b) greater dissemination of efficacious tailored programs takes place.

Using computer technology for HIV prevention among African-Americans: development of a tailored information program for safer sex (TIPSS)

New prevention options are urgently needed for African-Americans in the United States given the disproportionate impact of HIV/AIDS on this group. This combined with recent evidence supporting the efficacy of computer technology-based interventions in HIV prevention led our research group to pursue the development of a computer-delivered individually tailored intervention for heterosexually active African-Americans--the tailored information program for safer sex (TIPSS). In the current article, we discuss the development of the TIPSS program, including (i) the targeted population and behavior, (ii) theoretical basis for the intervention, (iii) design of the intervention, (iv) formative research, (v) technical development and testing and (vi) intervention delivery and ongoing randomized controlled trial. Given the many advantages of computer-based interventions, including low-cost delivery once developed, they offer much promise for the future of HIV prevention among African-Americans and other at-risk groups.

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.

Using Medical Words with Family Caregivers

BACKGROUND Although there is poor communication about pain management between informal caregivers and hospice providers, little research has examined these interactions. OBJECTIVE This study explored communication between informal caregivers and hospice team members by investigating the use of medical words in care planning discussions. DESIGN Transcripts of clinical communication between caregivers and hospice team members were reviewed for use of medical words, word placement (statement or question), whether or not the word was explained, and the caregivers response to the word. SETTING/SUBJECTS As part of an ongoing randomized clinical trial in the midwestern United States, informal hospice caregivers participated in recorded hospice care planning discussions. MEASURES A selection of videorecorded interactions from an ongoing study was analyzed. RESULTS Hospice team members used six times as many medical words compared to caregivers. The majority of medical words used by caregivers and team members were drug names. Medical words were predominantly used as statements rather than questions that sought clarification. Three-fourths of medical words used by team members were not explained to caregivers. Caregivers provided little response to medical word use, indicating a lack of understanding. CONCLUSIONS The propensity to use medical words during clinical communication with family caregivers is cautioned. In order to recognize the caregiver as a contributing team member, clinicians should limit the use of medical words, provide lay explanation alongside medical terminology, and use questions to check for understanding. More research is needed to determine assessment tools to capture the caregivers level of understanding of medication and pain management protocol.

Reactions to Safer-Sex Public Service Announcement Message Features Attention, Perceptions of Realism, and Cognitive Responses

For this article, we conducted a qualitative investigation of participants’ reactions to five televised public service announcements (PSAs) that were aired as part of a large safer-sex mass media campaign to increase condom use among young adults. We conducted qualitative interviews (N = 139) to determine which features of PSAs participants thought were most effective in terms of attention and recall, perceived realism of characters and situations, and cognitive responses. Our analysis of the results highlights the importance of high-sensation-value messages for gaining attention as well as the critical role of personal relevance for enhancing perceptions of realism. Cognitive responses to PSAs were mostly positive, but there was evidence of third-person effects. That is, many participants indicated that the safer-sex messages were important for other people but not for themselves. We discuss the implications of our results for designing PSAs that are attention-catching, realistic, and persuasive.

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.

Online Cancer Information Seeking: Applying and Extending the Comprehensive Model of Information Seeking

ABSTRACT This study applied the comprehensive model of information seeking (CMIS) to online cancer information and extended the model by incorporating an exogenous variable: interest in online health information exchange with health providers. A nationally representative sample from the Health Information National Trends Survey 4 Cycle 4 was analyzed to examine the extended CMIS in predicting online cancer information seeking. Findings from a structural equation model supported most of the hypotheses derived from the CMIS, as well as the extension of the model related to interest in online health information exchange. In particular, socioeconomic status, beliefs, and interest in online health information exchange predicted utility. Utility, in turn, predicted online cancer information seeking, as did information-carrier characteristics. An unexpected but important finding from the study was the significant, direct relationship between cancer worry and online cancer information seeking. Theoretical and practical implications are discussed.

Meta-Analysis of the Persuasive Effects of Metaphorical vs. Literal Messages

This study uses meta-analysis to compare the persuasive effects of metaphorical and literal messages and assess various theoretical explanations for the relatively greater persuasiveness of metaphor. The meta-analysis includes studies from 2001 to 2015 that use various message formats and topics. Results indicate an overall effect size of r = 0.09, p < .001, 95% CI [0.06, 0.12], which supports the conclusion that metaphorical messages are more persuasive than literal messages. Moderator analyses indicate differences in effect sizes based on metaphor target familiarity, message topic, and message format. A meta-regression using the theoretical moderators indicates that message format was the strongest predictor of variation in effect size. This study provides implications related to the theoretical mechanism behind the greater persuasive effects of metaphor.This study uses meta-analysis to compare the persuasive effects of metaphorical and literal messages and assess various theoretical explanations for the relatively greater persuasiveness of metapho...