Yulia A. Strekalova

A Picture Really is Worth a Thousand Words: Public Engagement with the National Cancer Institute on Social Media

The National Cancer Institute (NCI) provides pertinent information about cancer prevention, treatment, and research advancements that is considered objective and accurate. NCI’s presence on social media is an example of a growing effort in promoting and facilitating audience engagement with evidence-based information about health and cancer. However, it is unknown what strategies are most effective for engaging audiences via this communication platform. To evaluate this important question, we analyzed data on posts, associated comments, and meta-data from official NCI Facebook page between July 2010 and February 2015 (end of data collection). Results show that audience engagement is associated with the format of cancer-related social media posts. Specifically, posts with photos received significantly more likes, comments, and shares than videos, links, and status updates. The findings have important implications for how social media can be more effectively utilized to promote public engagement with important public health issues.

Health Risk Information Engagement and Amplification on Social Media: News About an Emerging Pandemic on Facebook.

Emerging pandemics call for unique health communication and education strategies in which public health agencies need to satisfy the public’s information needs about possible risks while preventing risk exaggeration and dramatization. As a route to providing a framework for understanding public information behaviors in response to an emerging pandemic, this study examined the characteristics of communicative behaviors of social media audiences in response to Ebola outbreak news. Grounded in the social amplification of risks framework, this study adds to an understanding of information behaviors of online audiences by showing empirical differences in audience engagement with online health information. The data were collected from the Centers for Disease Control and Prevention (CDC) Facebook channel. The final data set included 809 CDC posts and 35,916 audience comments. The analysis identified the differences in audience information behaviors in response to an emerging pandemic, Ebola, and health promotion posts. While the CDC had fewer posts on Ebola than health promotion topics, the former received more attention from active page users. Furthermore, audience members who actively engaged with Ebola news had a small overlap with those who engaged with non-Ebola information during the same period. Overall, this study demonstrated that information behavior and audience engagement is topic dependent. Furthermore, audiences who commented on news about an emerging pandemic were homogenous and varied in their degree of information amplification.

Seekers and avoiders: Using health information orientation to explore audience segmentation

Abstract Differentiation of health communication strategies can address a new type of health disparity, a communication inequity. This exploratory study collected survey data to identify online health information audience groups based on health information orientation and objective and perceived health literacy. Two groups were identified and compared showing that health information orientation could be used for systematic segmentation of the consumers of online health information. The two distinct information behaviors, health information engagement and health information apprehension, provided a stable foundation for audience segmentation. The paper discusses how the segmentation of audiences based on the reported information behaviors and information orientation can facilitate the development of targeted health communication and information engagement approaches.

Linguistic Strategies for Improving Informed Consent in Clinical Trials Among Low Health Literacy Patients.

Background Improving informed consent to participate in randomized clinical trials (RCTs) is a key challenge in cancer communication. The current study examines strategies for enhancing randomization comprehension among patients with diverse levels of health literacy and identifies cognitive and affective predictors of intentions to participate in cancer RCTs. Methods Using a post-test-only experimental design, cancer patients (n = 500) were randomly assigned to receive one of three message conditions for explaining randomization (ie, plain language condition, gambling metaphor, benign metaphor) or a control message. All statistical tests were two-sided. Results Health literacy was a statistically significant moderator of randomization comprehension ( P = .03). Among participants with the lowest levels of health literacy, the benign metaphor resulted in greater comprehension of randomization as compared with plain language ( P = .04) and control ( P = .004) messages. Among participants with the highest levels of health literacy, the gambling metaphor resulted in greater randomization comprehension as compared with the benign metaphor ( P = .04). A serial mediation model showed a statistically significant negative indirect effect of comprehension on behavioral intention through personal relevance of RCTs and anxiety associated with participation in RCTs ( P < .001). Conclusions The effectiveness of metaphors for explaining randomization depends on health literacy, with a benign metaphor being particularly effective for patients at the lower end of the health literacy spectrum. The theoretical model demonstrates the cognitive and affective predictors of behavioral intention to participate in cancer RCTs and offers guidance on how future research should employ communication strategies to improve the informed consent processes.Abstract Background: Improving informed consent to participate in randomized clinical trials (RCTs) is a key challenge in cancer communication. The current study examines strategies for enhancing randomization comprehension among patients with diverse levels of health literacy and identifies cognitive and affective predictors of intentions to participate in cancer RCTs. Methods: Using a post-test-only experimental design, cancer patients (n = 500) were randomly assigned to receive one of three message conditions for explaining randomization (ie, plain language condition, gambling metaphor, benign metaphor) or a control message. All statistical tests were two-sided. Results: Health literacy was a statistically significant moderator of randomization comprehension (P = .03). Among participants with the lowest levels of health literacy, the benign metaphor resulted in greater comprehension of randomization as compared with plain language (P = .04) and control (P = .004) messages. Among participants with the highest levels of health literacy, the gambling metaphor resulted in greater randomization comprehension as compared with the benign metaphor (P = .04). A serial mediation model showed a statistically significant negative indirect effect of comprehension on behavioral intention through personal relevance of RCTs and anxiety associated with participation in RCTs (P < .001). Conclusions: The effectiveness of metaphors for explaining randomization depends on health literacy, with a benign metaphor being particularly effective for patients at the lower end of the health literacy spectrum. The theoretical model demonstrates the cognitive and affective predictors of behavioral intention to participate in cancer RCTs and offers guidance on how future research should employ communication strategies to improve the informed consent processes.

I Understand How You Feel: The Language of Empathy in Virtual Clinical Training

Effective communication is one of the most fundamental aspects of successful patient care, and it frequently depends on the nurses’ ability to empathize with patients while finding effective ways to translate medical science into personally relevant health information. Skilled nurses are expected to understand the patient’s experiences and feelings and be able to communicate this understanding to the patient, but language strategies used to achieve the goal of empathic communication can vary. In this article, we employed the model of message design logics to evaluate what strategies nursing students (N = 343) used to express empathy during a simulated health history training. The results of this study advance our understanding of what constitutes a high-quality response to the disclosure of personal health history facts. In addition to providing a general framework for understanding empathic responses during health history assessment, the message design logic perspective highlights the differences in linguistic choices in simulated patient–provider conversations.

Informing Dissemination Research A Content Analysis of U.S. Newspaper Coverage of Medical Nanotechnology News

This study examined nanomedicine coverage by the elite and regional U.S. newspapers. The study sought to study prevalent topics; examine time, risk and benefit, thematic and episodic, and societal and personal impact frames; and identify dominating overarching themes.Technology application and economic consequence were dominant topics, but contrary to the studies of other emerging technologies, regulations and moral issues were the least discussed topics for nanomedicine. A variety of data analytic techniques, including cluster analysis, were performed to analyze data. The analysis has identified three themes, Technology Prospects, High-Risk High-Reward, and Investment Costs, that dominated nanomedicine coverage.

Emergent health risks and audience information engagement on social media

Social media can effectively reach large audiences and serve as an indicator for the publics sentiment and engagement in situations of disease outbreaks. This study used Centers for Disease Control and Prevention (CDC) Facebook posts between March 18 and October 31, 2014, surrounding the 2014 Ebola outbreak, to look at the audience engagement with online health information. The CDC submitted fewer posts about Ebola than about non-Ebola topics, but audience engagement with Ebola posts was significantly higher, and men were more interested in Ebola posts and submitted more comments per user.

Finding Motivation Online Information Seeking Following Newborn Screening for Cystic Fibrosis

Cystic fibrosis (CF) is a genetic disease that has no manifestations for carriers but is terminal for those diagnosed with it. CF is identified through newborn screening (NBS) tests, and most families have no knowledge about CF before their contact with a NBS program. Acknowledging the Internet as a popular health information source, this study examined information exchange about CF in online community forums. This article, guided by self-determination theory, aimed at providing understanding of psychological needs and motivation for health information seeking and active communication about CF. Through online communication with other families who share similar experience, caregivers of newborns diagnosed with CF sought and received support for their competence, autonomy, and relatedness needs during the initial CF testing and diagnosis reconciliation process. Online communities play an important role in the information seeking related to CF diagnosis and could become active partners in strategic knowledge dissemination efforts.

Using social media to assess care coordination goals and plans for leukemia patients and survivors

Care coordination has been shown to have a positive effect on the management of chronic disease. Specific to the management of leukemia, coordination may occur between primary care physician, medical and radiation oncologists, surgeons, cardiologists, and genetics specialists. Experiencing gaps in communication and care coordination, many health consumers seek instrumental support in their social circles, including online forums and networks. The goal of this theory-guided study was to provide an in-depth assessment of how individuals use online forums to deliberate about their goals and plans for leukemia care coordination. Guided by the planning theory of communication, the data were collected from the American Cancer Society Cancer Survivors Network and included 125 original posts and 1,248 responses. Thematic analysis and axial coding were applied to analyze the data. Goal-related themes included overcoming the diffusion of care coordination and achieving health management cohesion. Planning themes included social health management, communication self-efficacy, and role deliberation. Online patient forums provide an interactive platform for patients and caregivers to engage in active conversations, which in turn can serve as identifiers of care coordination needs. Communication with those who share similar experiences allows cancer patients and survivors to accumulate functional health literacy, gain communication self-efficacy, and articulate a care coordination role acceptable to them.

Empathic Communication in Virtual Education for Nursing Students: I'm Sorry to Hear That.

The current study examined the communication strategies used by undergraduate nursing students (N = 343) to express empathy during simulated health history interviews. Interacting with a virtual patient, students encountered up to 9 information disclosures that warranted the expression of empathy but recognized few (33.54%). Sophistication of language to express empathy varied depending on the disclosure topic. These findings suggest that empathy as a learned skill can be incorporated into a variety of nursing contexts.