Fighting obesity or obese persons? Public perceptions of obesity-related health messages.

PubMed

Puhl, R; Peterson, J L; Luedicke, J

2013-06-01

This study examined public perceptions of obesity-related public health media campaigns with specific emphasis on the extent to which campaign messages are perceived to be motivating or stigmatizing. In summer 2011, data were collected online from a nationally representative sample of 1014 adults. Participants viewed a random selection of 10 (from a total of 30) messages from major obesity public health campaigns from the United States, the United Kingdom and Australia, and rated each campaign message according to positive and negative descriptors, including whether it was stigmatizing or motivating. Participants also reported their familiarity with each message and their intentions to comply with the message content. Participants responded most favorably to messages involving themes of increased fruit and vegetable consumption, and general messages involving multiple health behaviors. Messages that have been publicly criticized for their stigmatizing content received the most negative ratings and the lowest intentions to comply with message content. Furthermore, messages that were perceived to be most positive and motivating made no mention of the word 'obesity' at all, and instead focused on making healthy behavioral changes without reference to body weight. These findings have important implications for framing messages in public health campaigns to address obesity, and suggest that certain types of messages may lead to increased motivation for behavior change among the public, whereas others may be perceived as stigmatizing and instill less motivation to improve health.

In Pursuit of Theoretical Ground in Behavior Change Support Systems: Analysis of Peer-to-Peer Communication in a Health-Related Online Community

PubMed Central

Cobb, Nathan; Cohen, Trevor

2016-01-01

Background Research studies involving health-related online communities have focused on examining network structure to understand mechanisms underlying behavior change. Content analysis of the messages exchanged in these communities has been limited to the “social support” perspective. However, existing behavior change theories suggest that message content plays a prominent role reflecting several sociocognitive factors that affect an individual’s efforts to make a lifestyle change. An understanding of these factors is imperative to identify and harness the mechanisms of behavior change in the Health 2.0 era. Objective The objective of this work is two-fold: (1) to harness digital communication data to capture essential meaning of communication and factors affecting a desired behavior change, and (2) to understand the applicability of existing behavior change theories to characterize peer-to-peer communication in online platforms. Methods In this paper, we describe grounded theory–based qualitative analysis of digital communication in QuitNet, an online community promoting smoking cessation. A database of 16,492 de-identified public messages from 1456 users from March 1-April 30, 2007, was used in our study. We analyzed 795 messages using grounded theory techniques to ensure thematic saturation. This analysis enabled identification of key concepts contained in the messages exchanged by QuitNet members, allowing us to understand the sociobehavioral intricacies underlying an individual’s efforts to cease smoking in a group setting. We further ascertained the relevance of the identified themes to theoretical constructs in existing behavior change theories (eg, Health Belief Model) and theoretically linked techniques of behavior change taxonomy. Results We identified 43 different concepts, which were then grouped under 12 themes based on analysis of 795 messages. Examples of concepts include “sleepiness,” “pledge,” “patch,” “spouse,” and “slip.” Examples of themes include “traditions,” “social support,” “obstacles,” “relapse,” and “cravings.” Results indicate that themes consisting of member-generated strategies such as “virtual bonfires” and “pledges” were related to the highest number of theoretical constructs from the existing behavior change theories. In addition, results indicate that the member-generated communication content supports sociocognitive constructs from more than one behavior change model, unlike the majority of the existing theory-driven interventions. Conclusions With the onset of mobile phones and ubiquitous Internet connectivity, online social network data reflect the intricacies of human health behavior as experienced by health consumers in real time. This study offers methodological insights for qualitative investigations that examine the various kinds of behavioral constructs prevalent in the messages exchanged among users of online communities. Theoretically, this study establishes the manifestation of existing behavior change theories in QuitNet-like online health communities. Pragmatically, it sets the stage for real-time, data-driven sociobehavioral interventions promoting healthy lifestyle modifications by allowing us to understand the emergent user needs to sustain a desired behavior change. PMID:26839162

Women’s Perceptions of Participation in an Extended Contact Text Message–Based Weight Loss Intervention: An Explorative Study

PubMed Central

Spark, Lauren C; Fjeldsoe, Brianna S; Eakin, Elizabeth G; Reeves, Marina M

2017-01-01

Background Extending contact with participants after the end of an initial weight loss intervention has been shown to lead to maintained weight loss and related behavioral change. Mobile phone text messaging (short message service, SMS) offers a low-cost and efficacious method to deliver extended contact. In this rapidly developing area, formative work is required to understand user perspectives of text message technology. An extended contact intervention delivered by text messages following an initial telephone-delivered weight loss intervention in breast cancer survivors provided this opportunity. Objective The aim of this study was to qualitatively explore women’s perceptions of participation in an extended contact intervention using text messaging to support long-term weight loss, physical activity, and dietary behavioral change. Methods Following the end of an initial 6-month randomized controlled trial of a telephone-delivered weight loss intervention (versus usual care), participants received a 6-month extended contact intervention via tailored text messages. Participant perceptions of the different types of text messages, the content, tailoring, timing, and frequency of the text messages, and the length of the intervention were assessed through semistructured interviews conducted after the extended contact intervention. The interviews were transcribed verbatim and analyzed with key themes identified. Results Participants (n=27) were a mean age of 56.0 years (SD 7.8) and mean body mass index of 30.4 kg/m2 (SD 4.2) and were at a mean of 16.1 months (SD 3.1) postdiagnosis at study baseline. Participants perceived the text messages to be useful behavioral prompts and felt the messages kept them accountable to their behavioral change goals. The individual tailoring of the text message content and schedules was a key to the acceptability of the messages; however, some women preferred the support and real-time discussion via telephone calls (during the initial intervention) compared with the text messages (during the extended contact intervention). Conclusions Text message support was perceived as acceptable for the majority of women as a way of extending intervention contact for weight loss and behavioral maintenance. Text messages supported the maintenance of healthy behaviors established in the intervention phase and kept the women accountable to their goals. A combination of telephone calls and text message support was suggested as a more acceptable option for some of the women for an extended contact intervention. PMID:28242595

Preferred Tone of Nutrition Text Messages for Young Adults: Focus Group Testing

PubMed Central

2016-01-01

Background Young adults are a particularly hard to reach group using conventional health promotion practices as they do not see nutrition messages as personally relevant to them. Text messaging (short message service, SMS) offers an innovative approach to reaching young adults to support and promote dietary behavior change. Objective The aim of this study was to develop and test tonal preferences for nutrition text messages among young adults using focus groups. Methods A total of 39 young adults aged 18-30 years residing in Perth, Western Australia participated in four focus groups. Participants briefly discussed their perception of healthy eating and their responses to messages about increasing fruit and vegetables, and reducing “junk food” and alcohol intake. They ranked their preference for 15 nutrition messages across 3 dietary behaviors (fruit and vegetables, junk food, and alcohol) with 5 different message tones (authoritative, empathetic, generation Y, solutions, and substitutions) and identified the messages most likely to persuade young adults to change their diet. A 5-point ranking of the nutrition messages was from the most likely to least likely to persuade (1-5). The focus groups were conducted by a trained facilitator and observer and were recorded. Data driven content analysis was used to explore themes. Tonal preferences and potential motivators were collated and frequencies presented. Results Participants ranked offering substitutes (29%, 11/39) and using empathy (22%, 9/39) as the most persuasive message techniques in improving diets of young adults, with low responses for Generation Y (17%, 7/39), solutions (17%, 7/39), and authoritative (15%, 6/39) tones. Females were more likely to consider substitution messages persuasive (35%, 7/20) compared with males (22%, 4/19). A greater proportion of males compared with females considered authoritative messages persuasive: (22%, 4/19) compared with (7%, 1/20). There is a strong preference for a substitution tone for fruit and vegetable messages (52%, 20/39), and no overall message tone preference for junk food and alcohol messages. Substitutions were viewed as helpful and practical. Empathy was liked as it acknowledged previous efforts. Responses to authoritative tone were mixed with some feeling guilt while others found them informative. Acceptability of the solutions depended on the behavioral change and acceptability of the solution proposed. Generation Y tone had some support for junk food and alcohol messages, and if favored, was considered casual, humorous, catchy, and motivational. Conclusions Substitutions and tone of empathy were favored as the most likely execution styles to motivate nutrition behavior change across all participants. There is no “one size fits all” with different tones preferred by individuals for different dietary behaviors. Although text messaging provides instant message delivery direct to the individual, these results demonstrate the complexity of developing motivational nutrition message for young adults. These findings reveal the importance of considering the tone and content and pretesting messages for health promotion text message interventions. PMID:26787115

Comparing the Effects of Negative and Mixed Emotional Messages on Predicted Occasional Excessive Drinking

PubMed Central

Carrera, Pilar; Caballero, Amparo; Muñoz, Dolores

2008-01-01

In this work we present two types of emotional message, negative (sadness) versus mixed (joy and sadness), with the aim of studying their differential effect on attitude change and the probability estimated by participants of repeating the behavior of occasional excessive drinking in the near future. The results show that for the group of participants with moderate experience in this behavior the negative message, compared to the mixed one, is associated with higher probability of repeating the risk behavior and a less negative attitude toward it. These results suggest that mixed emotional messages (e.g. joy and sadness messages) could be more effective in campaigns for the prevention of this risk behavior. PMID:25977606

Adolescents just do not know what they want: a qualitative study to describe obese adolescents' experiences of text messaging to support behavior change maintenance post intervention.

PubMed

Smith, Kyla L; Kerr, Deborah A; Fenner, Ashley A; Straker, Leon M

2014-04-08

Adolescents are considered a hard to reach group and novel approaches are needed to encourage good health. Text messaging interventions have been reported as acceptable to adolescents but there is little evidence regarding the use of text messages with overweight and obese adolescents to support engagement or behavior change after the conclusion of a healthy lifestyle program. The intent of this study was to explore the opinions of overweight adolescents and their parents regarding the use of text messages as a support during the maintenance period following an intervention. This paper reports on the findings from focus groups conducted with adolescents (n=12) and parents (n=13) who had completed an eight-week intensive intervention known as Curtin University's Activity, Food and Attitudes Program (CAFAP). Focus groups were conducted three months post intensive intervention. Participants were asked about their experiences of the prior three-month maintenance phase during which adolescents had received tri-weekly text messages based on the self-determination theory and goal-setting theory. Participants were asked about the style and content of text messages used as well as how they used the text messages. Data were analyzed using content and thematic analyses. Two clear themes emerged from the focus groups relating to (1) what adolescents liked or thought they wanted in a text message to support behavior change, and (2) how they experienced or responded to text messages. Within the "like/want" theme, there were five sub-themes relating to the overall tone of the text, frequency, timing, reference to long-term goals, and inclusion of practical tips. Within the "response to text" theme, there were four sub-themes describing a lack of motivation, barriers to change, feelings of shame, and perceived unfavorable comparison with other adolescents. What adolescents said they wanted in text messages often conflicted with their actual experiences. Parent reports provided a useful secondary view of adolescent experience. The conflicting views described in this study suggest that overweight and obese adolescents may not know or have the ability to articulate how they would best be supported with text messages during a healthy lifestyle maintenance phase. Further, supporting both engagement and behavior change simultaneously with text messaging may not be possible. Intervention texts should be personalized as much as possible and minimize feelings of guilt and shame in overweight and obese adolescents. Future research with text messaging for overweight and obese adolescents should incorporate clear intervention aims and evaluation methods specifically related to adolescent engagement or behavior change. Australian New Zealand Clinical Trials Registry: ACTRN12611001187932; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611001187932.

Developing a theory driven text messaging intervention for addiction care with user driven content.

PubMed

Muench, Frederick; Weiss, Rebecca A; Kuerbis, Alexis; Morgenstern, Jon

2013-03-01

The number of text messaging interventions designed to initiate and support behavioral health changes have been steadily increasing over the past 5 years. Messaging interventions can be tailored and adapted to an individual's needs in their natural environment-fostering just-in-time therapies and making them a logical intervention for addiction continuing care. This study assessed the acceptability of using text messaging for substance abuse continuing care and the intervention preferences of individuals in substance abuse treatment in order to develop an interactive mobile text messaging intervention. Fifty individuals enrolled in intensive outpatient substance abuse treatment completed an assessment battery relating to preferred logistics of mobile interventions, behavior change strategies, and types of messages they thought would be most helpful to them at different time points. Results indicated that 98% participants were potentially interested in using text messaging as a continuing care strategy. Participants wrote different types of messages that they perceived might be most helpful, based on various hypothetical situations often encountered during the recovery process. Although individuals tended to prefer benefit driven over consequence driven messages, differences in the perceived benefits of change among individuals predicted message preference. Implications for the development of mobile messaging interventions for the addictions are discussed. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Hooked on a feeling: affective anti-smoking messages are more effective than cognitive messages at changing implicit evaluations of smoking

PubMed Central

Smith, Colin Tucker; De Houwer, Jan

2015-01-01

Because implicit evaluations are thought to underlie many aspects of behavior, researchers have started looking for ways to change them. We examine whether and when persuasive messages alter strongly held implicit evaluations of smoking. In smokers, an affective anti-smoking message led to more negative implicit evaluations on four different implicit measures as compared to a cognitive anti-smoking message which seemed to backfire. Additional analyses suggested that the observed effects were mediated by the feelings and emotions raised by the messages. In non-smokers, both the affective and cognitive message engendered slightly more negative implicit evaluations. We conclude that persuasive messages change implicit evaluations in a way that depends on properties of the message and of the participant. Thus, our data open new avenues for research directed at tailoring persuasive messages to change implicit evaluations. PMID:26557099

Hooked on a feeling: affective anti-smoking messages are more effective than cognitive messages at changing implicit evaluations of smoking.

PubMed

Smith, Colin Tucker; De Houwer, Jan

2015-01-01

Because implicit evaluations are thought to underlie many aspects of behavior, researchers have started looking for ways to change them. We examine whether and when persuasive messages alter strongly held implicit evaluations of smoking. In smokers, an affective anti-smoking message led to more negative implicit evaluations on four different implicit measures as compared to a cognitive anti-smoking message which seemed to backfire. Additional analyses suggested that the observed effects were mediated by the feelings and emotions raised by the messages. In non-smokers, both the affective and cognitive message engendered slightly more negative implicit evaluations. We conclude that persuasive messages change implicit evaluations in a way that depends on properties of the message and of the participant. Thus, our data open new avenues for research directed at tailoring persuasive messages to change implicit evaluations.

A Mobile Health Intervention to Sustain Recent Weight Loss

ERIC Educational Resources Information Center

Shaw, Ryan Jeffrey

2012-01-01

The goal of this study was to design an intervention that would help people stay in the continued response phase of the Behavior Change Process and help prevent weight relapse. Using the Behavior Change Process and regulatory focus theory, an intervention was developed that leveraged short message service (SMS) to deliver messages to people who…

Predicting Persuasion-Induced Behavior Change from the Brain

PubMed Central

Falk, Emily B.; Berkman, Elliot T.; Mann, Traci; Harrison, Brittany; Lieberman, Matthew D.

2011-01-01

Although persuasive messages often alter people’s self-reported attitudes and intentions to perform behaviors, these self-reports do not necessarily predict behavior change. We demonstrate that neural responses to persuasive messages can predict variability in behavior change in the subsequent week. Specifically, an a priori region of interest (ROI) in medial prefrontal cortex (MPFC) was reliably associated with behavior change (r = 0.49, p < 0.05). Additionally, an iterative cross-validation approach using activity in this MPFC ROI predicted an average 23% of the variance in behavior change beyond the variance predicted by self-reported attitudes and intentions. Thus, neural signals can predict behavioral changes that are not predicted from self-reported attitudes and intentions alone. Additionally, this is the first functional magnetic resonance imaging study to demonstrate that a neural signal can predict complex real world behavior days in advance. PMID:20573889

Effective communication of risks to young adults: using message framing and visual aids to increase condom use and STD screening.

PubMed

Garcia-Retamero, Rocio; Cokely, Edward T

2011-09-01

Sexually Transmitted Diseases (STDs)-including HIV/AIDS-are among the most common infectious diseases in young adults. How can we effectively promote prevention and detection of STDs in this high risk population? In a two-phase longitudinal experiment we examined the effects of a brief risk awareness intervention (i.e., a sexual health information brochure) in a large sample of sexually active young adults (n = 744). We assessed the influence of gain- and loss-framed messages, and visual aids, on affective reactions, risk perceptions, attitudes, behavioral intentions, and reported behaviors relating to the prevention and detection of STDs. Results indicate that gain-framed messages induced greater adherence for prevention behaviors (e.g., condom use), whereas loss-framed messages were more effective in promoting illness-detecting behaviors (e.g., making an appointment with a doctor to discuss about STD screening). The influence of the framed messages on prevention and detection of STDs was mediated by changes in participants' attitudes toward the health behaviors along with changes in their behavioral intentions. Moreover, when visual aids were added to the health information, both the gain- and loss-framed messages became equally and highly effective in promoting health behaviors. These results converge with other data indicating that well-constructed visual aids are often among the most highly effective, transparent, fast, memorable, and ethically desirable means of risk communication. Theoretical, economic, and public policy implications of these results are discussed. (c) 2011 APA, all rights reserved.

The Effect of Strategic Message Selection on Residents' Intent to Conserve Water in the Landscape

ERIC Educational Resources Information Center

Warner, Laura A.; Rumble, Joy; Martin, Emmett; Lamm, Alexa J.; Cantrell, Randall

2015-01-01

Changing individuals' behaviors is a critical challenge for Extension professionals who encourage good irrigation practices and technologies for landscape water conservation. Multiple messages were used to influence two predictors of behavioral intent informed by the theory of planned behavior, Florida residents' (N = 1,063) attitude and perceived…

Playing for real: video games and stories for health-related behavior change.

PubMed

Baranowski, Tom; Buday, Richard; Thompson, Debbe I; Baranowski, Janice

2008-01-01

Video games provide extensive player involvement for large numbers of children and adults, and thereby provide a channel for delivering health behavior change experiences and messages in an engaging and entertaining format. Twenty-seven articles were identified on 25 video games that promoted health-related behavior change through December 2006. Most of the articles demonstrated positive health-related changes from playing the video games. Variability in what was reported about the games and measures employed precluded systematically relating characteristics of the games to outcomes. Many of these games merged the immersive, attention-maintaining properties of stories and fantasy, the engaging properties of interactivity, and behavior-change technology (e.g., tailored messages, goal setting). Stories in video games allow for modeling, vicarious identifying experiences, and learning a story's "moral," among other change possibilities. Research is needed on the optimal use of game-based stories, fantasy, interactivity, and behavior change technology in promoting health-related behavior change.

Impact and characteristics of positive and fearful emotional messages during infant social referencing.

PubMed

Kim, Geunyoung; Walden, Tedra A; Knieps, Linda J

2010-04-01

Studies of infant social referencing have indicated that infants might be more influenced by vocal information contained in emotional messages than by facial expression, especially during fearful message conditions. The present study investigated the characteristics of emotional channels that parents used during social referencing, and corresponding infants' behavioral changes. Results of Study 1 indicated that parents used more vocal information during positive message conditions. Unlike previous findings, infants' behavioral change was related to the frequency of vocal information during positive condition. For fearful messages, infants were more influenced by the number of multi-modal channels used and the frequency of visual information. Study 2 further showed that the intensity of vocal tone was related to infant regulation only during positive message conditions. The results imply that understanding of social context is important to make sense of parent-infant's emotional interaction. Copyright 2010 Elsevier Inc. All rights reserved.

Adolescents Just Do Not Know What They Want: A Qualitative Study to Describe Obese Adolescents’ Experiences of Text Messaging to Support Behavior Change Maintenance Post Intervention

PubMed Central

Kerr, Deborah A; Fenner, Ashley A; Straker, Leon M

2014-01-01

Background Adolescents are considered a hard to reach group and novel approaches are needed to encourage good health. Text messaging interventions have been reported as acceptable to adolescents but there is little evidence regarding the use of text messages with overweight and obese adolescents to support engagement or behavior change after the conclusion of a healthy lifestyle program. Objective The intent of this study was to explore the opinions of overweight adolescents and their parents regarding the use of text messages as a support during the maintenance period following an intervention. Methods This paper reports on the findings from focus groups conducted with adolescents (n=12) and parents (n=13) who had completed an eight-week intensive intervention known as Curtin University’s Activity, Food and Attitudes Program (CAFAP). Focus groups were conducted three months post intensive intervention. Participants were asked about their experiences of the prior three-month maintenance phase during which adolescents had received tri-weekly text messages based on the self-determination theory and goal-setting theory. Participants were asked about the style and content of text messages used as well as how they used the text messages. Data were analyzed using content and thematic analyses. Results Two clear themes emerged from the focus groups relating to (1) what adolescents liked or thought they wanted in a text message to support behavior change, and (2) how they experienced or responded to text messages. Within the “like/want” theme, there were five sub-themes relating to the overall tone of the text, frequency, timing, reference to long-term goals, and inclusion of practical tips. Within the “response to text” theme, there were four sub-themes describing a lack of motivation, barriers to change, feelings of shame, and perceived unfavorable comparison with other adolescents. What adolescents said they wanted in text messages often conflicted with their actual experiences. Parent reports provided a useful secondary view of adolescent experience. Conclusions The conflicting views described in this study suggest that overweight and obese adolescents may not know or have the ability to articulate how they would best be supported with text messages during a healthy lifestyle maintenance phase. Further, supporting both engagement and behavior change simultaneously with text messaging may not be possible. Intervention texts should be personalized as much as possible and minimize feelings of guilt and shame in overweight and obese adolescents. Future research with text messaging for overweight and obese adolescents should incorporate clear intervention aims and evaluation methods specifically related to adolescent engagement or behavior change. Trial Registration Australian New Zealand Clinical Trials Registry: ACTRN12611001187932; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611001187932 (Archived by WebCite at http://www.webcitation.org/6LGSbk8d9). PMID:24713407

Motivational Text Message Intervention for Eating Disorders: A Single-Case Alternating Treatment Design Using Ecological Momentary Assessment.

PubMed

Shingleton, Rebecca M; Pratt, Elizabeth M; Gorman, Bernard; Barlow, David H; Palfai, Tibor P; Thompson-Brenner, Heather

2016-05-01

This study tested a motivational text message treatment adjunct for individuals with eating disorders (EDs) who exhibited high dietary restraint/restriction. A replicated single-case alternating treatment design was used to examine (a) the feasibility of combining a brief motivational interview with subsequent text messages and (b) the influence of the text messages on eating behaviors and motivation to change in individuals with EDs (N=12). The protocol was 8weeks and the text messages were adjunctive to cognitive-behavioral therapy. The intervention was well accepted (mean rating=7/10) and feasible within the context of monetary compensation (mean daily monitoring compliance =91%). Text messages did not impact behavioral outcomes: dietary restraint and kilocalorie intake. They had mixed effects on motivation to change dietary restraint, measured by the Readiness and Motivation Questionnaire (RMQ). When receiving text messages, RMQ precontemplation scores (desire to restrict) significantly increased, indicating decreased motivation; however, action scores (effort toward reducing dietary restraint) significantly increased, indicating increased motivation. These effects were moderated by weight status. Underweight individuals (n=4; body mass index [BMI]<19.0) reported increased ambivalence-that is, an increased desire to restrict and increased action toward reducing restriction-in response to the text messages. Normal weight participants (n=8; BMI>19.0) reported only increased action toward reducing restriction in response to the text messages. These data demonstrate text messages are a potentially feasible and acceptable treatment adjunct and may be effective at increasing motivation to change for normal weight individuals, while their influence on underweight patients is more complex. These findings provide a foundation for future research in technology-based motivational interventions for EDs and offer preliminary evidence for using these methods among normal weight individuals. Copyright © 2016. Published by Elsevier Ltd.

The Effects of Anger, Sadness and Happiness on Persuasive Message Processing: A Test of the Negative State Relief Model.

ERIC Educational Resources Information Center

Mitchell, Monique M.; Brown, Kenneth M.; Morris-Villagran, Melinda; Villagran, Paul D.

2001-01-01

Examines the strength of the effects of happiness and sadness on attitude change, and compares these effects with the effect of anger on attitude change and persuasive message processing. Finds that message strength was positively correlated with attitude, intention and behavior, but was negatively correlated with negative thoughts, and counter…

Examining the link between framed physical activity ads and behavior among women.

PubMed

Berenbaum, Erin; Latimer-Cheung, Amy E

2014-06-01

Gain-framed messages are more effective at promoting physical activity than loss-framed messages. However, the mechanism through which this effect occurs is unclear. The current experiment examined the effects of message framing on variables described in the communication behavior change model (McGuire, 1989), as well as the mediating effects of these variables on the message-frame-behavior relationship. Sixty low-to-moderately active women viewed 20 gain- or loss-framed ads and five control ads while their eye movements were recorded via eye tracking. The gain-framed ads attracted greater attention, ps < .05; produced more positive attitudes, p = .06; were better recalled, p < .001; influenced decisions to be active, p = .07; and had an immediate and delayed impact on behavior, ps < .05, compared with the loss-framed messages. Mediation analyses failed to reveal any significant effects. This study demonstrates the effects of framed messages on several outcomes; however, the mechanisms underlying these effects remain unclear.

Predictive Validity of an Empirical Approach for Selecting Promising Message Topics: A Randomized-Controlled Study

PubMed Central

Lee, Stella Juhyun; Brennan, Emily; Gibson, Laura Anne; Tan, Andy S. L.; Kybert-Momjian, Ani; Liu, Jiaying; Hornik, Robert

2016-01-01

Several message topic selection approaches propose that messages based on beliefs pretested and found to be more strongly associated with intentions will be more effective in changing population intentions and behaviors when used in a campaign. This study aimed to validate the underlying causal assumption of these approaches which rely on cross-sectional belief–intention associations. We experimentally tested whether messages addressing promising themes as identified by the above criterion were more persuasive than messages addressing less promising themes. Contrary to expectations, all messages increased intentions. Interestingly, mediation analyses showed that while messages deemed promising affected intentions through changes in targeted promising beliefs, messages deemed less promising also achieved persuasion by influencing nontargeted promising beliefs. Implications for message topic selection are discussed. PMID:27867218

Playing for Real: Video Games and Stories for Health-Related Behavior Change

PubMed Central

Baranowski, Tom; Buday, Richard; Thompson, Debbe I.; Baranowski, Janice

2008-01-01

Background Video games provide extensive player involvement for large numbers of children and adults, and thereby provide a channel for delivering health behavior change experiences and messages in an engaging and entertaining format. Method Twenty-seven articles were identified on 25 video games that promoted health-related behavior change through December 2006. Results Most of the articles demonstrated positive health-related changes from playing the video games. Variability in what was reported about the games and measures employed precluded systematically relating characteristics of the games to outcomes. Many of these games merged the immersive, attention-maintaining properties of stories and fantasy, the engaging properties of interactivity, and behavior-change technology (e.g., tailored messages, goal setting). Stories in video games allow for modeling, vicarious identifying experiences, and learning a story’s “moral,” among other change possibilities. Conclusions Research is needed on the optimal use of game-based stories, fantasy, interactivity, and behavior change technology in promoting health-related behavior change. PMID:18083454

Managing fear in public health campaigns: a theory-based formative evaluation process.

PubMed

Cho, Hyunyi; Witte, Kim

2005-10-01

The HIV/AIDS infection rate of Ethiopia is one of the world's highest. Prevention campaigns should systematically incorporate and respond to at-risk population's existing beliefs, emotions, and perceived barriers in the message design process to effectively promote behavior change. However, guidelines for conducting formative evaluation that are grounded in proven risk communication theory and empirical data analysis techniques are hard to find. This article provides a five-step formative evaluation process that translates theory and research for developing effective messages for behavior change. Guided by the extended parallel process model, the five-step process helps message designers manage public's fear surrounding issues such as HIV/AIDS. An entertainment education project that used the process to design HIV/AIDS prevention messages for Ethiopian urban youth is reported. Data were collected in five urban regions of Ethiopia and analyzed according to the process to develop key messages for a 26-week radio soap opera.

Using the integrative model of behavioral prediction to identify promising message strategies to promote healthy sleep behavior among college students.

PubMed

Robbins, Rebecca; Niederdeppe, Jeff

2015-01-01

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.

Designing a Text Messaging Intervention to Improve Physical Activity Behavior Among Low-Income Latino Patients With Diabetes: A Discrete-Choice Experiment, Los Angeles, 2014-2015.

PubMed

Ramirez, Magaly; Wu, Shinyi; Beale, Elizabeth

2016-12-22

Automated text messaging can deliver self-management education to activate self-care behaviors among people with diabetes. We demonstrated how a discrete-choice experiment was used to determine the features of a text-messaging intervention that are important to urban, low-income Latino patients with diabetes and that could support improvement in their physical activity behavior. In a discrete-choice experiment from December 2014 through August 2015 we conducted a survey to elicit information on patient preferences for 5 features of a text-messaging intervention. We described 2 hypothetical interventions and in 7 pairwise comparisons asked respondents to indicate which they preferred. Respondents (n = 125) were recruited in person from a diabetes management program of a safety-net ambulatory care clinic in Los Angeles; clinicians referred patients to the research assistant after routine clinic visits. Data were analyzed by using conditional logistic regression. We found 2 intervention features that were considered by the survey respondents to be important: 1) the frequency of text messaging and 2) physical activity behavior-change education (the former being more important than the latter). Physical activity goal setting, feedback on physical activity performance, and social support were not significantly important. A discrete-choice experiment is a feasible way to elicit information on patient preferences for a text-messaging intervention designed to support behavior change. However, discrepancies may exist between patients' stated preferences and their actual behavior. Future research should validate and expand our findings.

My Quest, an Intervention Using Text Messaging to Improve Dietary and Physical Activity Behaviors and Promote Weight Loss in Low-Income Women.

PubMed

Griffin, Jamie B; Struempler, Barb; Funderburk, Katie; Parmer, Sondra M; Tran, Cecilia; Wadsworth, Danielle D

2018-01-01

To evaluate changes in dietary and physical activity behaviors and weight after implementation of a 12-week text messaging initiative (My Quest). The researchers conducted a 1-group, pre- to posttest study design to determine changes after implementation of a text messaging initiative developed using the tenets of the Social Cognitive Theory. A total of 55 Alabama counties (84% rural) with high rates of poverty, overweight/obesity, and chronic diseases. Convenience sample of low-income, primarily overweight/obese women (n = 104). Short texts (n = 2-3/d) provided health tips, reminders, and goal-setting prompts. Weekly electronic newsletters provided tips and recipes. Participant self-monitored body weight weekly. Outcomes included goal setting, self-efficacy, behavioral and environmental factors, self-monitoring, and body weight; data collection occurred through text message response and online surveys. Analyses were conducted using McNemar test (dichotomous data), Wilcoxon signed rank test (ordinal data), or paired t test (continuous data). Participants significantly (P < .05) improved dietary and physical activity behaviors and food environment; increased dietary and physical activity goal setting; and reduced body weight. A low-cost, text messaging initiative particularly targeting women residing in rural communities with high rates of poverty and obesity can promote weight loss and improve dietary and physical activity behaviors. Future studies may include a control group and social support component such as group text messaging. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The effects of message framing within the stages of change on smoking cessation intentions and behaviors.

PubMed

Cornacchione, Jennifer; Smith, Sandi W

2012-01-01

This study examines two commonly used and accepted theoretical models in health communication-the stages of change and message framing-to determine whether gain- or loss-framed messages are more effective at getting people to intend to quit smoking depending on their current stage of change (precontemplation, contemplation, or preparation). One hundred forty-eight current smokers were exposed to one of four gain- or loss-framed messages that emphasized the benefits of cessation or the costs of smoking. Message believability, message processing, and stage movement were measured to see if any differences existed as a function of the individual's base stage of change and message frame exposure. Overall, results indicated that all participants, regardless of stage and frame, engaged in more central than peripheral message processing. However, those in the precontemplation/loss frame and preparation/gain frame conditions engaged in significantly less cognitive processing than those in all other conditions. Additionally, gain-framed messages were most influential at getting individuals to progress from the contemplation to the preparation stage. Implications and future directions for research are also discussed.

The impact of self-affirmation on health-behavior change: a meta-analysis.

PubMed

Epton, Tracy; Harris, Peter R; Kane, Rachel; van Koningsbruggen, Guido M; Sheeran, Paschal

2015-03-01

Self-affirmation (induced by reflecting upon important values, attributes, or social relations) appears to reduce defensive resistance to health-risk information and increase subsequent readiness for health behavior change. However, these effects of self-affirmation have yet to be subjected to formal, quantitative integration. Consequently, the current article reports a meta-analysis of the impact of self-affirmation on outcomes at 3 key points in the process of health-behavior change: (a) message acceptance, (b) intentions to change, and (c) subsequent behavior. The literature search identified 144 experimental tests of the effects of manipulating self-affirmation on these outcomes. Effect sizes were extracted and meta-analyzed. Across 34 tests of message acceptance (N = 3,433), 64 tests of intentions (N = 5,564), and 46 tests of behavior (N = 2,715), random effects models indicated small but reliable positive effects of self-affirmation on each outcome: acceptance, d+ = .17(CI = .03 to .31); intentions, d+ = .14 (CI = .05 to .23); behavior, d+ = .32 (CI = .19 to .44). Findings held across a range of health problems and behaviors. The results suggest that deploying self-affirmation inductions alongside persuasive health information has positive effects, promoting message acceptance, intentions to change, and subsequent behavior. Though the effects are small in magnitude, they are comparable to those obtained in meta-analyses of other health-behavior change interventions. These findings are relevant to researchers and practitioners working to understand why people resist beneficial health information and how such resistance can be reduced. PsycINFO Database Record (c) 2015 APA, all rights reserved

Testing a social cognitive theory-based model of indoor tanning: implications for skin cancer prevention messages.

PubMed

Noar, Seth M; Myrick, Jessica Gall; Zeitany, Alexandra; Kelley, Dannielle; Morales-Pico, Brenda; Thomas, Nancy E

2015-01-01

The lack of a theory-based understanding of indoor tanning is a major impediment to the development of effective messages to prevent or reduce this behavior. This study applied the Comprehensive Indoor Tanning Expectations (CITE) scale in an analysis of indoor tanning behavior among sorority women (total N = 775). Confirmatory factor analyses indicated that CITE positive and negative expectations were robust, multidimensional factors and that a hierarchical structure fit the data well. Social cognitive theory-based structural equation models demonstrated that appearance-oriented variables were significantly associated with outcome expectations. Outcome expectations were, in turn, significantly associated with temptations to tan, intention to tan indoors, and indoor tanning behavior. The implications of these findings for the development of messages to prevent and reduce indoor tanning behavior are discussed in two domains: (a) messages that attempt to change broader societal perceptions about tan skin, and (b) messages that focus more narrowly on indoor tanning-challenging positive expectations, enhancing negative expectations, and encouraging substitution of sunless tanning products.

The social marketing of safety behaviors: a quasi-randomized controlled trial of tractor retrofitting incentives.

PubMed

Sorensen, Julie A; Jenkins, Paul L; Emmelin, Maria; Stenlund, Hans; Weinehall, Lars; Earle-Richardson, Giulia B; May, John J

2011-04-01

We assessed the effect of social marketing incentives on dispositions toward retrofitting and retrofitting behavior among farmers whose tractors lacked rollover protective structures. From 2006 to 2007, we conducted a quasi-randomized controlled trial with 391 farm owners in New York and Pennsylvania surveyed before and after exposure to 1 of 3 tractor retrofitting incentive combinations. These combinations were offered in 3 trial regions; region 1 received rebates; region 2 received rebates, messages, and promotion and was considered the social marketing region; and region 3 received messages and promotion. A fourth region served as a control. The social marketing region generated the greatest increases in readiness to retrofit, intentions to retrofit, and message recall. In addition, postintervention stage of change, intentions, attitudes, subjective norms, and perceived behavioral control levels were higher among farmers who had retrofitted tractors. Our results showed that a social marketing approach (financial incentives, tailored messages, and promotion) had the greatest influence on message recall, readiness to retrofit tractors, and intentions to retrofit tractors and that behavioral measures were fairly good predictors of tractor retrofitting behaviors.

The role of social message using norm abstraction level and ecological value orientation to achieve sustainable consumption

NASA Astrophysics Data System (ADS)

Ekasari, A.

2018-01-01

Pro-environmental behavior is one of human activities to achieve sustainability. In order to encourage people to do so, it needs contribution from marketing discipline using social message. The research aims to investigate the effect of social message framed by norm abstraction level and ecological value orientation on attitude and intention to act pro-environmental behavior in the context of littering. This study implemented a 3 (message framing: biospheric/altruistic/egoistic) × 2 (norm abstraction level : abstract/concrete) between subject experimental design to collect the data. An independent sample t test was used to analyze the data. The results indicate that a social message using concrete norm combined with the three ecological value orientation gains more positive response than the use of abstract norm with the same ecological value orientations. Findings of the research are expected to help government or other institutions to create an appropriate social message in anti littering campaign and motivates people to change their behavior in practicing sustainable consumption.

The message changes belief and the rest is theory: the "1% or less" milk campaign and reasoned action.

PubMed

Booth-Butterfield, Steve; Reger, Bill

2004-09-01

Theory-based approaches to public health interventions are useful for designing, implementing, and evaluating research. This paper describes and presents data to support the theoretical force behind the "1% or less" nutrition intervention studies. Using the Theory of Reasoned Action (TRA), high-fat (whole and 2%) milk users were targeted. Supermarket milk sale data were collected, and randomly selected intervention and comparison community residents were surveyed via telephone to assess milk use. TRA constructs were used in the surveys that were conducted immediately before and after a 6-week mass media campaign. Campaign messages were aimed at changing behavioral rather than normative beliefs. We found significant and predicted changes in intervention participants on intention, attitude, and behavioral beliefs, but not subjective norm outcomes. A path model showed support that TRA variables mediated significant changes in self-reported milk use. The analysis further validates the TRAs and supports a template using both the Principle of Compatibility and TRA to aid development and implementation of messages for effective behavior change field interventions.

Optimizing Tailored Communications for Health Risk Assessment: A Randomized Factorial Experiment of the Effects of Expectancy Priming, Autonomy Support, and Exemplification

PubMed Central

Ribisl, Kurt M; Mayer, Deborah K; Tate, Deborah F

2018-01-01

Background Health risk assessments with tailored feedback plus health education have been shown to be effective for promoting health behavior change. However, there is limited evidence to guide the development and delivery of online automated tailored feedback. Objective The goal of this study was to optimize tailored feedback messages for an online health risk assessment to promote enhanced user engagement, self-efficacy, and behavioral intentions for engaging in healthy behaviors. We examined the effects of three theory-based message factors used in developing tailored feedback messages on levels of engagement, self-efficacy, and behavioral intentions. Methods We conducted a randomized factorial experiment to test three different components of tailored feedback messages: tailored expectancy priming, autonomy support, and use of an exemplar. Individuals (N=1945) were recruited via Amazon Mechanical Turk and randomly assigned to one of eight different experimental conditions within one of four behavioral assessment and feedback modules (tobacco use, physical activity [PA], eating habits, and weight). Participants reported self-efficacy and behavioral intentions pre- and postcompletion of an online health behavior assessment with tailored feedback. Engagement and message perceptions were assessed at follow-up. Results For the tobacco module, there was a significant main effect of the exemplar factor (P=.04); participants who received exemplar messages (mean 3.31, SE 0.060) rated their self-efficacy to quit tobacco higher than those who did not receive exemplar messages (mean 3.14, SE 0.057). There was a three-way interaction between the effect of message conditions on self-efficacy to quit tobacco (P=.02), such that messages with tailored priming and an exemplar had the greatest impact on self-efficacy to quit tobacco. Across PA, eating habits, and weight modules, there was a three-way interaction among conditions on self-efficacy (P=.048). The highest self-efficacy scores were reported among those who were in the standard priming condition and received both autonomy supportive and exemplar messages. In the PA module, autonomy supportive messages had a stronger effect on self-efficacy for PA in the standard priming condition. For PA, eating habits, and weight-related behaviors, the main effect of exemplar messages on behavioral intentions was in the hypothesized direction but did not reach statistical significance (P=.08). When comparing the main effects of different message conditions, there were no differences in engagement and message perceptions. Conclusions Findings suggest that tailored feedback messages that use exemplars helped improve self-efficacy related to tobacco cessation, PA, eating habits, and weight control. Combining standard priming and autonomy supportive message components shows potential for optimizing tailored feedback for tobacco cessation and PA behaviors. PMID:29496652

Messages promoting genetic modification of crops in the context of climate change: Evidence for psychological reactance.

PubMed

Lu, Hang; McComas, Katherine A; Besley, John C

2017-01-01

Genetic modification (GM) of crops and climate change are arguably two of today's most challenging science communication issues. Increasingly, these two issues are connected in messages proposing GM as a viable option for ensuring global food security threatened by climate change. This study examines the effects of messages promoting the benefits of GM in the context of climate change. Further, it examines whether explicit reference to "climate change," or "global warming" in a GM message results in different effects than each other, or an implicit climate reference. An online sample of U.S. participants (N = 1050) were randomly assigned to one of four conditions: "climate change" cue, "global warming" cue, implicit cue, or control (no message). Generally speaking, framing GM crops as a way to help ensure global food security proved to be an effective messaging strategy in increasing positive attitudes toward GM. In addition, the implicit cue condition led to liberals having more positive attitudes and behavioral intentions toward GM than the "climate change" cue condition, an effect mediated by message evaluations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Can functional magnetic resonance imaging studies help with the optimization of health messaging for lifestyle behavior change? A systematic review.

PubMed

Whelan, Maxine E; Morgan, Paul S; Sherar, Lauren B; Orme, Mark W; Esliger, Dale W

2017-06-01

Unhealthy behaviors, including smoking, poor nutrition, excessive alcohol consumption, physical inactivity and sedentary lifestyles, are global risk factors for non-communicable diseases and premature death. Functional magnetic resonance imaging (fMRI) offers a unique approach to optimize health messages by examining how the brain responds to information relating to health. Our aim was to systematically review fMRI studies that have investigated variations in brain activation in response to health messages relating to (i) smoking; (ii) alcohol consumption; (iii) physical activity; (iv) diet; and (v) sedentary behavior. The electronic databases used were Medline/PubMed, Web of Science (Core Collection), PsychINFO, SPORTDiscuss, Cochrane Library and Open Grey. Studies were included if they investigated subjects aged ≥10years and were published before January 2017. Of the 13,836 studies identified in the database search, 18 studies (smoking k=15; diet k=2; physical activity/sedentary behavior k=1) were included in the review. The prefrontal cortex was activated in seven (47%) of the smoking-related studies and the physical activity study. Results suggest that activation of the ventromedial, dorsolateral and medial prefrontal cortex regions were predictive of subsequent behavior change following exposure to aversive anti-smoking stimuli. Studies investigating the neurological responses to anti-smoking material were most abundant. Of note, the prefrontal cortex and amygdala were most commonly activated in response to health messages across lifestyle behaviors. The review highlights an important disparity between research focusing on different lifestyle behaviors. Insights from smoking literature suggest fMRI may help to optimize health messaging in relation to other lifestyle behaviors. Copyright © 2017 Elsevier Inc. All rights reserved.

Validation of persuasive messages for the promotion of physical activity among people with coronary heart disease.

PubMed

Mendez, Roberto Della Rosa; Rodrigues, Roberta Cunha Matheus; Spana, Thaís Moreira; Cornélio, Marília Estevam; Gallani, Maria Cecília Bueno Jayme; Pérez-Nebra, Amalia Raquel

2012-01-01

to validate the content of persuasive messages for promoting walking among patients with coronary heart disease (CHD). The messages were constructed to strengthen or change patients' attitudes to walking. the selection of persuasive arguments was based on behavioral beliefs (determinants of attitude) related to walking. The messages were constructed based in the Elaboration Likelihood Model and were submitted to content validation. the data was analyzed with the content validity index and by the importance which the patients attributed to the messages' persuasive arguments. Positive behavioral beliefs (i.e. positive and negative reinforcement) and self-efficacy were the appeals which the patients considered important. The messages with validation evidence will be tested in an intervention study for the promotion of the practice of physical activity among patients with CHD.

Enhancing community knowledge and health behaviors to eliminate blinding trachoma in Mali using radio messaging as a strategy.

PubMed

Bamani, Sanoussi; Toubali, Emily; Diarra, Sadio; Goita, Seydou; Berté, Zana; Coulibaly, Famolo; Sangaré, Hama; Tuinsma, Marjon; Zhang, Yaobi; Dembelé, Benoit; Melvin, Palesa; MacArthur, Chad

2013-04-01

The National Blindness Prevention Program in Mali has broadcast messages on the radio about trachoma as part of the country's trachoma elimination strategy since 2008. In 2011, a radio impact survey using multi-stage cluster sampling was conducted in the regions of Kayes and Segou to assess radio listening habits, coverage of the broadcasts, community knowledge and behavior specific to trachoma and facial cleanliness of children. Radio access and listening were high, with 60% of respondents having heard a message on the radio about trachoma. The majority of respondents knew about trachoma, its root causes, its impact on health and prevention measures. Additionally, 66% reported washing their children's faces more than or equal to twice/day and 94% reported latrine disposal of feces. A high percentage of persons who gave a positive response to knowledge and behavior questions reported hearing the trachoma messages on the radio with 60% reporting that the radio is where they learned about trachoma. There was no significant difference in facial cleanliness when comparing children whose primary caregiver had/had not heard the trachoma messages. Next steps include revising the current messages to include more focused behavior change messaging and to engage in a more robust use of community radios.

The Stages of Change Model: An Effective Audience Analysis Tool Used To Design and Implement Health Promoting Messages.

ERIC Educational Resources Information Center

Smith, Ronda L.

Researchers have been slow to acknowledge the salient role communication can play in motivating people to adopt more healthy lifestyles. Because persuasive messages increase awareness and can increase health promoting behaviors, it is important to determine the most effective health promoting messages in various health contexts. Thus, the primary…

Remote health coaching for interactive exercise with older adults in a home environment.

PubMed

Jimison, Holly B; Hagler, Stuart; Kurillo, Gregorij; Bajcsy, Ruzena; Pavel, Misha

2015-01-01

Optimal health coaching interventions are tailored to individuals' needs, preferences, motivations, barriers, timing, and readiness to change. Technology approaches are useful in both monitoring a user's adherence to their behavior change goals and also in providing just-in-time feedback and coaching messages. User models that incorporate dynamically varying behavior change variables with algorithms that trigger tailored messages provide a framework for making health interventions more effective. These principles are applied in the described system for assisting older adults in meeting their physical exercise goals with a tailored interactive video system with just-in-time feedback and encouragement.

The Social Marketing of Safety Behaviors: A Quasi–Randomized Controlled Trial of Tractor Retrofitting Incentives

PubMed Central

Jenkins, Paul L.; Emmelin, Maria; Stenlund, Hans; Weinehall, Lars; Earle-Richardson, Giulia B.; May, John J.

2011-01-01

Objectives. We assessed the effect of social marketing incentives on dispositions toward retrofitting and retrofitting behavior among farmers whose tractors lacked rollover protective structures. Methods. From 2006 to 2007, we conducted a quasi–randomized controlled trial with 391 farm owners in New York and Pennsylvania surveyed before and after exposure to 1 of 3 tractor retrofitting incentive combinations. These combinations were offered in 3 trial regions; region 1 received rebates; region 2 received rebates, messages, and promotion and was considered the social marketing region; and region 3 received messages and promotion. A fourth region served as a control. Results. The social marketing region generated the greatest increases in readiness to retrofit, intentions to retrofit, and message recall. In addition, postintervention stage of change, intentions, attitudes, subjective norms, and perceived behavioral control levels were higher among farmers who had retrofitted tractors. Conclusions. Our results showed that a social marketing approach (financial incentives, tailored messages, and promotion) had the greatest influence on message recall, readiness to retrofit tractors, and intentions to retrofit tractors and that behavioral measures were fairly good predictors of tractor retrofitting behaviors. PMID:21330581

Optimizing Tailored Communications for Health Risk Assessment: A Randomized Factorial Experiment of the Effects of Expectancy Priming, Autonomy Support, and Exemplification.

PubMed

Valle, Carmina G; Queen, Tara L; Martin, Barbara A; Ribisl, Kurt M; Mayer, Deborah K; Tate, Deborah F

2018-03-01

Health risk assessments with tailored feedback plus health education have been shown to be effective for promoting health behavior change. However, there is limited evidence to guide the development and delivery of online automated tailored feedback. The goal of this study was to optimize tailored feedback messages for an online health risk assessment to promote enhanced user engagement, self-efficacy, and behavioral intentions for engaging in healthy behaviors. We examined the effects of three theory-based message factors used in developing tailored feedback messages on levels of engagement, self-efficacy, and behavioral intentions. We conducted a randomized factorial experiment to test three different components of tailored feedback messages: tailored expectancy priming, autonomy support, and use of an exemplar. Individuals (N=1945) were recruited via Amazon Mechanical Turk and randomly assigned to one of eight different experimental conditions within one of four behavioral assessment and feedback modules (tobacco use, physical activity [PA], eating habits, and weight). Participants reported self-efficacy and behavioral intentions pre- and postcompletion of an online health behavior assessment with tailored feedback. Engagement and message perceptions were assessed at follow-up. For the tobacco module, there was a significant main effect of the exemplar factor (P=.04); participants who received exemplar messages (mean 3.31, SE 0.060) rated their self-efficacy to quit tobacco higher than those who did not receive exemplar messages (mean 3.14, SE 0.057). There was a three-way interaction between the effect of message conditions on self-efficacy to quit tobacco (P=.02), such that messages with tailored priming and an exemplar had the greatest impact on self-efficacy to quit tobacco. Across PA, eating habits, and weight modules, there was a three-way interaction among conditions on self-efficacy (P=.048). The highest self-efficacy scores were reported among those who were in the standard priming condition and received both autonomy supportive and exemplar messages. In the PA module, autonomy supportive messages had a stronger effect on self-efficacy for PA in the standard priming condition. For PA, eating habits, and weight-related behaviors, the main effect of exemplar messages on behavioral intentions was in the hypothesized direction but did not reach statistical significance (P=.08). When comparing the main effects of different message conditions, there were no differences in engagement and message perceptions. Findings suggest that tailored feedback messages that use exemplars helped improve self-efficacy related to tobacco cessation, PA, eating habits, and weight control. Combining standard priming and autonomy supportive message components shows potential for optimizing tailored feedback for tobacco cessation and PA behaviors. ©Carmina G Valle, Tara L Queen, Barbara A Martin, Kurt M Ribisl, Deborah K Mayer, Deborah F Tate. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.03.2018.

A systematic review of three approaches for constructing physical activity messages: What messages work and what improvements are needed?

PubMed Central

2010-01-01

Background To motivate individuals to adhere to a regular physical activity regime, guidelines must be supplemented with persuasive messages that are disseminated widely. While substantial research has examined effective strategies for disseminating physical activity messages, there has been no systematic effort to examine optimal message content. This paper reviews studies that evaluate the effectiveness of three approaches for constructing physical activity messages including tailoring messages to suit individual characteristics of message recipients (message tailoring), framing messages in terms of gains versus losses (message framing), and targeting messages to affect change in self-efficacy (i.e., a theoretical determinant of behavior change). Methods We searched the MEDLINE, PsycINFO, EMBASE and CINAHL databases up to July 2008. Relevant reference lists also were searched. We included intervention trials, field experiments, and laboratory-based studies that aimed to test the efficacy or effectiveness of tailored messages, framed messages and self-efficacy change messages among healthy adults. We used a descriptive approach to analyze emerging patterns in research findings. Based on this evidence we made recommendations for practice and future research. Results Twenty-two studies were identified. Twelve studies evaluated message tailoring. In 10 of these studies, tailored messages resulted in greater physical activity than a control message. Six studies evaluated framed messages. Five of these studies demonstrated that gain-framed messages lead to stronger intentions to be active compared to a control message. Moreover, a gain-frame advantage was evident in three of the four studies that assessed physical activity. Four studies evaluated self-efficacy change messages. The two studies that used an experimental design provide a clear indication that individuals' beliefs can be affected by messages that incorporate types of information known to be determinants of self-efficacy. Overall, strong evidence to support definitive recommendations for optimal message content and structure was lacking. Conclusions Additional research testing the optimal content of messages used to supplement physical activity guidelines is needed. Tailored messages, gain-framed messages, and self-efficacy change messages hold promise as strategies for constructing physical activity messages and should be a focus of future research. PMID:20459779

The message development tool: a case for effective operationalization of messaging in social marketing practice.

PubMed

Mattson, Marifran; Basu, Ambar

2010-07-01

That messages are essential, if not the most critical component of any communicative process, seems like an obvious claim. More so when the communication is about health--one of the most vital and elemental of human experiences (Babrow & Mattson, 2003). Any communication campaign that aims to change a target audience's health behaviors needs to centralize messages. Even though messaging strategies are an essential component of social marketing and are a widely used campaign model, health campaigns based on this framework have not always been able to effectively operationalize this key component, leading to cases where initiating and sustaining prescribed health behavior has been difficult (MacStravic, 2000). Based on an examination of the VERB campaign and an Australian breastfeeding promotion campaign, we propose a message development tool within the ambit of the social marketing framework that aims to extend the framework and ensure that the messaging component of the model is contextualized at the core of planning, implementation, and evaluation efforts.

Mobile phone use among female entertainment workers in Cambodia: an observation study.

PubMed

Brody, Carinne; Tatomir, Brent; Sovannary, Tuot; Pal, Khuondyla; Mengsrun, Song; Dionosio, Jennifer; Luong, Minh-Anh; Yi, Siyan

2017-01-01

Text or voice messages containing health behavior change content may be an inexpensive, discreet, sustainable and scalable way to reach populations at high risk for HIV. In Cambodia, one of the important high-risk populations is female entertainment workers (FEWs). This ethnographic study aims to explore typical phone use, examining patterns and behaviors that may influence the design of future mHealth interventions. The study consisted of one 8-hour non-participant observation session for 15 randomly sampled FEWs. Observations focused on capturing normal daily use of mobile devices. Observation checklists were populated by observers during the observations and a post-observation survey was conducted. Findings were discussed with Cambodian HIV outreach workers and HIV research fellows and their interpretations are summarized below. In this ethnographic study, all 15 participants made calls, checked the time and received research-related texts. More than half (n=8) of the participants engaged in texting to a non-research recipient. About half (n=7) went on Facebook (FB) and some (n=5) listened to music and looked at their FB newsfeed. Fewer played a mobile game, posted a photo to FB, went on YouTube, used FB chat/messenger, watched a video on FB, played a game on FB, used FB call/voice chat, looked at their phone's background or used the LINE app. Fewer still shared their phones, left them unattended, added airtime or changed their SIM cards. When participants received a research text message, most did not share the text message with anyone, did not ask for help deciphering the message and did not receive help composing a response. Notable themes from observer notes, HIV outreach workers and researchers include reasons why phone calls were the most frequent mode of communication, examples of how cell phone company text messages are used as a form of behavior change, literacy as a persistent barrier for some FEWs, and FEWs' high interest in receiving health-related messages and less concern about privacy and phone-sharing issues than expected. This study suggests texting is a part of normal phone use although not as frequently used as voice calls or Facebook. Despite the less frequent use, FEWs were able to send and receive messages, were interested in health messages and were not overly concerned about privacy issues. Texting and voice messaging may be useful tools for health behavior change within the FEW population in Cambodia.

Mobile phone use among female entertainment workers in Cambodia: an observation study

PubMed Central

Tatomir, Brent; Sovannary, Tuot; Pal, Khuondyla; Mengsrun, Song; Dionosio, Jennifer; Luong, Minh-Anh; Yi, Siyan

2017-01-01

Background Text or voice messages containing health behavior change content may be an inexpensive, discreet, sustainable and scalable way to reach populations at high risk for HIV. In Cambodia, one of the important high-risk populations is female entertainment workers (FEWs). This ethnographic study aims to explore typical phone use, examining patterns and behaviors that may influence the design of future mHealth interventions. Methods The study consisted of one 8-hour non-participant observation session for 15 randomly sampled FEWs. Observations focused on capturing normal daily use of mobile devices. Observation checklists were populated by observers during the observations and a post-observation survey was conducted. Findings were discussed with Cambodian HIV outreach workers and HIV research fellows and their interpretations are summarized below. Results In this ethnographic study, all 15 participants made calls, checked the time and received research-related texts. More than half (n=8) of the participants engaged in texting to a non-research recipient. About half (n=7) went on Facebook (FB) and some (n=5) listened to music and looked at their FB newsfeed. Fewer played a mobile game, posted a photo to FB, went on YouTube, used FB chat/messenger, watched a video on FB, played a game on FB, used FB call/voice chat, looked at their phone’s background or used the LINE app. Fewer still shared their phones, left them unattended, added airtime or changed their SIM cards. When participants received a research text message, most did not share the text message with anyone, did not ask for help deciphering the message and did not receive help composing a response. Notable themes from observer notes, HIV outreach workers and researchers include reasons why phone calls were the most frequent mode of communication, examples of how cell phone company text messages are used as a form of behavior change, literacy as a persistent barrier for some FEWs, and FEWs’ high interest in receiving health-related messages and less concern about privacy and phone-sharing issues than expected. Conclusions This study suggests texting is a part of normal phone use although not as frequently used as voice calls or Facebook. Despite the less frequent use, FEWs were able to send and receive messages, were interested in health messages and were not overly concerned about privacy issues. Texting and voice messaging may be useful tools for health behavior change within the FEW population in Cambodia. PMID:28293620

[Attitudes, communication and family planning: a conceptual framework applicable to Rwanda].

PubMed

Nsengimana, D; Ndinkabandi, E

1991-08-01

An important objective of Rwanda's National Office of Population (ONAPO) is to study psychosocial and cultural variables that encourage or impede family planning use and to define effective communication strategies based on them that can be carried out by ONAPO promoters. The definition and measurement of such variables are discussed in terms of theories of attitude changes and communication. Attitude is a hypothetical construction inferred from opinions and expressive behavior. The concept of attitude has 3 dimensions, the cognitive-evaluative, the affective-emotional, and the behavioral. The affective-emotional dimension is considered the most important by many theoreticians of attitude change. A basic characteristic of attitudes is stability. Communication theory furnishes a model for processes of attitude change, which postulates a source or emitter sending elements of information or messages to a recipient. Feedback from the recipient to the sender allows the efficacy of the message to be assessed and permits the sender to adjust actions until the objective is attained. Feedback is always possible in interpersonal communications between individuals in permanent contact, but becomes more difficult in mass communication. Among the many variables intervening in the formation or change of attitudes toward family planning are sex, age, residence, education, occupation, religion, marital status, and fertility. The psychosocial variables influencing family planning acceptance are at the level of the source, the message, and the recipient. 3 important factors at the level of the source are the credibility, attractiveness, and power or prestige of the source. The message should contain a suggestion that the desired behavior should be adopted and should follow a certain order in presenting information. Factors at the level of the receptor include susceptibility to persuasion, the way in which the message affects the recipient's needs, the selectivity necessary in perceiving the information contained in the message, and the degree of resistance in regard to the message. A 2-stage theory of communication suggests that horizontal communication within small groups is a stronger determinant of attitudes than is verbal communication from authority figures. Communication is the most important factor in all attempts to change attitudes.

Do Health Beliefs and Behaviors Differ According to Severity of Obesity? A Qualitative Study of Australian Adults

PubMed Central

Lewis, Sophie; Thomas, Samantha L.; Blood, R. Warwick; Hyde, Jim; Castle, David J.; Komesaroff, Paul A.

2010-01-01

Public responses to obesity have focused on providing standardized messages and supports to all obese individuals, but there is limited understanding of the impact of these messages on obese adults. This descriptive qualitative study using in-depth interviews and a thematic method of analysis, compares the health beliefs and behaviors of 141 Australian adults with mild to moderate (BMI 30−39.9) and severe (BMI ≥ 40) obesity. Mildly obese individuals felt little need to change their health behaviors or to lose weight for health reasons. Most believed they could “lose weight” if they needed to, distanced themselves from the word obesity, and stigmatized those “fatter” than themselves. Severely obese individuals felt an urgent need to change their health behaviors, but felt powerless to do so. They blamed themselves for their weight, used stereotypical language to describe their health behaviors, and described being “at war” with their bodies. Further research, particularly about the role of stigma and stereotyping, is needed to fully understand the impact of obesity messaging on the health beliefs, behaviors, and wellbeing of obese and severely obese adults. PMID:20616984

Attitude ambivalence, social norms, and behavioral intentions: Developing effective antitobacco persuasive communications.

PubMed

Hohman, Zachary P; Crano, William D; Niedbala, Elizabeth M

2016-03-01

This study assessed the moderating effects of attitude ambivalence on the relationship between social norms, attitudes, and behavioral intentions to use tobacco. It was predicted that people would use social norms to reduce attitude ambivalence, and that reduced ambivalence would lead to changes in attitudes and behavioral intentions. To test this hypothesis, participants (N = 152) were exposed to persuasive communications designed to influence attitude ambivalence and perceived social norms regarding tobacco use. Analysis indicated that providing a social norm antagonistic to tobacco use significantly reduced ambivalence among participants reading the ambivalence message (p < .001). Examining changes in tobacco attitudes from pre- to postpersuasive communications demonstrated a significant decrease in tobacco attitudes only for participants reading the ambivalence message who were provided with the antitobacco use norm (p < .001). Ambivalent message participants also expressed significantly lower intentions to use tobacco when provided with social norms indicating antitobacco sentiments (p < .02), and this significant decrease in intentions was associated with changes in attitudes toward tobacco. These results point to the important role of social norms in mediating the effects of attitude ambivalence on subsequent behavior in preventative programs targeting tobacco use. (c) 2016 APA, all rights reserved).

Attitude Ambivalence, Social Norms, and Behavioral Intentions: Developing Effective Antitobacco Persuasive Communications

PubMed Central

Hohman, Zachary P.; Crano, William D.; Niedbala, Elizabeth M.

2018-01-01

This study assessed the moderating effects of attitude ambivalence on the relationship between social norms, attitudes, and behavioral intentions to use tobacco. It was predicted that people would use social norms to reduce attitude ambivalence, and that reduced ambivalence would lead to changes in attitudes and behavioral intentions. To test this hypothesis, participants (N =152) were exposed to persuasive communications designed to influence attitude ambivalence and perceived social norms regarding tobacco use. Analysis indicated that providing a social norm antagonistic to tobacco use significantly reduced ambivalence among participants reading the ambivalence message (p <.001). Examining changes in tobacco attitudes from pre- to postpersuasive communications demonstrated a significant decrease in tobacco attitudes only for participants reading the ambivalence message who were provided with the antitobacco use norm (p <.001). Ambivalent message participants also expressed significantly lower intentions to use tobacco when provided with social norms indicating antitobacco sentiments (p <.02), and this significant decrease in intentions was associated with changes in attitudes toward tobacco. These results point to the important role of social norms in mediating the effects of attitude ambivalence on subsequent behavior in preventative programs targeting tobacco use. PMID:26460476

A systematic review and meta-analysis of face-to-face communication of tailored health messages: implications for practice.

PubMed

Wanyonyi, Kristina L; Themessl-Huber, Markus; Humphris, Gerry; Freeman, Ruth

2011-12-01

To conduct a systematic review of the effect of face-to-face delivered tailored health messages on patient behavior and applications for practice. A systematic literature review and meta-analysis. Systematic searches of a number of electronic databases were conducted and criteria for selection of studies were specified. 6 experimental studies published between 2003 and 2009 were included. The studies were all randomized controlled trials to evaluate the effectiveness of a face-to-face tailored messaging intervention. There were variation in their research design and methods used to randomize. All participants were aged at least 18 years. All of the studies reported positive changes in participants' health behavior with varying degrees of effect size and duration. A meta-analysis of the available data also confirmed an overall positive effect of tailored messaging on participants' health behaviors. The systematic review and the meta-analysis demonstrate a significant and positive effective of face-to-face tailored messaging upon participants' health behaviors. Health practitioners should be encouraged to allot time in their work routines to discover their patients' psycho-social characteristics and felt needs in order that they can provide a tailored health message to enable the patient to adopt health-promoting regimes into their lifestyle. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Promoting healthy eating and physical activity short-term effects of a mass media campaign.

PubMed

Beaudoin, Christopher E; Fernandez, Carolyn; Wall, Jerry L; Farley, Thomas A

2007-03-01

Soaring obesity levels present a severe health risk in the United States, especially in low-income minority populations. High-frequency paid television and radio advertising, as well as bus and streetcar signage. A mass media campaign in New Orleans to promote walking and fruit and vegetable consumption in a low-income, predominantly African-American urban population. Messages tailored with consideration of the African-American majority. Random-digit-dial telephone surveys using cross-sectional representative samples at baseline in 2004 and following the onset of the campaign in 2005. Survey items on campaign message recall; attitudes toward walking, snack food avoidance, and fruit and vegetable consumption; and behaviors related to fruit and vegetable consumption, snack food consumption, and utilitarian and leisure walking. From baseline, there were significant increases in message recall measures, positive attitudes toward fruit and vegetable consumption, and positive attitudes toward walking. Behaviors did not change significantly. In 2005, message recall measures were associated with positive levels of each of the outcome variables. Over 5 months, the media campaign appeared to have stimulated improvements in attitudes toward healthy diet and walking behaviors addressed by the campaign. These findings encourage the continuation of the media campaign, with future evaluation to consider whether the behavioral measures change.

Coherent activity between brain regions that code for value is linked to the malleability of human behavior

PubMed Central

Cooper, Nicole; Bassett, Danielle S.; Falk, Emily B.

2017-01-01

Brain activity in medial prefrontal cortex (MPFC) during exposure to persuasive messages can predict health behavior change. This brain-behavior relationship has been linked to areas of MPFC previously associated with self-related processing; however, the mechanism underlying this relationship is unclear. We explore two components of self-related processing – self-reflection and subjective valuation – and examine coherent activity between relevant networks of brain regions during exposure to health messages encouraging exercise and discouraging sedentary behaviors. We find that objectively logged reductions in sedentary behavior in the following month are linked to functional connectivity within brain regions associated with positive valuation, but not within regions associated with self-reflection on personality traits. Furthermore, functional connectivity between valuation regions contributes additional information compared to average brain activation within single brain regions. These data support an account in which MPFC integrates the value of messages to the self during persuasive health messaging and speak to broader questions of how humans make decisions about how to behave. PMID:28240271

Predicting risk behaviors: development and validation of a diagnostic scale.

PubMed

Witte, K; Cameron, K A; McKeon, J K; Berkowitz, J M

1996-01-01

The goal of this study was to develop and validate the Risk Behavior Diagnosis (RBD) Scale for use by health care providers and practitioners interested in promoting healthy behaviors. Theoretically guided by the Extended Parallel Process Model (EPPM; a fear appeal theory), the RBD scale was designed to work in conjunction with an easy-to-use formula to determine which types of health risk messages would be most appropriate for a given individual or audience. Because some health risk messages promote behavior change and others backfire, this type of scale offers guidance to practitioners on how to develop the best persuasive message possible to motivate healthy behaviors. The results of the study demonstrate the RBD scale to have a high degree of content, construct, and predictive validity. Specific examples and practical suggestions are offered to facilitate use of the scale for health practitioners.

Disease Messaging in Churches: Implications for Health in African-American Communities

PubMed Central

Harmon, Brook E.; Chock, Marci; Brantley, Elizabeth; Wirth, Michael D.; Hébert, James R.

2016-01-01

Using the right messaging strategies, churches can help promote behavior change. Frequencies of disease-specific messages in 21 African-American churches were compared to overall and cancer-specific mortality and morbidity rates as well as church-level variables. Disease messages were found in 1025 of 2166 items. Frequently referenced topics included cancer (n=316), mental health conditions (n=253), heart disease (n=246), and infectious diseases (n=220). Messages for lung and colorectal cancers appeared at low frequency despite high mortality rates in African-American communities. Season, church size, and denomination showed significant associations with health messages. Next steps include testing messaging strategies aimed at improving the health of churchgoing communities. PMID:26296703

Mobile phone text messaging intervention to improve alertness and reduce sleepiness and fatigue during shiftwork among emergency medicine clinicians: study protocol for the SleepTrackTXT pilot randomized controlled trial.

PubMed

Patterson, Paul Daniel; Moore, Charity G; Weaver, Matthew D; Buysse, Daniel J; Suffoletto, Brian P; Callaway, Clifton W; Yealy, Donald M

2014-06-21

Mental and physical fatigue while at work is common among emergency medical services (EMS) shift workers. Extended shifts (for example 24 hours) and excessive amounts of overtime work increase the likelihood of negative safety outcomes and pose a challenge for EMS fatigue-risk management. Text message-based interventions are a potentially high-impact, low-cost platform for sleep and fatigue assessment and distributing information to workers at risk of negative safety outcomes related to sleep behaviors and fatigue. We will conduct a pilot randomized trial with a convenience sample of adult EMS workers recruited from across the United States using a single study website. Participants will be allocated to one of two possible arms for a 90-day study period. The intervention arm will involve text message assessments of sleepiness, fatigue, and difficulty with concentration at the beginning, during, and end of scheduled shifts. Intervention subjects reporting high levels of sleepiness or fatigue will receive one of four randomly selected intervention messages promoting behavior change during shiftwork. Control subjects will receive assessment only text messages. We aim to determine the performance characteristics of a text messaging tool for the delivery of a sleep and fatigue intervention. We seek to determine if a text messaging program with tailored intervention messages is effective at reducing perceived sleepiness and/or fatigue among emergency medicine clinician shift workers. Additional aims include testing whether a theory-based behavioral intervention, delivered by text message, changes 'alertness behaviors'. The SleepTrackTXT pilot trial could provide evidence of compliance and effectiveness that would support rapid widespread expansion in one of two forms: 1) a stand-alone program in the form of a tailored/individualized sleep monitoring and fatigue reduction support service for EMS workers; or 2) an add-on to a multi-component fatigue risk management program led and maintained by employers or by safety and risk management services. Clinicaltrials.gov NCT02063737, Registered on 10 January 2014.

College Students' Responses to Emotional Anti-Alcohol Abuse Media Messages: Should We Scare or Amuse Them?

PubMed

Lee, Moon J

2018-05-01

This study examined college students' responses to emotional anti-alcohol abuse media messages (i.e., fear vs. humor appeal) aimed at discouraging heavy/binge drinking. An experiment was conducted with 94 college students. As expected, college students generally expressed higher levels of interest in anti-alcohol abuse media messages when watching fear appeal than those watching humor appeal. However, college binge drinkers who watched the fear appeal reported lower levels of readiness to change their drinking behavior than those who watched the humor appeal. This pattern was the opposite among college nonbinge drinkers, in that college nonbinge drinkers were more likely to say they would change their drinking behaviors when exposed to fear appeal than those who were exposed to humor appeal or those who did not watch any media messages. Conventional fear appeal to scare college binge drinkers seems ineffective and even counterproductive while humor appeal, if well designed, could offer alternative ways to communicate with college binge drinkers.

Unpacking the Black Box: A Formative Research Approach to the Development of Theory-Driven, Evidence-Based, and Culturally Safe Text Messages in Mobile Health Interventions.

PubMed

Maar, Marion A; Yeates, Karen; Toth, Zsolt; Barron, Marcia; Boesch, Lisa; Hua-Stewart, Diane; Liu, Peter; Perkins, Nancy; Sleeth, Jessica; Wabano, Mary Jo; Williamson, Pamela; Tobe, Sheldon W

2016-01-22

Mobile-cellular subscriptions have increased steadily over the past decade. The accessibility of SMS messages over existing mobile networks is high and has almost universal availability even on older and unsophisticated mobile phones and in geographic settings where wireless coverage is weak. There is intensive exploration of this inexpensive mobile telecommunication technology to improve health services and promote behavior change among vulnerable populations. However, a neglected area of research is the documentation and critical analysis of the formative research process required in the development and refinement of effective SMS messages. The objective of this qualitative research study was to identify major factors that may impact on the effectiveness of evidence-based SMS messages designed to reduce health inequities in hypertension management in low resource settings, including Aboriginal populations in high-income countries and rural populations in low-income countries. Specifically, we were interested in uncovering the range of mediators that impact on appropriate message content transmission and, ultimately, on health behavior improvements in a range of these sociocultural settings. Collaborative qualitative research with Canadian Aboriginal and Tanzanian participants was conducted to deconstruct the content and transmission of evidence-based health information contained in SMS messages in the context of an international research project designed to address health inequalities in hypertension, and to develop a grounded theory of the major factors that mediate the effectiveness of this communication. We also examined the interrelationship of these mediators with the three essential conditions of the behavior system of the Behavioral Change Wheel model (capability, opportunity, and motivation) and cultural safety. Four focus groups with a total of 45 participants were conducted. Our grounded theory research revealed how discrepancies develop between the evidence-based text message created by researchers and the message received by the recipient in mobile health interventions. These discrepancies were primarily generated by six mediators of meaning in SMS messages: (1) negative or non-affirming framing of advocacies, (2) fear- or stress-inducing content, (3) oppressive or authoritarian content, (4) incongruity with cultural and traditional practices, (5) disconnect with the reality of the social determinants of health and the diversity of cultures within a population, and (6) lack of clarity and/or practicality of content. These 6 mediators of meaning provide the basis for sound strategies for message development because they impact directly on the target populations' capability, opportunity, and motivation for behavior change. The quality of text messages impacts significantly on the effectiveness of a mobile health intervention. Our research underscores the urgent need for interventions to incorporate and evaluate the quality of SMS messages and to examine the mediators of meaning within each targeted cultural and demographic group. Reporting on this aspect of mobile health intervention research will allow researchers to move away from the current black box of SMS text message development, thus improving the transparency of the process as well as the quality of the outcomes.

Unpacking the Black Box: A Formative Research Approach to the Development of Theory-Driven, Evidence-Based, and Culturally Safe Text Messages in Mobile Health Interventions

PubMed Central

Yeates, Karen; Toth, Zsolt; Barron, Marcia; Boesch, Lisa; Hua-Stewart, Diane; Liu, Peter; Perkins, Nancy; Sleeth, Jessica; Wabano, Mary Jo; Williamson, Pamela; Tobe, Sheldon W

2016-01-01

Background Mobile-cellular subscriptions have increased steadily over the past decade. The accessibility of SMS messages over existing mobile networks is high and has almost universal availability even on older and unsophisticated mobile phones and in geographic settings where wireless coverage is weak. There is intensive exploration of this inexpensive mobile telecommunication technology to improve health services and promote behavior change among vulnerable populations. However, a neglected area of research is the documentation and critical analysis of the formative research process required in the development and refinement of effective SMS messages. Objective The objective of this qualitative research study was to identify major factors that may impact on the effectiveness of evidence-based SMS messages designed to reduce health inequities in hypertension management in low resource settings, including Aboriginal populations in high-income countries and rural populations in low-income countries. Specifically, we were interested in uncovering the range of mediators that impact on appropriate message content transmission and, ultimately, on health behavior improvements in a range of these sociocultural settings. Methods Collaborative qualitative research with Canadian Aboriginal and Tanzanian participants was conducted to deconstruct the content and transmission of evidence-based health information contained in SMS messages in the context of an international research project designed to address health inequalities in hypertension, and to develop a grounded theory of the major factors that mediate the effectiveness of this communication. We also examined the interrelationship of these mediators with the three essential conditions of the behavior system of the Behavioral Change Wheel model (capability, opportunity, and motivation) and cultural safety. Results Four focus groups with a total of 45 participants were conducted. Our grounded theory research revealed how discrepancies develop between the evidence-based text message created by researchers and the message received by the recipient in mobile health interventions. These discrepancies were primarily generated by six mediators of meaning in SMS messages: (1) negative or non-affirming framing of advocacies, (2) fear- or stress-inducing content, (3) oppressive or authoritarian content, (4) incongruity with cultural and traditional practices, (5) disconnect with the reality of the social determinants of health and the diversity of cultures within a population, and (6) lack of clarity and/or practicality of content. These 6 mediators of meaning provide the basis for sound strategies for message development because they impact directly on the target populations’ capability, opportunity, and motivation for behavior change. Conclusions The quality of text messages impacts significantly on the effectiveness of a mobile health intervention. Our research underscores the urgent need for interventions to incorporate and evaluate the quality of SMS messages and to examine the mediators of meaning within each targeted cultural and demographic group. Reporting on this aspect of mobile health intervention research will allow researchers to move away from the current black box of SMS text message development, thus improving the transparency of the process as well as the quality of the outcomes. PMID:26800712

The theory of active involvement: processes underlying interventions that engage adolescents in message planning and/or production.

PubMed

Greene, Kathryn

2013-01-01

Adolescence is a time of increased risk taking, and recent intervention strategies have included adolescents planning or producing antirisk messages for their peers. Although these projects may generate enthusiasm, we know little about message planning or production as a strategy for changing adolescent decision-making and behavior. This article articulates the Theory of Active Involvement (TAI) to describe and explain the processes through which these active involvement interventions influence adolescents. TAI is based on social cognitive theory's notion of self-regulation and examines multiple perspective taking and activating the self-reflection processes. The theory specifically describes the process of cognitive changes experienced by participants in active involvement interventions. The sequence is conceptualized as starting when engagement with the intervention (arousal and involvement) produces skill and knowledge gains (immediate outcomes) that lead to reflection (perceived discrepancy) and then other cognitions (expectancies, norms, intentions), with the ultimate outcome being behavior change. Engaging the target audience in a process of self-reflection is conceptualized as the crucial ingredient for meaningful and sustainable change in cognitions and behavior. This article provides valuable insight into how active involvement strategies function and how to best design these interventions, particularly those targeting adolescents.

Messages influencing college women's tanning bed use: statistical versus narrative evidence format and a self-assessment to increase perceived susceptibility.

PubMed

Greene, Kathryn; Brinn, Laura S

2003-01-01

Understanding the effect of messages and other influences on health decision-making has the potential to decrease risky behavior such as tanning bed use. This study explores the effect of type of evidence, self-assessments of risk for skin cancer, and personality factors on intention to use and use of tanning beds among Caucasian female college students. Specifically, it targeted the perceived susceptibility component of the Health Belief Model and its impact on intention to tan as well as changes in actual tanning behavior. College students (N=141) in the southeast United States read randomly assigned messages and self-assessments, filled out surveys, and were later contacted for a follow-up telephone survey. The statistical message was rated higher on information value and also resulted in decreased intention to tan, decreased tanning behavior, and increased perceived susceptibility to skin cancer. The narrative message, in contrast, increased perceptions of realism and also worked to decrease intentions to tan. Additionally, the self-assessment manipulation resulted in increased susceptibility and decreased intention to tan and post tanning behavior. Personality factors explained small portions of variance. Key limitations and directions for future research are also addressed.

How Does Health-Related Advertising with a Regulatory Focus and Goal Framing Affect Attitudes toward Ads and Healthy Behavior Intentions?

PubMed Central

Lin, Chia-Yen; Yeh, Wei-Ju

2017-01-01

The health costs of colorectal cancer have increased over the years in Taiwan. The National Health Insurance Administration (NHI) and the Health Promotion Administration of the Ministry of Health and Welfare (MOHW) in Taiwan advocate that people have to change their unhealthy behaviors; however, the number of patients of colorectal cancer is increasing annually. This research discussed the effects of healthy diet advocacy advertisements (ads) on healthy diet behavior intentions as influenced by the interactions between regulatory focus theory (RFT) and message framing effects. Both regulatory focus theory and message framing effect were discussed for the relationship between advertisement and behavior change in many fields, such as health-related behavior, pro-environmental behavior, consumer choice, etc. We executed an experiment with four different types of public health advocacy ads. A 2 (regulatory focus: promotion vs. prevention) × 2 (message framing: gain framing vs. loss framing) two-factor experiment was adopted, and 201 valid participants responded to the questionnaire. Results indicated that if the ad’s regulatory focus is promotion focus, viewers’ attitudes toward the ad and their behavior intentions are more positive when the slogan of the ad is gain framing rather than loss framing via the multiple analysis of variance (MANOVA), and vice versa. Respondents found the communication easier to comprehend when the ads evoked the respondents’ regulatory focus and applied the appropriate message framing, thus improving the efficacy of health-related advertising. We offer suggestions regarding the future use of health-related advertising for the MOHW. PMID:29207544

How Does Health-Related Advertising with a Regulatory Focus and Goal Framing Affect Attitudes toward Ads and Healthy Behavior Intentions?

PubMed

Lin, Chia-Yen; Yeh, Wei-Ju

2017-12-04

The health costs of colorectal cancer have increased over the years in Taiwan. The National Health Insurance Administration (NHI) and the Health Promotion Administration of the Ministry of Health and Welfare (MOHW) in Taiwan advocate that people have to change their unhealthy behaviors; however, the number of patients of colorectal cancer is increasing annually. This research discussed the effects of healthy diet advocacy advertisements (ads) on healthy diet behavior intentions as influenced by the interactions between regulatory focus theory (RFT) and message framing effects. Both regulatory focus theory and message framing effect were discussed for the relationship between advertisement and behavior change in many fields, such as health-related behavior, pro-environmental behavior, consumer choice, etc. We executed an experiment with four different types of public health advocacy ads. A 2 (regulatory focus: promotion vs. prevention) × 2 (message framing: gain framing vs. loss framing) two-factor experiment was adopted, and 201 valid participants responded to the questionnaire. Results indicated that if the ad's regulatory focus is promotion focus, viewers' attitudes toward the ad and their behavior intentions are more positive when the slogan of the ad is gain framing rather than loss framing via the multiple analysis of variance (MANOVA), and vice versa. Respondents found the communication easier to comprehend when the ads evoked the respondents' regulatory focus and applied the appropriate message framing, thus improving the efficacy of health-related advertising. We offer suggestions regarding the future use of health-related advertising for the MOHW.

Prevention messages and AIDS risk behavior in Kampala, Uganda.

PubMed

Hearst, Norman; Kajubi, Phoebe; Hudes, Esther Sid; Maganda, Albert K; Green, Edward C

2012-01-01

Uganda was one of the first countries to substantially reduce HIV rates through behavior change, but these gains have not continued in recent years. Little is known about what messages Ugandans are currently hearing about AIDS prevention, what they themselves believe to be important prevention strategies, and how these beliefs are associated with behavior. We interviewed men and women aged between 20 and 39 in two poor peri-urban areas of Kampala, using a random sample, cross-sectional household survey design. Respondents provided detailed reports of sexual behavior over the past six months, the main prevention message they are currently hearing about AIDS, and their own ranking of the importance of prevention strategies. Condom use was the main AIDS prevention message that respondents reported hearing, followed by getting tested. These were also what respondents themselves considered most important, followed closely by faithfulness. Abstinence was the lowest ranked strategy, but a higher ranking for this prevention strategy was the only one consistently associated with less risky behavior. A higher ranking for condoms was associated with higher levels of risk behavior, while the ranking of testing made no difference in any behavior. These results present challenges for AIDS prevention strategies that rely primarily on promoting condoms and testing. HIV prevention programs need to assess their impact on behavior.

CDC MessageWorks: Designing and Validating a Social Marketing Tool to Craft and Defend Effective Messages.

PubMed

Cole, Galen E; Keller, Punam A; Reynolds, Jennifer; Schaur, Michelle; Krause, Diane

2016-03-01

The Centers for Disease Control and Prevention's Division of Cancer Prevention and Control, in partnership with Oak Ridge Associated Universities, designed an online social marketing strategy tool, MessageWorks, to help health communicators effectively formulate messages aimed at changing health behaviors and evaluate message tactics and audience characteristics. MessageWorks is based on the advisor for risk communication model that identifies 10 variables that can be used to predict target audience intentions to comply with health recommendations. This article discusses the value of the MessageWorks tool to health communicators and to the field of social marketing by (1) describing the scientific evidence supporting use of MessageWorks to improve health communication practice and (2) summarizing how to use MessageWorks and interpret the results it produces.

Correlates of Healthy Lifestyle Beliefs and Behaviors in Parents of Overweight or Obese Preschool Children Before and After a Cognitive Behavioral Therapy Intervention With Text Messaging.

PubMed

Militello, Lisa K; Melnyk, Bernadette Mazurek; Hekler, Eric; Small, Leigh; Jacobson, Diana

2016-01-01

Significant gaps exist in the published literature regarding the treatment of overweight/obesity in preschool-aged children, especially in primary care settings. Parental influence plays an important factor in the development of healthy behaviors in children, yet there is no consensus about why some behavior change intervention strategies for parents of young children are more influential and effective than others. The purpose of this secondary data analysis was to assess correlations among the study variables (healthy lifestyle beliefs, perceived difficulty, and healthy lifestyle behaviors) in parents of overweight/obese preschool children. A second aim explored if the parent's level of cognitive beliefs and perceived difficulty of engaging in healthy lifestyle behaviors correlated with text messaging cognitive behavioral support. Fifteen preschool-parent dyads from primary care clinics completed a 7-week cognitive behavioral skills building intervention. Beck's Cognitive Theory guided the intervention content, and Fogg's Behavior Model guided the implementation. The intervention was delivered using a combination of face-to-face clinic visits and ecological momentary interventions using text messaging. Supported are the interconnected relationships among the study variables, that is, parental healthy lifestyle beliefs, thoughts, and behaviors. At baseline, parental healthy lifestyle belief scores significantly correlated with perceived difficulty (rs = 0.598, p < .05) and healthy lifestyle behaviors (rs = 0.545, p < .05). These associations strengthened after the intervention. Furthermore, as parental healthy lifestyle beliefs increased and perceived difficulty lessened, their response rate and subsequent feedback lessened to the static text messaging support. Findings from this study support the interconnections between parents' thoughts, feelings, and actions toward healthy lifestyles. As parental beliefs became stronger through cognitive behavioral skills building and tailored text messaging, the need for general support via text messaging lessened, warranting additional research. Published by Elsevier Inc.

Changing health behaviors with social marketing.

PubMed

Suarez-Almazor, M E

2011-08-01

Social marketing uses marketing techniques to promote healthy attitudes and behaviors. As in traditional marketing, the development and implementation of social marketing programs is based on the four P's: product, price, place, and promotion, but it also incorporates the partnership and participation of stakeholders to enhance public health and engage policy makers. The "product" in social marketing is generally a behavior, such as a change in lifestyle (e.g., diet) or an increase in a desired health practice (e.g., screening). In order for people to desire this product, it must offer a solution to a problem that is weighed with respect to the price to pay. The price is not just monetary, and it often involves giving something up, such as time (e.g., exercising) or a wanted, satisfying behavior (e.g., smoking). In its development phase, social marketing incorporates qualitative methods to create messages that are powerful and potentially effective. The implementation of the programs commonly involves mass campaigns with advertisement in various media. There have been a few social media campaigns targeting bone health that have been disseminated with substantial outreach. However, these have not been systematically evaluated, specifically with respect to change in behavior and health outcomes. Future campaigns should identify target behaviors that are amenable to change such as bone mass measurement screening or exercise. Audience segmentation will be crucial, since a message for young women to increase peak bone mass would be very different from a message for older individuals who have just experienced a fracture. Campaigns should involve key stakeholders, including policy makers, health providers, and the public. Finally, success must be carefully evaluated, not just by the outreach of the campaign, but also by a change in relevant behaviors and a decrease in deleterious health outcomes.

Analyzing the Structure and Content of Public Health Messages

PubMed Central

Morrison, Frances P.; Kukafka, Rita; Johnson, Stephen B.

2005-01-01

Background Health messages are crucial to the field of public health in effecting behavior change, but little research is available to assist writers in composing the overall structure of a message. In order to develop software to assist individuals in constructing effective messages, the structure of existing health messages must be understood, and an appropriate method for analyzing health message structure developed. Methods 72 messages from expert sources were used for development of the method, which was then tested for reproducibility using ten randomly selected health messages. Four raters analyzed the messages and inter-coder agreement was calculated. Results A method for analyzing the structure of the messages was developed using sublanguage analysis and discourse analysis. Overall kappa between four coders was 0.69. Conclusion A novel framework for characterizing health message structure and a method for analyzing messages appears to be reproducible and potentially useful for creating an authoring tool. PMID:16779098

Regulatory focus and adherence to self-care behaviors among adults with type 2 diabetes.

PubMed

Avraham, Rinat; Van Dijk, Dina; Simon-Tuval, Tzahit

2016-09-01

The aims of this study were, first, to test the association between regulatory focus of adults with type 2 diabetes and their adherence to two types of self-care behaviors - lifestyle change (e.g. physical activity and diet) and medical care regimens (blood-glucose monitoring, foot care and medication usage). Second, to explore whether a fit between the message framing and patients' regulatory focus would improve their intentions to adhere specifically when the type of behavior fits the patients' regulatory focus as well. A cross-sectional study was conducted among 130 adults with type 2 diabetes who were hospitalized in an academic medical center. The patients completed a set of questionnaires that included their diabetes self-care activities, regulatory focus, self-esteem and demographic, socioeconomic and clinical data. In addition, participants were exposed to either a gain-framed or a loss-framed message, and were then asked to indicate their intention to improve adherence to self-care behaviors. A multivariable linear regression model revealed that promoters reported higher adherence to lifestyle change behaviors than preventers did (B = .60, p = .028). However, no effect of regulatory focus on adherence to medical care regimens was found (B = .46, p = .114). In addition, preventers reported higher intentions to adhere to medical care behaviors when the message framing was congruent with prevention focus (B = 1.16, p = .023). However, promoters did not report higher intentions to adhere to lifestyle behaviors when the message framing was congruent with promotion focus (B = -.16, p = .765). These findings justify the need to develop tailor-made interventions that are adjusted to both patients' regulatory focus and type of health behavior.

Climate change helplessness and the (de)moralization of individual energy behavior.

PubMed

Salomon, Erika; Preston, Jesse L; Tannenbaum, Melanie B

2017-03-01

Although most people understand the threat of climate change, they do little to modify their own energy conservation behavior. One reason for this gap between belief and behavior may be that individual actions seem unimpactful and therefore are not morally relevant. This research investigates how climate change helplessness-belief that one's actions cannot affect climate change-can undermine the moralization of climate change and personal energy conservation. In Study 1, climate change efficacy predicted both moralization of energy use and energy conservation intentions beyond individual belief in climate change. In Studies 2 and 3, participants read information about climate change that varied in efficacy message, that is, whether individual actions (e.g., using less water, turning down heat) make a difference in the environment. Participants who read that their behavior made no meaningful impact reported weaker moralization and intentions (Study 2), and reported more energy consumption 1 week later (Study 3). Moreover, effects on intentions and actions were mediated by changes in moralization. We discuss ways to improve climate change messages to foster environmental efficacy and moralization of personal energy use. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Designing prenatal care messages for low-income Mexican women.

PubMed Central

Alcalay, R; Ghee, A; Scrimshaw, S

1993-01-01

Communication theories and research data were used to design cross-cultural health education messages. A University of California Los Angeles-Universidad Autonoma in Tijuana, Mexico, research team used the methods of ethnographic and survey research to study behaviors, attitudes, and knowledge concerning prenatal care of a sample of pregnant low-income women living in Tijuana. This audience provided information that served as a framework for a series of messages to increase awareness and change prenatal care behaviors. The message design process was guided by persuasion theories that included Petty and Caccioppo's elaboration likelihood model, McGuire's persuasion matrix, and Bandura's social learning theory. The results from the research showed that poor women in Tijuana tend to delay or not seek prenatal care. They were not aware of symptoms that could warn of pregnancy complications. Their responses also revealed pregnant women's culturally specific beliefs and behaviors regarding pregnancy. After examination of these and other results from the study, prenatal care messages about four topics were identified as the most relevant to communicate to this audience: health services use, the mother's weight gain, nutrition and anemia, and symptoms of high-risk complications during pregnancy. A poster, a calendar, a brochure, and two radio songs were produced and pretested in focus groups with low-income women in Tijuana. Each medium included one or more messages addressing informational, attitudinal, or behavioral needs, or all three, of the target population. PMID:8497574

CDC MessageWorks: Designing and Validating a Social Marketing Tool to Craft and Defend Effective Messages

PubMed Central

Cole, Galen E.; Keller, Punam A.; Reynolds, Jennifer; Schaur, Michelle; Krause, Diane

2016-01-01

The Centers for Disease Control and Prevention’s Division of Cancer Prevention and Control, in partnership with Oak Ridge Associated Universities, designed an online social marketing strategy tool, MessageWorks, to help health communicators effectively formulate messages aimed at changing health behaviors and evaluate message tactics and audience characteristics. MessageWorks is based on the advisor for risk communication model that identifies 10 variables that can be used to predict target audience intentions to comply with health recommendations. This article discusses the value of the MessageWorks tool to health communicators and to the field of social marketing by (1) describing the scientific evidence supporting use of MessageWorks to improve health communication practice and (2) summarizing how to use MessageWorks and interpret the results it produces. PMID:26877714

Specification and misspecification of theoretical foundations and logic models for health communication campaigns.

PubMed

Slater, Michael D

2006-01-01

While increasingly widespread use of behavior change theory is an advance for communication campaigns and their evaluation, such theories provide a necessary but not sufficient condition for theory-based communication interventions. Such interventions and their evaluations need to incorporate theoretical thinking about plausible mechanisms of message effect on health-related attitudes and behavior. Otherwise, strategic errors in message design and dissemination, and misspecified campaign logic models, insensitive to campaign effects, are likely to result. Implications of the elaboration likelihood model, attitude accessibility, attitude to the ad theory, exemplification, and framing are explored, and implications for campaign strategy and evaluation designs are briefly discussed. Initial propositions are advanced regarding a theory of campaign affect generalization derived from attitude to ad theory, and regarding a theory of reframing targeted health behaviors in those difficult contexts in which intended audiences are resistant to the advocated behavior or message.

Scripted messages delivered by nurses and radio changed beliefs, attitudes, intentions, and behaviors regarding infant and young child feeding in Mexico.

PubMed

Monterrosa, Eva C; Frongillo, Edward A; González de Cossío, Teresa; Bonvecchio, Anabelle; Villanueva, Maria Angeles; Thrasher, James F; Rivera, Juan A

2013-06-01

Scalable interventions are needed to improve infant and young child feeding (IYCF). We evaluated whether an IYCF nutrition communication strategy using radio and nurses changed beliefs, attitudes, social norms, intentions, and behaviors related to breastfeeding (BF), dietary diversity, and food consistency. Women with children 6-24 mo were randomly selected from 6 semi-urban, low-income communities in the Mexican state of Morelos (intervention, n = 266) and from 3 comparable communities in Puebla (control, n = 201). Nurses delivered only once 5 scripted messages: BF, food consistency, flesh-food and vegetable consumption, and feed again if food was rejected; these same messages aired 7 times each day on 3 radio stations for 21 d. The control communities were not exposed to scripted messages via nurse and radio. We used a pre-/post-test design to evaluate changes in beliefs, attitudes, norms, and intentions as well as change in behavior with 7-d food frequency questions. Mixed models were used to examine intervention-control differences in pre-/post changes. Coverage was 87% for the nurse component and 34% for radio. Beliefs, attitudes, and intention, but not social norms, about IYCF significantly improved in the intervention communities compared with control. Significant pre-/post changes in the intervention communities compared with control were reported for BF frequency (3.7 ± 0.6 times/d), and consumption of vegetables (0.6 ± 0.2 d) and beef (0.2 ± 0.1 d) and thicker consistency of chicken (0.6 ± 0.2 d) and vegetable broths (0.8 ± 0.4 d). This study provides evidence that a targeted communication strategy using a scalable model significantly improves IYCF.

Can Text Messages Increase Empathy and Prosocial Behavior? The Development and Initial Validation of Text to Connect.

PubMed

Konrath, Sara; Falk, Emily; Fuhrel-Forbis, Andrea; Liu, Mary; Swain, James; Tolman, Richard; Cunningham, Rebecca; Walton, Maureen

2015-01-01

To what extent can simple mental exercises cause shifts in empathic habits? Can we use mobile technology to make people more empathic? It may depend on how empathy is measured. Scholars have identified a number of different facets and correlates of empathy. This study is among the first to take a comprehensive, multidimensional approach to empathy to determine how empathy training could affect these different facets and correlates. In doing so, we can learn more about empathy and its multifaceted nature. Participants (N = 90) were randomly assigned to receive either an empathy-building text message program (Text to Connect) or one of two control conditions (active versus passive). Respondents completed measures of dispositional empathy (i.e. self-perceptions of being an empathic person), affective empathy (i.e. motivations to help, immediate feelings of empathic concern), and prosocial behavior (i.e. self-reports and observer-reports) at baseline, and then again after the 14 day intervention period. We found that empathy-building messages increased affective indicators of empathy and prosocial behaviors, but actually decreased self-perceptions of empathy, relative to control messages. Although the brief text messaging intervention did not consistently impact empathy-related personality traits, it holds promise for the use of mobile technology for changing empathic motivations and behaviors.

Can Text Messages Increase Empathy and Prosocial Behavior? The Development and Initial Validation of Text to Connect

PubMed Central

Konrath, Sara; Falk, Emily; Fuhrel-Forbis, Andrea; Liu, Mary; Swain, James; Tolman, Richard; Cunningham, Rebecca; Walton, Maureen

2015-01-01

To what extent can simple mental exercises cause shifts in empathic habits? Can we use mobile technology to make people more empathic? It may depend on how empathy is measured. Scholars have identified a number of different facets and correlates of empathy. This study is among the first to take a comprehensive, multidimensional approach to empathy to determine how empathy training could affect these different facets and correlates. In doing so, we can learn more about empathy and its multifaceted nature. Participants (N = 90) were randomly assigned to receive either an empathy-building text message program (Text to Connect) or one of two control conditions (active versus passive). Respondents completed measures of dispositional empathy (i.e. self-perceptions of being an empathic person), affective empathy (i.e. motivations to help, immediate feelings of empathic concern), and prosocial behavior (i.e. self-reports and observer-reports) at baseline, and then again after the 14 day intervention period. We found that empathy-building messages increased affective indicators of empathy and prosocial behaviors, but actually decreased self-perceptions of empathy, relative to control messages. Although the brief text messaging intervention did not consistently impact empathy-related personality traits, it holds promise for the use of mobile technology for changing empathic motivations and behaviors. PMID:26356504

Playing for Real, Video Games and Stories for Health-Related Behavior Change

USDA-ARS?s Scientific Manuscript database

Video games provide extensive player involvement for large numbers of children and adults, and thereby provide a channel for delivering health behavior change experiences and messages in an engaging and entertaining format. Twenty-seven articles were identified on 25 video games that promoted health...

The Theory of Active Involvement: Processes Underlying Interventions that Engage Adolescents in Message Planning and/or Production

PubMed Central

Greene, Kathryn

2013-01-01

Adolescence is a time of increased risk-taking and recent intervention strategies have included adolescents planning or producing anti-risk messages for their peers. Although these projects may generate enthusiasm, we know little about message planning or production as a strategy for changing adolescent decision-making and behavior. The paper articulates the Theory of Active Involvement (TAI) to describe and explain the processes through which these active involvement interventions influence adolescents. TAI is based on social cognitive theory’s notion of self-regulation and examines multiple perspective-taking and activating the self-reflection processes. The theory specifically describes the process of cognitive changes experienced by participants in active involvement interventions. The sequence is conceptualized as starting when engagement with the intervention (arousal and involvement) produces skill and knowledge gains (immediate outcomes) that lead to reflection (perceived discrepancy) and then other cognitions (expectancies, norms, intentions), with the ultimate outcome being behavior change. Engaging the target audience in a process of self-reflection is conceptualized as the crucial ingredient for meaningful and sustainable change in cognitions and behavior. This paper provides valuable insight into how active involvement strategies function and how to best design these interventions, particularly those targeting adolescents. PMID:23980581

Small is big: Interactive Trumps passive information in breaking information barriers and impacting behavioral antecedents

DOE PAGES

Beck, Ariane L.; Lakkaraju, Kiran; Rai, Varun; ...

2017-01-18

The wealth of information available on seemingly every topic creates a considerable challenge both for information providers trying to rise above the noise and discerning individuals trying to find relevant, trustworthy information. We approach this information problem by investigating how passive versus interactive information interventions can impact the antecedents of behavior change using the context of solar energy adoption, where persistent information gaps are known to reduce market potential. We use two experiments to investigate the impact of both passive and interactive approaches to information delivery on the antecedents (attitudes, subjective norms, and perceived behavioral control in the Theory ofmore » Planned Behavior) of intentions and behavior, as well as their effect on intentions and behavior directly. The passive information randomized control trial delivered via Amazon Mechanical Turk tests the effectiveness of delivering the same content in a single message versus multiple shorter messages. The interactive information delivery uses an online (mobile and PC) trivia-style gamification platform. Both experiments use the same content and are carried out over a two-week time period. Lastly, our findings suggest that interactive, gamified information has greater impact than passive information, and that shorter multiple messages of passive information are more effective than a single passive message.« less

Small is big: Interactive Trumps passive information in breaking information barriers and impacting behavioral antecedents

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beck, Ariane L.; Lakkaraju, Kiran; Rai, Varun

The wealth of information available on seemingly every topic creates a considerable challenge both for information providers trying to rise above the noise and discerning individuals trying to find relevant, trustworthy information. We approach this information problem by investigating how passive versus interactive information interventions can impact the antecedents of behavior change using the context of solar energy adoption, where persistent information gaps are known to reduce market potential. We use two experiments to investigate the impact of both passive and interactive approaches to information delivery on the antecedents (attitudes, subjective norms, and perceived behavioral control in the Theory ofmore » Planned Behavior) of intentions and behavior, as well as their effect on intentions and behavior directly. The passive information randomized control trial delivered via Amazon Mechanical Turk tests the effectiveness of delivering the same content in a single message versus multiple shorter messages. The interactive information delivery uses an online (mobile and PC) trivia-style gamification platform. Both experiments use the same content and are carried out over a two-week time period. Lastly, our findings suggest that interactive, gamified information has greater impact than passive information, and that shorter multiple messages of passive information are more effective than a single passive message.« less

Small Is Big: Interactive Trumps Passive Information in Breaking Information Barriers and Impacting Behavioral Antecedents.

PubMed

Beck, Ariane L; Lakkaraju, Kiran; Rai, Varun

2017-01-01

The wealth of information available on seemingly every topic creates a considerable challenge both for information providers trying to rise above the noise and discerning individuals trying to find relevant, trustworthy information. We approach this information problem by investigating how passive versus interactive information interventions can impact the antecedents of behavior change using the context of solar energy adoption, where persistent information gaps are known to reduce market potential. We use two experiments to investigate the impact of both passive and interactive approaches to information delivery on the antecedents (attitudes, subjective norms, and perceived behavioral control in the Theory of Planned Behavior) of intentions and behavior, as well as their effect on intentions and behavior directly. The passive information randomized control trial delivered via Amazon Mechanical Turk tests the effectiveness of delivering the same content in a single message versus multiple shorter messages. The interactive information delivery uses an online (mobile and PC) trivia-style gamification platform. Both experiments use the same content and are carried out over a two-week time period. Our findings suggest that interactive, gamified information has greater impact than passive information, and that shorter multiple messages of passive information are more effective than a single passive message.

Small Is Big: Interactive Trumps Passive Information in Breaking Information Barriers and Impacting Behavioral Antecedents

PubMed Central

2017-01-01

The wealth of information available on seemingly every topic creates a considerable challenge both for information providers trying to rise above the noise and discerning individuals trying to find relevant, trustworthy information. We approach this information problem by investigating how passive versus interactive information interventions can impact the antecedents of behavior change using the context of solar energy adoption, where persistent information gaps are known to reduce market potential. We use two experiments to investigate the impact of both passive and interactive approaches to information delivery on the antecedents (attitudes, subjective norms, and perceived behavioral control in the Theory of Planned Behavior) of intentions and behavior, as well as their effect on intentions and behavior directly. The passive information randomized control trial delivered via Amazon Mechanical Turk tests the effectiveness of delivering the same content in a single message versus multiple shorter messages. The interactive information delivery uses an online (mobile and PC) trivia-style gamification platform. Both experiments use the same content and are carried out over a two-week time period. Our findings suggest that interactive, gamified information has greater impact than passive information, and that shorter multiple messages of passive information are more effective than a single passive message. PMID:28099478

Self-affirmation alters the brain’s response to health messages and subsequent behavior change

PubMed Central

Falk, Emily B.; O’Donnell, Matthew Brook; Cascio, Christopher N.; Tinney, Francis; Kang, Yoona; Lieberman, Matthew D.; Taylor, Shelley E.; An, Lawrence; Resnicow, Kenneth; Strecher, Victor J.

2015-01-01

Health communications can be an effective way to increase positive health behaviors and decrease negative health behaviors; however, those at highest risk are often most defensive and least open to such messages. For example, increasing physical activity among sedentary individuals affects a wide range of important mental and physical health outcomes, but has proven a challenging task. Affirming core values (i.e., self-affirmation) before message exposure is a psychological technique that can increase the effectiveness of a wide range of interventions in health and other domains; however, the neural mechanisms of affirmation’s effects have not been studied. We used functional magnetic resonance imaging (fMRI) to examine neural processes associated with affirmation effects during exposure to potentially threatening health messages. We focused on an a priori defined region of interest (ROI) in ventromedial prefrontal cortex (VMPFC), a brain region selected for its association with self-related processing and positive valuation. Consistent with our hypotheses, those in the self-affirmation condition produced more activity in VMPFC during exposure to health messages and went on to increase their objectively measured activity levels more. These findings suggest that affirmation of core values may exert its effects by allowing at-risk individuals to see the self-relevance and value in otherwise-threatening messages. PMID:25646442

Influence in Action in "Catch Me if You Can"

ERIC Educational Resources Information Center

Meyer, Gary; Roberto, Anthony J.

2005-01-01

For decades, scholars have worked to understand the precise manner in which messages affect attitudes and ultimately behaviors. The dominant paradigm suggests that there are two methods or routes to attitude change, one based on careful consideration of the messages and the other based on simple decision rules, often referred to as heuristics…

Getting the message across: age differences in the positive and negative framing of health care messages.

PubMed

Shamaskin, Andrea M; Mikels, Joseph A; Reed, Andrew E

2010-09-01

Although valenced health care messages influence impressions, memory, and behavior (Levin, Schneider, & Gaeth, 1998) and the processing of valenced information changes with age (Carstensen & Mikels, 2005), these 2 lines of research have thus far been disconnected. This study examined impressions of, and memory for, positively and negatively framed health care messages that were presented in pamphlets to 25 older adults and 24 younger adults. Older adults relative to younger adults rated positive pamphlets more informative than negative pamphlets and remembered a higher proportion of positive to negative messages. However, older adults misremembered negative messages to be positive. These findings demonstrate the age-related positivity effect in health care messages with promise as to the persuasive nature and lingering effects of positive messages. (c) 2010 APA, all rights reserved.

Perceived visual informativeness (PVI): construct and scale development to assess visual information in printed materials.

PubMed

King, Andy J; Jensen, Jakob D; Davis, LaShara A; Carcioppolo, Nick

2014-01-01

There is a paucity of research on the visual images used in health communication messages and campaign materials. Even though many studies suggest further investigation of these visual messages and their features, few studies provide specific constructs or assessment tools for evaluating the characteristics of visual messages in health communication contexts. The authors conducted 2 studies to validate a measure of perceived visual informativeness (PVI), a message construct assessing visual messages presenting statistical or indexical information. In Study 1, a 7-item scale was created that demonstrated good internal reliability (α = .91), as well as convergent and divergent validity with related message constructs such as perceived message quality, perceived informativeness, and perceived attractiveness. PVI also converged with a preference for visual learning but was unrelated to a person's actual vision ability. In addition, PVI exhibited concurrent validity with a number of important constructs including perceived message effectiveness, decisional satisfaction, and three key public health theory behavior predictors: perceived benefits, perceived barriers, and self-efficacy. Study 2 provided more evidence that PVI is an internally reliable measure and demonstrates that PVI is a modifiable message feature that can be tested in future experimental work. PVI provides an initial step to assist in the evaluation and testing of visual messages in campaign and intervention materials promoting informed decision making and behavior change.

Paid advertising for AIDS prevention--would the ends justify the means?

PubMed Central

Donovan, R J; Jason, J; Gibbs, D A; Kroger, F

1991-01-01

An examination by the Centers for Disease Control and the Research Triangle Institute concluded that "hard-to-reach" populations could be reached with AIDS prevention messages through the broadcast and print media and that a study should be undertaken to assess whether paid placement of these messages could have an effect on HIV-related behaviors. The recommended target population for a study of paid advertising would be sexually active 18-24-year-old black urban dwellers. Its behavioral objectives would include abstinence and safer sex practices. For any evaluation of a paid advertising campaign to be valid, there would have to be extensive audience profiling, research into the development of the message, pretesting of the message, and involvement of the community. The proposed study would include measurement of various "dosage" levels of paid advertising, use of a no-intervention comparison group, and a novel data collection technique. Although a specific target group and specific messages would be involved, the evaluation would make a substantial contribution to resolving the broader issue of whether and how mass media should be used directly or indirectly to change or reinforce health-related behaviors. PMID:1659711

When Different Message Frames Motivate Different Routes to the Same Health Outcome.

PubMed

Gerend, Mary A; Shepherd, Melissa A

2016-04-01

Message framing is an effective strategy for promoting health behavior. We examined the relative effectiveness of framed messages that simultaneously promoted two different health behaviors-eating a calcium-rich diet and taking calcium supplements-for preventing osteoporosis. Because those behaviors are associated with different perceptions of risk, we predicted that gain- and loss-framed messages would have opposite effects. In two experiments, participants (N1 = 69; N2 = 219) were randomly assigned to a gain- or loss-framed message presenting two osteoporosis prevention behaviors. A gain-framed advantage was observed for dietary calcium consumption, but the opposite-a loss-framed advantage-was observed for use of calcium supplements. Message frame interacted with baseline calcium consumption behavior for some outcomes. Both gain- and loss-framed messages increased osteoporosis prevention behavior, but their relative effectiveness depended on the type of behavior. Framed messages can have opposite effects on different behaviors used to achieve a common health goal.

Mobile phone text messaging intervention to improve alertness and reduce sleepiness and fatigue during shiftwork among emergency medicine clinicians: study protocol for the SleepTrackTXT pilot randomized controlled trial

PubMed Central

2014-01-01

Background Mental and physical fatigue while at work is common among emergency medical services (EMS) shift workers. Extended shifts (for example 24 hours) and excessive amounts of overtime work increase the likelihood of negative safety outcomes and pose a challenge for EMS fatigue-risk management. Text message-based interventions are a potentially high-impact, low-cost platform for sleep and fatigue assessment and distributing information to workers at risk of negative safety outcomes related to sleep behaviors and fatigue. Methods/Design We will conduct a pilot randomized trial with a convenience sample of adult EMS workers recruited from across the United States using a single study website. Participants will be allocated to one of two possible arms for a 90-day study period. The intervention arm will involve text message assessments of sleepiness, fatigue, and difficulty with concentration at the beginning, during, and end of scheduled shifts. Intervention subjects reporting high levels of sleepiness or fatigue will receive one of four randomly selected intervention messages promoting behavior change during shiftwork. Control subjects will receive assessment only text messages. We aim to determine the performance characteristics of a text messaging tool for the delivery of a sleep and fatigue intervention. We seek to determine if a text messaging program with tailored intervention messages is effective at reducing perceived sleepiness and/or fatigue among emergency medicine clinician shift workers. Additional aims include testing whether a theory-based behavioral intervention, delivered by text message, changes ‘alertness behaviors’. Discussion The SleepTrackTXT pilot trial could provide evidence of compliance and effectiveness that would support rapid widespread expansion in one of two forms: 1) a stand-alone program in the form of a tailored/individualized sleep monitoring and fatigue reduction support service for EMS workers; or 2) an add-on to a multi-component fatigue risk management program led and maintained by employers or by safety and risk management services. Trial Registration Clinicaltrials.gov NCT02063737, Registered on 10 January 2014 PMID:24952387

Exploring the feasibility of text messaging to support substance abuse recovery among youth in treatment

PubMed Central

Gonzales, Rachel; Douglas Anglin, M.; Glik, Deborah C.

2014-01-01

This exploratory study examined treatment involved youth opinions about (i) the utility of using text messaging to support recovery behaviors after treatment; (ii) important types of text messages that could help youth self-manage their substance use behaviors after treatment; and (iii) programmatic or logistical areas associated with text messaging programs. Eight focus groups were conducted with 67 youth (aged 12–24) enrolled in outpatient and residential publicly funded substance abuse treatment programs around Los Angeles County, California. Results highlight that 70% of youth positively endorsed text messaging as a viable method of intervention during aftercare, 20% expressed ambivalent feelings, and 10% conveyed dislike. Thematic data exploration revealed seven themes related to the types of text messages youth recommend for helping youth avoid relapse after treatment, including positive appraisal (90%), lifestyle change tips (85%), motivational reinforcing (80%), coping advice (75%), confidence boosters (65%), inspiration encouragement (55%), and informational resources (50%). Youth opinions about key logistical features of text messaging programs, including frequency, timing, sender, and length are also examined. Findings offer insight for the development and enhancement of recovery support interventions with substance abusing youth. Results imply text messaging may serve as a promising opportunity for recovery support for young people with substance abuse problems. PMID:24038196

Exploring the feasibility of text messaging to support substance abuse recovery among youth in treatment.

PubMed

Gonzales, Rachel; Douglas Anglin, M; Glik, Deborah C

2014-02-01

This exploratory study examined treatment involved youth opinions about (i) the utility of using text messaging to support recovery behaviors after treatment; (ii) important types of text messages that could help youth self-manage their substance use behaviors after treatment; and (iii) programmatic or logistical areas associated with text messaging programs. Eight focus groups were conducted with 67 youth (aged 12-24) enrolled in outpatient and residential publicly funded substance abuse treatment programs around Los Angeles County, California. Results highlight that 70% of youth positively endorsed text messaging as a viable method of intervention during aftercare, 20% expressed ambivalent feelings, and 10% conveyed dislike. Thematic data exploration revealed seven themes related to the types of text messages youth recommend for helping youth avoid relapse after treatment, including positive appraisal (90%), lifestyle change tips (85%), motivational reinforcing (80%), coping advice (75%), confidence boosters (65%), inspiration encouragement (55%), and informational resources (50%). Youth opinions about key logistical features of text messaging programs, including frequency, timing, sender, and length are also examined. Findings offer insight for the development and enhancement of recovery support interventions with substance abusing youth. Results imply text messaging may serve as a promising opportunity for recovery support for young people with substance abuse problems.

Developing Family Healthware, a family history screening tool to prevent common chronic diseases.

PubMed

Yoon, Paula W; Scheuner, Maren T; Jorgensen, Cynthia; Khoury, Muin J

2009-01-01

Family health history reflects the effects of genetic, environmental, and behavioral factors and is an important risk factor for a variety of disorders including coronary heart disease, cancer, and diabetes. In 2004, the Centers for Disease Control and Prevention developed Family Healthware, a new interactive, Web-based tool that assesses familial risk for 6 diseases (coronary heart disease, stroke, diabetes, and colorectal, breast, and ovarian cancer) and provides a "prevention plan" with personalized recommendations for lifestyle changes and screening. The tool collects data on health behaviors, screening tests, and disease history of a person's first- and second-degree relatives. Algorithms in the software analyze the family history data and assess familial risk based on the number of relatives affected, their age at disease onset, their sex, how closely related the relatives are to each other and to the user, and the combinations of diseases in the family. A second set of algorithms uses the data on familial risk level, health behaviors, and screening to generate personalized prevention messages. Qualitative and quantitative formative research on lay understanding of family history and genetics helped shape the tool's content, labels, and messages. Lab-based usability testing helped refine messages and tool navigation. The tool is being evaluated by 3 academic centers by using a network of primary care practices to determine whether personalized prevention messages tailored to familial risk will motivate people at risk to change their lifestyles or screening behaviors.

Ubiquitous computing technology for just-in-time motivation of behavior change.

PubMed

Intille, Stephen S

2004-01-01

This paper describes a vision of health care where "just-in-time" user interfaces are used to transform people from passive to active consumers of health care. Systems that use computational pattern recognition to detect points of decision, behavior, or consequences automatically can present motivational messages to encourage healthy behavior at just the right time. Further, new ubiquitous computing and mobile computing devices permit information to be conveyed to users at just the right place. In combination, computer systems that present messages at the right time and place can be developed to motivate physical activity and healthy eating. Computational sensing technologies can also be used to measure the impact of the motivational technology on behavior.

The effect of social marketing communication on safe driving.

PubMed

Yang, Dong-Jenn; Lin, Wan-Chen; Lo, Jyue-Yu

2011-12-01

Processing of cognition, affect, and intention was investigated in viewers of advertisements to prevent speeding while driving. Results indicated that anchoring-point messages had greater effects on viewers' cognition, attitude, and behavioral intention than did messages without anchoring points. Further, the changes in message anchoring points altered participants' perceptions of acceptable and unacceptable judgments: a higher anchoring point in the form of speeding mortality was more persuasive in promoting the idea of reducing driving speed. Implications for creation of effective safe driving communications are discussed.

Social Media as a Tool to Promote Health Awareness: Results from an Online Cervical Cancer Prevention Study.

PubMed

Lyson, Helena C; Le, Gem M; Zhang, Jingwen; Rivadeneira, Natalie; Lyles, Courtney; Radcliffe, Kate; Pasick, Rena J; Sawaya, George; Sarkar, Urmimala; Centola, Damon

2018-06-11

Online social media platforms represent a promising opportunity for public health promotion. Research is limited, however, on the effectiveness of social media at improving knowledge and awareness of health topics and motivating healthy behavior change. Therefore, we investigated whether participation in an online social media platform and receipt of brief, tailored messages is effective at increasing knowledge, awareness, and prevention behaviors related to human papillomavirus (HPV) and cervical cancer. We conducted an online study in which 782 recruited participants were consecutively assigned to nine-person groups on a social media platform. Participants were shown a unique random set of 20 tailored messages per day over five days. Participants completed a baseline and post survey to assess their knowledge, awareness, and prevention behaviors related to HPV and cervical cancer. There were no statistically significant changes in knowledge and prevention behaviors from the baseline to the post survey among study participants. There was a modest, statistically significant change in response to whether participants had ever heard of HPV, increasing from 90 to 94% (p = 0.003). Our findings suggest that most study participants had substantial knowledge, awareness, and engagement in positive behaviors related to cervical cancer prevention at the start of the study. Nevertheless, we found that HPV awareness can be increased through brief participation in an online social media platform and receipt of tailored health messages. Further investigation that explores how social media can be used to improve knowledge and adoption of healthy behaviors related to cervical cancer is warranted.

Self-Determination Theory and Risk Behavior in a Collectivistic Society: Preventing Reckless Driving in Urban Nepal.

PubMed

Ranjit, Yerina S; Snyder, Leslie B; Hamilton, Mark A; Rimal, Rajiv N

2017-08-01

Traffic road accidents are one of the leading causes of mortality in Nepal and around the world. Drivers in Nepal are not adequately educated about road safety rules. Road conditions are chaotic as traffic regulations are also not strictly enforced. Public safety campaigns may be able to alter drivers' attitudes and behaviors; however, little is known about which persuasive strategies may be most effective. Drawing on self-determination theory and the Health Belief Model, the current study used a post-only experimental design to test the impact of a short video message. The video included collective vs. individual appeals, and messages emphasizing one's ability to make the right choice (autonomy support) vs. directive language. Participants were Nepali college students (mean age 20, N = 199). Using structural equation modeling, the study found that directive messages rather than autonomy support influenced an individual seeing value in the recommended behavior (identified regulation), which in turn influenced perceived susceptibility, perceived severity, and behavioral intention. The study also proposed a behavior change model by incorporating the stage of identification with the message upon exposure. This model aims to expand the model proposed by the Health Belief Model, to include a stage of value identification before cues to action influence perception of threat. Further implications are discussed.

Adolescents’ Text Message Communication and Growth in Antisocial Behavior across the First Year of High School

PubMed Central

Ehrenreich, Samuel E.; Underwood, Marion K.; Ackerman, Robert A.

2013-01-01

This study examined whether adolescents communicate about antisocial topics and behaviors via text messaging and how adolescents’ antisocial text message communication relates to growth in rule-breaking and aggression as reported by youth, parents, and teachers. Participants (n = 172; 82 girls) received BlackBerry devices configured to capture all text messages sent and received. Four days of text messages during the 9th grade year were coded for discussion of antisocial activities. The majority of participants engaged in at least some antisocial text message communication. Text messaging about antisocial activities significantly predicted increases in parent, teacher, and self-reports of adolescents’ rule-breaking behavior, as well as teacher and self-reports of adolescents’ aggressive behavior. Text message communication may provide instrumental information about how to engage in antisocial behavior and reinforce these behaviors as normative within the peer group. PMID:24014161

Design and Multi-Country Validation of Text Messages for an mHealth Intervention for Primary Prevention of Progression to Hypertension in Latin America.

PubMed

Diez-Canseco, Francisco; Zavala-Loayza, J Alfredo; Beratarrechea, Andrea; Kanter, Rebecca; Ramirez-Zea, Manuel; Rubinstein, Adolfo; Martinez, Homero; Miranda, J Jaime

2015-02-18

Mobile health (mHealth) has been posited to contribute to the reduction in health gaps and has shown fast and widespread growth in developing countries. This growth demands understanding of, and preparedness for, local cultural contexts. To describe the design and validation of text messages (short message service, SMS) that will be used for an mHealth behavioral change intervention to prevent hypertension in three Latin American countries: Argentina, Guatemala, and Peru. An initial set of 64 SMS text messages were designed to promote healthy lifestyles among individuals in different stages of behavior change, addressing four key domains: salt and sodium intake, fruit and vegetable intake, consumption of high fat and sugar foods, and physical activity. The 64 SMS text messages were organized into nine subsets for field validation. In each country 36 people were recruited, half of them being male. Of the participants, 4 per country evaluated each subset of SMS text messages, which contained between 6 and 8 SMS text messages regarding different key domains and stages of change. The understanding and appeal of each SMS text message was assessed using a 7-item questionnaire. The understanding and appeal ratings were used to reach a final set of 56 SMS text messages. Overall, each of the 64 SMS text messages received a total of 12 evaluations (4 per country). The majority of evaluations-742 out of a total of 767 (96.7%) valid responses-revealed an adequate understanding of the key idea contained in the SMS text message. On a scale from 1 to 10, the average appeal score was 8.7 points, with a range of 4 to 10 points. Based on their low scores, 8 SMS text messages per country were discarded. Once the final set of 56 SMS text messages was established, and based on feedback obtained in the field, wording and content of some SMS text messages were improved. Of the final set, 9, 8, and 16 of the SMS text messages were improved based on participant evaluations from Argentina, Guatemala, and Peru, respectively. Most SMS text messages selected for the final set (49/56, 88%) were the same in all countries, except for small wording differences. The final set of SMS text messages produced had very high rates of understanding and appeal in three different Latin American countries. This study highlights the importance of developing and validating a package of simple, preventative SMS text messages, grounded in evidence and theory, across three different Latin American countries with active engagement of end users.

Design and Multi-Country Validation of Text Messages for an mHealth Intervention for Primary Prevention of Progression to Hypertension in Latin America

PubMed Central

Diez-Canseco, Francisco; Zavala-Loayza, J Alfredo; Beratarrechea, Andrea; Kanter, Rebecca; Ramirez-Zea, Manuel; Rubinstein, Adolfo; Martinez, Homero

2015-01-01

Background Mobile health (mHealth) has been posited to contribute to the reduction in health gaps and has shown fast and widespread growth in developing countries. This growth demands understanding of, and preparedness for, local cultural contexts. Objective To describe the design and validation of text messages (short message service, SMS) that will be used for an mHealth behavioral change intervention to prevent hypertension in three Latin American countries: Argentina, Guatemala, and Peru. Methods An initial set of 64 SMS text messages were designed to promote healthy lifestyles among individuals in different stages of behavior change, addressing four key domains: salt and sodium intake, fruit and vegetable intake, consumption of high fat and sugar foods, and physical activity. The 64 SMS text messages were organized into nine subsets for field validation. In each country 36 people were recruited, half of them being male. Of the participants, 4 per country evaluated each subset of SMS text messages, which contained between 6 and 8 SMS text messages regarding different key domains and stages of change. The understanding and appeal of each SMS text message was assessed using a 7-item questionnaire. The understanding and appeal ratings were used to reach a final set of 56 SMS text messages. Results Overall, each of the 64 SMS text messages received a total of 12 evaluations (4 per country). The majority of evaluations—742 out of a total of 767 (96.7%) valid responses—revealed an adequate understanding of the key idea contained in the SMS text message. On a scale from 1 to 10, the average appeal score was 8.7 points, with a range of 4 to 10 points. Based on their low scores, 8 SMS text messages per country were discarded. Once the final set of 56 SMS text messages was established, and based on feedback obtained in the field, wording and content of some SMS text messages were improved. Of the final set, 9, 8, and 16 of the SMS text messages were improved based on participant evaluations from Argentina, Guatemala, and Peru, respectively. Most SMS text messages selected for the final set (49/56, 88%) were the same in all countries, except for small wording differences. Conclusions The final set of SMS text messages produced had very high rates of understanding and appeal in three different Latin American countries. This study highlights the importance of developing and validating a package of simple, preventative SMS text messages, grounded in evidence and theory, across three different Latin American countries with active engagement of end users. PMID:25693595

Cell Phone-Based Expert Systems for Smoking Cessation

DTIC Science & Technology

2011-09-01

computerized tailored intervention (CTI) with feedback messages delivered via cell phone . CTIs have shown increasing promise as useful behavior change programs...behaviors. This will be the first study to adapt a smoking cessation Internet-based CTI to provide personalized feedback on a cell phone to reduce smoking behaviors in military veterans.

Health message framing effects on attitudes, intentions, and behavior: a meta-analytic review.

PubMed

Gallagher, Kristel M; Updegraff, John A

2012-02-01

Message framing has been an important focus in health communication research, yet prior meta-analyses found limited support for using framing to increase persuasiveness of health messages. This meta-analysis distinguished the outcomes used to assess the persuasive impact of framed messages (attitudes, intentions, or behavior). One hundred eighty-nine effect sizes were identified from 94 peer-reviewed, published studies which compared the persuasive impact of gain- and loss-framed messages. Gain-framed messages were more likely than loss-framed messages to encourage prevention behaviors (r = 0.083, p = 0.002), particularly for skin cancer prevention, smoking cessation, and physical activity. No effect of framing was found when persuasion was assessed by attitudes/intentions or among studies encouraging detection. Gain-framed messages appear to be more effective than loss-framed messages in promoting prevention behaviors. Research should examine the contexts in which loss-framed messages are most effective, and the processes that mediate the effects of framing on behavior.

On the Usefulness of Narratives: An Interdisciplinary Review and Theoretical Model.

PubMed

Shaffer, Victoria A; Focella, Elizabeth S; Hathaway, Andrew; Scherer, Laura D; Zikmund-Fisher, Brian J

2018-04-19

How can we use stories from other people to promote better health experiences, improve judgments about health, and increase the quality of medical decisions without introducing bias, systematically persuading the listeners to change their attitudes, or altering behaviors in nonoptimal ways? More practically, should narratives be used in health education, promotion, or behavior change interventions? In this article, we address these questions by conducting a narrative review of a diverse body of literature on narratives from several disciplines to gain a better understanding about what narratives do, including their role in communication, engagement, recall, persuasion, and health behavior change. We also review broad theories about information processing and persuasion from psychology and more specific models about narrative messaging found in the health communication and marketing literatures to provide insight into the processes by which narratives have their effect on health behavior. To address major gaps in our theoretical understanding about how narratives work and what effects they will have on health behavior, we propose the Narrative Immersion Model, whose goal is to identify the parameters that predict the specific impact of a particular narrative (e.g. persuade, inform, comfort, etc.) based on the type of narrative message (e.g. process, experience, or outcome narrative). Further, the Narrative Immersion Model describes the magnitude of the effect as increasing through successive layers of engagement with the narrative: interest, identification, and immersion. Finally, the Narrative Immersion Model identifies characteristics of the narrative intervention that encourage greater immersion within a given narrative. We believe there are important communication gaps in areas areas of behavioral medicine that could be addressed with narratives; however, more work is needed in order to employ narrative messaging systematically. The Narrative Immersion Model advances our theoretical understanding about narrative processing and its subsequent effects on knowledge, attitudes, and behavior.

Driving Less for Better Air: Impacts of a Public Information Campaign

ERIC Educational Resources Information Center

Henry, Gary T.; Gordon, Craig S.

2003-01-01

In the wake of the 1990 amendments to the Clean Air Act, localities across the United States initiated public information campaigns both to raise awareness of threats to air quality and to change behavior related to air pollution by recommending specific behavioral changes in the campaign messages. These campaigns are designed to reduce the health…

Normative prompts reduce consumer food waste in restaurants.

PubMed

Stöckli, Sabrina; Dorn, Michael; Liechti, Stefan

2018-05-03

This field study demonstrates that prompts reduce food waste in a restaurant. Based on the behavioral change literature, it was hypothesized that (1) informational prompts encourage consumers to reduce food waste, and that (2) an informational prompt with a normative message is more effective than a prompt with only an informative message. The results were mixed. As expected, diners who were exposed to prompts asked to take away their leftovers more frequently than diners who were exposed to no prompts. However, prompts with an informative and normative message were no more powerful than prompts with only an informative message. Copyright © 2018 Elsevier Ltd. All rights reserved.

Tweet for Behavior Change: Using Social Media for the Dissemination of Public Health Messages.

PubMed

Gough, Aisling; Hunter, Ruth F; Ajao, Oluwaseun; Jurek, Anna; McKeown, Gary; Hong, Jun; Barrett, Eimear; Ferguson, Marbeth; McElwee, Gerry; McCarthy, Miriam; Kee, Frank

2017-03-23

Social media public health campaigns have the advantage of tailored messaging at low cost and large reach, but little is known about what would determine their feasibility as tools for inducing attitude and behavior change. The aim of this study was to test the feasibility of designing, implementing, and evaluating a social media-enabled intervention for skin cancer prevention. A quasi-experimental feasibility study used social media (Twitter) to disseminate different message "frames" related to care in the sun and cancer prevention. Phase 1 utilized the Northern Ireland cancer charity's Twitter platform (May 1 to July 14, 2015). Following a 2-week "washout" period, Phase 2 commenced (August 1 to September 30, 2015) using a bespoke Twitter platform. Phase 2 also included a Thunderclap, whereby users allowed their social media accounts to automatically post a bespoke message on their behalf. Message frames were categorized into 5 broad categories: humor, shock or disgust, informative, personal stories, and opportunistic. Seed users with a notable following were contacted to be "influencers" in retweeting campaign content. A pre- and postintervention Web-based survey recorded skin cancer prevention knowledge and attitudes in Northern Ireland (population 1.8 million). There were a total of 417,678 tweet impressions, 11,213 engagements, and 1211 retweets related to our campaign. Shocking messages generated the greatest impressions (shock, n=2369; informative, n=2258; humorous, n=1458; story, n=1680), whereas humorous messages generated greater engagement (humorous, n=148; shock, n=147; story, n=117; informative, n=100) and greater engagement rates compared with story tweets. Informative messages, resulted in the greatest number of shares (informative, n=17; humorous, n=10; shock, n=9; story, n=7). The study findings included improved knowledge of skin cancer severity in a pre- and postintervention Web-based survey, with greater awareness that skin cancer is the most common form of cancer (preintervention: 28.4% [95/335] vs postintervention: 39.3% [168/428] answered "True") and that melanoma is most serious (49.1% [165/336] vs 55.5% [238/429]). The results also show improved attitudes toward ultraviolet (UV) exposure and skin cancer with a reduction in agreement that respondents "like to tan" (60.5% [202/334] vs 55.6% [238/428]). Social media-disseminated public health messages reached more than 23% of the Northern Ireland population. A Web-based survey suggested that the campaign might have contributed to improved knowledge and attitudes toward skin cancer among the target population. Findings suggested that shocking and humorous messages generated greatest impressions and engagement, but information-based messages were likely to be shared most. The extent of behavioral change as a result of the campaign remains to be explored, however, the change of attitudes and knowledge is promising. Social media is an inexpensive, effective method for delivering public health messages. However, existing and traditional process evaluation methods may not be suitable for social media. ©Aisling Gough, Ruth F Hunter, Oluwaseun Ajao, Anna Jurek, Gary McKeown, Jun Hong, Eimear Barrett, Marbeth Ferguson, Gerry McElwee, Miriam McCarthy, Frank Kee. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 23.03.2017.

Tweet for Behavior Change: Using Social Media for the Dissemination of Public Health Messages

PubMed Central

Hunter, Ruth F; Ajao, Oluwaseun; Jurek, Anna; McKeown, Gary; Hong, Jun; Barrett, Eimear; Ferguson, Marbeth; McElwee, Gerry; McCarthy, Miriam; Kee, Frank

2017-01-01

Background Social media public health campaigns have the advantage of tailored messaging at low cost and large reach, but little is known about what would determine their feasibility as tools for inducing attitude and behavior change. Objective The aim of this study was to test the feasibility of designing, implementing, and evaluating a social media–enabled intervention for skin cancer prevention. Methods A quasi-experimental feasibility study used social media (Twitter) to disseminate different message “frames” related to care in the sun and cancer prevention. Phase 1 utilized the Northern Ireland cancer charity’s Twitter platform (May 1 to July 14, 2015). Following a 2-week “washout” period, Phase 2 commenced (August 1 to September 30, 2015) using a bespoke Twitter platform. Phase 2 also included a Thunderclap, whereby users allowed their social media accounts to automatically post a bespoke message on their behalf. Message frames were categorized into 5 broad categories: humor, shock or disgust, informative, personal stories, and opportunistic. Seed users with a notable following were contacted to be “influencers” in retweeting campaign content. A pre- and postintervention Web-based survey recorded skin cancer prevention knowledge and attitudes in Northern Ireland (population 1.8 million). Results There were a total of 417,678 tweet impressions, 11,213 engagements, and 1211 retweets related to our campaign. Shocking messages generated the greatest impressions (shock, n=2369; informative, n=2258; humorous, n=1458; story, n=1680), whereas humorous messages generated greater engagement (humorous, n=148; shock, n=147; story, n=117; informative, n=100) and greater engagement rates compared with story tweets. Informative messages, resulted in the greatest number of shares (informative, n=17; humorous, n=10; shock, n=9; story, n=7). The study findings included improved knowledge of skin cancer severity in a pre- and postintervention Web-based survey, with greater awareness that skin cancer is the most common form of cancer (preintervention: 28.4% [95/335] vs postintervention: 39.3% [168/428] answered “True”) and that melanoma is most serious (49.1% [165/336] vs 55.5% [238/429]). The results also show improved attitudes toward ultraviolet (UV) exposure and skin cancer with a reduction in agreement that respondents “like to tan” (60.5% [202/334] vs 55.6% [238/428]). Conclusions Social media–disseminated public health messages reached more than 23% of the Northern Ireland population. A Web-based survey suggested that the campaign might have contributed to improved knowledge and attitudes toward skin cancer among the target population. Findings suggested that shocking and humorous messages generated greatest impressions and engagement, but information-based messages were likely to be shared most. The extent of behavioral change as a result of the campaign remains to be explored, however, the change of attitudes and knowledge is promising. Social media is an inexpensive, effective method for delivering public health messages. However, existing and traditional process evaluation methods may not be suitable for social media. PMID:28336503

Design and Feasibility of a Text Messaging Intervention to Prevent Indoor Tanning Among Young Adult Women: A Pilot Study

PubMed Central

Mays, Darren

2016-01-01

Background Although skin cancer is largely preventable, it affects nearly 1 of 5 US adults. There is a need for research on how to optimally design persuasive public health indoor tanning prevention messages. Objective The objective of our study was to examine whether framed messages on indoor tanning behavioral intentions delivered through short message service (SMS) text messaging would produce (1) positive responses to the messages, including message receptivity and emotional response; (2) indoor tanning efficacy beliefs, including response efficacy and self-efficacy; and (3) indoor tanning risk beliefs. Methods We conducted a pilot study of indoor tanning prevention messages delivered via mobile phone text messaging in a sample of 21 young adult women who indoor tan. Participants completed baseline measures, were randomly assigned to receive gain-, loss-, or balanced-framed text messages, and completed postexposure outcome measures on indoor tanning cognitions and behaviors. Participants received daily mobile phone indoor tanning prevention text messages for 1 week and completed the same postexposure measures as at baseline. Results Over the 1-week period there were trends or significant changes after receipt of the text messages, including increased perceived susceptibility (P<.001), response efficacy beliefs (P<.001), and message receptivity (P=.03). Ordinary least squares stepwise linear regression models showed an effect of text message exposure on self-efficacy to quit indoor tanning (t6=–2.475, P<.02). Ordinary least squares linear regression including all measured scales showed a marginal effect of SMS texts on self-efficacy (t20=1.905, P=.08). Participants endorsed highly favorable views toward the text messaging protocol. Conclusions This study supports this use of mobile text messaging as an indoor tanning prevention strategy. Given the nature of skin cancer risk perceptions, the addition of multimedia messaging service is another area of potential innovation for disseminating indoor tanning prevention messages. PMID:28007691

Design and Feasibility of a Text Messaging Intervention to Prevent Indoor Tanning Among Young Adult Women: A Pilot Study.

PubMed

Evans, William D; Mays, Darren

2016-12-22

Although skin cancer is largely preventable, it affects nearly 1 of 5 US adults. There is a need for research on how to optimally design persuasive public health indoor tanning prevention messages. The objective of our study was to examine whether framed messages on indoor tanning behavioral intentions delivered through short message service (SMS) text messaging would produce (1) positive responses to the messages, including message receptivity and emotional response; (2) indoor tanning efficacy beliefs, including response efficacy and self-efficacy; and (3) indoor tanning risk beliefs. We conducted a pilot study of indoor tanning prevention messages delivered via mobile phone text messaging in a sample of 21 young adult women who indoor tan. Participants completed baseline measures, were randomly assigned to receive gain-, loss-, or balanced-framed text messages, and completed postexposure outcome measures on indoor tanning cognitions and behaviors. Participants received daily mobile phone indoor tanning prevention text messages for 1 week and completed the same postexposure measures as at baseline. Over the 1-week period there were trends or significant changes after receipt of the text messages, including increased perceived susceptibility (P<.001), response efficacy beliefs (P<.001), and message receptivity (P=.03). Ordinary least squares stepwise linear regression models showed an effect of text message exposure on self-efficacy to quit indoor tanning (t 6 =-2.475, P<.02). Ordinary least squares linear regression including all measured scales showed a marginal effect of SMS texts on self-efficacy (t 20 =1.905, P=.08). Participants endorsed highly favorable views toward the text messaging protocol. This study supports this use of mobile text messaging as an indoor tanning prevention strategy. Given the nature of skin cancer risk perceptions, the addition of multimedia messaging service is another area of potential innovation for disseminating indoor tanning prevention messages. ©William Evans, Darren Mays. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 22.12.2016.

Young People’s Views and Experiences of a Mobile Phone Texting Intervention to Promote Safer Sex Behavior

PubMed Central

McCarthy, Ona; Baraitser, Paula; Wellings, Kaye; Bailey, Julia V; Free, Caroline

2016-01-01

Background The risk of poor sexual health, including unplanned pregnancy and sexually transmitted infections (STIs), is greatest amongst young people. Innovative and acceptable interventions to improve sexual health are required. Mobile phone text messaging (short message service, SMS) interventions have the potential to reach large numbers of people at relatively low cost, but greater understanding is needed on how these interventions should be developed and how they work. Objectives The aim of this paper is to explore young people’s views of and experiences with a mobile phone text messaging intervention to promote safer sex behavior. Methods We undertook qualitative interviews with young people aged 16 to 24 years as part of a pilot trial of a sexual health intervention delivered by text message in the United Kingdom. Study participants received sexual health promotion text messages based on behavior-change techniques. The message content, tailored by gender and STI status, included support for correct STI treatment and promotion of safer sex behaviors. Young people were eligible if they had received a positive chlamydia test or had more than one partner and at least one episode of unprotected sex in the last year. Telephone interviews were conducted 2 to 3 weeks after initiation of the intervention. A semi-structured topic guide was followed to explore participant experiences and a thematic analysis was conducted. Results We conducted 16 telephone interviews with participants who had received the text intervention and an additional four interviews with those in the control group (13 women and 7 men). Intervention participants found text messages easy to understand and appearing to come from a friendly and trustworthy source. They considered the frequency and timing of messages to be appropriate, and delivery via mobile phones convenient. Receipt of support by text message allowed recipients to assimilate information at their own pace, and prompted reflection on and sharing of messages with friends, family members, and partners, thus providing opportunities for education and discussion. For some recipients, the messages had increased their knowledge of how to correctly use condoms. Some described how the messages had increased their confidence and reduced stigma, enabling them to disclose infection to a partner and/or to do so sooner and more calmly. Discussing the messages with a partner reportedly enabled some women to negotiate condom use. Conclusion From the perspective of the recipients, the tone, frequency, and content of the text messaging-based sexual health intervention was acceptable and appropriate. Their accounts indicated that the intervention increased knowledge, confidence, and safer sex behaviors. A large-scale randomized controlled trial (RCT) is needed to assess effectiveness. PMID:27083784

Young People's Views and Experiences of a Mobile Phone Texting Intervention to Promote Safer Sex Behavior.

PubMed

French, Rebecca Sophia; McCarthy, Ona; Baraitser, Paula; Wellings, Kaye; Bailey, Julia V; Free, Caroline

2016-04-15

The risk of poor sexual health, including unplanned pregnancy and sexually transmitted infections (STIs), is greatest amongst young people. Innovative and acceptable interventions to improve sexual health are required. Mobile phone text messaging (short message service, SMS) interventions have the potential to reach large numbers of people at relatively low cost, but greater understanding is needed on how these interventions should be developed and how they work. The aim of this paper is to explore young people's views of and experiences with a mobile phone text messaging intervention to promote safer sex behavior. We undertook qualitative interviews with young people aged 16 to 24 years as part of a pilot trial of a sexual health intervention delivered by text message in the United Kingdom. Study participants received sexual health promotion text messages based on behavior-change techniques. The message content, tailored by gender and STI status, included support for correct STI treatment and promotion of safer sex behaviors. Young people were eligible if they had received a positive chlamydia test or had more than one partner and at least one episode of unprotected sex in the last year. Telephone interviews were conducted 2 to 3 weeks after initiation of the intervention. A semi-structured topic guide was followed to explore participant experiences and a thematic analysis was conducted. We conducted 16 telephone interviews with participants who had received the text intervention and an additional four interviews with those in the control group (13 women and 7 men). Intervention participants found text messages easy to understand and appearing to come from a friendly and trustworthy source. They considered the frequency and timing of messages to be appropriate, and delivery via mobile phones convenient. Receipt of support by text message allowed recipients to assimilate information at their own pace, and prompted reflection on and sharing of messages with friends, family members, and partners, thus providing opportunities for education and discussion. For some recipients, the messages had increased their knowledge of how to correctly use condoms. Some described how the messages had increased their confidence and reduced stigma, enabling them to disclose infection to a partner and/or to do so sooner and more calmly. Discussing the messages with a partner reportedly enabled some women to negotiate condom use. From the perspective of the recipients, the tone, frequency, and content of the text messaging-based sexual health intervention was acceptable and appropriate. Their accounts indicated that the intervention increased knowledge, confidence, and safer sex behaviors. A large-scale randomized controlled trial (RCT) is needed to assess effectiveness.

Designing Patient-Centered Text Messaging Interventions for Increasing Physical Activity Among Participants With Type 2 Diabetes: Qualitative Results From the Text to Move Intervention.

PubMed

Horner, Gabrielle N; Agboola, Stephen; Jethwani, Kamal; Tan-McGrory, Aswita; Lopez, Lenny

2017-04-24

Type 2 diabetes mellitus (T2DM) is a disease affecting approximately 29.1 million people in the United States, and an additional 86 million adults have prediabetes. Diabetes self-management education, a complex health intervention composed of 7 behaviors, is effective at improving self-care behaviors and glycemic control. Studies have employed text messages for education, reminders, and motivational messaging that can serve as "cues to action," aiming to improve glucose monitoring, self-care behaviors, appointment attendance, and medication adherence. The Text to Move (TTM) study was a 6-month 2-parallel group randomized controlled trial of individuals with T2DM to increase physical activity, measured by a pedometer. The intervention arm received text messages twice daily for 6 months that were tailored to the participant's stage of behavior change as defined by the transtheoretical model of behavior change. We assessed participants' attitudes regarding their experience with text messaging, focusing on perceived barriers and facilitators, through two focus groups and telephone interviews. All interviews were audiorecorded, transcribed verbatim, coded, and analyzed using a grounded theory approach. The response rate was 67% (31/46 participants). The average age was 51.4 years and 61% (19/31 participants) were male. The majority of individuals were English speakers and married, had completed at least 12th grade and approximately half of the participants were employed full-time. Overall, participants were satisfied with the TTM program and recalled the text messages as educational, informational, and motivational. Program involvement increased the sense of connection with their health care center. The wearing of pedometers and daily step count information served as motivational reminders and created a sense of accountability through the sentinel effect. However, there was frustration concerning the automation of the text message program, including the repetitiveness, predictability of text time delivery, and lack of customization and interactivity of text message content. Participants recommended personalization of texting frequency as well as more contact time with personnel for a stronger sense of support, including greater surveillance and feedback based on their own results and comparison to other participants. Participants in a theory-based text messaging intervention identified key facilitators and barriers to program efficacy that should be incorporated into future texting interventions to optimize participant satisfaction and outcomes. Clinicaltrials.gov NCT01569243; http://clinicaltrials.gov/ct2/show/NCT01569243 (Archived by Webcite at http://www.webcitation.org/6pfH6yXag). ©Gabrielle N Horner, Stephen Agboola, Kamal Jethwani, Aswita Tan-McGrory, Lenny Lopez. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 24.04.2017.

Why are you bringing up condoms now? The effect of message content on framing effects of condom use messages.

PubMed

Kiene, Susan M; Barta, William D; Zelenski, John M; Cothran, Dee Lisa

2005-05-01

According to prospect theory (A. Tversky & D. Kahneman, 1981), messages advocating a low-risk (i.e., easy, low-cost) behavior are most effective if they stress the benefits of adherence (gain framed), whereas messages advocating a risky behavior are most effective if they stress the costs of nonadherence (loss framed). Although condom use is viewed as a low-risk behavior, it may entail risky interpersonal negotiations. Study 1 (N = 167) compared ratings of condom use messages advocating relational behaviors (e.g., discussing condoms) or health behaviors (e.g., carrying condoms). As predicted, loss-framed relational messages and gain-framed health messages received higher evaluations. Study 2 (N = 225) offers a replication and evidence of issue involvement and gender as moderators. Results are discussed with reference to the design of condom use messages. ((c) 2005 APA, all rights reserved).

From Our Practices to Yours: Key Messages for the Journey to Integrated Behavioral Health.

PubMed

Gold, Stephanie B; Green, Larry A; Peek, C J

The historic, cultural separation of primary care and behavioral health has caused the spread of integrated care to lag behind other practice transformation efforts. The Advancing Care Together study was a 3-year evaluation of how practices implemented integrated care in their local contexts; at its culmination, practice leaders ("innovators") identified lessons learned to pass on to others. Individual feedback from innovators, key messages created by workgroups of innovators and the study team, and a synthesis of key messages from a facilitated discussion were analyzed for themes via immersion/crystallization. Five key themes were captured: (1) frame integrated care as a necessary paradigm shift to patient-centered, whole-person health care; (2) initialize: define relationships and protocols up-front, understanding they will evolve; (3) build inclusive, empowered teams to provide the foundation for integration; (4) develop a change management strategy of continuous evaluation and course-correction; and (5) use targeted data collection pertinent to integrated care to drive improvement and impart accountability. Innovators integrating primary care and behavioral health discerned key messages from their practical experience that they felt were worth sharing with others. Their messages present insight into the challenges unique to integrating care beyond other practice transformation efforts. © Copyright 2017 by the American Board of Family Medicine.

Text messaging-based smoking cessation intervention: a narrative review.

PubMed

Kong, Grace; Ells, Daniel M; Camenga, Deepa R; Krishnan-Sarin, Suchitra

2014-05-01

Smoking cessation interventions delivered via text messaging on mobile phones may enhance motivations to quit smoking. The goal of this narrative review is to describe the text messaging interventions' theoretical contents, frequency and duration, treatment outcome, and sample characteristics such as age and motivation to quit, to better inform the future development of this mode of intervention. Studies were included if text messaging was primarily used to deliver smoking cessation intervention and published in English in a peer-reviewed journal. All articles were coded by two independent raters to determine eligibility and to extract data. Twenty-two studies described 15 text messaging interventions. About half of the interventions recruited adults (ages 30-40) and the other half targeted young adults (ages 18-29). Fourteen interventions sent text messages during the quit phase, 10 had a preparation phase and eight had a maintenance phase. The number of text messages and the duration of the intervention varied. All used motivational messages grounded in social cognitive behavioral theories, 11 used behavioral change techniques, and 14 used individually tailored messages. Eleven interventions also offered other smoking cessation tools. Three interventions yielded smoking cessation outcomes greater than the control condition. The proliferation of text messaging in recent years suggests that text messaging interventions may have the potential to improve smoking cessation rates. Detailed summary of the interventions suggests areas for future research and clinical application. More rigorous studies are needed to identify components of the interventions that can enhance their acceptability, feasibility and efficacy. Copyright © 2013. Published by Elsevier Ltd.

Text Messaging-Based Smoking Cessation Intervention: A Narrative Review

PubMed Central

Kong, Grace; Ells, Daniel; Camenga, Deepa R.; Krishnan-Sarin, Suchitra

2014-01-01

Introduction Smoking cessation interventions delivered via text messaging on mobile phones may enhance motivations to quit smoking. The goal of this narrative review is to describe the text messaging interventions’ theoretical contents, frequency and duration, treatment outcome, and sample characteristics such as age and motivation to quit, to better inform the future development of this mode of intervention. Methods Studies were included if text messaging was primarily used to deliver smoking cessation intervention and published in English in a peer-reviewed journal. All articles were coded by two independent raters to determine eligibility and to extract data. Results Twenty-two studies described 15 text messaging interventions. About half of the interventions recruited adults (ages 30-40s) and the other half targeted young adults (ages 18-29). Fourteen interventions sent text messages during the quit phase, 10 had a preparation phase and eight had a maintenance phase. The number of text messages and the duration of the intervention varied. All used motivational messages grounded in social cognitive behavioral theories, 11 used behavioral change techniques, and 14 used individually tailored messages. Eleven interventions also offered other smoking cessation tools. Three interventions yielded smoking cessation outcomes greater than the control condition. Conclusions The proliferation of text messaging in recent years suggests that text messaging interventions may have the potential to improve smoking cessation rates. Detailed summary of the interventions suggest areas for future research and clinical application. More rigorous studies are needed to identify components of the interventions that can enhance their acceptability, feasibility and efficacy. PMID:24462528

Empowerment in the process of health messaging for rural low-income mothers: an exploratory message design project.

PubMed

Aldoory, Linda; Braun, Bonnie; Maring, Elisabeth Fost; Duggal, Mili; Briones, Rowena Lynn

2015-01-01

Rural, low-income mothers face challenges to their health equal to or greater than those of low-income mothers from urban areas. This study put health message design into the hands of low-income rural mothers. The current study filled a research gap by analyzing a participatory process used to design health messages tailored to the everyday lives of rural low-income mothers. A total of forty-three mothers participated in nine focus groups, which were held from 2012 to 2013, in eight states. The mothers were from different racial and ethnic backgrounds. Participants discussed food security, physical activity, and oral health information. They created messages by considering several elements: visuals, length of message, voice/perspective, self-efficacy and personal control, emotional appeals, positive and negative reinforcements, and steps to health behavior change. This study was innovative in its focus on empowerment as a key process to health message design.

Development of patient-centric linguistically tailored psychoeducational messages to support nutrition and medication self-management in type 2 diabetes: a feasibility study

PubMed Central

Ellis, Rebecca J Bartlett; Connor, Ulla; Marshall, James

2014-01-01

Purpose This study evaluated the feasibility of developing linguistically tailored educational messages designed to match the linguistic styles of patients segmented into types with the Descriptor™, and to determine patient preferences for tailored or standard messages based on their segments. Patients and methods Twenty patients with type 2 diabetes (T2DM) were recruited from a diabetes health clinic. Participants were segmented using the Descriptor™, a language-based questionnaire, to identify patient types based on their control orientation (internal/external), agency (high/low), and affect (positive/negative), which are well studied constructs related to T2DM self-management. Two of the seven self-care behaviors described by the American Association of Diabetes Educators (healthy eating and taking medication) were used to develop standard messages and then linguistically tailored using features of the six different construct segment types of the Descriptor™. A subset of seven participants each provided feedback on their preference for standard or linguistically tailored messages; 12 comparisons between standard and tailored messages were made. Results Overall, the tailored messages were preferred to the standard messages. When the messages were matched to specific construct segment types, the tailored messages were preferred over the standard messages, although this was not statistically significant. Conclusion Linguistically tailoring messages based on construct segments is feasible. Furthermore, tailored messages were more often preferred over standard messages. This study provides some preliminary evidence for tailoring messages based on the linguistic features of control orientation, agency, and affect. The messages developed in this study should be tested in a larger more representative sample. The present study did not explore whether tailored messages were better understood. This research will serve as preliminary evidence to develop future studies with the ultimate goal to design intervention studies to investigate if linguistically tailoring communication within the context of patient education influences patient knowledge, motivation, and activation toward making healthy behavior changes in T2DM self-management. PMID:25336928

Health behavior change in pregnant women: a two-phase study.

PubMed

Davis, Ann M; Wambach, Karen A; Nelson, Eve Lynn; Odar, Cathleen; Lillis, Teresa; McKinley, Amanda; Gallagher, Mia

2014-12-01

Maternal health behaviors during pregnancy/infancy can have a significant impact on maternal and child health. Many women engage in health risk behaviors during pregnancy. Multiple health behavior change (MHBC) interventions provide support to change health behaviors, but further information is needed on potential targets for such an intervention, as well as on the feasibility of technology use and e-health with this population. Two studies were completed as part of this project. First, a survey to examine views regarding health behaviors, desires to change health behaviors, and use of technology was completed by 68 pregnant women presenting for routine care. Based on survey findings, a brief MHBC e-health educational intervention related to breastfeeding, healthy nutrition/lifestyle, and stress management, using iPad(®) (Apple, Cupertino, CA) and text-messaging media, was then developed and piloted in the home with five pregnant women. In the survey, the majority of participants reported interest in receiving help to improve health behaviors, including losing weight or eating a healthier diet, breastfeeding, smoking cessation, and help with depression. The majority of women reported access to a computer with Internet, a phone, and frequent use of text messaging. In the second phase, results suggest that the home-based intervention was feasible and that the technology was convenient and user-friendly. Pregnant women are interested in improving health behaviors and found a brief technology-based e-health intervention feasible, convenient, and user-friendly. In-home technology appears to be a feasible and convenient approach to addressing the multiple health behavior change needs of pregnant women.

Use of text messaging for maternal and infant health: a systematic review of the literature.

PubMed

Poorman, Elisabeth; Gazmararian, Julie; Parker, Ruth M; Yang, Baiyu; Elon, Lisa

2015-05-01

Text messaging is an increasingly popular communication tool in health interventions, but has been little studied in maternal and infant health. This literature review evaluates studies of text messaging that may be applied to the promotion of maternal and infant health. Articles from peer-reviewed journals published before June 2012 were included if they were experimental or quasi-experimental studies of behaviors endorsed either by the American College of Obstetrics and Gynecology, the American Pediatrics Association, or the United States Preventive Services Task Force; included reproductive age women (12-50 years) or infants up to 2 years of age; and were available in English. Qualitative studies of text messaging specific to pregnant women were also included. Studies were compared and contrasted by key variables, including: design, time-period, study population, and results. Forty-eight articles were included, 30 of which were randomized controlled trials. Interventions vary greatly in effectiveness and soundness of methodology, but collectively indicate that there is a wide range of preventative behaviors that text message interventions can effectively promote, including smoking cessation, diabetes control, appointment reminders, medication adherence, weight loss, and vaccine uptake. Common methodological issues include not accounting for attention affect and not aligning text message content to measured outcomes. Those interventions that are based on an established theory of behavior change and use motivational as opposed to informational language are more likely to be successful. Building on the growing body of evidence for text message interventions reviewed here, as well as the growing popularity of text messaging as a medium, researchers should be able to use this technology to engage difficult to reach populations.

Changing the conversation: the influence of emotions on conversational valence and alcohol consumption.

PubMed

Hendriks, Hanneke; van den Putte, Bas; de Bruijn, Gert-Jan

2014-10-01

Health campaign effects may be improved by taking interpersonal communication processes into account. The current study, which employed an experimental, pretest-posttest, randomized exposure design (N = 208), investigated whether the emotions induced by anti-alcohol messages influence conversational valence about alcohol and subsequent persuasion outcomes. The study produced three main findings. First, an increase in the emotion fear induced a negative conversational valence about alcohol. Second, fear was most strongly induced by a disgusting message, whereas a humorous appeal induced the least fear. Third, a negative conversational valence elicited healthier binge drinking attitudes, subjective norms, perceived behavioral control, intentions, and behaviors. Thus, health campaign planners and health researchers should pay special attention to the emotional characteristics of health messages and should focus on inducing a healthy conversational valence.

Design Considerations in Developing a Text Messaging Program Aimed at Smoking Cessation

PubMed Central

Holtrop, Jodi Summers; Bağci Bosi, A Tülay; Emri, Salih

2012-01-01

Background Cell phone text messaging is gaining increasing recognition as an important tool that can be harnessed for prevention and intervention programs across a wide variety of health research applications. Despite the growing body of literature reporting positive outcomes, very little is available about the design decisions that scaffold the development of text messaging-based health interventions. What seems to be missing is documentation of the thought process of investigators in the initial stages of protocol and content development. This omission is of particular concern because many researchers seem to view text messaging as the intervention itself instead of simply a delivery mechanism. Certainly, aspects of this technology may increase participant engagement. Like other interventions, however, the content is a central driver of the behavior change. Objective To address this noted gap in the literature, we discuss the protocol decisions and content development for SMS Turkey (or Cebiniz birakin diyor in Turkish), a smoking cessation text messaging program for adult smokers in Turkey. Methods Content was developed in English and translated into Turkish. Efforts were made to ensure that the protocol and content were grounded in evidence-based smoking cessation theory, while also reflective of the cultural aspects of smoking and quitting in Turkey. Results Methodological considerations included whether to provide cell phones and whether to reimburse participants for texting costs; whether to include supplementary intervention resources (eg, personal contact); and whether to utilize unidirectional versus bidirectional messaging. Program design considerations included how messages were tailored to the quitting curve and one’s smoking status after one’s quit date, the number of messages participants received per day, and over what period of time the intervention lasted. Conclusion The content and methods of effective smoking cessation quitline programs were a useful guide in developing SMS Turkey. Proposed guidelines in developing text messaging-based behavior change programs are offered. PMID:22832182

Perceived peer drinking norms and responsible drinking in UK university settings.

PubMed

Robinson, Eric; Jones, Andrew; Christiansen, Paul; Field, Matt

2014-09-01

Heavy drinking is common among students at UK universities. US students overestimate how much their peers drink and correcting this through the use of social norm messages may promote responsible drinking. We tested whether there is an association between perceived campus drinking norms and usual drinking behavior in UK university students and whether norm messages about responsible drinking correct normative misperceptions and increase students' intentions to drink responsibly. 1,020 UK university students took part in an online study. Participants were exposed to one of five message types: a descriptive norm, an injunctive norm, a descriptive and injunctive norm, or one of two control messages. Message credibility was assessed. Afterwards participants completed measures of intentions to drink responsibly and we measured usual drinking habits and perceptions of peer drinking. Perceptions of peer drinking were associated modestly with usual drinking behavior, whereby participants who believed other students drank responsibly also drank responsibly. Norm messages changed normative perceptions, but not in the target population of participants who underestimated responsible drinking in their peers at baseline. Norm messages did not increase intentions to drink responsibly and although based on accurate data, norm messages were not seen as credible. In this UK based study, although perceived social norms about peer drinking were associated with individual differences in drinking habits, campus wide norm messages about responsible drinking did not affect students' intentions to drink more responsibly. More research is required to determine if this approach can be applied to UK settings.

Cigarette constituent health communications for smokers: impact of chemical, imagery, and source.

PubMed

Kowitt, Sarah; Sheeran, Paschal; Jarman, Kristen L; Ranney, Leah M; Schmidt, Allison M; Noar, Seth M; Huang, Li-Ling; Goldstein, Adam O

2017-10-03

Communication campaigns are incorporating tobacco constituent messaging to reach smokers, yet there is a dearth of research on how such messages should be constructed or will be received by smokers. In a 2x2x2 experiment, we manipulated three cigarette constituent message components: (1) the toxic constituent of tobacco (arsenic vs. lead) with a corresponding health effect, (2) the presence or absence of an evocative image, and (3) the source of the message (FDA vs. no source). We recruited smokers (N = 1,669, 55.4% women) via an online platform and randomized them to 1 of the 8 message conditions. Participants viewed the message and rated its believability and perceived effectiveness, the credibility of the message source, and action expectancies (i.e., likelihood of seeking additional information and help with quitting as a result of seeing the message). We found significant main effects of image, constituent, and source on outcomes. The use of arsenic as the constituent, the presence of an evocative image, and the FDA as the source increased the believability, source credibility, and perceived effectiveness of the tobacco constituent health message. Multiple elements of a constituent message, including type of constituent, imagery, and message source, impact their reception among smokers. Specifically, communication campaigns targeting smokers that utilize arsenic as the tobacco constituent, visual imagery, and the FDA logo may be particularly effective in changing key outcomes that are associated with subsequent attitude and behavioral changes. This paper describes how components of communication campaigns about cigarette constituents are perceived. Multiple elements of a tobacco constituent message, including type of constituent, image, and message source may influence the reception of messages among current smokers. Communication campaigns targeting smokers that utilize arsenic as the tobacco constituent, visual imagery, and the FDA logo may be particularly effective in changing key outcomes among smokers. The effects of such campaigns should be examined, as well as the mechanisms through which such campaigns affect change. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Hantavirus Public Health Outreach Effectiveness in Three Populations: An Overview of Northwestern New Mexico, Los Santos Panama, and Region IX Chile

PubMed Central

McConnell, Marjorie S.

2014-01-01

This research compared the effectiveness of Hantavirus Pulmonary Syndrome (HPS) outreach programs in New Mexico, Panama, and Chile. Understanding the role of human demographics, disease ecology, and human behavior in the disease process is critical to the examination of community responses in terms of behavior changes. Attitudes, knowledge, and behavior across three populations were measured through the implementation of a self-administered questionnaire (N = 601). Surveys implemented in Chile and Panama in 2004, followed by northwestern New Mexico in 2008, attempted to assess knowledge and behavior change with respect to hantavirus in high- and lower-risk prevalence areas during endemic periods. While levels of concern over contracting hantavirus were lowest in New Mexico, they were highest in Panama. Respondents in Chile showed mid-level concern and exhibited a tendency to practice proper cleaning methods more than in New Mexico and Panama. This indicates that public health messages appear to be more effective in Chile. However, since negative behavior changes, such as sweeping and vacuuming, occur at some level in all three populations, improved messages should help decrease risk of exposure to HPS. PMID:24584027

The need to reemphasize behavior change for HIV prevention in Uganda: a qualitative study.

PubMed

Green, Edward C; Kajubi, Phoebe; Ruark, Allison; Kamya, Sarah; D'Errico, Nicole; Hearst, Norman

2013-03-01

Uganda has long been considered an AIDS success story, although in recent years declines in prevalence and incidence appear to have stalled or even reversed. During the early stages of Uganda's AIDS prevention program, health messages emphasized behavior change, especially fidelity. Ugandans were made to fear AIDS and feel personally at risk of dying from a new, poorly understood disease. In this research, six focus group discussions with 64 participants in peri-urban and rural areas outside Kampala suggest that HIV prevention messages have shifted in the direction of risk reduction: condoms, testing, and drugs. Ugandans now seem less afraid of becoming infected with HIV, at least in part because antiretroviral therapy is available, and this diminished fear may be having a disinhibiting effect on sexual behavior. Participants believe that HIV rates are on the rise, that more individuals are engaged in multiple and concurrent sexual partnerships, and that sexual behavior is less restrained than a generation ago. These findings suggest that AIDS-prevention programs in Uganda would benefit from refocusing on the content that yielded success previously-sexual behavior change strategies. © 2013 The Population Council, Inc.

Hantavirus Public Health outreach effectiveness in three populations: an overview of northwestern New Mexico, Los Santos Panama, and Region IX Chile.

PubMed

McConnell, Marjorie S

2014-02-27

This research compared the effectiveness of Hantavirus Pulmonary Syndrome (HPS) outreach programs in New Mexico, Panama, and Chile. Understanding the role of human demographics, disease ecology, and human behavior in the disease process is critical to the examination of community responses in terms of behavior changes. Attitudes, knowledge, and behavior across three populations were measured through the implementation of a self-administered questionnaire (N = 601). Surveys implemented in Chile and Panama in 2004, followed by northwestern New Mexico in 2008, attempted to assess knowledge and behavior change with respect to hantavirus in high- and lower-risk prevalence areas during endemic periods. While levels of concern over contracting hantavirus were lowest in New Mexico, they were highest in Panama. Respondents in Chile showed mid-level concern and exhibited a tendency to practice proper cleaning methods more than in New Mexico and Panama. This indicates that public health messages appear to be more effective in Chile. However, since negative behavior changes, such as sweeping and vacuuming, occur at some level in all three populations, improved messages should help decrease risk of exposure to HPS.

Exploring a Model of Symbolic Social Communication: The Case of ‘Magic’ Johnson

PubMed Central

FLORA, JUNE A.; SCHOOLER, CAROLINE; MAYS, VICKIE M.; COCHRAN, SUSAN D.

2009-01-01

We propose a model of symbolic social communication to explain the process whereby sociocultural identity mediates relationships among receivers, sources and messages to shape message effects. This exploratory study examines how two at-risk groups of African American men responded to various HIV prevention messages delivered by celebrity and professional sources. We interviewed 47 men from a homeless shelter and 50 male college students. Members of both groups were likely to select Johnson as the best person to deliver HIV prevention messages among a list of African American celebrity and professional sources. Results suggest the symbolic meanings embedded in celebrities and message topics are important and enduring influences on message effects. The images and ideas that a source represents are transferred to the advocated behavior, attitude or knowledge change and thus shape how messages are interpreted and received. Further understanding of how culture influences the effects of persuasive messages is critical for the improvement of health-communication campaigns. PMID:22011997

The use of messages in altering risky gambling behavior in experienced gamblers.

PubMed

Jardin, Bianca F; Wulfert, Edelgard

2012-03-01

The present study was an experimental analogue that examined the relationship between gambling-related irrational beliefs and risky gambling behavior. Eighty high-frequency gamblers were randomly assigned to four conditions and played a chance-based computer game in a laboratory setting. Depending on the condition, during the game a pop-up screen repeatedly displayed either accurate or inaccurate messages concerning the game, neutral messages, or no messages. Consistent with a cognitive-behavioral model of gambling, accurate messages that correctly described the random contingencies governing the game decreased risky gambling behavior. Contrary to predictions, inaccurate messages designed to mimic gamblers' irrational beliefs about their abilities to influence chance events did not lead to more risky gambling behavior than exposure to neutral or no messages. Participants in the latter three conditions did not differ significantly from one another and all showed riskier gambling behavior than participants in the accurate message condition. The results suggest that harm minimization strategies that help individuals maintain a rational perspective while gambling may protect them from unreasonable risk-taking. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Persuading drivers to refrain from speeding: Effects of message sidedness and regulatory fit.

PubMed

Pierro, Antonio; Giacomantonio, Mauro; Pica, Gennaro; Giannini, Anna Maria; Kruglanski, Arie W; Higgins, E Tory

2013-01-01

Building on regulatory fit theory (Higgins, 2000, 2005), we tested whether two-sided ads were more effective than one-sided ads in changing intentions toward driving behavior when message recipients were high in assessment orientation rather than locomotion orientation. In one study either a locomotion or an assessment orientation were situationally induced (Study 1) and in another study these different orientations were chronic predispositions (Study 2). As predicted, both studies found that for participants high in assessment, two-sided ads were more effective than one-sided ads, as reflected in stronger engagement with the persuasive message and stronger intentions to reduce driving speed. In contrast, for participants high in locomotion, one-sided ads were more effective than two-sided ads. There was also evidence that the fit effect on intentions to comply was mediated by strength of engagement with the message. Implications for persuasion concerning driving behaviors are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Behavioral frequency moderates the effects of message framing on HPV vaccine acceptability.

PubMed

Gerend, Mary A; Shepherd, Janet E; Monday, Kara A

2008-04-01

Research suggests that gain-framed messages are generally more effective than loss-framed messages at promoting preventive health behaviors. Virtually all previous studies, however, have examined prevention behaviors that require regular and repeated action to be effective. Little is known about the utility of message framing for promoting low-frequency prevention behaviors such as vaccination. Moreover, few studies have identified mediators of framing effects. We investigated whether behavioral frequency (operationalized as the number of shots required) moderated the effect of framed health messages on women's intentions to receive the human papillomavirus (HPV) vaccine. We also sought to identify mediators of framing effects. Undergraduate women (N = 237) were randomly assigned to read an HPV vaccination booklet that varied by message frame (gain vs. loss) and behavioral frequency (one shot vs. six shots). We observed a frame-by-frequency interaction such that the loss-framed message led to greater vaccination intentions than did the gain-framed message but only among participants in the one-shot condition. Perceived susceptibility to HPV infection mediated the observed framing effects. This study provides an important exception to the commonly observed gain-framed advantage for preventive health behaviors. Loss-framed appeals appear to be particularly effective in promoting interest in low-frequency prevention behaviors such as HPV vaccination.

Social marketing: an approach to planned social change.

PubMed

Kotler, P; Zaltman, G

1971-07-01

This article examines the applicability of marketing concepts to social causes and social change. Social marketing is defined as the design, implementation, and control of programs calculated to influence the acceptability of social ideas and involving considerations of product planning, pricing, communication, distribution and marketing research. Wiebe examined four social advertising campaigns and concluded that their effectiveness depended on the presence of adequate force, direction, adequate and compatible social mechanism, and distance (the "cost" of the new attitude as seen by message's message"s recepient). A marketing planning approach is not a guarantee for the achievement of social objectives; yet, it represents a bridging mechanism linking the knowledge of the behavioral scientist with the socially useful implementation of that knowledge.

A practical, cost-effective method for recruiting people into healthy eating behavior programs.

PubMed

McDonald, Paul W

2007-04-01

The population impact of programs designed to develop healthy eating behaviors is limited by the number of people who use them. Most public health providers and researchers rely on purchased mass media, which can be expensive, on public service announcements, or clinic-based recruitment, which can have limited reach. Few studies offer assistance for selecting high-outreach and low-cost strategies to promote healthy eating programs. The purpose of this study was 1) to determine whether classified newspaper advertising is an effective and efficient method of recruiting participants into a healthy eating program and 2) to determine whether segmenting messages by transtheoretical stage of change would help engage individuals at all levels of motivation to change their eating behavior. For 5 days in 1997, three advertisements corresponding to different stages of change were placed in a Canadian newspaper with a daily circulation of 75,000. There were 282 eligible people who responded to newspaper advertisements, and the cost was Can $1.11 (U.S. $0.72) per recruit. This cost compares favorably with the cost efficiency of mass media, direct mail, and other common promotional methods. Message type was correlated with respondent's stage of change, and this correlation suggested that attempts to send different messages to different audience segments were successful. Classified advertisements appear to be a highly cost-efficient method for recruiting a diverse range of participants into healthy eating programs and research about healthy eating.

Experiences of recovery in binge-eating disorder: a qualitative approach using online message boards.

PubMed

Lord, Vanessa M; Reiboldt, Wendy; Gonitzke, Dariella; Parker, Emily; Peterson, Caitlin

2018-02-01

In this study, qualitative methods were employed to analyze secondary data from the anonymous postings of a pro-recovery website in an effort to investigate the changes in thinking of binge-eating disorder (BED) sufferers who were able to recover from the disorder, understand more fully how guilt and self-blame affect recovery, and explore the perceived motivators and challenges to recovery. 681 messages from 65 participants pertaining to BED were analyzed from January 1, 2014-January 1, 2015 through thematic analysis. Coding strategies were employed to reveal patterns within the experiences of the participants. The researchers identified three themes surrounding "changes in thinking" from analysis of the message board postings: admitting the disorder, recognizing unhealthy coping behaviors, and seeing recovery. Further analysis of postings suggested that guilt and self-blame hinder recovery by promoting a feedback cycle of binging, which leads to further guilt and self-blame. The data ultimately identified experiences that resulted in or hindered recovery. The experience of validation appeared to result in recovery; those who experienced validation were less inclined to engage in disordered eating behaviors. Conversely, weight loss or attempts at weight loss hindered recovery by ultimately promoting more disordered eating behaviors. This qualitative analysis of message board postings offers authentic, credible data with a unique perspective. Practitioners working in the field of eating disorders such as registered dietitian nutritionists or therapists might use evidence from the data to guide their practice.

Is health literacy related to health behaviors and cell phone usage patterns among the text4baby target population?

PubMed

Poorman, Elisabeth; Gazmararian, Julie; Elon, Lisa; Parker, Ruth

2014-01-01

Text4baby provides educational text messages to pregnant and postpartum women and targets underserved women. The primary purpose of this study is to examine the health behaviors and cell phone usage patterns of a text4baby target population and the associations with health literacy. Pregnant and postpartum women were recruited from two Women, Infant and Children clinics in Atlanta. Women were asked about their demographics, selected pregnancy or postpartum health behaviors, and cell phone usage patterns. Health literacy skills were measured with the English version of the Newest Vital Sign. Multivariable logistic regression was used to examine health behaviors and cell usage patterns by health literacy classification, controlling for commonly accepted confounders. Four hundred sixty-eight women were recruited, and 445 completed the Newest Vital Sign. Of these, 22% had inadequate health literacy, 50% had intermediate health literacy, and 28% had adequate health literacy skills. Compared to adequate health literacy, limited literacy was independently associated with not taking a daily vitamin during pregnancy (OR 3.6, 95% CI: 1.6, 8.5) and never breastfeeding their infant (OR 1.4, 95% CI: 1.1, 1.8). The majority (69.4%) of respondents received nine or more text messages a day prior to enrollment, one in four participants (24.6%) had changed their number within the last six months, and 7.0% of study participants shared a cell phone. Controlling for potentially confounding factors, those with limited health literacy were more likely to share a cell phone than those with adequate health literacy (OR 2.57, 95% CI: 1.79, 3.69). Text4baby messages should be appropriate for low health literacy levels, especially as this population may have higher prevalence of targeted unhealthy behaviors. Text4baby and other mhealth programs targetting low health literacy populations should also be aware of the different ways that these populations use their cell phones, including: sharing cell phones, which may mean participants will not receive messages or have special privacy concerns; frequently changing cell phone numbers which could lead to higher drop-off rates; and the penetrance of text messages in a population that receives many messages daily.

How Do Mobile Phone Diabetes Programs Drive Behavior Change?

PubMed Central

Nundy, Shantanu; Mishra, Anjuli; Hogan, Patrick; Lee, Sang Mee; Solomon, Marla C.; Peek, Monica E.

2015-01-01

Purpose The purpose of this study was to investigate the behavioral effects of a theory-driven, mobile phone–based intervention that combines automated text messaging and remote nursing, using an automated, interactive text messaging system. Methods This was a mixed methods observational cohort study. Study participants were members of the University of Chicago Health Plan (UCHP) who largely reside in a working-class, urban African American community. Surveys were conducted at baseline, 3 months (mid-intervention), and 6 months (postintervention) to test the hypothesis that the intervention would be associated with improvements in self-efficacy, social support, health beliefs, and self-care. In addition, in-depth individual interviews were conducted with 14 participants and then analyzed using the constant comparative method to identify new behavioral constructs affected by the intervention. Results The intervention was associated with improvements in 5 of 6 domains of self-care (medication taking, glucose monitoring, foot care, exercise, and healthy eating) and improvements in 1 or more measures of self-efficacy, social support, and health beliefs (perceived control). Qualitatively, participants reported that knowledge, attitudes, and ownership were also affected by the program. Together these findings were used to construct a new behavioral model. Conclusions This study’s findings challenge the prevailing assumption that mobile phones largely affect behavior change through reminders and support the idea that behaviorally driven mobile health interventions can address multiple behavioral pathways associated with sustained behavior change. PMID:25278512

Using metaphorical techniques in focus groups to uncover mothers' feelings about family meals.

PubMed

Kling, Leslie; Cotugna, Nancy; Snider, Sue; Peterson, P Michael

2009-01-01

Traditional nutrition education has not been shown to consistently produce behavior change. While it has been suggested that using emotion-based messages may be a better way to influence nutrition behavior change, this has not been well tested. Producing emotion-based messages is a multi-step process that begins with exploring subconscious barriers to behavior change rather than the more obvious and typically reported barriers. The purpose of this research was to uncover the emotional reasons, sometimes referred to as emotional pulse points, for mothers' choosing or not choosing to have more family meals. This would then serve as the first step to developing emotion-based messages promoting the benefits of family meals. Five focus group interviews were conducted with 51 low-income Black (n=28) and white (n=23) mothers. Metaphorical techniques were used to determine underlying feelings toward family and family meals. Discussions were video-taped, transcribed, and manually analyzed using a content-driven, immersion/crystallization approach to qualitative data analysis. Four themes emerged around the definition of family: acceptance, sharing, chaos, and protective/loyal. Some mothers felt mealtime was merely obligatory, and described it as stressful. Some reported a preference for attending to their own needs instead of sitting down with their children, while others felt that mealtime should be used to interact with and educate children and felt guilty when they were not able to provide family meals. Three themes emerged around feelings towards having or not having family meals: unimportant, important, and guilty. When explored further, mothers indicated that using the feeling of guilt to encourage family meals might be effective. Data obtained are being used to develop innovative, emotion-based messages that will be tested for effectiveness in promoting family meals.

Understanding Messaging Preferences to Inform Development of Mobile Goal-Directed Behavioral Interventions

PubMed Central

van Stolk-Cooke, Katherine; Morgenstern, Jon; Kuerbis, Alexis N; Markle, Kendra

2014-01-01

Background Mobile messaging interventions have been shown to improve outcomes across a number of mental health and health-related conditions, but there are still significant gaps in our knowledge of how to construct and deliver the most effective brief messaging interventions. Little is known about the ways in which subtle linguistic variations in message content can affect user receptivity and preferences. Objective The aim of this study was to determine whether any global messaging preferences existed for different types of language content, and how certain characteristics moderate those preferences, in an effort to inform the development of mobile messaging interventions. Methods This study examined user preferences for messages within 22 content groupings. Groupings were presented online in dyads of short messages that were identical in their subject matter, but structurally or linguistically varied. Participants were 277 individuals residing in the United States who were recruited and compensated through Amazon’s Mechanical Turk (MTurk) system. Participants were instructed to select the message in each dyad that they would prefer to receive to help them achieve a personal goal of their choosing. Results Results indicate global preferences of more than 75% of subjects for certain types of messages, such as those that were grammatically correct, free of textese, benefit-oriented, polite, nonaggressive, and directive as opposed to passive, among others. For several classes of messages, few or no clear global preferences were found. There were few personality- and trait-based moderators of message preferences, but subtle manipulations of message structure, such as changing “Try to…” to “You might want to try to…” affected message choice. Conclusions The results indicate that individuals are sensitive to variations in the linguistic content of text messages designed to help them achieve a personal goal and, in some cases, have clear preferences for one type of message over another. Global preferences were indicated for messages that contained accurate spelling and grammar, as well as messages that emphasize the positive over the negative. Research implications and a guide for developing short messages for goal-directed behaviors are presented in this paper. PMID:24500775

Effects of Self-Efficacy and Response Efficacy Messages in Health News: Changing Health Attitudes and Behavioral Intentions

ERIC Educational Resources Information Center

Moriarty, Cortney Michelle

2009-01-01

Cancer is now the second leading cause of death for Americans, behind heart disease. By current estimates, up to two thirds of cancer diagnoses could be avoided or prevented with behavior changes such as the adoption of healthier lifestyles. One way that individuals learn about cancer is through the news media. Of all of the sources of health…

Fear, threat, and perceptions of efficacy from frightening skin cancer messages.

PubMed

Stephenson, M T; Witte, K

1998-01-01

Fear appeal messages were designed and tested to ascertain their effectiveness in promoting skin protective behaviors. Theoretically guided by the Extended Parallel Process Model, the fear appeal messages in this study conveyed the seriousness of exposed and unprotected skin for college students in the Southwestern United States, and recommended a series of behaviors that would protect individuals from serious sunburns. The results demonstrated that fear appeals are effective in promoting skin protective behaviors. Specifically, highly threatening fear appeal messages were most effective when combined with a strong efficacy message emphasizing the effectiveness of the recommended behaviors.

"When diet and exercise are not enough": an examination of lifestyle change inefficacy claims in direct-to-consumer advertising.

PubMed

Byrne, Sahara; Niederdeppe, Jeff; Avery, Rosemary J; Cantor, Jonathan

2013-01-01

Previous research suggests that direct-to-consumer (DTC) advertisements for pharmaceutical drugs have the potential to influence consumers' perceptions of whether symptoms should be treated medically and/or through behavior change. However, the relative frequency of messages emphasizing these approaches in pharmaceutical advertising remains largely unknown. A content analysis of print and television advertisements for cholesterol management medication between 1994 and 2005 (for print) and between 1999 and 2007 (for television) was conducted. First, the extent to which established theoretical constructs drawn from health communication scholarship are depicted in the content of DTC cholesterol advertisements is quantified. Second, specific claims about behavior change inefficacy when a pharmaceutical alternative is available are identified. Findings indicate that DTC ads offer many mixed messages about the efficacy of diet and exercise in reducing cholesterol and risk of heart disease. Theoretical and practical implications of this work are discussed.

The Differential Effects of Rape Prevention Programming on Attitudes, Behavior, and Knowledge.

ERIC Educational Resources Information Center

Heppner, Mary J.; And Others

1995-01-01

Evaluates whether type of programming differentially affects the processing of rape prevention messages, attitudes, knowledge, behaviors, and stability of change. Participants (n=258) were assigned to a didactic-video program, an interactive drama, or control. Results indicated that the interactive video was most effective in central route…

Do Fitness Apps Need Text Reminders? An Experiment Testing Goal-Setting Text Message Reminders to Promote Self-Monitoring.

PubMed

Liu, Shuang; Willoughby, Jessica F

2018-01-01

Fitness tracking apps have the potential to change unhealthy lifestyles, but users' lack of compliance is an issue. The current intervention examined the effectiveness of using goal-setting theory-based text message reminders to promote tracking activities on fitness apps. We conducted a 2-week experiment with pre- and post-tests with young adults (n = 50). Participants were randomly assigned to two groups-a goal-setting text message reminder group and a generic text message reminder group. Participants were asked to use a fitness tracking app to log physical activity and diet for the duration of the study. Participants who received goal-setting reminders logged significantly more physical activities than those who only received generic reminders. Further, participants who received goal-setting reminders liked the messages and showed significantly increased self-efficacy, awareness of personal goals, motivation, and intention to use the app. The study shows that incorporating goal-setting theory-based text message reminders can be useful to boost user compliance with self-monitoring fitness apps by reinforcing users' personal goals and enhancing cognitive factors associated with health behavior change.

Theory-Based Formative Research on an Anti-Cyberbullying Victimization Intervention Message.

PubMed

Savage, Matthew W; Deiss, Douglas M; Roberto, Anthony J; Aboujaoude, Elias

2017-02-01

Cyberbullying is a common byproduct of the digital revolution with serious consequences to victims. Unfortunately, there is a dearth of empirically based methods to confront it. This study used social cognitive theory to design and test an intervention message aimed at persuading college students to abstain from retaliation, seek social support, save evidence, and notify authorities-important victim responses identified and recommended in previous research. Using a posttest-only control group design, this study tested the effectiveness of an intervention message in changing college students' perceived susceptibility to and perceived severity of cyberbullying as well as their self-efficacy, response efficacy, attitudes, and behavioral intentions toward each recommended response in future episodes of cyberbullying. Results indicated that the intervention message caused participants in the experimental condition to report significantly higher susceptibility, but not perceived severity, to cyberbullying than those in the control condition. The intervention message also caused expected changes in all outcomes except self-efficacy for not retaliating and in all outcomes for seeking social support, saving evidence, and notifying an authority. Implications for message design and future research supporting evidence-based anti-cyberbullying health communication campaigns are discussed.

A randomized controlled trial of the impact of a family planning mHealth service on knowledge and use of contraception.

PubMed

Johnson, Douglas; Juras, Randall; Riley, Pamela; Chatterji, Minki; Sloane, Phoebe; Choi, Soon Kyu; Johns, Ben

2017-01-01

mHealth, or the use of mobile phones for health, is a promising but largely untested method for increasing family planning knowledge in developing countries. This study estimates the effect of m4RH, an mHealth service in Kenya that provides family planning information via text message, on consumers' knowledge and use of contraception. We randomly assigned new consumers of the m4RH service to receive either full access or limited access to m4RH. We collected data on outcomes by sending questions directly to consumers via text message. Response rates to the text message surveys ranged from 51.8% to 13.5%. Despite relatively low response rates, response rates were very similar across the full-access and limited-access groups. We find that full access to m4RH increased consumers' scores on a test of contraceptive knowledge by 14% (95% confidence interval: 9.9%-18.2%) compared to a control group with limited access to m4RH. m4RH did not increase consumers' use of contraception, likelihood of discussing family planning with their partners, or likelihood of visiting a clinic to discuss family planning. Text messages may increase family planning knowledge but do not, by themselves, lead to behavior change. Text messages can be an effective method of increasing family planning knowledge but may be insufficient on their own to cause behavior change. Copyright © 2016 Elsevier Inc. All rights reserved.

The impact of cultural exposure and message framing on oral health behavior: Exploring the role of message memory

PubMed Central

Brick, Cameron; McCully, Scout N.; Updegraff, John A.; Ehret, Phillip J.; Areguin, Maira A.; Sherman, David K.

2015-01-01

Background Health messages are more effective when framed to be congruent with recipient characteristics, and health practitioners can strategically decide on message features to promote adherence to recommended behaviors. We present exposure to United States (U.S.) culture as a moderator of the impact of gain- vs. loss-frame messages. Since U.S. culture emphasizes individualism and approach orientation, greater cultural exposure was expected to predict improved patient choices and memory for gain-framed messages, whereas individuals with less exposure to U.S. culture would show these advantages for loss-framed messages. Methods 223 participants viewed a written oral health message in one of three randomized conditions: gain-frame, loss-frame, or no-message control, and were given ten flosses. Cultural exposure was measured with the proportions of life spent and parents born in the U.S. At baseline and one week later, participants completed recall tests and reported recent flossing behavior. Results Message frame and cultural exposure interacted to predict improved patient decisions (increased flossing) and memory maintenance for the health message over one week. E.g., those with low cultural exposure who saw a loss-frame message flossed more. Incongruent messages led to the same flossing rates as no message. Memory retention did not explain the effect of message congruency on flossing. Limitations Flossing behavior was self-reported. Cultural exposure may only have practical application in either highly individualistic or collectivistic countries. Conclusions In healthcare settings where patients are urged to follow a behavior, asking basic demographic questions could allow medical practitioners to intentionally communicate in terms of gains or losses to improve patient decision making and treatment adherence. PMID:25654986

Impact of Cultural Exposure and Message Framing on Oral Health Behavior: Exploring the Role of Message Memory.

PubMed

Brick, Cameron; McCully, Scout N; Updegraff, John A; Ehret, Phillip J; Areguin, Maira A; Sherman, David K

2016-10-01

Health messages are more effective when framed to be congruent with recipient characteristics, and health practitioners can strategically choose message features to promote adherence to recommended behaviors. We present exposure to US culture as a moderator of the impact of gain-frame versus loss-frame messages. Since US culture emphasizes individualism and approach orientation, greater cultural exposure was expected to predict improved patient choices and memory for gain-framed messages, whereas individuals with less exposure to US culture would show these advantages for loss-framed messages. 223 participants viewed a written oral health message in 1 of 3 randomized conditions-gain-frame, loss-frame, or no-message control-and were given 10 flosses. Cultural exposure was measured with the proportions of life spent and parents born in the US. At baseline and 1 week later, participants completed recall tests and reported recent flossing behavior. Message frame and cultural exposure interacted to predict improved patient decisions (increased flossing) and memory maintenance for the health message over 1 week; for example, those with low cultural exposure who saw a loss-frame message flossed more. Incongruent messages led to the same flossing rates as no message. Memory retention did not explain the effect of message congruency on flossing. Flossing behavior was self-reported. Cultural exposure may only have practical application in either highly individualistic or collectivistic countries. In health care settings where patients are urged to follow a behavior, asking basic demographic questions could allow medical practitioners to intentionally communicate in terms of gains or losses to improve patient decision making and treatment adherence. © The Author(s) 2015.

Effects of Brief Messages About Antiretroviral Therapy and Condom Use Benefits Among Black and Latino MSM in Three U.S. Cities.

PubMed

Herbst, Jeffrey H; Mansergh, Gordon; Pitts, Nicole; Denson, Damian; Mimiaga, Matthew J; Holman, Jeremy

2018-01-01

This pilot study examined effects of HIV prevention messages about self and partner benefits of antiretroviral therapy (ART) and condom effectiveness on increased intentions for behavior change. Data were from Messages4Men, a study examining prevention messages among 320 HIV-positive and 605 HIV-negative Black and Latino MSM. Men completed a computer-based assessment after message exposure, and multivariable models controlled for risky sex and demographics. A majority of HIV-positive men reported increased intentions for ART use; 22% reported partner benefit information was new. HIV-positive men with a detectable viral load had significantly greater adjusted odds of reporting intentions for ART use. Over half of HIV-negative MSM reported ART benefit information was new, and 88% reported increased intentions to discuss ART use with infected partners. Black MSM anticipated they would increase condom use in response to the self and partner benefit messages. Tailored messages on benefits of ART are needed for MSM.

Perspectives on communication problems in the English-speaking Caribbean.

PubMed

Okwesa, B A

1984-03-01

The Caribbean is experiencing a host of serious socioeconomic problems that prevent the majority of the population from realizing and maintaining a satisfactory standard of living. Food and Nutrition Surveys of some countries identified a lack of information on health, food, and nutrition as a primary reason for the prevalence of malnutrition, infectious diseases, and nutrition related diseases. "Misinformation" creates an often insurmountable barrier to effective communication between source and receiver, in this case the health, food, and nutrition sector and the wider community. Misinformation occurs when the message is either incorrect, incomplete, inconsistent with other messages in the same program, or contradictory. This element of "misinformation" can negate the effectiveness of the message and an entire communication program. Some examples are cited which show that in programs aimed at effecting change in attitude or behavior it is essential to ensure that messages are clearly communicated to avoid misunderstanding and the right infrastructure is in place for the innovation proposed by the message to be carried out. In the Jamaica Nutrition Education Program (JNEP) were used to communicate the messages. Evaluation revealed that health staff were providing incorrect and contradictory advice about breastfeeding, which showed that they lacked basic information on the subject. In Barbados, despite an intensified health education campaign, face to face instruction in the clinics, and extensive use of the Caribbean Food and Nutrition Institute (CFNI) Breastfeeding Package as well as other locally developed materials, a marked decline in breastfeeding was recorded over the 1969-81 survey period. Misinformation and misunderstanding among mothers were identified as the key reasons for the failure of breastfeeding. In relation to the decline in breaastfeeding and incorrect weaning practices, mass media was implicated as luring mothers away from natural feeding methods towards the use of expensive imported products. A 1976 CFNI meeting established strong linkages between mass media and nutrition personnel and was the factor most responsible for the selection of an advertising/marketing approach as the chief component of the mass media strategy. In sum, there is more to communication than mere information transfer. Effective communication can produce/create the right climate for change to occur. The nature of the message is an important determining factor in attitude and behavior change, and the message must fit the intended audience. The medium of the message must be appropriate, culturally relevant, familiar and liked.

Action Tendency Emotions Evoked by Memorable Breast Cancer Messages and Their Association With Prevention and Detection Behaviors

PubMed Central

Smith, Sandi W.; Hamel, Lauren M; Kotowski, Michael R.; Nazione, Samantha; LaPlante, Carolyn; Atkin, Charles K.; Stohl, Cynthia; Skubisz, Christine

2010-01-01

Memorable messages about breast cancer sent by different sources, such as friends and family members, were analyzed for the action tendency emotions that they evoked. Negative emotions of fear, sadness, and anger, and positive emotions of hope and relief were analyzed for their associations with prevention and detection breast cancer behaviors. Messages that evoked fear were significantly more likely to be associated with detection behaviors, whereas messages that evoked relief were significantly less likely to be associated with detection behaviors than messages that did not evoke these emotions. These results are consistent with control theory and also show that friends and family are important sources of memorable messages about breast cancer. PMID:21153990

More Than a Text Message: Dismantling Digital Triggers to Curate Behavior Change in Patient-Centered Health Interventions

PubMed Central

2017-01-01

Digital triggers such as text messages, emails, and push alerts are designed to focus an individual on a desired goal by prompting an internal or external reaction at the appropriate time. Triggers therefore have an essential role in engaging individuals with digital interventions delivered outside of traditional health care settings, where other events in daily lives and fluctuating motivation to engage in effortful behavior exist. There is an emerging body of literature examining the use of digital triggers for short-term action and longer-term behavior change. However, little attention has been given to understanding the components of digital triggers. Using tailoring as an overarching framework, we separated digital triggers into 5 primary components: (1) who (sender), (2) how (stimulus type, delivery medium, heterogeneity), (3) when (delivered), (4) how much (frequency, intensity), and (5) what (trigger’s target, trigger’s structure, trigger’s narrative). We highlighted key considerations when tailoring each component and the pitfalls of ignoring common mistakes, such as alert fatigue and habituation. As evidenced throughout the paper, there is a broad literature base from which to draw when tailoring triggers to curate behavior change in health interventions. More research is needed, however, to examine differences in efficacy based on component tailoring, to best use triggers to facilitate behavior change over time, and to keep individuals engaged in physical and mental health behavior change efforts. Dismantling digital triggers into their component parts and reassembling them according to the gestalt of one’s change goals is the first step in this development work. PMID:28550001

The constructive, destructive, and reconstructive power of social norms.

PubMed

Schultz, P Wesley; Nolan, Jessica M; Cialdini, Robert B; Goldstein, Noah J; Griskevicius, Vladas

2007-05-01

Despite a long tradition of effectiveness in laboratory tests, normative messages have had mixed success in changing behavior in field contexts, with some studies showing boomerang effects. To test a theoretical account of this inconsistency, we conducted a field experiment in which normative messages were used to promote household energy conservation. As predicted, a descriptive normative message detailing average neighborhood usage produced either desirable energy savings or the undesirable boomerang effect, depending on whether households were already consuming at a low or high rate. Also as predicted, adding an injunctive message (conveying social approval or disapproval) eliminated the boomerang effect. The results offer an explanation for the mixed success of persuasive appeals based on social norms and suggest how such appeals should be properly crafted.

The use of mHealth to deliver tailored messages reduces reported energy and fat intake

PubMed Central

Ambeba, Erica J.; Ye, Lei; Sereika, Susan M.; Styn, Mindi A.; Acharya, Sushama D.; Sevick, Mary Ann; Ewing, Linda J.; Conroy, Molly B.; Glanz, Karen; Zheng, Yaguang; Goode, Rachel W.; Mattos, Meghan; Burke, Lora E.

2016-01-01

Background Evidence supports the role of feedback in reinforcing motivation for behavior change. Feedback that provides reinforcement has the potential to increase dietary self-monitoring and enhance attainment of recommended dietary intake. Objective To examine the impact of daily feedback (DFB) messages, delivered remotely, on changes in dietary intake. Methods A secondary analysis of the SMART trial, a single-center, 24-month randomized clinical trial of behavioral treatment for weight loss. Participants included 210 obese adults (mean body mass index=34.0 kg/m2) who were randomized to either a paper diary (PD), personal digital assistant (PDA), or PDA plus daily, tailored feedback messages (PDA+FB). To determine the role of daily tailored feedback in dietary intake, we compared the self-monitoring with daily feedback group (DFB, n=70) to the self-monitoring without daily feedback group (No-DFB, n=140). All participants received a standard behavioral intervention for weight loss. Self-reported changes in dietary intake were compared between the DFB and No-DFB groups and were measured at baseline, 6, 12, 18, and 24 months. Linear mixed modeling was used to examine percent changes in dietary intake from baseline. Results Compared to the No-DFB group, the DFB group achieved a larger reduction in energy (−22.8% vs. −14.0%, p=0.02) and saturated fat (−11.3% vs. −0.5%, p=0.03) intake, and a trend toward a greater decrease in total fat intake (−10.4% vs. −4.7%, p=0.09). There were significant improvements over time in carbohydrate intake and total fat intake for both groups (p’s<0.05). Conclusion Daily, tailored feedback messages, designed to target energy and fat intake and delivered remotely in real-time using mobile devices, may play an important role in the reduction of energy and fat intake. PMID:24434827

How Can Implicit and Explicit Attitudes Both Be Changed? Testing Two Interventions to Promote Consumption of Green Vegetables.

PubMed

Mattavelli, Simone; Avishai, Aya; Perugini, Marco; Richetin, Juliette; Sheeran, Paschal

2017-08-01

Although correlational studies have demonstrated that implicit and explicit attitudes are both important in predicting eating behavior, few studies targeting food choice have attempted to change both types of attitudes. We tested the impact of (a) an evaluative learning intervention that uses the self to change attitudes (i.e., a Self-Referencing task) and (b) a persuasive communication in modifying implicit and explicit attitudes towards green vegetables and promoting readiness to change. The study targeted individuals who explicitly reported they did not like or only moderately liked green vegetables. Participants (N = 273) were randomly allocated to a 2 (self-referencing: present vs. absent) × 2 (persuasive message: present vs. absent) factorial design. The outcomes were implicit and explicit attitudes as well as readiness to increase consumption of green vegetables. Implicit attitudes increased after repeatedly pairing green vegetable stimuli with the self in the self-referencing task but did not change in response to the persuasive communication. The persuasive message increased explicit attitudes and readiness to change, but did not alter implicit attitudes. A three-way interaction with pre-existing explicit attitudes was also observed. In the absence of a persuasive message, the self-referencing task increased on readiness to change among participants with more negative pre-existing explicit attitudes. This study is the first to demonstrate that a self-referencing task is effective in changing both implicit attitudes and readiness to change eating behavior. Findings indicate that distinct intervention strategies are needed to change implicit and explicit attitudes towards green vegetables.

The Influence of Framed Messages and Self-Affirmation on Indoor Tanning Behavioral Intentions among 18 to 30 Year Old Women

PubMed Central

Mays, Darren; Zhao, Xiaoquan

2016-01-01

Objective To investigate the effects of gain- and loss-framed indoor tanning (IT) prevention messages among young adult women, and examine the potential moderating effect of self-affirmation. Methods Young adult women ages 18 to 30 who reported IT at least once in the past year (n = 475) participated in an online experiment. Participants first completed assessments of IT behavior and related constructs and were randomized to either a self-affirmation manipulation or control condition. Then, participants were randomized to either a gain-framed message emphasizing the benefits of avoiding IT or a loss-framed message emphasizing the risks of IT. Participants completed outcome measures of intentions to IT, intentions to quit IT, and emotional and cognitive responses to the framed messages. Results Compared with gain-framed messages, loss-framed messages led to weaker intentions to IT and stronger intentions to quit IT. Self-affirmation did not moderate message framing effects, but had a main effect increasing intentions to IT. Mediation analyses indicate that loss-framed messages affect IT behavioral intentions by increasing fear and self-affirmation may have increased intentions to IT by producing defensive reactions to the framed messages. Conclusions Loss-framed messages were more effective for reducing intentions to IT and promoting intentions to quit IT among young women after a brief exposure, and emotional response appears to be one pathway through which loss-framed messages affect behavioral outcomes. Messages emphasizing the risks of IT may be optimal as a public health intervention strategy. Unlike other behavioral domains, self-affirmation did not reduce defensive processing of loss-framed messages. PMID:26192383

The influence of framed messages and self-affirmation on indoor tanning behavioral intentions in 18- to 30-year-old women.

PubMed

Mays, Darren; Zhao, Xiaoquan

2016-02-01

To investigate the effects of gain- and loss-framed indoor tanning (IT) prevention messages among young adult women, and examine the potential moderating effect of self-affirmation. Young adult women ages 18 to 30 who reported IT at least once in the past year (n = 475) participated in an online experiment. Participants first completed assessments of IT behavior and related constructs and were randomized to either a self-affirmation manipulation or control condition. Then, participants were randomized to either a gain-framed message emphasizing the benefits of avoiding IT or a loss-framed message emphasizing the risks of IT. Participants completed outcome measures of intentions to IT, intentions to quit IT, and emotional and cognitive responses to the framed messages. Compared with gain-framed messages, loss-framed messages led to weaker intentions to IT and stronger intentions to quit IT. Self-affirmation did not moderate message framing effects, but had a main effect increasing intentions to IT. Mediation analyses indicate that loss-framed messages affect IT behavioral intentions by increasing fear, and self-affirmation may have increased intentions to IT by producing defensive reactions to the framed messages. Loss-framed messages were more effective for reducing intentions to IT and promoting intentions to quit IT among young women after a brief exposure, and emotional response appears to be 1 pathway through which loss-framed messages affect behavioral outcomes. Messages emphasizing the risks of IT may be optimal as a public health intervention strategy. Unlike other behavioral domains, self-affirmation did not reduce defensive processing of loss-framed messages. (c) 2016 APA, all rights reserved).

A Woman in Transition: can drama deliver a cancer awareness message?

PubMed

Cheney, Lydia C; Kohler, Connie; Legge Muilenburg, Jessica

2006-01-01

Entertainment education is a field of health communication that utilizes a variety of entertainment to change health behaviors. In this article, we describe a pilot project in which we measured the effectiveness of drama as a health communication tool. Attendees completed a pretest and posttest measuring knowledge, attitudes, and behavior related to breast cancer screening. At posttest, more women indicated breast self-exam rather than mammogram to be the "best method of early detection." Researchers who use drama as a communication tool cannot be assured of the final health message delivered. Careful evaluation to monitor the effectiveness of drama as a cancer awareness tool is vital.

Get real: how current behavior influences perceptions of realism and behavioral intent for public service announcements.

PubMed

Nelson, Michelle R; Zhu, Xuan; Li, Yingying; Fiese, Barbara; Koester, Brenda

2015-01-01

This research examined how realism and current behavior influence message reception and processing for public service announcements (PSAs) designed to help parents with meal planning. Findings from 19 in-depth interviews revealed that the perceived realism of the message, the similarity, and the wishful identification with informants' lives influenced message acceptance, in line with the Message Interpretation Process (MIP) model. Results of an online survey with mothers show that realism matters more for those individuals who already engage in the featured behavior. In line with theory, "experts" (meal planners) show increased behavioral intent of the featured behaviors when viewing the more realistic PSA.

Text2Floss: the feasibility and acceptability of a text messaging intervention to improve oral health behavior and knowledge.

PubMed

Hashemian, Tony S; Kritz-Silverstein, Donna; Baker, Ryan

2015-01-01

Text messaging is useful for promoting numerous health-related behaviors. The Text2Floss Study examines the feasibility and utility of a 7-day text messaging intervention to improve oral health knowledge and behavior in mothers of young children. Mothers were recruited from a private practice and a community clinic. Of 156 mothers enrolled, 129 randomized into text (n = 60) and control groups (n = 69) completed the trial. Participants in the text group received text messages for 7 days, asking about flossing and presenting oral health information. Oral health behaviors and knowledge were surveyed pre- and post-intervention. At baseline, there were no differences between text and control group mothers in knowledge and behaviors (P > 0.10). Post-intervention, text group mothers flossed more (P = 0.01), had higher total (P = 0.0006) and specific (P < 0.05) knowledge, and tried to improve their child's oral health behaviors (P = 0.03) and decrease their soda and sugary snacks (P = 0.05) more than control mothers. Text messages were accepted and perceived as useful. Mothers receiving text messages improved their own oral health behaviors and knowledge as well as their behaviors regarding their children's oral health. Text messaging represents a viable method to improve oral health behaviors and knowledge. Its high acceptance may make it useful for preventing oral disease. © 2014 American Association of Public Health Dentistry.

Modulating the neural bases of persuasion: why/how, gain/loss, and users/non-users

PubMed Central

Katzman, Perri L.; Ames, Daniel L.; Falk, Emily B.; Lieberman, Matthew D.

2017-01-01

Abstract Designing persuasive content is challenging, in part because people can be poor predictors of their actions. Medial prefrontal cortex (MPFC) activation during message exposure reliably predicts downstream behavior, but past work has been largely atheoretical. We replicated past results on this relationship and tested two additional framing effects known to alter message receptivity. First, we examined gain- vs. loss-framed reasons for a health behavior (sunscreen use). Consistent with predictions from prospect theory, we observed greater MPFC activity to gain- vs. loss-framed messages, and this activity was associated with behavior. This relationship was stronger for those who were not previously sunscreen users. Second, building on theories of action planning, we compared neural activity during messages regarding how vs. why to enact the behavior. We observed rostral inferior parietal lobule and posterior inferior frontal gyrus activity during action planning (“how” messages), and this activity was associated with behavior; this is in contrast to the relationship between MPFC activity during the “why” (i.e., gain and loss) messages and behavior. These results reinforce that persuasion occurs in part via self-value integration—seeing value and incorporating persuasive messages into one's self-concept—and extend this work to demonstrate how message framing and action planning may influence this process. PMID:27521303

Change over Time in Children's Co-Constructed Writing

ERIC Educational Resources Information Center

Harmey, Sinead Judith

2015-01-01

The development of expertise in writing is a complex but important achievement for young children as they become literate. Writing is a critical component of literacy development, yet there are few accounts of change over time in early writing development that attend to both changes in writing behaviors, the complexity of written messages, and the…

Life or Death Decisions: Framing the Call for Help

PubMed Central

Chou, Eileen Y.; Murnighan, J. Keith

2013-01-01

Background Chronic blood shortages in the U.S. would be alleviated by small increases, in percentage terms, of people donating blood. The current research investigated the effects of subtle changes in charity-seeking messages on the likelihood of people responses to a call for help. We predicted that “avoid losses” messages would lead to more helping behavior than “promote gains” messages would. Method Two studies investigated the effects of message framing on helping intentions and behaviors. With the help and collaboration of the Red Cross, Study 1, a field experiment, directly assessed the effectiveness of a call for blood donations that was presented as either death-preventing (losses) or life-saving (gains), and as being of either more or less urgent need. With the help and collaboration of a local charity, Study 2, a lab experiment, assessed the effects of the gain-versus-loss framing of a donation-soliciting flyer on individuals’ expectations of others’ monetary donations as well their own volunteering behavior. Study 2 also assessed the effects of three emotional motivators - feelings of empathy, positive affect, and relational closeness. Result Study 1 indicated that, on a college campus, describing blood donations as a way to “prevent a death” rather than “save a life” boosted the donation rate. Study 2 showed that framing a charity’s appeals as helping people to avoid a loss led to larger expected donations, increased intentions to volunteer, and more helping behavior, independent of other emotional motivators. Conclusion This research identifies and demonstrates a reliable and effective method for increasing important helping behaviors by providing charities with concrete ideas that can effectively increase helping behavior generally and potentially death-preventing behavior in particular. PMID:23483903

Life or death decisions: framing the call for help.

PubMed

Chou, Eileen Y; Murnighan, J Keith

2013-01-01

Chronic blood shortages in the U.S. would be alleviated by small increases, in percentage terms, of people donating blood. The current research investigated the effects of subtle changes in charity-seeking messages on the likelihood of people responses to a call for help. We predicted that "avoid losses" messages would lead to more helping behavior than "promote gains" messages would. Two studies investigated the effects of message framing on helping intentions and behaviors. With the help and collaboration of the Red Cross, Study 1, a field experiment, directly assessed the effectiveness of a call for blood donations that was presented as either death-preventing (losses) or life-saving (gains), and as being of either more or less urgent need. With the help and collaboration of a local charity, Study 2, a lab experiment, assessed the effects of the gain-versus-loss framing of a donation-soliciting flyer on individuals' expectations of others' monetary donations as well their own volunteering behavior. Study 2 also assessed the effects of three emotional motivators - feelings of empathy, positive affect, and relational closeness. Study 1 indicated that, on a college campus, describing blood donations as a way to "prevent a death" rather than "save a life" boosted the donation rate. Study 2 showed that framing a charity's appeals as helping people to avoid a loss led to larger expected donations, increased intentions to volunteer, and more helping behavior, independent of other emotional motivators. This research identifies and demonstrates a reliable and effective method for increasing important helping behaviors by providing charities with concrete ideas that can effectively increase helping behavior generally and potentially death-preventing behavior in particular.

Changes in cardiovascular disease knowledge and behavior in a low-education population of African-American and white adults.

PubMed

Smith, N L; Croft, J B; Heath, G W; Cokkinides, V

1996-01-01

Racial differences in secular changes in cardiovascular disease risk factor knowledge and behaviors were assessed among adults with low levels of education throughout a community-wide cardiovascular disease prevention program. Four independent cross-sectional telephone surveys were conducted with the random-digit-dialing technique in 1987, 1988, 1989, and 1991 in a biracial South Carolina community. Community-wide cardiovascular disease intervention programs were initiated in 1988 and continued through 1990. Changes in the prevalence of cardiovascular risk factor knowledge, dietary fat intake, leisure-time physical activity, smoking, and cholesterol screening behavior were compared between African-American and white respondents in a population subset with less than 12 years of education using analysis of covariance regression techniques. Mean intake of high fat foods was lower in 1991 than in 1987 among both white and African-American respondents; the trend for lower mean intake began in 1989 among African-American adults. Prevalence of the correct exercise knowledge was higher in 1988 than in 1987 for both groups, but this trend was maintained only among white respondents. However, prevalence of leisure-time physical activity did not change significantly between 1987 and 1991. Prevalence of cholesterol level knowledge and screening behavior increased over time among both groups; however, greater increasing trends between 1987 and 1991 were observed among white adults. Favorable secular changes in fat intake, exercise knowledge, cholesterol level knowledge, and cholesterol screening behavior were observed among both race groups during a time period that coincided with community-wide intervention efforts and messages. Greater changes in most of these behaviors and knowledge were observed among white adults suggesting that health behavior messages may not have reached all segments of this community.

mHealth Intervention to Improve Diabetes Risk Behaviors in India: A Prospective, Parallel Group Cohort Study.

PubMed

Pfammatter, Angela; Spring, Bonnie; Saligram, Nalini; Davé, Raj; Gowda, Arun; Blais, Linelle; Arora, Monika; Ranjani, Harish; Ganda, Om; Hedeker, Donald; Reddy, Sethu; Ramalingam, Sandhya

2016-08-05

In low/middle income countries like India, diabetes is prevalent and health care access limited. Most adults have a mobile phone, creating potential for mHealth interventions to improve public health. To examine the feasibility and initial evidence of effectiveness of mDiabetes, a text messaging program to improve diabetes risk behaviors, a global nonprofit organization (Arogya World) implemented mDiabetes among one million Indian adults. A prospective, parallel cohort design was applied to examine whether mDiabetes improved fruit, vegetable, and fat intakes and exercise. Intervention participants were randomly selected from the one million Nokia subscribers who elected to opt in to mDiabetes. Control group participants were randomly selected from non-Nokia mobile phone subscribers. mDiabetes participants received 56 text messages in their choice of 12 languages over 6 months; control participants received no contact. Messages were designed to motivate improvement in diabetes risk behaviors and increase awareness about the causes and complications of diabetes. Participant health behaviors (exercise and fruit, vegetable, and fat intake) were assessed between 2012 and 2013 via telephone surveys by blinded assessors at baseline and 6 months later. Data were cleaned and analyzed in 2014 and 2015. 982 participants in the intervention group and 943 in the control group consented to take the phone survey at baselne. At the end of the 6-month period, 611 (62.22%) in the intervention and 632 (67.02%) in the control group completed the follow-up telephone survey. Participants receiving texts demonstrated greater improvement in a health behavior composite score over 6 months, compared with those who received no messages F(1, 1238) = 30.181, P<.001, 95% CI, 0.251-0.531. Fewer intervention participants demonstrated health behavior decline compared with controls. Improved fruit, vegetable, and fat consumption (P<.01) but not exercise were observed in those receiving messages, as compared with controls. A text messaging intervention was feasible and showed initial evidence of effectiveness in improving diabetes-related health behaviors, demonstrating the potential to facilitate population-level behavior change in a low/middle income country. Australian New Zealand Clinical Trials Registry (ACTRN): 12615000423516; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367946&isReview=true (Archived by WebCite at http://www.webcitation.org/6j5ptaJgF).

Using theory-based messages to motivate U.S. pregnant women to prevent cytomegalovirus infection: results from formative research.

PubMed

Levis, Denise M; Hillard, Christina L; Price, Simani M; Reed-Gross, Erika; Bonilla, Erika; Amin, Minal; Stowell, Jennifer D; Clark, Rebekah; Johnson, Delaney; Mask, Karen; Carpentieri, Cynthia; Cannon, Michael J

2017-12-14

An estimated 1 in 150 infants is born each year with congenital cytomegalovirus (CMV); nearly 1 in 750 suffers permanent disabilities. Congenital CMV is the result of a pregnant woman becoming infected with CMV. Educating pregnant women about CMV is currently the best approach to prevention. Limited research is available on how to effectively communicate with women about CMV. We conducted formative research on fear appeals theory-based messages about CMV and prevention with U.S. women. Fear appeal theories suggest that message recipients will take action if they feel fear. First, we conducted in-depth interviews (N = 32) with women who had young children who tested positive for CMV. Second, we conducted eight focus groups (N = 70) in two phases and two cities (Phase 2: Atlanta, GA; Phase 3: San Diego, CA) with pregnant women and non-pregnant women who had young children. Few participants knew about CMV before the focus groups. Participants reviewed and gave feedback on messages created around fear appeals theory-based communication concepts. The following concepts were tested in one or more of the three phases of research: CMV is severe, CMV is common, CMV is preventable, CMV preventive strategies are similar to other behavior changes women make during pregnancy, CMV preventive strategies can be incorporated in moderation to reduce exposure, and CMV is severe but preventable. Participants recommended communicating that CMV is common by using prevalence ratios (e.g., 1 in 150) or comparing CMV to other well-known disabilities. To convey the severity of CMV, participants preferred stories about CMV along with prevention strategies. Participants also welcomed prevention strategies when it included a message about risk reduction. In general, participants said messages were motivating, even if they felt that it could be difficult to make certain behavior changes. Findings from this research can contribute to future efforts to educate pregnant women about CMV, especially regarding use of fear appeals-based messages. Pregnant women may face certain challenges to practicing prevention strategies but, overall, are motivated make changes to increase their chances of having a healthy baby.

Promoting healthy behaviors: how do we get the message across?

PubMed

Myers, Rachel E

2010-04-01

The world is experiencing a rapid rise in chronic health problems, which places an enormous burden on health care services. Modifiable health behaviors are largely responsible for this high prevalence and incidence of chronic diseases. This realization has made initiatives that promote healthy behaviors an international and interdisciplinary priority. How can nurses and other health care providers get the message across to their patients in order to maximize likelihood of leading to desired outcomes? Message tailoring is a well-established health communication approach shown to increase the persuasiveness of message effects in the promotion of healthy behaviors. Message framing is an effective message tailoring strategy that has been well-studied in the psychology literature over the past 20-plus years across a breadth of health behaviors while being severely understudied in the nursing literature. Numerous variables, especially those related to individual differences, have been shown to moderate message framing effects, a finding of great utility for nursing. This article presents a detailed review of the current state of the message framing literature, offers specific suggestions for advancing this literature, and highlights implications for research, education, and practice, with particular attention to nurses. Copyright 2009 Elsevier Ltd. All rights reserved.

A Field Experiment Testing the Utility of Regulatory Fit Messages for Promoting Physical Activity.

PubMed

Latimer, Amy E; Rivers, Susan E; Rench, Tara A; Katulak, Nicole A; Hicks, Althea; Hodorowski, Julie Keany; Higgins, E Tory; Salovey, Peter

2008-05-01

Guided by regulatory focus theory, we examined whether messages tailored to individuals' promotion- or prevention-goal orientation (regulatory focus) elicit positive thoughts and feelings about physical activity and increase participation in physical activity. Inactive participants (N = 206) were assigned randomly to receive either promotion-focused or prevention-focused messages encouraging physical activity. Two weeks after message exposure, we assessed participants' thoughts and feelings about physical activity and physical activity behavior. Tailored messages that fit individuals' regulatory focus led to greater physical activity participation and more positive feelings than non-fit messages, particularly in the promotion-focused condition. Furthermore, positive retrospective feelings about physical activity mediated the effects of the tailored messages on behavior. These findings provide support for regulatory focus theory and direction for enhancing the effectiveness of messages encouraging physical activity and other health behaviors.

Developing a Behavioral Model for Mobile Phone-Based Diabetes Interventions

PubMed Central

Nundy, Shantanu; Dick, Jonathan J.; Solomon, Marla C.; Peek, Monica E.

2013-01-01

Objectives Behavioral models for mobile phone-based diabetes interventions are lacking. This study explores the potential mechanisms by which a text message-based diabetes program affected self-management among African-Americans. Methods We conducted in-depth, individual interviews among 18 African-American patients with type 2 diabetes who completed a 4-week text message-based diabetes program. Each interview was audio- taped, transcribed verbatim, and imported into Atlas.ti software. Coding was done iteratively. Emergent themes were mapped onto existing behavioral constructs and then used to develop a novel behavioral model for mobile phone-based diabetes self-management programs. Results The effects of the text message-based program went beyond automated reminders. The constant, daily communications reduced denial of diabetes and reinforced the importance of self-management (Rosenstock Health Belief Model). Responding positively to questions about self-management increased mastery experience (Bandura Self-Efficacy). Most surprisingly, participants perceived the automated program as a “friend” and “support group” that monitored and supported their self-management behaviors (Barrera Social Support). Conclusions A mobile phone-based diabetes program affected self-management through multiple behavioral constructs including health beliefs, self-efficacy, and social support. Practice implications: Disease management programs that utilize mobile technologies should be designed to leverage existing models of behavior change and can address barriers to self-management associated with health disparities. PMID:23063349

Neural Activity During Health Messaging Predicts Reductions in Smoking Above and Beyond Self-Report

PubMed Central

Falk, Emily B.; Berkman, Elliot T.; Whalen, Danielle; Lieberman, Matthew D.

2011-01-01

Objective The current study tested whether neural activity in response to messages designed to help smokers quit could predict smoking reduction, above and beyond self-report. Design Using neural activity in an a priori region of interest (a subregion of medial prefrontal cortex [MPFC]), in response to ads designed to help smokers quit smoking, we prospectively predicted reductions in smoking in a community sample of smokers (N = 28) who were attempting to quit smoking. Smoking was assessed via expired carbon monoxide (CO; a biological measure of recent smoking) at baseline and 1 month following exposure to professionally developed quitting ads. Results A positive relationship was observed between activity in the MPFC region of interest and successful quitting (increased activity in MPFC was associated with a greater decrease in expired CO). The addition of neural activity to a model predicting changes in CO from self-reported intentions, self-efficacy, and ability to relate to the messages significantly improved model fit, doubling the variance explained ( Rself−report2=.15,Rself−report+neuralactivity2=.35,Rchange2=.20). Conclusion: Neural activity is a useful complement to existing self-report measures. In this investigation, we extend prior work predicting behavior change based on neural activity in response to persuasive media to an important health domain and discuss potential psychological interpretations of the brain–behavior link. Our results support a novel use of neuroimaging technology for understanding the psychology of behavior change and facilitating health promotion. PMID:21261410

Memorable Messages as Guides to Self-Assessment of Behavior: The Role of Instrumental Values.

ERIC Educational Resources Information Center

Smith, Sandi W.; Ellis, Jennifer Butler; Yoo, Hyo-Jin

2001-01-01

Uses control theory to predict how important instrumental values and internalized memorable messages work together when undergraduate students self-assess their previous behavior. Finds none of the four higher-order value factors predicted the hypothesized relationships among values, messages, and behaviors; but the value of…

Emotional Responses to Environmental Messages and Future Behavioral Intentions

ERIC Educational Resources Information Center

Perrin, Jeffrey L.

2011-01-01

The present research investigated effects of message framing (losses-framed or gains-framed), message modality (video with text or text-only) and emotional arousal on environmentally responsible behavioral intentions. The sample consisted of 161 college students. The present research did not find a significant difference in behavioral intentions…

A meta-analysis of fear appeals: implications for effective public health campaigns.

PubMed

Witte, K; Allen, M

2000-10-01

The fear appeal literature is examined in a comprehensive synthesis using meta-analytical techniques. The meta-analysis suggests that strong fear appeals produce high levels of perceived severity and susceptibility, and are more persuasive than low or weak fear appeals. The results also indicate that fear appeals motivate adaptive danger control actions such as message acceptance and maladaptive fear control actions such as defensive avoidance or reactance. It appears that strong fear appeals and high-efficacy messages produce the greatest behavior change, whereas strong fear appeals with low-efficacy messages produce the greatest levels of defensive responses. Future directions and practical implications are provided.

Mobile text messaging for health: a systematic review of reviews.

PubMed

Hall, Amanda K; Cole-Lewis, Heather; Bernhardt, Jay M

2015-03-18

The aim of this systematic review of reviews is to identify mobile text-messaging interventions designed for health improvement and behavior change and to derive recommendations for practice. We have compiled and reviewed existing systematic research reviews and meta-analyses to organize and summarize the text-messaging intervention evidence base, identify best-practice recommendations based on findings from multiple reviews, and explore implications for future research. Our review found that the majority of published text-messaging interventions were effective when addressing diabetes self-management, weight loss, physical activity, smoking cessation, and medication adherence for antiretroviral therapy. However, we found limited evidence across the population of studies and reviews to inform recommended intervention characteristics. Although strong evidence supports the value of integrating text-messaging interventions into public health practice, additional research is needed to establish longer-term intervention effects, identify recommended intervention characteristics, and explore issues of cost-effectiveness.

Mobile Text Messaging for Health: A Systematic Review of Reviews

PubMed Central

Hall, Amanda K.; Cole-Lewis, Heather; Bernhardt, Jay M.

2015-01-01

The aim of this systematic review of reviews is to identify mobile text-messaging interventions designed for health improvement and behavior change and to derive recommendations for practice. We have compiled and reviewed existing systematic research reviews and meta-analyses to organize and summarize the text-messaging intervention evidence base, identify best-practice recommendations based on findings from multiple reviews, and explore implications for future research. Our review found that the majority of published text-messaging interventions were effective when addressing diabetes self-management, weight loss, physical activity, smoking cessation, and medication adherence for antiretroviral therapy. However, we found limited evidence across the population of studies and reviews to inform recommended intervention characteristics. Although strong evidence supports the value of integrating text-messaging interventions into public health practice, additional research is needed to establish longer-term intervention effects, identify recommended intervention characteristics, and explore issues of cost-effectiveness. PMID:25785892

Investigating the Perceptions of Care Coordinators on Using Behavior Theory-Based Mobile Health Technology With Medicaid Populations: A Grounded Theory Study

PubMed Central

2017-01-01

Background Medicaid populations are less engaged in their health care than the rest of the population, translating to worse health outcomes and increased health care costs. Since theory-based mobile health (mHealth) interventions have been shown to increase patient engagement, mobile phones may be an optimal strategy to reach this population. With increased development of theory-based mHealth technology, these interventions must now be evaluated with these medically underserved populations in a real-world setting. Objective The aim of our study was to investigate care coordinators’ perceived value of using a health behavior theory-based mHealth platform with Medicaid clients. In particular, attention was paid to the perceived impact on patient engagement. This research was conducted using the patient-provider text messaging (short message service, SMS) platform, Sense Health (now Wellpass), which integrates the transtheoretical model (TTM), also called the stages of change model; social cognitive theory (SCT); supportive accountability; and motivational interviewing (MI). Methods Interviews based in grounded theory methodology were conducted with 10 care managers to understand perceptions of the relationship between mHealth and patient engagement. Results The interviews with care managers yielded a foundation for a grounded theory model, presenting themes that suggested 4 intertwined correlative relationships revolving around patient engagement: (1) A text messaging (short message service, SMS) platform supplements the client-care manager dynamic, which is grounded in high quality, reciprocal-communication to increase patient engagement; (2) Texting enhances the relationship between literacy and access to care for Medicaid patients, increasing low-literacy patients’ agency to access services; (3) Texting enhances communication, providing care managers with a new means to support their clients; and (4) Reminders augment client accountability, leading to both increased motivation and readiness to change behaviors, as well as an improved client-care manager relationship. Conclusions Messaging platform features tied to health behavior theory appear to be effective in improving patient engagement. Two-way communication (supportive accountability), trusted relationships (supportive accountability, SCT), personalized messages (TTM), and patient input (TTM, SCT, MI) appeared as the most relevant components in achieving desired outcomes. Additionally, reminder messages were noted as especially useful in making Medicaid patients accountable and in turn engaging them in their health and health care. These findings convey suggested elements for inclusion in other mHealth interventions aiming to improve patient engagement in Medicaid populations. PMID:28325711

Investigating the Perceptions of Care Coordinators on Using Behavior Theory-Based Mobile Health Technology With Medicaid Populations: A Grounded Theory Study.

PubMed

Sigler, Brittany Erika

2017-03-21

Medicaid populations are less engaged in their health care than the rest of the population, translating to worse health outcomes and increased health care costs. Since theory-based mobile health (mHealth) interventions have been shown to increase patient engagement, mobile phones may be an optimal strategy to reach this population. With increased development of theory-based mHealth technology, these interventions must now be evaluated with these medically underserved populations in a real-world setting. The aim of our study was to investigate care coordinators' perceived value of using a health behavior theory-based mHealth platform with Medicaid clients. In particular, attention was paid to the perceived impact on patient engagement. This research was conducted using the patient-provider text messaging (short message service, SMS) platform, Sense Health (now Wellpass), which integrates the transtheoretical model (TTM), also called the stages of change model; social cognitive theory (SCT); supportive accountability; and motivational interviewing (MI). Interviews based in grounded theory methodology were conducted with 10 care managers to understand perceptions of the relationship between mHealth and patient engagement. The interviews with care managers yielded a foundation for a grounded theory model, presenting themes that suggested 4 intertwined correlative relationships revolving around patient engagement: (1) A text messaging (short message service, SMS) platform supplements the client-care manager dynamic, which is grounded in high quality, reciprocal-communication to increase patient engagement; (2) Texting enhances the relationship between literacy and access to care for Medicaid patients, increasing low-literacy patients' agency to access services; (3) Texting enhances communication, providing care managers with a new means to support their clients; and (4) Reminders augment client accountability, leading to both increased motivation and readiness to change behaviors, as well as an improved client-care manager relationship. Messaging platform features tied to health behavior theory appear to be effective in improving patient engagement. Two-way communication (supportive accountability), trusted relationships (supportive accountability, SCT), personalized messages (TTM), and patient input (TTM, SCT, MI) appeared as the most relevant components in achieving desired outcomes. Additionally, reminder messages were noted as especially useful in making Medicaid patients accountable and in turn engaging them in their health and health care. These findings convey suggested elements for inclusion in other mHealth interventions aiming to improve patient engagement in Medicaid populations. ©Brittany Erika Sigler. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 21.03.2017.

Do Sexual Assault Bystander Interventions Change Men's Intentions? Applying the Theory of Normative Social Behavior to Predicting Bystander Outcomes.

PubMed

Mabry, Amanda; Turner, Monique Mitchell

2016-01-01

The high prevalence of sexual assault on college campuses has led to the implementation of health communication programs to prevent sexual assault. A few novel programs focus on primary prevention by targeting social norms related to gender and masculinity among men through bystander intervention. Guided by the theory of normative social behavior, this study sought to examine the relative effect of campaigns communicating positive versus negative injunctive norms and the interaction between exposure to such campaign messages and perceived descriptive norms and relevant cognitive moderators (e.g., outcome expectations, injunctive norms, group identity, ego involvement) among men. A 2 (high/low descriptive norms) × 2 (high/low moderator) × 3 (public service announcement) independent groups quasi-experimental design (N = 332) was used. Results indicated that messages communicating positive injunctive norms were most effective among men who were least likely to engage in bystander intervention. Furthermore, descriptive norms played a significant role in behavioral intentions, such that those with stronger norms were more likely to report intentions to engage in bystander behaviors in the future. Similarly, the moderators of aspiration, injunctive norms, social approval, and ego involvement had a significant positive effect on behavioral intentions. These findings have important implications for future message design strategy and audience segmentation.

Incorporating immersive virtual environments in health promotion campaigns: a construal level theory approach.

PubMed

Ahn, Sun Joo Grace

2015-01-01

In immersive virtual environments (IVEs), users may observe negative consequences of a risky health behavior in a personally involving way via digital simulations. In the context of an ongoing health promotion campaign, IVEs coupled with pamphlets are proposed as a novel messaging strategy to heighten personal relevance and involvement with the issue of soft-drink consumption and obesity, as well as perceptions that the risk is proximal and imminent. The framework of construal level theory guided the design of a 2 (tailoring: other vs. self) × 2 (medium: pamphlet only vs. pamphlet with IVEs) between-subjects experiment to test the efficacy in reducing the consumption of soft drinks over 1 week. Immediately following exposure, tailoring the message to the self (vs. other) seemed to be effective in reducing intentions to consume soft drinks. The effect of tailoring dissipated after 1 week, and measures of actual soft-drink consumption 1 week following experimental treatments demonstrated that coupling IVEs with the pamphlet was more effective. Behavioral intention was a significant predictor of actual behavior, but underlying mechanisms driving intentions and actual behavior were distinct. Results prescribed a messaging strategy that incorporates both tailoring and coupling IVEs with traditional media to increase behavioral changes over time.

Exploring the use of storybooks to reach mothers of preschoolers with nutrition and physical activity messages.

PubMed

Bellows, Laura; Spaeth, Amanda; Lee, Victoria; Anderson, Jennifer

2013-01-01

To assess perceptions stay-at-home mothers have about their preschoolers' eating and physical activity behaviors and to explore the feasibility of using storybooks in home-based nutrition and activity programming. Focus groups were conducted with 24 mothers, intercept interviews were conducted with 30 parents, and a storybook prototype was developed and pretested in 8 preschool classrooms. Mothers acknowledged picky eating as an issue and were less likely to identify issues with physical activity, but they were interested in information on gross motor development. Mothers strongly supported storybooks as a modality to convey and reinforce health messages at home. The storybook prototype was well liked by parents, teachers, and preschoolers. Storybooks are a practical method to reach mothers and preschoolers and have the potential to elicit changes in eating and activity behaviors. Understanding mothers' perceptions of healthy eating and physical activity is essential to ensure that storybook messages resonate with this audience. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Modulating the neural bases of persuasion: why/how, gain/loss, and users/non-users.

PubMed

Vezich, I Stephanie; Katzman, Perri L; Ames, Daniel L; Falk, Emily B; Lieberman, Matthew D

2017-02-01

Designing persuasive content is challenging, in part because people can be poor predictors of their actions. Medial prefrontal cortex (MPFC) activation during message exposure reliably predicts downstream behavior, but past work has been largely atheoretical. We replicated past results on this relationship and tested two additional framing effects known to alter message receptivity. First, we examined gain- vs. loss-framed reasons for a health behavior (sunscreen use). Consistent with predictions from prospect theory, we observed greater MPFC activity to gain- vs. loss-framed messages, and this activity was associated with behavior. This relationship was stronger for those who were not previously sunscreen users. Second, building on theories of action planning, we compared neural activity during messages regarding how vs. why to enact the behavior. We observed rostral inferior parietal lobule and posterior inferior frontal gyrus activity during action planning ("how" messages), and this activity was associated with behavior; this is in contrast to the relationship between MPFC activity during the "why" (i.e., gain and loss) messages and behavior. These results reinforce that persuasion occurs in part via self-value integration-seeing value and incorporating persuasive messages into one's self-concept-and extend this work to demonstrate how message framing and action planning may influence this process. © The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Effects of message, source, and context on evaluations of employee voice behavior.

PubMed

Whiting, Steven W; Maynes, Timothy D; Podsakoff, Nathan P; Podsakoff, Philip M

2012-01-01

The article contained a production-related error. In Table 5, the four values in the rows for Study 1 Prosocial motives and Study 1 Constructive voice should have been shifted one column to the right, to the Direct and Total Performance evaluations columns. All versions of this article have been corrected.] Although employee voice behavior is expected to have important organizational benefits, research indicates that employees voicing their recommendations for organizational change may be evaluated either positively or negatively by observers. A review of the literature suggests that the perceived efficacy of voice behaviors may be a function of characteristics associated with the (a) source, (b) message, and (c) context of the voice event. In this study, we manipulated variables from each of these categories based on a model designed to predict when voice will positively or negatively impact raters' evaluations of an employee's performance. To test our model, we conducted 3 laboratory studies in which we manipulated 2 source factors (voicer expertise and trustworthiness), 2 message factors (recommending a solution and positively vs. negatively framing the message), and 2 context factors (timing of the voice event and organizational norms for speaking up vs. keeping quiet). We also examined the mediating effects of liking, prosocial motives, and perceptions that the voice behavior was constructive on the relationships between the source, message, and context factors and performance evaluations. Generally speaking, we found that at least one of the variables from each category had an effect on performance evaluations for the voicer and that most of these effects were indirect, operating through one or more of the mediators. Implications for theory and future research are discussed.

Are you Scared Yet?: Evaluating Fear Appeal Messages in Tweets about the Tips Campaign.

PubMed

Emery, Sherry L; Szczypka, Glen; Abril, Eulàlia Puig; Kim, Yoonsang; Vera, Lisa

2014-04-01

In March 2012, the CDC launched "Tips from Former Smokers," a $54 million national campaign featuring individuals experiencing long-term health consequences of smoking. The campaign approach was based on strong evidence that anti-tobacco ads portraying fear, graphic images, and personal testimonials are associated with attitudinal and behavior change. Yet it was also controversial; critics cited the danger that viewers might reject such intensely graphic messages. Tasked with informing this debate, our study analyzes the corpus of Tips campaign-related tweets obtained via the Twitter Firehose. We provide a novel and rigorous method for media campaign evaluation within the framework of the Extended Parallel Process Model. Among the relevant Tweets, 87% showed evidence of message acceptance, while 7% exhibited message rejection.

Multi-level scaling properties of instant-message communications

NASA Astrophysics Data System (ADS)

Chen, Guanxiong; Han, Xiaopu; Wang, Binghong

2010-08-01

To research the statistical properties of human's communication behaviors is one of the highlight areas of Human Dynamics. In this paper, we analyze the instant message data of QICQ from volunteers, and discover that there are many forms of non-Poisson characters, such as inter-event distributions of sending and receiving messages, communications between two friends, log-in activities, the distribution of online time, quantities of messages, and so on. These distributions not only denote the pattern of human communication activities, but also relate to the statistical property of human behaviors in using software. We find out that most of these exponents distribute between -1 and -2, which indicates that the Instant Message (IM) communication behavior of human is different from Non-IM communication behaviors; there are many fat-tail characters related to IM communication behavior.

More Than a Text Message: Dismantling Digital Triggers to Curate Behavior Change in Patient-Centered Health Interventions.

PubMed

Muench, Frederick; Baumel, Amit

2017-05-26

Digital triggers such as text messages, emails, and push alerts are designed to focus an individual on a desired goal by prompting an internal or external reaction at the appropriate time. Triggers therefore have an essential role in engaging individuals with digital interventions delivered outside of traditional health care settings, where other events in daily lives and fluctuating motivation to engage in effortful behavior exist. There is an emerging body of literature examining the use of digital triggers for short-term action and longer-term behavior change. However, little attention has been given to understanding the components of digital triggers. Using tailoring as an overarching framework, we separated digital triggers into 5 primary components: (1) who (sender), (2) how (stimulus type, delivery medium, heterogeneity), (3) when (delivered), (4) how much (frequency, intensity), and (5) what (trigger's target, trigger's structure, trigger's narrative). We highlighted key considerations when tailoring each component and the pitfalls of ignoring common mistakes, such as alert fatigue and habituation. As evidenced throughout the paper, there is a broad literature base from which to draw when tailoring triggers to curate behavior change in health interventions. More research is needed, however, to examine differences in efficacy based on component tailoring, to best use triggers to facilitate behavior change over time, and to keep individuals engaged in physical and mental health behavior change efforts. Dismantling digital triggers into their component parts and reassembling them according to the gestalt of one's change goals is the first step in this development work. ©Frederick Muench, Amit Baumel. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.05.2017.

Efficacy methods to evaluate health communication and marketing campaigns.

PubMed

Evans, W Douglas; Uhrig, Jennifer; Davis, Kevin; McCormack, Lauren

2009-06-01

Communication and marketing are growing areas of health research, but relatively few rigorous efficacy studies have been conducted in these fields. In this article, we review recent health communication and marketing efficacy research, present two case studies that illustrate some of the considerations in making efficacy design choices, and advocate for greater emphasis on rigorous health communication and marketing efficacy research and the development of a research agenda. Much of the outcomes research in health communication and marketing, especially mass media, utilizes effectiveness designs conducted in real time, in the media markets or communities in which messages are delivered. Such evaluations may be impractical or impossible, however, imiting opportunities to advance the state of health communication and marketing research and the knowledge base on effective campaign strategies, messages, and channels. Efficacy and effectiveness studies use similar measures of behavior change. Efficacy studies, however, offer greater opportunities for experimental control, message exposure, and testing of health communication and marketing theory. By examining the literature and two in-depth case studies, we identify advantages and limitations to efficacy studies. We also identify considerations for when to adopt efficacy and effectiveness methods, alone or in combination. Finally, we outline a research agenda to investigate issues of internal and external validity, mode of message presentation, differences between marketing and message strategies, and behavioral outcomes.

Source Credibility in Tobacco Control Messaging

PubMed Central

Schmidt, Allison M.; Ranney, Leah M.; Pepper, Jessica K.; Goldstein, Adam O.

2016-01-01

Objectives Perceived credibility of a message’s source can affect persuasion. This paper reviews how beliefs about the source of tobacco control messages may encourage attitude and behavior change. Methods We conducted a series of searches of the peer-reviewed literature using terms from communication and public health fields. We reviewed research on source credibility, its underlying concepts, and its relation to the persuasiveness of tobacco control messages. Results We recommend an agenda for future research to bridge the gaps between communication literature on source credibility and tobacco control research. Our recommendations are to study the impact of source credibility on persuasion with long-term behavior change outcomes, in different populations and demographic groups, by developing new credibility measures that are topic- and organization-specific, by measuring how credibility operates across media platforms, and by identifying factors that enhance credibility and persuasion. Conclusions This manuscript reviews the state of research on source credibility and identifies gaps that are maximally relevant to tobacco control communication. Knowing first whether a source is perceived as credible, and second, how to enhance perceived credibility, can inform the development of future tobacco control campaigns and regulatory communications. PMID:27525298

Evaluators' Perceptions of Teachers' Use of Behavior Alteration Techniques.

ERIC Educational Resources Information Center

Allen, Terre; Edwards, Renee

1988-01-01

Examines which message-based behavior alteration techniques (BATs) teacher evaluators perceive as commonly used by good, average, and poor teachers. Reports that principals equate reward-type messages with effective teaching and punishment-type messages with ineffective teaching. (MM)

Achieving Energy Efficiency Through Real-Time Feedback

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nesse, Ronald J.

2011-09-01

Through the careful implementation of simple behavior change measures, opportunities exist to achieve strategic gains, including greater operational efficiencies, energy cost savings, greater tenant health and ensuing productivity and an improved brand value through sustainability messaging and achievement.

Do Emotions Expressed Online Correlate with Actual Changes in Decision-Making?: The Case of Stock Day Traders.

PubMed

Liu, Bin; Govindan, Ramesh; Uzzi, Brian

2016-01-01

Emotions are increasingly inferred linguistically from online data with a goal of predicting off-line behavior. Yet, it is unknown whether emotions inferred linguistically from online communications correlate with actual changes in off-line activity. We analyzed all 886,000 trading decisions and 1,234,822 instant messages of 30 professional day traders over a continuous 2 year period. Linguistically inferring the traders' emotional states from instant messages, we find that emotions expressed in online communications reflect the same distributions of emotions found in controlled experiments done on traders. Further, we find that expressed online emotions predict the profitability of actual trading behavior. Relative to their baselines, traders who expressed little emotion or traders that expressed high levels of emotion made relatively unprofitable trades. Conversely, traders expressing moderate levels of emotional activation made relatively profitable trades.

Do Emotions Expressed Online Correlate with Actual Changes in Decision-Making?: The Case of Stock Day Traders

PubMed Central

Liu, Bin; Govindan, Ramesh; Uzzi, Brian

2016-01-01

Emotions are increasingly inferred linguistically from online data with a goal of predicting off-line behavior. Yet, it is unknown whether emotions inferred linguistically from online communications correlate with actual changes in off-line activity. We analyzed all 886,000 trading decisions and 1,234,822 instant messages of 30 professional day traders over a continuous 2 year period. Linguistically inferring the traders’ emotional states from instant messages, we find that emotions expressed in online communications reflect the same distributions of emotions found in controlled experiments done on traders. Further, we find that expressed online emotions predict the profitability of actual trading behavior. Relative to their baselines, traders who expressed little emotion or traders that expressed high levels of emotion made relatively unprofitable trades. Conversely, traders expressing moderate levels of emotional activation made relatively profitable trades. PMID:26765539

The Effect of Public Service Advertising on Cardiovascular Disease in Korea.

PubMed

Jang, Juhyun; Na, Baeg Ju; Lee, Moo-Sik; Seo, Soonryu; Sung, Changhyun; Kim, Hyun Joo; Lee, Jin Yong

2016-08-01

Public Service Advertising (PSA) is a public interest message disseminated in the form of an advertisement communication and its main purpose is to promote public behavioral changes regarding a social issue. Korea Centers for Disease Control and Prevention (KCDC) has been delivering PSA by various media. However, the effect of PSAs has never been evaluated. The purpose of this study was to estimate the effects of broadcasted PSA produced by KCDC on cardiovascular disease (CVD). One thousand adult participants throughout 15 provinces in Korea were chosen through the quota sampling method in 2012. A face-to-face research survey with 13 questions was conducted using a Computer Assisted Personal Interview (CAPI) system. Previous exposure to the PSA message, understanding, and behavioral intention to change was assessed. After watching the PSA, about 75% of participants answered that they could understand the contents well and 70% had willingness to change their behaviors associated with CVD. However, only 24% of participants answered they watched the PSA during the past year. The PSA had positive effects on increasing the level of understanding and intention to change behaviors regarding CVD. However, the level of exposure was low. KCDC should make an effort to increase the public exposure level, which could be an important success factor regarding the PSA. In addition, KCDC should consider customized PSA for vulnerable people such as multi-cultural families, the disabled, and the elderly.

Quality-of-life policing Do offenders get the message?

PubMed Central

Golub, Andrew; Johnson, Bruce D.; Taylor, Angela; Eterno, John

2013-01-01

In the 1990s, the New York City Police Department expanded its focus on reducing behaviors that detract from the overall quality of life (QOL) in the city. Many have credited this effort for the decline in the city’s overall crime rate. They often cite the fixing broken windows argument, which maintains that reducing disorder sets off a chain of events leading to less crime. However, systematic research has not yet documented this chain of events. Looks at one of the first linkages, whether QOL policing sends a message to offenders not to engage in disorderly behaviors in public locales. The project interviewed 539 New York City arrestees in 1999. Almost all of them were aware that police were targeting various disorderly behaviors. Among those that engaged in disorderly behaviors, about half reported that they had stopped or cut back in the past six months. They reported a police presence was the most important factor behind their behavioral changes. These findings support the idea that QOL policing has a deterrent effect. PMID:24431981

Sexting and sexual behavior in at-risk adolescents.

PubMed

Houck, Christopher D; Barker, David; Rizzo, Christie; Hancock, Evan; Norton, Alicia; Brown, Larry K

2014-02-01

This study aimed to examine the prevalence of sexting behaviors (sexually explicit messages and/or pictures) among an at-risk sample of early adolescents as well as the associations between sexting behaviors and sexual behaviors, risk-related cognitions, and emotional regulation skills. It also aimed to determine whether differences in risk were associated with text-based versus photo-based sexts. Seventh-grade adolescents participating in a sexual risk prevention trial for at-risk early adolescents completed a computer-based survey at baseline regarding sexting behavior (having sent sexually explicit messages and/or pictures), sexual activities, intentions to have sex, perceived approval of sexual activity, and emotional regulation skills. Twenty-two percent of the sample reported having sexted in the past 6 months; sexual messages were endorsed by 17% (n = 71), sexual messages and photos by 5% (n = 21). Pictures were endorsed significantly more often by females (χ(2)[2] = 7.33, P = .03) and Latinos (χ(2)[2] = 7.27, P = .03). Sexting of any kind was associated with higher rates of engaging in a variety of sexual behaviors, and sending photos was associated with higher rates of sexual activity than sending text messages only. This was true for a range of behaviors from touching genitals over clothes (odds ratio [OR] = 1.98, P = .03) to oral sex (OR = 2.66, P < .01) to vaginal sex (OR = 2.23, P < .01). Sexting behavior (both photo and text messages) was not uncommon among middle school youth and co-occurred with sexual behavior. These data suggest that phone behaviors, even flirtatious messages, may be an indicator of risk. Clinicians, parents, and health programs should discuss sexting with early adolescents.

Sexting and Sexual Behavior in At-Risk Adolescents

PubMed Central

Barker, David; Rizzo, Christie; Hancock, Evan; Norton, Alicia; Brown, Larry K.

2014-01-01

OBJECTIVES: This study aimed to examine the prevalence of sexting behaviors (sexually explicit messages and/or pictures) among an at-risk sample of early adolescents as well as the associations between sexting behaviors and sexual behaviors, risk-related cognitions, and emotional regulation skills. It also aimed to determine whether differences in risk were associated with text-based versus photo-based sexts. METHODS: Seventh-grade adolescents participating in a sexual risk prevention trial for at-risk early adolescents completed a computer-based survey at baseline regarding sexting behavior (having sent sexually explicit messages and/or pictures), sexual activities, intentions to have sex, perceived approval of sexual activity, and emotional regulation skills. RESULTS: Twenty-two percent of the sample reported having sexted in the past 6 months; sexual messages were endorsed by 17% (n = 71), sexual messages and photos by 5% (n = 21). Pictures were endorsed significantly more often by females (χ2[2] = 7.33, P = .03) and Latinos (χ2[2] = 7.27, P = .03). Sexting of any kind was associated with higher rates of engaging in a variety of sexual behaviors, and sending photos was associated with higher rates of sexual activity than sending text messages only. This was true for a range of behaviors from touching genitals over clothes (odds ratio [OR] = 1.98, P = .03) to oral sex (OR = 2.66, P < .01) to vaginal sex (OR = 2.23, P < .01). CONCLUSIONS: Sexting behavior (both photo and text messages) was not uncommon among middle school youth and co-occurred with sexual behavior. These data suggest that phone behaviors, even flirtatious messages, may be an indicator of risk. Clinicians, parents, and health programs should discuss sexting with early adolescents. PMID:24394678

Evaluation of an Internet, Stage-Based Physical Activity Intervention.

ERIC Educational Resources Information Center

Hager, Ronald L.; Hardy, Aaron; Aldana, Steven G.; George, James D.

2002-01-01

Evaluated the impact of online, stage-based materials on exercise behavior and stage of readiness to change. College faculty participated in stage-based, action-message, or control groups. Occupational and leisure activity, 7-day physical activity, exercise self-efficacy, and stage of readiness to change were assessed at baseline and 6 weeks.…

I Persuade, They Persuade, It Persuades!

NASA Astrophysics Data System (ADS)

Preece, Jennifer J.

Persuasion changes behavior. Persuasive people encourage us to do things we might not otherwise do, such as buying a new coat, taking a trip, changing jobs, and so on. Artifacts can persuade too: marketing specialists know that slick ads, sexy slogans, colorful packaging, empathic messages, elegant and beautiful designs are persuasive - they sell products.

Assessing college students' attitudes toward responsible drinking messages to identify promising binge drinking intervention strategies.

PubMed

Pilling, Valerie K; Brannon, Laura A

2007-01-01

Health communication appeals were utilized through a Web site simulation to evaluate the potential effectiveness of 3 intervention approaches to promote responsible drinking among college students. Within the Web site simulation, participants were exposed to a persuasive message designed to represent either the generalized social norms advertising approach (based on others' behavior), the personalized behavioral feedback approach (tailored to the individual's behavior), or the schema-based approach (tailored to the individual's self-schema, or personality). A control group was exposed to a message that was designed to be neutral (it was designed to discourage heavy drinking, but it did not represent any of the previously mentioned approaches). It was hypothesized that the more personalized the message was to the individual, the more favorable college students' attitudes would be toward the responsible drinking message. Participants receiving the more personalized messages did report more favorable attitudes toward the responsible drinking message.

The relationship of parental reinforcement of media messages to college students' alcohol-related behaviors.

PubMed

Weintraub Austin, Erica; Chen, Yin Ju

2003-01-01

Although alcohol consumption is a problem on the college campus, beliefs and behaviors predictive of alcohol use are in development in children as young as third grade. Because they develop partially in response to interpretations of media messages, for which parents can have an influence, this study examined how college students' (N=300) recollections of parental reinforcement of media messages associated with alcohol-related beliefs and behaviors. Structural equation modeling showed that recalled positive mediation negatively predicted skepticism, and positively predicted desirability and expectancies. Desirability of media messages predicted more positive norms perceptions, and a lack of skepticism predicted more positive expectancies. With age of first experimentation controlled, expectancies predicted heavier current drinking behavior. Norms did not predict behavior, and positive mediation did not predict norms. The study concludes that to the extent parental communication leads adolescents to interpret media messages less skeptically, they encourage adolescents to find alcohol portrayals appealing. This in turn appears to lead toward more risky behaviors. The results suggest that college-based anti-alcohol campaigns can benefit by acknowledging the appeal of competing messages and by including parents as a campaign target.

Motivating parent support for physical activity: the role of framed persuasive messages.

PubMed

Bassett-Gunter, Rebecca; Stone, Rachael; Jarvis, Jocelyn; Latimer-Cheung, Amy

2017-10-01

Parent support for physical activity (PA) is a behavior unto itself that requires motivation. Persuasive messages may be one method for motivating parent support for their children's PA. Message framing is one strategy for optimizing the impact of messages. The current study examined the relative effectiveness of gain- versus loss-framed messages for encouraging parent support for children's PA. Regardless of message frame, parents had an increase in social cognitive antecedents (e.g. perceived behavioral control, intentions) and support for children's PA following message exposure. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Impact of media literacy education on knowledge and behavioral intention of adolescents in dealing with media messages according to Stages of Change

PubMed Central

GERAEE, NARJES; KAVEH, MOHAMMAD HOSSEIN; SHOJAEIZADEH, DAVOD; TABATABAEE, HAMID REZA

2015-01-01

Introduction: Mass media influence the health behaviors of adolescents. Evidence shows that traditional strategies such as censorship or limitation are no longer efficient; therefore, teaching media literacy is the best way to protect adolescents from harmful effects. The aim of this pilot study was to evaluate the effects of a media literacy training program on knowledge and behavioral intention of a sample of female students according to the stages of change in dealing with media messages. Methods: The study was conducted based on a pre-test and post-test control group design. Some 198 female students including 101 in the intervention group and 97 in the control group participated in this study. The educational program was run using interactive teaching-learning techniques. Data collection was performed using a validated and reliable self-administered questionnaire in three phases including a pre-test, post-test, 1 and post-test, 2. The research data was analyzed through SPSS statistical software, version 14 using both descriptive and inferential statistics. Results: The results of the study showed a significant increase (p=0.001) in the intervention group’s knowledge mean scores after the training program. On the other hand, the difference was not significant in the control group (p=0.200). A considerable percentage of the participants, in the intervention and control groups, were in pre contemplation and contemplation stages in the pre-test (64 and 61, respectively). After the intervention, however, a significant improvement (p=0.001) was observed in the intervention group’s stages of change compared to that in the control group. The distribution of the control group students regarding the stages of change was similar to that in the pre-test. Conclusion: The study findings revealed that the planned education programs are efficient to improve the adolescents’ knowledge and behavioral intention in dealing with mass media messages. PMID:25587549

Young children's perceptions of fire-safety messages: do framing and parental mediation matter?

PubMed

Borzekowski, Dina; Clearfield, Elizabeth; Rimal, Rajiv; Gielen, Andrea

2014-01-01

Media can deliver health and safety messages promoting child health and injury prevention. This study examined the effects of message framing and parental mediation on children's perceptions of fire-safety messages. Using a 2 × 3 randomized experimental design, this study considered both message framing (gain or loss) and parental mediation (no mediation/control, unscripted, or scripted) with 320 children who were 4 and 5 years of age. Children saw two messages (burn and smoke inhalation) embedded in a cartoon. Afterward, researchers assessed children's recall, understanding, and perceptions of self-efficacy and social norms. Children were more likely to recall the safety messages if they were older (burn: adjusted odds ration [AOR] = 2.74 and smoke: AOR = 2.58), and could recall the smoke inhalation message if they had unscripted mediation (AOR = 3.16). Message understanding was poor, with only about 50% of children choosing a correct behavior in a similar scenario. For the burn message, correct understanding was associated with gain-framing and scripted mediation (AOR = 3.22 and 5.77, respectively). Only the scripted mediation group was significantly associated with an increase in perceived social norms (burn: coefficient =.37 and smoke: coefficient =.55; P <.001. Gain-framing was associated with increased odds of self-efficacy for both behaviors (burn: AOR = 1.77 and smoke: AOR = 1.77). Messages that show positive outcomes combined with scripted parental mediation appear most effective in communicating safety behaviors, but the overall effectiveness of video-based messages to teach children safety behaviors needs to be enhanced.

Source Similarity and Social Media Health Messages: Extending Construal Level Theory to Message Sources.

PubMed

Young, Rachel

2015-09-01

Social media users post messages about health goals and behaviors to online social networks. Compared with more traditional sources of health communication such as physicians or health journalists, peer sources are likely to be perceived as more socially close or similar, which influences how messages are processed. This experimental study uses construal level theory of psychological distance to predict how mediated health messages from peers influence health-related cognition and behavioral intention. Participants were exposed to source cues that identified peer sources as being either highly attitudinally and demographically similar to or different from participants. As predicted by construal level theory, participants who perceived sources of social media health messages as highly similar listed a greater proportion of beliefs about the feasibility of health behaviors and a greater proportion of negative beliefs, while participants who perceived sources as more dissimilar listed a greater proportion of positive beliefs about the health behaviors. Results of the study could be useful in determining how health messages from peers could encourage individuals to set realistic health goals.

Differential effects of exposure to social norms campaigns: a cause for concern.

PubMed

Campo, Shelly; Cameron, Kenzie A

2006-01-01

College students' processing of alcohol social norms messages, related effects on normative judgments, attitudes toward their own behaviors, and perception of undergraduate attitudes were examined using expectancy violation theories and social norms marketing. Data were collected from 2 universities (N = 393). Following message exposure, the majority moved their normative judgments toward the statistic provided in the message. Slight attitude change occurred but not always in the desired direction. Those most likely to develop unhealthier attitudes drank more than those who developed healthier attitudes, consistent with psychological reactance to the messages. Therefore, the effects of social norms campaigns on those at greatest risk for primary and secondary alcohol effects due to their increased alcohol consumption could lead to increased risk for those participants, indicating that the widespread use of social norms campaigns needs to be scrutinized.

Using text messages to bridge the intention-behavior gap? A pilot study on the use of text message reminders to increase objectively assessed physical activity in daily life.

PubMed

Schwerdtfeger, Andreas R; Schmitz, Catalina; Warken, Matthias

2012-01-01

Sedentarism is a serious health concern in industrialized countries throughout the world. We examined whether a text message-based intervention, targeted at increasing daily levels of physical activity, would be more effective than a standard psychoeducational intervention and a control condition. Sixty-three individuals (43 women) with a mean age of 23.7 years participated in the study. They were randomly assigned to a psychoeducational standard intervention; an augmented intervention with additional short text messages sent to the mobile phones to remind participants of their action plans, and a control condition. Objectively assessed physical activity and self-efficacy were assessed pre- and post-intervention. Participants in the control condition showed a significant decline in physical activity from pre-assessment to post-assessment, whereas participants in both intervention arms exhibited a slight increase. Moreover, the augmented intervention resulted in a marginally significant increase in self-efficacy, whereas the standard intervention resulted in a significant decrease. The findings suggest that short text messages reminding individuals of their action plans are not more effective than an intervention without text messages, although there seems to be a beneficial effect on self-efficacy, which might facilitate behavior change in the long-term. Challenging aspects of the research design (e.g., reactivity of the assessment protocol) are discussed and suggestions for future research are highlighted.

The relative persuasiveness of gain-framed and loss-framed messages for encouraging disease prevention behaviors: a meta-analytic review.

PubMed

O'Keefe, Daniel J; Jensen, Jakob D

2007-01-01

A meta-analytic review of 93 studies (N = 21,656) finds that in disease prevention messages, gain-framed appeals, which emphasize the advantages of compliance with the communicator's recommendation, are statistically significantly more persuasive than loss-framed appeals, which emphasize the disadvantages of noncompliance. This difference is quite small (corresponding to r = .03), however, and appears attributable to a relatively large (and statistically significant) effect for messages advocating dental hygiene behaviors. Despite very good statistical power, the analysis finds no statistically significant differences in persuasiveness between gain- and loss-framed messages concerning other preventive actions such as safer-sex behaviors, skin cancer prevention behaviors, or diet and nutrition behaviors.

Benefits for me or risks for others: a cross-culture investigation of the effects of message frames and cultural appeals.

PubMed

Yu, Nan; Shen, Fuyuan

2013-01-01

This study examined the effects of message frames when they were culturally tailored. Focusing on one aspect of culture-individualism and collectivism-the study discovered some similar patterns across cultures: The effect of message framing in motivating preventive behaviors could be moderated by the cultural values embedded in the messages. Messages focusing on individualistic gains and collectivistic losses successfully increased people's intention to adopt preventive behaviors. Practical and theoretical implications are discussed.

Nonprice incentives and energy conservation

PubMed Central

Asensio, Omar I.; Delmas, Magali A.

2015-01-01

In the electricity sector, energy conservation through technological and behavioral change is estimated to have a savings potential of 123 million metric tons of carbon per year, which represents 20% of US household direct emissions in the United States. In this article, we investigate the effectiveness of nonprice information strategies to motivate conservation behavior. We introduce environment and health-based messaging as a behavioral strategy to reduce energy use in the home and promote energy conservation. In a randomized controlled trial with real-time appliance-level energy metering, we find that environment and health-based information strategies, which communicate the environmental and public health externalities of electricity production, such as pounds of pollutants, childhood asthma, and cancer, outperform monetary savings information to drive behavioral change in the home. Environment and health-based information treatments motivated 8% energy savings versus control and were particularly effective on families with children, who achieved up to 19% energy savings. Our results are based on a panel of 3.4 million hourly appliance-level kilowatt–hour observations for 118 residences over 8 mo. We discuss the relative impacts of both cost-savings information and environmental health messaging strategies with residential consumers. PMID:25583494

Nonprice incentives and energy conservation.

PubMed

Asensio, Omar I; Delmas, Magali A

2015-02-10

In the electricity sector, energy conservation through technological and behavioral change is estimated to have a savings potential of 123 million metric tons of carbon per year, which represents 20% of US household direct emissions in the United States. In this article, we investigate the effectiveness of nonprice information strategies to motivate conservation behavior. We introduce environment and health-based messaging as a behavioral strategy to reduce energy use in the home and promote energy conservation. In a randomized controlled trial with real-time appliance-level energy metering, we find that environment and health-based information strategies, which communicate the environmental and public health externalities of electricity production, such as pounds of pollutants, childhood asthma, and cancer, outperform monetary savings information to drive behavioral change in the home. Environment and health-based information treatments motivated 8% energy savings versus control and were particularly effective on families with children, who achieved up to 19% energy savings. Our results are based on a panel of 3.4 million hourly appliance-level kilowatt-hour observations for 118 residences over 8 mo. We discuss the relative impacts of both cost-savings information and environmental health messaging strategies with residential consumers.

Formative Research regarding Kidney Disease Health Information in a Latino American Sample: Associations among Message Frame, Threat, Efficacy, Message Effectiveness, and Behavioral Intention

ERIC Educational Resources Information Center

Maguire, Katheryn C.; Gardner, Jay; Sopory, Pradeep; Jian, Guowei; Roach, Marcia; Amschlinger, Joe; Moreno, Marcia; Pettey, Gary; Piccone, Gianfranco

2010-01-01

Using prospect theory and the extended parallel process model, this study examined the effect of gain/loss message framing on perceptions of severity, susceptibility, response efficacy, and self efficacy (derived from the extended parallel process model), as well as perception of message effectiveness and behavioral intention in a community based…

The impact of emotional tone, message, and broadcast parameters in youth anti-smoking advertisements.

PubMed

Biener, Lois; Ji, Ming; Gilpin, Elizabeth A; Albers, Alison B

2004-01-01

In the context of controversy regarding the optimal characteristics of anti-smoking advertisements for youth, this study examines the impact on recall and perceived effectiveness of variations in the message, emotional tone, reach and frequency of broadcast, remoteness of broadcast, and characteristics of the adolescent audience such as changes in smoking behavior, ownership of cigarette promotional items, and demographic variables. A two-wave longitudinal survey of a population-based sample of 618 Massachusetts youth 12 to 15 years old was carried out in 1993 and 1997. A Generalized Estimating Equation (GEE) approach was used to model the recall and perceived effectiveness of eight advertisements as a function of viewer and ad characteristics. Advertisements featuring messages about serious health consequences which had been independently rated as high in negative emotion were more likely to be recalled and were perceived as more effective by youth survey respondents than ads featuring messages about normative behavior for teens or ads relying on humor. Advertising intensity, while contributing to recall, was negatively related to perceived effectiveness. This study supports mounting evidence that negative emotion in anti-smoking advertisements is effective with youth audiences.

Effects of messages emphasizing environmental determinants of obesity on intentions to engage in diet and exercise behaviors.

PubMed

Niederdeppe, Jeff; Roh, Sungjong; Shapiro, Michael A; Kim, Hye Kyung

2013-12-12

Reducing rates of obesity will require interventions that influence both individual decisions and environmental factors through changes in public policy. Previous work indicates that messages emphasizing environmental determinants increases support for public policies, but some suspect this strategy may undermine motivation to engage in diet and exercise. Study 1 involved 485 adults recruited from a shopping mall in New York. Study 2 involved 718 adult members of a Web-based national panel of US adults. Respondents in both studies were randomly assigned to read a story that emphasized environmental determinants of health or a control condition. The stories varied in the extent to which they described the story character as taking personal responsibility for weight management. Logistic regression and ordered logit models were used to test for differences in intentions to engage in diet and exercise behaviors based on which story the participant read. Analyses were also performed separately by participants' weight status. In both studies, messages that acknowledged personal responsibility while emphasizing environmental causes of obesity increased intentions to engage in healthy behavior for at least 1 weight status group. Emphasizing factors outside of personal control appears to enhance rather than undermine motivations to engage in healthy diet and exercise behavior.

Effects of Messages Emphasizing Environmental Determinants of Obesity on Intentions to Engage in Diet and Exercise Behaviors

PubMed Central

Roh, Sungjong; Shapiro, Michael A.; Kim, Hye Kyung

2013-01-01

Introduction Reducing rates of obesity will require interventions that influence both individual decisions and environmental factors through changes in public policy. Previous work indicates that messages emphasizing environmental determinants increases support for public policies, but some suspect this strategy may undermine motivation to engage in diet and exercise. Methods Study 1 involved 485 adults recruited from a shopping mall in New York. Study 2 involved 718 adult members of a Web-based national panel of US adults. Respondents in both studies were randomly assigned to read a story that emphasized environmental determinants of health or a control condition. The stories varied in the extent to which they described the story character as taking personal responsibility for weight management. Logistic regression and ordered logit models were used to test for differences in intentions to engage in diet and exercise behaviors based on which story the participant read. Analyses were also performed separately by participants’ weight status. Results In both studies, messages that acknowledged personal responsibility while emphasizing environmental causes of obesity increased intentions to engage in healthy behavior for at least 1 weight status group. Conclusion Emphasizing factors outside of personal control appears to enhance rather than undermine motivations to engage in healthy diet and exercise behavior. PMID:24331282

Online Health Communities and Chronic Disease Self-Management.

PubMed

Willis, Erin; Royne, Marla B

2017-03-01

This research uses content analysis (N = 1,960) to examine the computer-mediated communication within online health communities for evidence of chronic disease self-management behaviors, including the perceived benefits and perceived barriers to participating in such behaviors. Online health communities act as informal self-management programs led by peers with the same chronic disease through the exchange of health information. Online health communities provide opportunities for health behavior change messages to educate and persuade regarding chronic disease self-management behaviors.

Twitter weather warnings: Communicating risk in 140 characters-the impact of imperative and declarative message style on weather risk perception and behavioral intentions.

PubMed

Rainear, Adam M; Lachlan, Kenneth A; Spence, Patric R

Understanding how individuals utilize risk messages is important for protecting lives and gaining compliance toward safe behaviors. Recent advances in technology afford users with timeliness when needing to acquire information, and research investigating imperative and declarative message styles suggests utilizing both strategies is most effective. Similarly, the element of time can play a role when an individual engages in certain behaviors. This study employed an experimental design to better understand how imperative and declarative tweets, and time can contribute to risk perceptions and behavioral intentions. Results indicate the most negative affect is experienced after receiving an imperative-only tweet in a short-lead time condition, whereas a tweet utilizing both message styles in a long-lead time condition induces the most fear. Future research should investigate stylistic message elements on new media platforms to better understand how messages can be effectively sent and received by the intended audience within character-limited platforms.

Exploring the use of Storybooks to Reach Mothers of Preschoolers with Nutrition and Physical Activity Messages

PubMed Central

Bellows, Laura; Spaeth, Amanda; Lee, Victoria; Anderson, Jennifer

2013-01-01

Objectives To assess perceptions stay-at-home mothers have about their preschoolers’ eating and physical activity behaviors and to explore the feasibility of utilizing storybooks in home-based nutrition and activity programming. Methods Focus groups were conducted with 24 mothers; intercept interviews with 30 parents; and a storybook prototype was developed and pretested in 8 preschool classrooms. Results Mothers acknowledged picky eating as an issue and were less likely to identify issues with physical activity but were interested in information on gross motor development. Mothers strongly supported storybooks as a modality to convey and reinforce health messages at home. The storybook prototype was well liked by parents, teachers and preschoolers. Conclusions and Implications Storybooks are a practical method to reach mothers and preschoolers and have the potential to elicit changes in eating and activity behaviors. Understanding mothers’ perceptions of healthy eating and physical activity is essential to ensure that storybook messages resonate with this audience. PMID:23415760

Text-Messaging-Enhanced HIV Intervention for African American Adolescents: A Feasibility Study

PubMed Central

Cornelius, Judith B.; Dmochowski, Jacek; Boyer, Cherrie; St Lawrence, Janet; Lightfoot, Marguerita; Moore, Michael

2013-01-01

We examined the feasibility and acceptability of an HIV prevention intervention for African American adolescents delivered via mobile cell phones and looked at intervention-related changes in beliefs and sexual behaviors. We used a longitudinal one-group comparison design with data collected at three points. Forty adolescents, 13–18 years old, participated in the Becoming a Responsible Teen intervention followed by the delivery of daily multimedia messages for 3 months. The mobile-cell-phone enhanced intervention was feasible and acceptable to the participants. Greater HIV knowledge, improved attitudes toward condoms, and increased perceived HIV risk scores were observed with older adolescents (16–18 years old). Behavior trends showed a decrease in the number of times participants reported engaging in unprotected sexual intercourse over the previous 2 months. Mobile-cell-phone multimedia-text-messaging boosters tested in this study provided preliminary evidence of efficacy of the enhanced HIV prevention intervention for African American youth. PMID:23122907

Mobile Diabetes Intervention Study of Patient Engagement and Impact on Blood Glucose: Mixed Methods Analysis

PubMed Central

Butler, Erin C; Swasey, Krystal K; Shardell, Michelle D; Terrin, Michael D; Barr, Erik A; Gruber-Baldini, Ann L

2018-01-01

Background Successful treatment of diabetes includes patient self-management behaviors to prevent or delay complications and comorbid diseases. On the basis of findings from large clinical trials and professional guidelines, diabetes education programs and health providers prescribe daily regimens of glucose monitoring, healthy eating, stress management, medication adherence, and physical activity. Consistent, long-term commitment to regimens is challenging. Mobile health is increasingly being used to assist patients with lifestyle changes and self-management behaviors between provider visits. The effectiveness of mobile health to improve diabetes outcomes depends on patient engagement with a technology, content, or interactions with providers. Objectives In the current analysis, we aimed to identify patient engagement themes in diabetes messaging with diabetes providers and determine if differences in engagement in the Mobile Diabetes Intervention Study (MDIS) influenced changes in glycated hemoglobin A1c (HbA1c) over a 1-year treatment period (1.9% absolute decrease in the parent study). Methods In the primary MDIS study, 163 patients were enrolled into 1 of 3 mobile intervention groups or a usual care control group based on their physician cluster randomization assignment. The control group received care from their physicians as usual. Participants in each intervention group had access to a patient portal where they could record monitoring values for blood glucose, blood pressure, medication changes, or other self-management information while also assigned to varying levels of physician access to patient data. Intervention participants could choose to send and receive messages to assigned certified diabetes educators with questions or updates through the secure Web portal. For this secondary analysis, patient engagement was measured using qualitative methods to identify self-care themes in 4109 patient messages. Mixed methods were used to determine the impact of patient engagement on change in HbA1c over 1 year. Results Self-care behavior themes that received the highest engagement for participants were glucose monitoring (75/107, 70.1%), medication management (71/107, 66.4%), and reducing risks (71/107, 66.4%). The average number of messages sent per patient were highest for glucose monitoring (9.2, SD 14.0) and healthy eating (6.9, SD 13.2). Compared to sending no messages, sending any messages about glucose monitoring (P=.03) or medication (P=.01) led to a decrease in HbA1c of 0.62 and 0.72 percentage points, respectively. Sending any messages about healthy eating, glucose monitoring, or medication combined led to a decrease in HbA1c of 0.54 percentage points compared to not sending messages in these themes (P=.045). Conclusions The findings from this study help validate the efficacy of the mobile diabetes intervention. The next step is to determine differences between patients who engage in mobile interventions and those who do not engage and identify methods to enhance patient engagement. Trial Registration ClinicalTrials.gov: NCT01107015; https://clinicaltrials.gov/ct2/show/NCT01107015 (Archived by WebCite at http://www.webcitation.org/6wh4ekP4R) PMID:29396389

Persuasive Communications to Change Actions: An Analysis of Behavioral and Cognitive Impact in HIV Prevention

PubMed Central

Albarracín, Dolores; McNatt, Penny S.; Klein, Cynthia T. F.; Ho, Ringo M.; Mitchell, Amy L.; Kumkale, G. Tarcan

2016-01-01

This meta-analysis examined the validity of various theoretical assumptions about cognitive and behavioral change following a communication recommending condom use. The synthesis comprised 82 treatment and 29 control groups included in 46 longitudinal reports with measures of perceived severity and susceptibility, attitudes and expectancies, norms, perceptions of control, intentions, knowledge, behavioral skills, or condom use. Results indicated that across the sample of studies, communications taught recipients about facts related to HIV and also induced favorable attitudes and expectancies, greater control perceptions, and stronger intentions to use condoms in the future. Moreover, messages that presented attitudinal information and modeled behavioral skills led to increased condom use. Results are discussed in the context of theories of human behavior and change and in reference to HIV-prevention interventions. PMID:12683737

Experimental pretesting of hand-washing interventions in a natural setting.

PubMed

Judah, Gaby; Aunger, Robert; Schmidt, Wolf-Peter; Michie, Susan; Granger, Stewart; Curtis, Val

2009-10-01

We pretested interventions derived from different domains of behavior change theory to determine their effectiveness at increasing hand washing with soap in a natural setting. We installed wireless devices in highway service station restrooms to record entry and soap use. Two text-only messages for each of 7 psychological domains were compared for their effect on soap-use rates. We collected data on nearly 200 000 restroom uses. The knowledge activation domain was most effective for women, with a relative increase in soap use of 9.4% compared with the control condition (P = .001). For men, disgust was the most effective, increasing soap use by 9.8% (P = .001). Disgust was not significantly better than the control condition for women, nor was knowledge activation for men. Messages based on social norms and social status were effective for both genders. Our data show that unobtrusive observation of behavior in a natural setting can help identify the most effective interventions for changing behaviors of public health importance. The gender differences we found suggest that public health interventions should target men and women differently.

Cognitive Processing and the Functional Matching Effect in Persuasion: The Mediating Role of Subjective Perceptions of Message Quality

PubMed

Lavine; Snyder

1996-11-01

In two experiments, we examined the hypothesis that subjective perceptions of message quality mediate the functional matching effect in persuasion. In Experiment 1, participants whose attitudes and behaviors serve primarily a value-expressive function (i.e., low self-monitors) or a social-adjustive function (i.e., high self-monitors) were exposed to persuasive messages that contained value-expressive, social-adjustive, or both types of arguments in favor of voting. Functionally-relevant messages (i.e., the social-adjustive message for high self-monitors and the value-expressive message for low self-monitors) produced enhanced perceptions of message quality and persuasiveness, more positive attitudes, and more message-related behavior than functionally nonrelevant messages. Functionally mixed messages were generally more effective than messages containing only functionally nonrelevant arguments, but less effective than messages containing only functionally relevant arguments. Path analyses indicated that the influence of functional relevance on attitudes and behavior was significantly mediated by subjective perceptions of the quality of the message. In Experiment 2, we exposed participants to a functionally relevant or nonrelevant voting appeal five days before a presidential election. Results replicated those of Experiment 1; functionally relevant messages produced more favorable attitudes, and this effect was mediated by enhanced perceptions of message quality. Finally, postmessage attitudes exerted a significant influence on whether participants voted in the election, and this effect was mediated by voting intentions. Discussion focuses on the subjective nature of message evaluation and on the cognitive processes underlying the functional matching effect in persuasion.

The Impact of Gain- and Loss-Framed Messages on Young Adults’ Sexual Decision Making: An Experimental Study

PubMed Central

Macapagal, Kathryn; Janssen, Erick; Matson, Margaret; Finn, Peter R.; Heiman, Julia R.

2015-01-01

Messages that frame a target behavior in terms of its benefits (gain frame) or costs (loss frame) have been widely and successfully used for health promotion and risk reduction. However, the impact of framed messages on decisions to have sex and sexual risk, as well as moderators of these effects, has remained largely unexplored. We used a computerized laboratory task to test the effects of framed messages about condom use on young adults’ sexual decision making. Participants (N = 127) listened to both gain- and loss-framed messages and rated their intentions to have sex with partners who posed a high and low risk for sexually transmitted infections (STIs). The effects of message frame, partner risk, participant gender, ability to adopt the messages, and message presentation order on intentions to have sex were examined. Intentions to have sex with high-risk partners significantly decreased after the loss-framed message, but not after the gain-framed message, and intentions to have sex increased for participants who received the gain-framed message first. Yet, participants found it easier to adopt the gain-framed message. Results suggest that loss-framed messages may be particularly effective in reducing intentions to have sex with partners who might pose a higher risk for STIs, and that message presentation order may alter the relative effectiveness of gain- and loss-framed messages on sexual decision making. Future studies should examine the precise conditions under which gain- and loss-framed messages can promote healthy sexual behaviors and reduce sexual risk behaviors. PMID:26696408

The Impact of Gain- and Loss-Framed Messages on Young Adults' Sexual Decision Making: An Experimental Study.

PubMed

Macapagal, Kathryn; Janssen, Erick; Matson, Margaret; Finn, Peter R; Heiman, Julia R

2017-02-01

Messages that frame a target behavior in terms of its benefits (gain frame) or costs (loss frame) have been widely and successfully used for health promotion and risk reduction. However, the impact of framed messages on decisions to have sex and sexual risk, as well as moderators of these effects, has remained largely unexplored. We used a computerized laboratory task to test the effects of framed messages about condom use on young adults' sexual decision making. Participants (N = 127) listened to both gain- and loss-framed messages and rated their intentions to have sex with partners who posed a high and low risk for sexually transmitted infections (STIs). The effects of message frame, partner risk, participant gender, ability to adopt the messages, and message presentation order on intentions to have sex were examined. Intentions to have sex with high-risk partners significantly decreased after the loss-framed message, but not after the gain-framed message, and intentions to have sex increased for participants who received the gain-framed message first. Yet, participants found it easier to adopt the gain-framed message. Results suggest that loss-framed messages may be particularly effective in reducing intentions to have sex with partners who might pose a higher risk for STIs, and that message presentation order may alter the relative effectiveness of gain- and loss-framed messages on sexual decision making. Future studies should examine the precise conditions under which gain- and loss-framed messages can promote healthy sexual behaviors and reduce sexual risk behaviors.

Social Marketing Risk-Framing Approaches for Dental Sealants in Rural American Indian Children

PubMed Central

Champine, Dorothy; Hoyt, Dee; Lin, Lillian; Salois, Emily; Silvas, Sharon; Tail, Terri Weasel; Williams, Matthew

2015-01-01

Objective To compare three variants of a culturally-relevant and theoretically-based message to determine the most influential risk framing approach for improving intention to place dental sealants for preschool children. Design and Sample A convenience sample of adult, American Indian participants (n = 89) attending a community health fair were assigned to view a gain-framed, loss-framed, or mix-framed dental sealant message. Measurements We compared participant's scores on a 46-item survey to determine the relative effect of the frame assignment on seven indices of behavior change. Results The mean difference in participant's stage-of-change scores (x = 1.17, n = 89, sd = 1.90) demonstrated a significant improvement for all groups after watching the dental sealant message t(88) = 5.81, p < .0001, 95% CI [0.77 – 1.57]. Self-efficacy was the only construct for which we detected a statistically significant difference as a function of frame assignment. Overall, the mix-framed message resulted in the highest scores. The gain-framed message was the least influential on four constructs. This finding is in contrast to findings that gain-framed oral health messages are most influential (Gallagher & Updegraff, 2012; O'Keefe & Jensen, 2007). Conclusions Community advisory board members determined to use the mix-framed approach in an oral-health social marketing campaign with a rural, American Indian audience. PMID:26032902

Social Marketing Risk-Framing Approaches for Dental Sealants in Rural American Indian Children.

PubMed

Larsson, Laura S; Champine, Dorothy; Hoyt, Dee; Lin, Lillian; Salois, Emily; Silvas, Sharon; Tail, Terri Weasel; Williams, Matthew

2015-01-01

To compare three variants of a culturally relevant and theoretically based message to determine the most influential risk-framing approach for improving intention to place dental sealants for preschool children. A convenience sample of adult, American Indian participants (n = 89) attending a community health fair were assigned to view a gain-framed, loss-framed, or mix-framed dental sealant message. We compared participants' scores on a 46-item survey to determine the relative effect of the frame assignment on seven indices of behavior change. The mean difference in participants' stage-of-change scores (x = 1.17, n = 89, SD = 1.90) demonstrated a significant improvement for all groups after watching the dental sealant message t88  = 5.81, p < .0001, 95% CI [0.77-1.57]. Self-efficacy was the only construct for which we detected a statistically significant difference as a function of frame assignment. Overall, the mix-framed message resulted in the highest scores. The gain-framed message was the least influential on four constructs. This finding is in contrast to findings that gain-framed oral health messages are most influential (Gallagher & Updegraff, 2012; O'Keefe & Jensen, 2007). Community advisory board members determined to use the mix-framed approach in an oral health social marketing campaign with a rural, American Indian audience. © 2015 Wiley Periodicals, Inc.

Patient-clinician mobile communication: analyzing text messaging between adolescents with asthma and nurse case managers.

PubMed

Yoo, Woohyun; Kim, Soo Yun; Hong, Yangsun; Chih, Ming-Yuan; Shah, Dhavan V; Gustafson, David H

2015-01-01

With the increasing penetration of digital mobile devices among adolescents, mobile texting messaging is emerging as a new channel for patient-clinician communication for this population. In particular, it can promote active communication between healthcare clinicians and adolescents with asthma. However, little is known about the content of the messages exchanged in medical encounters via mobile text messaging. Therefore, this study explored the content of text messaging between clinicians and adolescents with asthma. We collected a total of 2,953 text messages exchanged between 5 nurse case managers and 131 adolescents with asthma through a personal digital assistant. The text messages were coded using a scheme developed by adapting categories from the Roter Interaction Analysis System. Nurse case managers sent more text messages (n=2,639) than adolescents with asthma. Most messages sent by nurse case managers were targeted messages (n=2,475) directed at all adolescents with asthma, whereas there were relatively few tailored messages (n=164) that were created personally for an individual adolescent. In addition, both targeted and tailored messages emphasized task-focused behaviors over socioemotional behaviors. Likewise, text messages (n=314) sent by adolescents also emphasized task-focused over socioemotional behaviors. Mobile texting messaging has the potential to play an important role in patient-clinician communication. It promotes not only active interaction, but also patient-centered communication with clinicians. In order to achieve this potential, healthcare clinicians may need to focus on socioemotional communication as well as task-oriented communication.

Fear, anger, fruits, and veggies: interactive effects of emotion and message framing on health behavior.

PubMed

Gerend, Mary A; Maner, Jon K

2011-07-01

Message framing is a theoretically grounded health communication strategy designed to motivate action by emphasizing either the benefits of engaging in a particular behavior (gains) or the costs of failing to engage in the behavior (losses). This study investigated whether the effectiveness of a framed message depends on the emotional state of the message recipient. We examined effects of fear versus anger, emotions that frequently occur within the context of health decision-making. Undergraduate students (N = 133) were randomly assigned to complete a fear or anger induction task after which they read a gain- or loss-framed pamphlet promoting fruit and vegetable consumption. Fruit and vegetable intake (servings per day) subsequently was assessed over the following 2 weeks. As predicted, a significant frame by emotion interaction was observed, such that participants in the fear condition reported eating more servings of fruits and vegetables after exposure to a loss-framed message than to a gain-framed message. In contrast, participants in the anger condition reported eating (marginally) more servings of fruits and vegetables after exposure to a gain-framed message than to a loss-framed message. Greater increases in fruit and vegetable intake from baseline to follow-up were observed when the message frame was matched to the participant's emotional state. The effectiveness of framed health communications depends on the message recipient's current emotional state. Affective factors that are incidental to the behavior recommended in a health communication can affect the relative success of gain- and loss-framed appeals.

Tailored motivational message generation: A model and practical framework for real-time physical activity coaching.

PubMed

Op den Akker, Harm; Cabrita, Miriam; Op den Akker, Rieks; Jones, Valerie M; Hermens, Hermie J

2015-06-01

This paper presents a comprehensive and practical framework for automatic generation of real-time tailored messages in behavior change applications. Basic aspects of motivational messages are time, intention, content and presentation. Tailoring of messages to the individual user may involve all aspects of communication. A linear modular system is presented for generating such messages. It is explained how properties of user and context are taken into account in each of the modules of the system and how they affect the linguistic presentation of the generated messages. The model of motivational messages presented is based on an analysis of existing literature as well as the analysis of a corpus of motivational messages used in previous studies. The model extends existing 'ontology-based' approaches to message generation for real-time coaching systems found in the literature. Practical examples are given on how simple tailoring rules can be implemented throughout the various stages of the framework. Such examples can guide further research by clarifying what it means to use e.g. user targeting to tailor a message. As primary example we look at the issue of promoting daily physical activity. Future work is pointed out in applying the present model and framework, defining efficient ways of evaluating individual tailoring components, and improving effectiveness through the creation of accurate and complete user- and context models. Copyright © 2015 Elsevier Inc. All rights reserved.

It's no laughing matter: An exploratory study of the use of ironic versus sarcastic humor in health-related advertising messages.

PubMed

Iles, Irina Alexandra; Nan, Xiaoli

2017-01-01

We examined the persuasive effects of ironic and sarcastic versus no humor appeals in health messages and the potential differential effects of ironic versus sarcastic humor. Findings of a controlled experiment (N = 303) suggested that sarcastic messages, as compared to no humor messages, resulted in less negative affect, more counterarguing, and decreased perceived argument strength. Ironic messages led to more counterarguing than no humor messages. Significant differences in counterarguing, perceived argument strength, and attitudes toward the risky behavior were detected between the two humor types. Counterarguing mediated the indirect effect of message type on attitudes toward the risky behavior.

An evaluation of diet and physical activity messaging in African American churches.

PubMed

Harmon, Brook E; Blake, Christine E; Thrasher, James F; Hébert, James R

2014-04-01

The use of faith-based organizations as sites to deliver diet and physical activity interventions is increasing. Methods to assess the messaging environment within churches are limited. Our research aimed to develop and test an objective assessment methodology to characterize health messages, particularly those related to diet and physical activity, within a sample of African American churches. Written messages (bulletins, brochures, magazines) were systematically collected over 1 year and analyzed with a coding scheme that had high interrater reliability (average κ = .77). Within all health messages (n = 1109), diet and physical activity messages were prevalent (47% and 32%, respectively). Consistent with prior qualitative research, messages related to meals and to providing food to people in need were frequently found (54% and 25% of diet messages, respectively). Contrary to past research, sports and physical activity as praise (e.g., praise dancing) were the most prevalent physical activity messages (36% and 31% of physical activity messages, respectively). Bulletins, flyers, and brochures were the media in which diet and physical activity messages were most frequently found (14%, 33%, and 24%, respectively), and the church was the most frequent source (41%). Only diet and physical activity messages focused on disease prevention were more likely to originate from national health organizations than from the church (26% vs. 16%). Churches varied in the topics, media types, and sources of health messages, an important factor to consider when planning and implementing health promotion research. Future research should determine whether the enhancement of church messaging environments can produce behavioral change.

Don't Say That to ME: Opposition to Targeting in Weight-Centric Intervention Messages.

PubMed

Robinson, Becky; Coveleski, Samantha

2018-02-01

Obesity is a global health issue. Despite well-intentioned efforts by public institutions, traditional health promotion techniques often lead to offending those most in need of weight loss. For example, when Bryn Mawr College targeted overweight students to offer a free fitness and nutrition program, it was met with accusations of fat-shaming, indicating that weight-centric messages operate in a more complex sociocultural system than many public health concerns. To better understand reactions to weight-centric health messages, college-aged women evaluated the Bryn Mawr College e-mail. Using an embedded mixed-methods design, analysis revealed that reactions followed four positive themes, six negative themes, and one neutral theme. Statistical tests indicated that health literacy, feminist identification, body dissatisfaction, and body size discrepancy influenced evaluations of message offensiveness and effectiveness. Contrary to the recommendations of traditional behavior change research, these results indicate that audience segmentation and message tailoring may not be effective for promoting weight loss.

Games for health for children—Current status and needed research

USDA-ARS?s Scientific Manuscript database

Videogames for health (G4H) offer exciting, innovative, potentially highly effective methods for increasing knowledge, delivering persuasive messages, changing behaviors, and influencing health outcomes. Although early outcome results are promising, additional research is needed to determine the gam...

TravelAid : in-vehicle signing and variable speed limit evaluation

DOT National Transportation Integrated Search

2001-12-01

This report discusses the effectiveness of using variable message signs (VMSs) and in-vehicle traffic advisory systems (IVUs) on a mountainous pass (Snoqualmie Pass on Interstate 90 in Washington State) for changing driver behavior. As part of this p...

Communication, Reasoning, and Planned Behaviors: Unveiling the Effect of Interactive Communication in an Anti-Smoking Social Media Campaign.

PubMed

Namkoong, Kang; Nah, Seungahn; Record, Rachael A; Van Stee, Stephanie K

2017-01-01

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.

Risk perception measures' associations with behavior intentions, affect, and cognition following colon cancer screening messages.

PubMed

Dillard, Amanda J; Ferrer, Rebecca A; Ubel, Peter A; Fagerlin, Angela

2012-01-01

Risk perception is important for motivating health behavior (e.g., Janz & Becker, 1984), but different measures of the construct may change how important that relationship appears. In two studies, we examined associations between four measures of risk perception, health behavior intentions and possible behavioral determinants. Participants in these studies, who were due for colorectal cancer screening, read an online message about the importance of screening to reduce the chance of cancer. We examined bivariate and multivariate associations between risk perception measures, including absolute, comparative, and feelings-of-risk, and behavioral intentions to screen, general worry, and knowledge and attitudes related to screening. Results across the two studies were consistent, with all risk perception measures being correlated with intentions and attitudes. Multivariate analyses revealed that feelings-of-risk was most predictive of all variables, with the exception of general worry, for which comparative measures were the most predictive. Researchers interested in risk perception should assess feelings-of-risk along with more traditional measures. Those interested in influencing health behavior specifically should attempt to increase feelings of vulnerability rather than numerical risk.

Repeated exposure to media messages encouraging parent-child communication about sex: differential trajectories for mothers and fathers.

PubMed

Blitstein, Jonathan L; Evans, W Douglas; Davis, Kevin C; Kamyab, Kian

2012-01-01

To examine changes in parent-child communication related to sexual behavior after exposure to public health messages. Randomized, controlled trial that was part of precampaign message testing. Exposure occurred online or through DVDs mailed to participants and viewed on their personal computers. Data collection occurred via a secure Web site. Participants included parents (n  =  1969) living with a child age 10 to 14 years drawn from a nationally representative sample of U.S. households. Treatment participants were exposed to video, audio, and print advertisements that promoted the benefits of speaking to their children early and often about delaying initiation of sexual activity; messages also directed parents to an informational Web site. The dependent variable assessed frequency of parent-child communication related to sexual behavior. The primary independent variable was treatment assignment. Longitudinal growth modeling that included five waves of data. The trajectory of growth over time differed between fathers in the treatment group and fathers in the control group (F[1, 2357]  =  4.15; p < .042), indicating more frequent communication among treatment fathers than among control fathers. Trajectories did not differ between mothers in treatment and control groups. This study demonstrates that father-child and mother-child communication patterns differ over time in response to public health messages. Findings have implication for researchers developing health marketing campaigns.

Death narratives and cervical cancer: Impact of character death on narrative processing and HPV vaccination.

PubMed

Krakow, Melinda; Yale, Robert N; Perez Torres, Debora; Christy, Katheryn; Jensen, Jakob D

2017-12-01

Narratives hold promise as an effective public health message strategy for health behavior change, yet research on what types of narratives are most persuasive is still in the formative stage. Narrative persuasion research has identified 2 promising features of such messages that could influence behavior: whether characters live or die, and whether characters encounter key barriers. This study investigated the effects of these 2 narrative message features on young women's HPV vaccination intentions and examined mediating psychological processes of narrative persuasion in the context of cervical cancer messages. We manipulated these 2 features in a narrative HPV vaccine intervention targeted to a national sample of U.S. women 18-26 who had not initiated the vaccine (N = 247). Participants were randomized in a 2 × 2 between-subjects experiment. Compared to death narratives, survival narratives increased narrative believability and self-efficacy while lowering perceived barriers to vaccination. As features interacted, survival narratives featuring social barriers led to greater narrative transportation (absorption into the story) than other combinations. Moderated mediation analysis tested 10 theoretically derived mediators; transportation and risk severity mediated the narrative-intention relationship. Findings provide evidence for key psychological postulates of narrative persuasion theory. Results inform practical application for the construction of effective narrative message content in cervical cancer prevention campaigns for young women. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

When Communications Collide With Recipients’ Actions: Effects of Post-Message Behavior on Intentions to Follow the Message Recommendation

PubMed Central

Albarracín, Dolores; Cohen, Joel B.; Kumkale, G. Tarcan

2013-01-01

Two experiments investigated the processes through which post-message behavior (e.g., noncompliance) influences resistance to the message. Participants in Experiment 1 read preventive, consumer-education messages that either opposed the consumption of an alcohol-like product or recommended moderation. Half of the participants then tried the product, whereas the remaining participants performed a filler task. In the absence of trial, the two messages had the same effect. However, recipients of the abstinence-promoting preventive message who tried the product had stronger intentions to use the product in the future than recipients of the moderation message. This finding suggests that assessments of message impact may be inadequate unless an opportunity for trial is also provided. Results are interpreted in terms of self-perception and cognitive dissonance and contrasted from psychological reactance. PMID:15018672

Associations among Text Messaging, Academic Performance, and Sexual Behaviors of Adolescents

ERIC Educational Resources Information Center

Perry, Raymond C. W.; Braun, Rebecca A.; Cantu, Michelle; Dudovitz, Rebecca N.; Sheoran, Bhupendra; Chung, Paul J.

2014-01-01

Background: Text messaging is an increasingly common mode of communication, especially among adolescents, and frequency of texting may be a measure of one's sociability. This study examined how text messaging ("texting") frequency and academic performance are associated with adolescent sexual behaviors. Methods: A cross-sectional survey…

Evaluating a fear appeal message to reduce alcohol use among "Greeks".

PubMed

Moscato, S; Black, D R; Blue, C L; Mattson, M; Galer-Unti, R A; Coster, D C

2001-01-01

To evaluate the impact of a fear appeal message on college students' drinking behavior using the extended parallel process model. A survey was administered to a random sample of undergraduates (n=224) in 38 national fraternal organizations. Both perceived efficacy and perceived threat were significantly correlated with drinking behavior. There was a significant difference both in drinking behavior and attendance at alcohol-free events between those who heard and those who did not hear the message. Theoretically based fear appeal messages may be a useful way to promote responsible drinking among college students.

Sociolinguistic and psycholinguistic indications of behavior disorders: analysis of a prisoner's discourse.

PubMed

Timor, Uri; Weiss, Joshua M

2008-02-01

Human verbal language communicates both manifest and latent messages concerning the speaker's world and behavior. To understand his world and analyze his problems,(1) it is important to decode the latent messages as they may hint at the root causes. The authors present a discourse analysis of a prisoner's text and a semantic and morphological analysis of it. This text reflects contempt for the law and its representatives, together with a weak attachment to legitimate society, neutralization of personal responsibility, denial of guilt, and low self-esteem. Sociolinguistic and psycholinguistic analysis points toward a more profound evaluation of the perceptions and world of the speaker. It seems that he yearns for attachment, for understanding and social acceptance, and perhaps even to abandon crime. The prisoner's latent feelings of helplessness and fear of humiliation may help the therapist establish a therapeutic relationship and help him change his perceptions and behavior.

Precision of information, sensational information, and self-efficacy information as message-level variables affecting risk perceptions.

PubMed

Dahlstrom, Michael F; Dudo, Anthony; Brossard, Dominique

2012-01-01

Studies that investigate how the mass media cover risk issues often assume that certain characteristics of content are related to specific risk perceptions and behavioral intentions. However, these relationships have seldom been empirically assessed. This study tests the influence of three message-level media variables--risk precision information, sensational information, and self-efficacy information--on perceptions of risk, individual worry, and behavioral intentions toward a pervasive health risk. Results suggest that more precise risk information leads to increased risk perceptions and that the effect of sensational information is moderated by risk precision information. Greater self-efficacy information is associated with greater intention to change behavior, but none of the variables influence individual worry. The results provide a quantitative understanding of how specific characteristics of informational media content can influence individuals' responses to health threats of a global and uncertain nature. © 2011 Society for Risk Analysis.

An Experimental Test of the Roles of Audience Involvement and Message Frame in Shaping Public Reactions to Celebrity Illness Disclosures.

PubMed

Myrick, Jessica Gall

2018-04-13

Much research has investigated what happens when celebrities disclose an illness (via media) to the public. While audience involvement (i.e., identification and parasocial relationships) is often the proposed mechanism linking illness disclosures with audience behavior change, survey designs have prevented researchers from understanding if audience involvement prior to the illness disclosure actually predicts post-disclosure emotions, cognitions, and behaviors. Rooted in previous work on audience involvement as well as the Extended Parallel Process Model, the present study uses a national online experiment (N = 1,068) to test how pre-disclosure audience involvement may initiate post-disclosure effects for the message context of skin cancer. The data demonstrate that pre-disclosure audience involvement as well as the celebrity's framing of the disclosure can shape emotional responses (i.e., fear and hope), and that cognitive perceptions of the illness itself also influence behavioral intentions.

Use of a text message program to raise type 2 diabetes risk awareness and promote health behavior change (part II): assessment of participants' perceptions on efficacy.

PubMed

Buis, Lorraine R; Hirzel, Lindsey; Turske, Scott A; Des Jardins, Terrisca R; Yarandi, Hossein; Bondurant, Patricia

2013-12-19

Although there is great enthusiasm in both the public and private sector for the further development and use of large-scale consumer-facing public health applications for mobile platforms, little is known about user experience and satisfaction with this type of approach. As a part of the Beacon Community Cooperative Agreement Program, txt4health, a public-facing, mobile phone-based health information service targeting type 2 diabetes, was launched in 3 Beacon Communities: the Southeast Michigan Beacon Community in Detroit, MI, the Greater Cincinnati Beacon Community in Cincinnati, OH, and the Crescent City Beacon Community in New Orleans, LA. This program was marketed via large public health campaigns and drew many users within the respective communities. The purpose of this investigation was to use the RE-AIM framework to document txt4health efficacy by focusing on perceptions of satisfaction, usage, and behavior change among individuals who used txt4health in pilot studies in Southeast Michigan and Greater Cincinnati. We conducted a multimodal user survey with txt4health users recruited via text message through the program to understand participant perceptions of program use and satisfaction, as well as self-reported perceptions of behavior change as a result of using txt4health. Txt4health users reported very high levels of program satisfaction, with 67.1% (108/161) reporting satisfaction scores of ≥8 on a 10-point scale, with 10 equivalent to most satisfied (mean 8.2, SD 1.6). All survey participants agreed/strongly agreed that the messages included in txt4health were clear and easy to understand (100.0%, 160/160), and most found txt4health made them knowledgeable about their risk for type 2 diabetes (88.1%, 140/159) and made them conscious of their diet and physical activity (88.8%, 142/160). Most participants reported that txt4health helped them to make behavior changes related to diet; after having completed txt4health, most agreed/strongly agreed that they are more likely to replace sugary drinks, such as juice or soda, with water (78.0%, 124/159), have a piece of fresh fruit instead of dessert (74.2%, 118/159), substitute a small salad for chips or fries when dining out (76.1%, 121/159), buy healthier foods when grocery shopping (79.7%, 126/158), and eat more grilled, baked, or broiled foods instead of fried (75.5%, 120/159). Results from this study suggest that participants in txt4health, a large-scale, public health-focused text message program targeting type 2 diabetes, have positive perceptions of the program and that participation has led to positive behavior change.

Targeted Messages Increase Dairy Consumption in Adults: a Randomized Controlled Trial.

PubMed

Jung, Mary E; Latimer-Cheung, Amy E; Bourne, Jessica E; Martin Ginis, Kathleen A

2017-02-01

Dairy consumption amongst North Americans aged 30-50 has been declining. Targeted messages have been identified as a cost-efficient method through which to increase health-enhancing behavior, such as dairy intake. The aim of this study is to assess the utility of targeted, framed, efficacy-enhancing messages on calcium consumption from dairy in adults aged 30-50 in a randomized controlled trial. Seven hundred and thirty-two individuals (463 women, 269 men; M age  = 40.57 years) were randomly assigned to one of five message conditions: (1) gain-framed (GF), (2) loss-framed (LF), (3) self-regulatory efficacy-enhancing (SRE), (4) GF plus SRE (GF + SRE), or (5) LF plus SRE (LF + SRE). Conditions were separate for men and women. Each condition received an emailed message on four consecutive days. Calcium intake from dairy, self-regulatory efficacy, outcome expectations, and outcome value were measured at baseline, 1 and 4 weeks following the intervention. Calcium intake from dairy significantly increased from baseline to week 1 post-intervention in all conditions (p < .001). A significant message condition x time interaction (p = .04) revealed that increases seen in the LF + SRE condition were maintained at week 4. All social cognitive constructs increased following the intervention (ps < .01). Self-regulatory efficacy (β = .28, p < .01) and outcome expectations (β = .19, p < .01) were significant predictors of subsequent calcium intake (week 4) from dairy. Taken together, it appears as though ensuring message content is targeted to the specific population's beliefs and motives is of importance when developing behavioral change intervention material.

Examining the Impact of a Public Health Message on Fish Consumption in Bermuda

PubMed Central

McLean Pirkle, Catherine; Peek-Ball, Cheryl; Outerbridge, Eugene; Rouja, Philippe Max

2015-01-01

Background In 2003 mean cord blood mercury concentrations in pregnant Bermudian women exceeded levels associated with adverse health outcomes in children. The principal mercury source was local fish species. Public health messages were developed suggesting pregnant women reduce consumption of fish species with higher mercury concentrations (e.g. swordfish), substituting species containing lower mercury concentrations, and elevated omega-3 fatty acids (e.g. anchovies). Recent evidence indicates mercury concentrations in Bermuda’s pregnant women have fallen five- fold. Objectives Assess whether changes in women’s fish eating patterns during pregnancy are consistent with the public health messaging. Determine who is making changes to their diet during pregnancy and why. Methods Mixed methods study with a cross-sectional survey of 121 pregnant women, including 13 opened-ended interviews. Health system, social vulnerability, public health messaging, and socio-demographic variables were characterized and related to changes in fish consumption during pregnancy. Qualitative data were coded according to nutritional advice messages, comprehension of communication strategies, and sources of information. Results 95% of women surveyed encountered recommendations about fish consumption during pregnancy. 75% reported modifying fish eating behaviors because of recommendations. Principal sources of information about fish consumption in pregnancy were health care providers and the Internet. 71% of women reported reducing consumption of large fish species with greater mercury levels, but 60% reported reduced consumption of smaller, low mercury fish. No participant mentioned hearing about the benefits of fish consumption. More frequent exposure to public health messages during pregnancy was associated with lower reported consumption. Bermudian born women were less likely to reduce consumption of large fish species during pregnancy. Conclusions In Bermuda, public health messages advocating reduced consumption of larger, higher mercury-containing fish species appear effective, but masked the nutritional value message of small fish species, with low mercury concentration. Adjustment is needed to better balance the risk communication. PMID:26426692

Examining the Impact of a Public Health Message on Fish Consumption in Bermuda.

PubMed

McLean Pirkle, Catherine; Peek-Ball, Cheryl; Outerbridge, Eugene; Rouja, Philippe Max

2015-01-01

In 2003 mean cord blood mercury concentrations in pregnant Bermudian women exceeded levels associated with adverse health outcomes in children. The principal mercury source was local fish species. Public health messages were developed suggesting pregnant women reduce consumption of fish species with higher mercury concentrations (e.g. swordfish), substituting species containing lower mercury concentrations, and elevated omega-3 fatty acids (e.g. anchovies). Recent evidence indicates mercury concentrations in Bermuda's pregnant women have fallen five- fold. Assess whether changes in women's fish eating patterns during pregnancy are consistent with the public health messaging. Determine who is making changes to their diet during pregnancy and why. Mixed methods study with a cross-sectional survey of 121 pregnant women, including 13 opened-ended interviews. Health system, social vulnerability, public health messaging, and socio-demographic variables were characterized and related to changes in fish consumption during pregnancy. Qualitative data were coded according to nutritional advice messages, comprehension of communication strategies, and sources of information. 95% of women surveyed encountered recommendations about fish consumption during pregnancy. 75% reported modifying fish eating behaviors because of recommendations. Principal sources of information about fish consumption in pregnancy were health care providers and the Internet. 71% of women reported reducing consumption of large fish species with greater mercury levels, but 60% reported reduced consumption of smaller, low mercury fish. No participant mentioned hearing about the benefits of fish consumption. More frequent exposure to public health messages during pregnancy was associated with lower reported consumption. Bermudian born women were less likely to reduce consumption of large fish species during pregnancy. In Bermuda, public health messages advocating reduced consumption of larger, higher mercury-containing fish species appear effective, but masked the nutritional value message of small fish species, with low mercury concentration. Adjustment is needed to better balance the risk communication.

The Effect of Public Service Advertising on Cardiovascular Disease in Korea

PubMed Central

JANG, Juhyun; NA, Baeg Ju; LEE, Moo-Sik; SEO, Soonryu; SUNG, Changhyun; KIM, Hyun Joo; LEE, Jin Yong

2016-01-01

Background: Public Service Advertising (PSA) is a public interest message disseminated in the form of an advertisement communication and its main purpose is to promote public behavioral changes regarding a social issue. Korea Centers for Disease Control and Prevention (KCDC) has been delivering PSA by various media. However, the effect of PSAs has never been evaluated. The purpose of this study was to estimate the effects of broadcasted PSA produced by KCDC on cardiovascular disease (CVD). Methods: One thousand adult participants throughout 15 provinces in Korea were chosen through the quota sampling method in 2012. A face-to-face research survey with 13 questions was conducted using a Computer Assisted Personal Interview (CAPI) system. Previous exposure to the PSA message, understanding, and behavioral intention to change was assessed. Results: After watching the PSA, about 75% of participants answered that they could understand the contents well and 70% had willingness to change their behaviors associated with CVD. However, only 24% of participants answered they watched the PSA during the past year. Conclusion: The PSA had positive effects on increasing the level of understanding and intention to change behaviors regarding CVD. However, the level of exposure was low. KCDC should make an effort to increase the public exposure level, which could be an important success factor regarding the PSA. In addition, KCDC should consider customized PSA for vulnerable people such as multi-cultural families, the disabled, and the elderly. PMID:27928529

The Saturation+ Approach to Behavior Change: Case Study of a Child Survival Radio Campaign in Burkina Faso.

PubMed

Murray, Joanna; Remes, Pieter; Ilboudo, Rita; Belem, Mireille; Salouka, Souleymane; Snell, Will; Wood, Cathryn; Lavoie, Matthew; Deboise, Laurent; Head, Roy

2015-11-03

A 35-month cluster randomized controlled trial was conducted in Burkina Faso to test whether a radio campaign focused on child health, broadcast between March 2012 and January 2015, could reduce under-5 mortality. This paper describes the design and implementation of the mass media intervention in detail, including the Saturation+ principles that underpinned the approach, the creative process, the lessons learned, and recommendations for implementing this intervention at scale. The Saturation+ approach focuses on the 3 core principles of saturation (ensuring high exposure to campaign messages), science (basing campaign design on data and modeling), and stories (focusing the dramatic climax on the target behavior) to maximize the impact of behavior change campaigns. In Burkina Faso, creative partnerships with local radio stations helped us obtain free airtime in exchange for training and investing in alternative energy supplies to solve frequent energy problems faced by the stations. The campaign used both short spots and longer drama formats, but we consider the short spots as a higher priority to retain during scale-up, as they are more cost-effective than longer formats and have the potential to ensure higher exposure of the population to the messages. The implementation research synthesized in this paper is designed to enable the effective adoption and integration of evidence-based behavior change communication interventions into health care policy and practice. © Murray et al.

The Saturation+ Approach to Behavior Change: Case Study of a Child Survival Radio Campaign in Burkina Faso

PubMed Central

Murray, Joanna; Remes, Pieter; Ilboudo, Rita; Belem, Mireille; Salouka, Souleymane; Snell, Will; Wood, Cathryn; Lavoie, Matthew; Deboise, Laurent; Head, Roy

2015-01-01

A 35-month cluster randomized controlled trial was conducted in Burkina Faso to test whether a radio campaign focused on child health, broadcast between March 2012 and January 2015, could reduce under-5 mortality. This paper describes the design and implementation of the mass media intervention in detail, including the Saturation+ principles that underpinned the approach, the creative process, the lessons learned, and recommendations for implementing this intervention at scale. The Saturation+ approach focuses on the 3 core principles of saturation (ensuring high exposure to campaign messages), science (basing campaign design on data and modeling), and stories (focusing the dramatic climax on the target behavior) to maximize the impact of behavior change campaigns. In Burkina Faso, creative partnerships with local radio stations helped us obtain free airtime in exchange for training and investing in alternative energy supplies to solve frequent energy problems faced by the stations. The campaign used both short spots and longer drama formats, but we consider the short spots as a higher priority to retain during scale-up, as they are more cost-effective than longer formats and have the potential to ensure higher exposure of the population to the messages. The implementation research synthesized in this paper is designed to enable the effective adoption and integration of evidence-based behavior change communication interventions into health care policy and practice. PMID:26681703

Are you Scared Yet?

PubMed Central

Emery, Sherry L.; Szczypka, Glen; Abril, Eulàlia Puig; Kim, Yoonsang; Vera, Lisa

2014-01-01

In March 2012, the CDC launched “Tips from Former Smokers,” a $54 million national campaign featuring individuals experiencing long-term health consequences of smoking. The campaign approach was based on strong evidence that anti-tobacco ads portraying fear, graphic images, and personal testimonials are associated with attitudinal and behavior change. Yet it was also controversial; critics cited the danger that viewers might reject such intensely graphic messages. Tasked with informing this debate, our study analyzes the corpus of Tips campaign-related tweets obtained via the Twitter Firehose. We provide a novel and rigorous method for media campaign evaluation within the framework of the Extended Parallel Process Model. Among the relevant Tweets, 87% showed evidence of message acceptance, while 7% exhibited message rejection. PMID:25429162

Texting to increase adolescent physical activity: Feasibility assessment

USDA-ARS?s Scientific Manuscript database

Feasibility trials assess whether a behavior change program warrants a definite trial evaluation. This paper reports the feasibility of an intervention consisting of Self Determination Theory-informed text messages, pedometers, and goal prompts to increase adolescent physical activity. A 4-group ran...

Social influence and motivation to change health behaviors among Mexican origin adults: Implications for diet and physical activity

PubMed Central

Ashida, Sato; Wilkinson, Anna V.; Koehly, Laura M.

2011-01-01

Purpose To evaluate whether influence from social network members is associated with motivation to change dietary and physical activity behaviors. Design Baseline assessment followed by mailing of family health history-based personalized messages (2 weeks) and follow-up assessment (3 months). Setting Families from an ongoing population-based cohort in Houston, TX. Subjects 475 adults from 161 Mexican origin families. Out of 347 households contacted, 162 (47%) participated. Measures Family health history, social networks, and motivation to change behaviors. Analysis Two-level logistic regression modeling. Results Having at least one network member who encourages one to eat more fruits and vegetables (p=.010) and to engage in regular physical activity (p=.046) was associated with motivation to change the relevant behavior. About 40% of the participants did not have encouragers for these behaviors. Conclusions Identification of new encouragers within networks and targeting natural encouragers (e.g., children, spouses) may increase the efficacy of interventions to motivate behavioral changes among Mexican origin adults. PMID:22208416

Social influence and motivation to change health behaviors among Mexican-origin adults: implications for diet and physical activity.

PubMed

Ashida, Sato; Wilkinson, Anna V; Koehly, Laura M

2012-01-01

To evaluate whether influence from social network members is associated with motivation to change dietary and physical activity behaviors. Baseline assessment followed by mailing of family health history-based personalized messages (2 weeks) and follow-up assessment (3 months). Families from an ongoing population-based cohort in Houston, Texas. 475 adults from 161 Mexican-origin families. Out of 347 households contacted, 162 (47%) participated. Family health history, social networks, and motivation to change behaviors. Two-level logistic regression modeling. Having at least one network member who encourages one to eat more fruits and vegetables (p = .010) and to engage in regular physical activity (p = .046) was associated with motivation to change the relevant behavior. About 40% of the participants did not have encouragers for these behaviors. Identification of new encouragers within networks and targeting natural encouragers (e.g., children, spouses) may increase the efficacy of interventions to motivate behavioral changes among Mexican-origin adults.

Patient–Clinician Mobile Communication: Analyzing Text Messaging Between Adolescents with Asthma and Nurse Case Managers

PubMed Central

Kim, Soo Yun; Hong, Yangsun; Chih, Ming-Yuan; Shah, Dhavan V.; Gustafson, David H.

2015-01-01

Abstract Background: With the increasing penetration of digital mobile devices among adolescents, mobile texting messaging is emerging as a new channel for patient–clinician communication for this population. In particular, it can promote active communication between healthcare clinicians and adolescents with asthma. However, little is known about the content of the messages exchanged in medical encounters via mobile text messaging. Therefore, this study explored the content of text messaging between clinicians and adolescents with asthma. Materials and Methods: We collected a total of 2,953 text messages exchanged between 5 nurse case managers and 131 adolescents with asthma through a personal digital assistant. The text messages were coded using a scheme developed by adapting categories from the Roter Interaction Analysis System. Results: Nurse case managers sent more text messages (n=2,639) than adolescents with asthma. Most messages sent by nurse case managers were targeted messages (n=2,475) directed at all adolescents with asthma, whereas there were relatively few tailored messages (n=164) that were created personally for an individual adolescent. In addition, both targeted and tailored messages emphasized task-focused behaviors over socioemotional behaviors. Likewise, text messages (n=314) sent by adolescents also emphasized task-focused over socioemotional behaviors. Conclusions: Mobile texting messaging has the potential to play an important role in patient–clinician communication. It promotes not only active interaction, but also patient-centered communication with clinicians. In order to achieve this potential, healthcare clinicians may need to focus on socioemotional communication as well as task-oriented communication. PMID:25401324

The effect of minimum impact education on visitor spatial behavior in parks and protected areas: An experimental investigation using GPS-based tracking.

PubMed

Kidd, Abigail M; Monz, Christopher; D'Antonio, Ashley; Manning, Robert E; Reigner, Nathan; Goonan, Kelly A; Jacobi, Charles

2015-10-01

The unmanaged impacts of recreation and tourism can often result in unacceptable changes in resource conditions and quality of the visitor experience. Minimum impact visitor education programs aim to reduce the impacts of recreation by altering visitor behaviors. Specifically, education seeks to reduce impacts resulting from lack of knowledge both about the consequences of one's actions and impact-minimizing best practices. In this study, three different on-site minimum impact education strategies ("treatments") and a control condition were applied on the trails and summit area of Sargent Mountain in Acadia National Park, Maine. Treatment conditions were designed to encourage visitors to stay on marked trails and minimize off-trail travel. Treatments included a message delivered via personal contact, and both an ecological-based message and an amenity-based message posted on signs located alongside the trail. A control condition of current trail markings and directional signs was also assessed. The efficacy of the messaging was evaluated through the use of Global Positioning System (GPS) tracking of visitor spatial behavior on/off trails. Spatial analysis of GPS tracks revealed statistically significant differences among treatments, with the personal contact treatment yielding significantly less dispersion of visitors on the mountain summit. Results also indicate that the signs deployed in the study were ineffective at limiting off-trail use beyond what can be accomplished with trail markers and directional signs. These findings suggest that personal contact by a uniformed ranger or volunteer may be the most effective means of message delivery for on-site minimum impact education. Copyright © 2015 Elsevier Ltd. All rights reserved.

A participatory concept of development and communication.

PubMed

Aubel, J

1992-01-01

The predominant position concerning health communication is that it basically consists of spreading carefully designed messages to certain groups to generate individual behavior change. This information transfer involves a 1-way direction and top down strategy. Even though these approaches may change individual knowledge and attitudes, changes in behavior do not always result. Indeed cultural or economic factors often prevent individuals from changing their behavior. Another belief is that health communication strategies should motivate community members and health workers to take part in dialogue and analysis of health problems. Feedback is thus instantaneous. This convergence model incorporates both community members and health workers and encourages them to draw from their own experiences and priorities to delineate strategies at the community and institutional levels. The advantages of the convergence model include: it aims to change community norms rather than individual behavior and to develop mutually acceptable health practices, it improves skills in 2-way communication, and it uses local communicators. This last advantage results in strengthened ability of these communicators to analyze problems and to encourage others among their social networks to participate in problem solving. Thus their participation fosters sustainable changes in health strategies. Several examples of local communicators generating changes in group norms in developing countries exist. Muslim leaders in the Gambia advance child health and family planning. In India and Bangladesh, respected women inform other women about appropriate child nutrition practices. In Malawi, women's groups wrote nutrition songs and choreographed dances to accompany the songs. If people perceive that educational content relates to their personal beliefs and experience, they become motivated. Facilitated structured learning activities such as open-ended stories are the most successful. Health workers should be facilitators and not just senders of the messages.

The impact of normative message types on off-trail hiking

Treesearch

P.L. Winter

2006-01-01

Depreciative activities and high annual visitation levels threaten the health and sustainability of the giant Sequoia. Signage is one route to managing visitor behavior. Research suggests a two-by-two conceptualization of normative messages in signs. Messages may present the "ought" (injunctive) or the "is" (descriptive) of behavior and may be...

The Reduction of Aggressive Behavior: Behavioral Strategies and Contingency Messages.

ERIC Educational Resources Information Center

Paul, Stephen C.; Thelen, Mark H.

College students were instigated by a confederate and then interacted with that same person on a reaction time completion task. The confederate informed half of the treatment subjects of the response strategy he intended to adopt. The other half received an irrelevant message. Subjects in both message conditions then competed against the…

Getting Students to Believe in Themselves

ERIC Educational Resources Information Center

Saphier, Jon

2017-01-01

Surrounding students with messages that they have the ability to learn and teaching them how is at the core of closing the achievement gap. Teachers can engage in verbal behaviors that counteract the negative messages that children of color receive outside the classroom. Those verbal behaviors can embed these messages for students: What we're…

Presenting the facts about smoking to adolescents: effects of an autonomy-supportive style.

PubMed

Williams, G C; Cox, E M; Kouides, R; Deci, E L

1999-09-01

To test the self-determination model of health-related behavior by examining whether the degree to which adolescents experience an appeal to not smoke as autonomy supportive would affect their autonomous motivation for not smoking and, in turn, their behavior of either refraining from smoking or smoking less, and to validate the measures of perceived autonomy support and autonomous motivation for not smoking. Two studies of physicians presenting information about not smoking using 2 message styles, 1 of which was designed to be more autonomy supportive. The preliminary study involved nonrandomized assignment to message style and only immediate assessment of perceptions, motivation, and behavior, while the primary study involved randomized assignment and 4-month longitudinal assessments. Nearly 400 ninth- through 12th-grade students at 2 suburban high schools in upstate New York. Adolescents' perceptions of the presentations' autonomy supportiveness of the presenters, as well as adolescents' autonomous motivation for not smoking and their self-reports of smoking. The primary study also assessed change in students' autonomous motivation and change in their self-reported smoking during 4 months. In both studies, the measures were reliable and valid. Students perceived significantly (P = .04 and P<.001, respectively) greater autonomy support in the "It's Your Choice" presentation, after controlling for whether the students were smokers. Perceived autonomy supportiveness of the presentation was positively correlated with autonomous reasons for not smoking in the preliminary study and with increases in autonomous motivation for not smoking in the primary study. Change in autonomous reasons for not smoking significantly (P<.001) predicted reduction in smoking during 4 months. When adolescents perceived messages about not smoking as autonomy supportive, they had more autonomous motivation for not smoking, and that, in turn, predicted a decrease in their self-reports of smoking.

[Health promoting messages posted in Facebook by the health ministries of Brazil and Peru during an AIDS awareness campaign].

PubMed

Cadaxa, Aedê Gomes; Sousa, Maria Fátima de; Mendonça, Ana Valéria Machado

2015-12-01

To identify health promoting contents (information that can be transformed into decision-making resources to improve quality of life and the health of individuals or groups) in Facebook postings by the ministries of health in Brazil and Peru. This case study compared the messages published in Facebook by the ministries of health from Brazil and Peru during World AIDS Day. Content analysis was employed to identify health promoting contents in the messages posted between November 2013 and February 2014. A total of 105 messages were published on the topic of interest (37 from Peru and 68 from Brazil). In both cases, most messages focused on individuals, addressing the change or adoption of personal behaviors relating to the prevention and detection of HIV - 34 messages (50.0%) for Brazil and 17 (45.9%) for Peru. Twenty-one (30.9%) messages with a structural emphasis were published by Brazil and 14 (37.8%) by Peru, addressing the context of health care system organization, including HIV/ AIDS health policies, available services, access to HIV testing and initiatives to promote testing. Hybrid messages, including both emphases, were less frequent: 13 (19.1%) for Brazil and six (16.2%) for Peru. Health promoting contents were identified in hybrid messages, which provided resources to expand the understanding of individuals about the susceptibility to AIDS.

Understanding narrative effects in physical activity promotion: the influence of breast cancer survivor testimony on exercise beliefs, self-efficacy, and intention in breast cancer patients.

PubMed

Falzon, Charlène; Radel, Rémi; Cantor, Ambre; d'Arripe-Longueville, Fabienne

2015-03-01

Research in health communication has shown that narratives contribute more positively to changing health behaviors than informational messages. The main purposes of this study were to examine and to compare the effects of two messages promoting physical activity, one narrative and the other informational, on the perceptions and behavioral intentions of cancer patients. A total of 158 women with breast cancer, undergoing chemotherapy and sedentary, were assigned to read the testimony of a breast cancer survivor who had been physically active during and after treatment (TE group), a content-equivalent message composed of expert recommendations about physical activity in breast cancer patients (RE group), or no message (control group). Source trust was higher in TE group than RE group (p < 0.001). Exercise self-efficacy and exercise intention were higher in TE group than RE and control groups (p < 0.001). However, scores in RE group were higher than those of TE group for beliefs about exercise benefits (p < 0.001) and lower than those of TE and control groups for beliefs about exercise risks (p < 0.001). Source trust, exercise self-efficacy, and beliefs about exercise benefits and risks mediated the relationship between the message and exercise intention. The results suggest that narratives may be more effective in improving perceived physical abilities and involvement in physical activity, whereas informational messages seem to be more appropriate to convey the benefits and the absence of risks related to physical activity.

Impact of Repeated Exposures on Information Spreading in Social Networks

PubMed Central

Zhou, Cangqi; Zhao, Qianchuan; Lu, Wenbo

2015-01-01

Clustered structure of social networks provides the chances of repeated exposures to carriers with similar information. It is commonly believed that the impact of repeated exposures on the spreading of information is nontrivial. Does this effect increase the probability that an individual forwards a message in social networks? If so, to what extent does this effect influence people’s decisions on whether or not to spread information? Based on a large-scale microblogging data set, which logs the message spreading processes and users’ forwarding activities, we conduct a data-driven analysis to explore the answer to the above questions. The results show that an overwhelming majority of message samples are more probable to be forwarded under repeated exposures, compared to those under only a single exposure. For those message samples that cover various topics, we observe a relatively fixed, topic-independent multiplier of the willingness of spreading when repeated exposures occur, regardless of the differences in network structure. We believe that this finding reflects average people’s intrinsic psychological gain under repeated stimuli. Hence, it makes sense that the gain is associated with personal response behavior, rather than network structure. Moreover, we find that the gain is robust against the change of message popularity. This finding supports that there exists a relatively fixed gain brought by repeated exposures. Based on the above findings, we propose a parsimonious model to predict the saturated numbers of forwarding activities of messages. Our work could contribute to better understandings of behavioral psychology and social media analytics. PMID:26465749

An Initial Investigation into Naturally Occurring Loss- and Gain-Framed Memorable Breast Cancer Messages

PubMed Central

LaPlante, Carolyn; Smith, Sandi; Kotowski, Michael; Nazione, Samantha; Stohl, Cynthia; Prestin, Abby; So, Jiyeon; Nabi, Robin

2012-01-01

Memorable message research examines interpersonal messages “…remembered for extremely long periods of time and which people perceive as a major influence on the course of their lives” (Knapp, Stohl, & Reardon, 1981, p. 27). They can also guide actions, such as health behaviors. This exploratory research examined self-reported memorable messages about breast cancer to determine if they were framed, emphasizing either the benefits (gain-framed) or the costs (loss-framed) of a behavior. About one-fourth of the messages were framed, with most being gain-framed. The messages tended to emphasize early detection actions. Study limitations and implications for future research are discussed. PMID:22539867

Application of a Tsunami Warning Message Metric to refine NOAA NWS Tsunami Warning Messages

NASA Astrophysics Data System (ADS)

Gregg, C. E.; Johnston, D.; Sorensen, J.; Whitmore, P.

2013-12-01

In 2010, the U.S. National Weather Service (NWS) funded a three year project to integrate social science into their Tsunami Program. One of three primary requirements of the grant was to make improvements to tsunami warning messages of the NWS' two Tsunami Warning Centers- the West Coast/Alaska Tsunami Warning Center (WCATWC) in Palmer, Alaska and the Pacific Tsunami Warning Center (PTWC) in Ewa Beach, Hawaii. We conducted focus group meetings with a purposive sample of local, state and Federal stakeholders and emergency managers in six states (AK, WA, OR, CA, HI and NC) and two US Territories (US Virgin Islands and American Samoa) to qualitatively asses information needs in tsunami warning messages using WCATWC tsunami messages for the March 2011 Tohoku earthquake and tsunami event. We also reviewed research literature on behavioral response to warnings to develop a tsunami warning message metric that could be used to guide revisions to tsunami warning messages of both warning centers. The message metric is divided into categories of Message Content, Style, Order and Formatting and Receiver Characteristics. A message is evaluated by cross-referencing the message with the operational definitions of metric factors. Findings are then used to guide revisions of the message until the characteristics of each factor are met. Using findings from this project and findings from a parallel NWS Warning Tiger Team study led by T. Nicolini, the WCATWC implemented the first of two phases of revisions to their warning messages in November 2012. A second phase of additional changes, which will fully implement the redesign of messages based on the metric, is in progress. The resulting messages will reflect current state-of-the-art knowledge on warning message effectiveness. Here we present the message metric; evidence-based rational for message factors; and examples of previous, existing and proposed messages.

Communication and marketing as climate change-intervention assets a public health perspective.

PubMed

Maibach, Edward W; Roser-Renouf, Connie; Leiserowitz, Anthony

2008-11-01

The understanding that global climate change represents a profound threat to the health and well-being of human and nonhuman species worldwide is growing. This article examines the potential of communication and marketing interventions to influence population behavior in ways consistent with climate change prevention and adaptation objectives. Specifically, using a framework based on an ecologic model of public health, the paper examines: (1) the potential of communication and marketing interventions to influence population behaviors of concern, including support for appropriate public policies; (2) potential target audiences for such programs; and (3) the attributes of effective climate change messages. Communication and marketing interventions appear to have considerable potential to promote important population behavior change objectives, but there is an urgent need for additional translational research to effectively harvest this potential to combat climate change.

Community Perspectives on Communication Strategies for Alcohol Abuse Prevention in Rural Central Kenya.

PubMed

Muturi, Nancy

2016-01-01

The current study explores community perspectives on alcohol abuse prevention strategies in rural Kenya. Data from focus group discussions with members of community organizations and in-depth interviews with a snowball sample of key informants revealed that rural communities view national alcohol abuse prevention interventions as ineffective and messages as unpersuasive in changing this high-risk behavior. The use of ethnic languages, stronger fear appeals, and visual aids were recommended for alcohol prevention messages aimed at communities with low literacy. Community members favored narratives and entertainment-education strategies, which are more engaging, and print media for their educational value. Health activism, although common, was viewed as less effective in motivating individuals to change drinking behavior but more effective in advocacy campaigns to pressure the government to enforce alcohol regulations. This study suggests further empirical research to inform evidence-based prevention campaigns and to understand how to communicate about alcohol-related health risks within communities that embrace alcohol consumption as a cultural norm.

Racial Socialization, Private Regard, and Behavior Problems in African American Youth: Global Self-Esteem as a Mediator

PubMed Central

Davis, BreAnna L.; Smith-Bynum, Mia A.; Saleem, Farzana T.; Francois, Tiffany; Lambert, Sharon F.

2017-01-01

Racial socialization messages appear to have varying impacts on the adjustment of African American youth. To further explore this, we examined how two types of racial socialization messages might influence African American youth internalizing and externalizing behavior. The Youth Self Report was used to measure these behavior outcomes. Given that racial socialization messages may not be directly linked to behavior outcomes, we considered private regard, an aspect of racial identity, to serve as a mediator. Additionally, we examined global self-esteem as a mediator of the complex dynamic between racial socialization messages and behavior outcomes. Adolescents in our study completed paper assessments. Majority of the participants were female (56 %) and reside in a metropolitan area in the Mid-Atlantic region. Adolescent’s ages ranged from 14 to 17 years with the average age being 15 years old. Path analysis revealed cultural pride and alertness to discrimination messages varied in their relation to private regard. Results also indicated a strong linkage between private regard, global self-esteem, and internalizing behaviors. Interestingly, the linkage between private regard, global self-esteem and externalizing behaviors was not as robust. Further, private regard appeared to directly and indirectly impact externalizing behaviors. The implications of these findings for racial socialization strategies, identity development (racial and global) as it pertains to behavior problems for African American adolescents are discussed. PMID:28546737

Message framing strategies to increase influenza immunization uptake among pregnant African American women.

PubMed

Marsh, Heather A; Malik, Fauzia; Shapiro, Eve; Omer, Saad B; Frew, Paula M

2014-09-01

We explored the attitudes, opinions, and concerns of African American women regarding influenza vaccination during pregnancy. As influenza immunization coverage rates remain suboptimal in the United States among this population, we elicited message framing strategies for multicomponent interventions aimed at decreasing future incident cases of maternal and neonatal influenza. Semi-structured in-depth interviews (N = 21) were conducted with pregnant African American women at urban OB/GYN clinics who had not received an influenza vaccine. Interviews were transcribed, subjected to intercoder reliability assessment, and content analyzed to identify common thematic factors related to acceptance of the influenza vaccine and health communication message preferences. Four major themes were identified. These were communication approaches, normal vaccine behavior, pregnancy vaccination, and positive versus negative framing. Two strong themes emerged: positively-framed messages were preferred over negatively-framed messages and those emphasizing the health of the infant. Additionally, previous immunization, message source, and vaccine misperceptions also played important roles in decision-making. The majority of women indicated that positively framed messages focusing on the infant's health would encourage them to receive an influenza vaccine. Messages emphasizing immunization benefits such as protection against preterm birth and low birth weight outcomes have potential to overcome widespread negative community perceptions and cultural beliefs. Additionally, messages transmitted via interpersonal networks and social media strongly influence motivation to obtain vaccination during pregnancy. The findings of this study will assist in developing tailored messages that change pregnant African American women's influenza vaccination decision-making to achieve improved coverage.

Laughing in the Face of Fear (of Disease Detection): Using Humor to Promote Cancer Self-Examination Behavior.

PubMed

Nabi, Robin L

2016-07-01

This research examines the possible benefit of using humor to reduce anxiety associated with performing cancer self-examination behaviors. In Study 1, 187 undergraduates read a humorous public service announcement (PSA) script promoting either breast or testicular self-exams. Results suggest that perception of humor reduced anxiety about self-exams, which, in turn, related to more positive self-exam attitudes. Simultaneously, humor perception associated with greater message processing motivation, which, in turn, associated with more supportive self-exam attitudes. Self-exam attitudes also positively associated with self-exam intentions. These results were largely replicated in Study 2. Further, self-exam intentions predicted self-exam behavior 1 week later. However, consistent with past research, the humorous and serious messages did not generate differences in subsequent self-exam behavior, though the intention-behavior relationship was stronger and significant for those exposed to the humorous versus the serious messages. In light of these findings, and given that humor has the advantage of attracting and holding attention in real message environments, the use of carefully constructed humor appeals may be a viable message strategy to promote health detection behaviors.

Nonverbal indicants of comprehension monitoring in language-disordered children.

PubMed

Skarakis-Doyle, E; MacLellan, N; Mullin, K

1990-08-01

This study investigated normal and language-disordered (LD) children's patterns of nonverbal behavior in response to messages varying in degree of ambiguity. Each LD child was matched to two normally developing children: one for comprehension level (LM) and the other for chronological age (CM). All children participated in a videotaped ambiguity detection task. Nonverbal behaviors that were produced between the time the message was completed and the examiner's acknowledgment of the response were scored for type of behavior exhibited including eye contact, hand behavior, body movement, and smile. Results demonstrated that all subjects increased their nonverbal behavior (e.g. eye contact) from unambiguous to ambiguous message conditions, suggesting awareness of the differences in these message types at a rudimentary level. Most often nonverbal indication was the only signal of ambiguity detection exhibited by the LD children and their LM peers. Only the CM children concurrently indicated awareness through more direct means (i.e., verbalization and pointing to all possible referents) in a consistent and accurate manner. The finding that LD children did differentiate inadequate from adequate messages in a rudimentary manner suggests that clinicians might promote the intentionality of these preintentional nonverbal behaviors as a possible intervention strategy.

Use of Text Messaging for Monitoring Sugar-Sweetened Beverages, Physical Activity, and Screen Time in Children: A Pilot Study

ERIC Educational Resources Information Center

Shapiro, Jennifer R.; Bauer, Stephanie; Hamer, Robert M.; Kordy, Hans; Ward, Dianne; Bulik, Cynthia M.

2008-01-01

Objective: To examine acceptability, attrition, adherence, and preliminary efficacy of mobile phone short message service (SMS; text messaging) for monitoring healthful behaviors in children. Design: All randomized children received a brief psychoeducational intervention. They then either monitored target behaviors via SMS with feedback or via…

A Systematic Review of Interventions to Enhance Healthy Lifestyle Behaviors in Adolescents Delivered via Mobile Phone Text Messaging.

PubMed

Loescher, Lois J; Rains, Stephen A; Kramer, Sandra S; Akers, Chelsie; Moussa, Renee

2018-05-01

To systematically review healthy lifestyle interventions targeted to adolescents and delivered using text messaging (TM). PubMed, Embase, CINAHL, PsycINFO, and Web of Science databases. Study Inclusion Criteria: Research articles published during 2011 to 2014; analyses focused on intervention targeting adolescents (10-19 years), with healthy lifestyle behaviors as main variables, delivered via mobile phone-based TM. The authors extracted data from 27 of 281 articles using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. Adolescent and setting characteristics, study design and rigor, intervention effectiveness, challenges, and risk of bias. Across studies, 16 (59.3%) of 27 included non-Caucasians. The gender was split for 22 (81.5%) of 27 studies. Thirteen studies were randomized controlled trials. There was heterogeneity among targeted conditions, rigor of methods, and intervention effects. Interventions for monitoring/adherence (n = 8) reported more positive results than those for health behavior change (n = 19). Studies that only included message delivered via TM (n = 14) reported more positive effects than studies integrating multiple intervention components. Interventions delivered using TM presented minimal challenges, but selection and performance bias were observed across studies. Interventions delivered using TM have the potential, under certain conditions, to improve healthy lifestyle behaviors in adolescents. However, the rigor of studies varies, and established theory and validated measures have been inconsistently incorporated.

Systematic review of public health branding.

PubMed

Evans, W Douglas; Blitstein, Jonathan; Hersey, James C; Renaud, Jeanette; Yaroch, Amy L

2008-12-01

Brands build relationships between consumers and products, services, or lifestyles by providing beneficial exchanges and adding value to their objects. Brands can be measured through associations that consumers hold for products and services. Public health brands are the associations that individuals hold for health behaviors, or lifestyles that embody multiple health behaviors. We systematically reviewed the literature on public health brands; developed a methodology for describing branded health messages and campaigns; and examined specific branding strategies across a range of topic areas, campaigns, and global settings. We searched the literature for published studies on public health branding available through all relevant, major online publication databases. Public health branding was operationalized as any manuscripts in the health, social science, and business literature on branding or brands in health promotion marketing. We developed formalized decision rules and applied them in identifying articles for review. We initially identified 154 articles and reviewed a final set of 37, 10 from Africa, Australia, and Europe. Branded health campaigns spanned most of the major domains of public health and numerous communication strategies and evaluation methodologies. Most studies provided clear information on planning, development, and evaluation of the branding effort, while some provided minimal information. Branded health messages typically are theory based, and there is a body of evidence on their behavior change effectiveness, especially in nutrition, tobacco control, and HIV/AIDS. More rigorous research is needed, however, on how branded health messages impact specific populations and behaviors.

Mobile Diabetes Intervention Study of Patient Engagement and Impact on Blood Glucose: Mixed Methods Analysis.

PubMed

Quinn, Charlene Connolly; Butler, Erin C; Swasey, Krystal K; Shardell, Michelle D; Terrin, Michael D; Barr, Erik A; Gruber-Baldini, Ann L

2018-02-02

Successful treatment of diabetes includes patient self-management behaviors to prevent or delay complications and comorbid diseases. On the basis of findings from large clinical trials and professional guidelines, diabetes education programs and health providers prescribe daily regimens of glucose monitoring, healthy eating, stress management, medication adherence, and physical activity. Consistent, long-term commitment to regimens is challenging. Mobile health is increasingly being used to assist patients with lifestyle changes and self-management behaviors between provider visits. The effectiveness of mobile health to improve diabetes outcomes depends on patient engagement with a technology, content, or interactions with providers. In the current analysis, we aimed to identify patient engagement themes in diabetes messaging with diabetes providers and determine if differences in engagement in the Mobile Diabetes Intervention Study (MDIS) influenced changes in glycated hemoglobin A 1c (HbA 1c ) over a 1-year treatment period (1.9% absolute decrease in the parent study). In the primary MDIS study, 163 patients were enrolled into 1 of 3 mobile intervention groups or a usual care control group based on their physician cluster randomization assignment. The control group received care from their physicians as usual. Participants in each intervention group had access to a patient portal where they could record monitoring values for blood glucose, blood pressure, medication changes, or other self-management information while also assigned to varying levels of physician access to patient data. Intervention participants could choose to send and receive messages to assigned certified diabetes educators with questions or updates through the secure Web portal. For this secondary analysis, patient engagement was measured using qualitative methods to identify self-care themes in 4109 patient messages. Mixed methods were used to determine the impact of patient engagement on change in HbA 1c over 1 year. Self-care behavior themes that received the highest engagement for participants were glucose monitoring (75/107, 70.1%), medication management (71/107, 66.4%), and reducing risks (71/107, 66.4%). The average number of messages sent per patient were highest for glucose monitoring (9.2, SD 14.0) and healthy eating (6.9, SD 13.2). Compared to sending no messages, sending any messages about glucose monitoring (P=.03) or medication (P=.01) led to a decrease in HbA 1c of 0.62 and 0.72 percentage points, respectively. Sending any messages about healthy eating, glucose monitoring, or medication combined led to a decrease in HbA 1c of 0.54 percentage points compared to not sending messages in these themes (P=.045). The findings from this study help validate the efficacy of the mobile diabetes intervention. The next step is to determine differences between patients who engage in mobile interventions and those who do not engage and identify methods to enhance patient engagement. ClinicalTrials.gov: NCT01107015; https://clinicaltrials.gov/ct2/show/NCT01107015 (Archived by WebCite at http://www.webcitation.org/6wh4ekP4R). ©Charlene Connolly Quinn, Erin C Butler, Krystal K Swasey, Michelle D Shardell, Michael D Terrin, Erik A Barr, Ann L Gruber-Baldini. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 02.02.2018.

Evidence-based identification of key beliefs explaining adult male circumcision motivation in Zimbabwe: targets for behavior change messaging.

PubMed

Montaño, Daniel E; Kasprzyk, Danuta; Hamilton, Deven T; Tshimanga, Mufuta; Gorn, Gerald

2014-05-01

Male circumcision (MC) reduces HIV acquisition among men, leading WHO/UNAIDS to recommend a goal to circumcise 80 % of men in high HIV prevalence countries. Significant investment to increase MC capacity in priority countries was made, yet only 5 % of the goal has been achieved in Zimbabwe. The integrated behavioral model (IBM) was used as a framework to investigate the factors affecting MC motivation among men in Zimbabwe. A survey instrument was designed based on elicitation study results, and administered to a representative household-based sample of 1,201 men aged 18-30 from two urban and two rural areas in Zimbabwe. Multiple regression analysis found all five IBM constructs significantly explained MC Intention. Nearly all beliefs underlying the IBM constructs were significantly correlated with MC Intention. Stepwise regression analysis of beliefs underlying each construct respectively found that 13 behavioral beliefs, 5 normative beliefs, 4 descriptive norm beliefs, 6 efficacy beliefs, and 10 control beliefs were significant in explaining MC Intention. A final stepwise regression of the five sets of significant IBM construct beliefs identified 14 key beliefs that best explain Intention. Similar analyses were carried out with subgroups of men by urban-rural and age. Different sets of behavioral, normative, efficacy, and control beliefs were significant for each sub-group, suggesting communication messages need to be targeted to be most effective for sub-groups. Implications for the design of effective MC demand creation messages are discussed. This study demonstrates the application of theory-driven research to identify evidence-based targets for intervention messages to increase men's motivation to get circumcised and thereby improve demand for male circumcision.

Promoting the Avoidance of High-Calorie Snacks: Priming Autonomy Moderates Message Framing Effects

PubMed Central

Pavey, Louisa; Churchill, Sue

2014-01-01

The beneficial effects of gain-framed vs. loss-framed messages promoting health protective behaviors have been found to be inconsistent, and consideration of potential moderating variables is essential if framed health promotion messages are to be effective. This research aimed to determine the influence of highlighting autonomy (choice and freedom) and heteronomy (coercion) on the avoidance of high-calorie snacks following reading gain-framed or loss-framed health messages. In Study 1 (N = 152) participants completed an autonomy, neutral, or heteronomy priming task, and read a gain-framed or loss-framed health message. In Study 2 (N = 242) participants read a gain-framed or loss-framed health message with embedded autonomy or heteronomy primes. In both studies, snacking intentions and behavior were recorded after seven days. In both studies, when autonomy was highlighted, the gain-framed message (compared to the loss-framed message) resulted in stronger intentions to avoid high-calorie snacks, and lower self-reported snack consumption after seven days. Study 2 demonstrated this effect occurred only for participants to whom the information was most relevant (BMI>25). The results suggest that messages promoting healthy dietary behavior may be more persuasive if the autonomy-supportive vs. coercive nature of the health information is matched to the message frame. Further research is needed to examine potential mediating processes. PMID:25078965

Promoting the avoidance of high-calorie snacks: priming autonomy moderates message framing effects.

PubMed

Pavey, Louisa; Churchill, Sue

2014-01-01

The beneficial effects of gain-framed vs. loss-framed messages promoting health protective behaviors have been found to be inconsistent, and consideration of potential moderating variables is essential if framed health promotion messages are to be effective. This research aimed to determine the influence of highlighting autonomy (choice and freedom) and heteronomy (coercion) on the avoidance of high-calorie snacks following reading gain-framed or loss-framed health messages. In Study 1 (N = 152) participants completed an autonomy, neutral, or heteronomy priming task, and read a gain-framed or loss-framed health message. In Study 2 (N = 242) participants read a gain-framed or loss-framed health message with embedded autonomy or heteronomy primes. In both studies, snacking intentions and behavior were recorded after seven days. In both studies, when autonomy was highlighted, the gain-framed message (compared to the loss-framed message) resulted in stronger intentions to avoid high-calorie snacks, and lower self-reported snack consumption after seven days. Study 2 demonstrated this effect occurred only for participants to whom the information was most relevant (BMI>25). The results suggest that messages promoting healthy dietary behavior may be more persuasive if the autonomy-supportive vs. coercive nature of the health information is matched to the message frame. Further research is needed to examine potential mediating processes.

Parents of children with eating disorders: developing theory-based health communication messages to promote caregiver well-being.

PubMed

Patel, Sheetal; Shafer, Autumn; Brown, Jane; Bulik, Cynthia; Zucker, Nancy

2014-01-01

Parents of children with eating disorders experience extreme emotional burden because of the intensity and duration of the recovery process. While parental involvement in a child's eating disorder treatment improves outcomes, parents often neglect their own well-being, which can impede their child's recovery. This study extends the research on caregivers and on health theory in practice by conducting formative research to develop a theory-based communication intervention encouraging parents to engage in adaptive coping and self-care behaviors. The Transactional Model of Stress and Coping and the Transtheoretical Model guided qualitative assessments of the determinants of parents' coping behaviors. Three focus groups with 19 parents of children with eating disorders and 19 semi-structured interviews with experts specializing in eating disorders were conducted. Findings indicate that parents and experts see parents' need for permission to take time for themselves as the main barrier to self-care. The main motivator for parents to engage in coping behaviors is awareness of a connection between self-care and their child's health outcomes. Participant evaluation of six potential messages for main themes and effectiveness revealed that theory-based elements, such as certain processes of change within the Transtheoretical Model, were important to changing health behavior.

Heeding the behavioral message of elders with dementia in day care.

PubMed

Ito, Mio; Takahashi, Ryutaro; Liehr, Patricia

2007-01-01

Embodied language is unity of bodily, linguistic, and behavioral descriptors, expressed as health. Disagreement behavior, client unwillingness to respond as requested when uncomfortable in a situation, occurs in elders with dementia. Case study analysis suggests that agitation/aggression may be avoided if disagreement behavior is recognized as a message of discomfort.

Community-made mobile videos as a mechanism for maternal, newborn and child health education in rural Uganda; a qualitative evaluation.

PubMed

Mutanda, Juliet Ntuulo; Waiswa, Peter; Namutamba, Sarah

2016-12-01

In Uganda, the maternal, newborn and child mortality is highest in rural areas, which are least served by health services and are also least reached by effective behavior change communication for health. Though maternal and child health related messages are available, they are still not culture and context specific for effective behaviour change. This study aimed at evaluating the feasibility of using locally made videos by local community groups in local languages as a channel for increasing knowledge, practices, demand and use of maternal and child health messages among women living in rural communities in Eastern Uganda. This paper describes the qualitative findings from a quasi experimental study targeting the rural semi-illiterate populations in hard to reach areas. Videos were developed and implemented based on Ministry of Health. Focus group discussions and KIs targeted pregnant and post natal mothers. Data transcription and content analysis was done. Local mobile community videos were effective in communicating knowledge about key maternal and child health messages to both women and their male partners. Locally made mobile community videos are effective in improving knowledge, attitudes, practices and use of maternal and child health messages among rural semi-illiterate communities.

Fear, Anger, Fruits, and Veggies: Interactive Effects of Emotion and Message Framing on Health Behavior

PubMed Central

Gerend, Mary A.; Maner, Jon K.

2010-01-01

Objective Message framing is a theoretically grounded health communication strategy designed to motivate action by emphasizing the benefits of engaging in a particular behavior (gains) or the costs of failing to engage in the behavior (losses). This study investigated whether the effectiveness of a framed message depends on the emotional state of the message recipient. We examined effects of fear versus anger, emotions that frequently occur within the context of health decision-making. Methods Undergraduate students (N = 133) were randomly assigned to complete a fear or anger induction task after which they read a gain- or loss-framed pamphlet promoting fruit and vegetable consumption. Fruit and vegetable intake (servings per day) was subsequently assessed over the following two weeks. Results As predicted, a significant frame by emotion interaction was observed, such that participants in the fear condition reported eating more servings of fruits and vegetables after exposure to a loss-framed message than to a gain-framed message. In contrast, participants in the anger condition reported eating (marginally) more servings of fruits and vegetables after exposure to a gain-framed message than to a loss-framed message. That is, greater increases in fruit and vegetable intake from baseline to follow-up were observed when frame was matched to participants’ emotional state than when it was mismatched. Conclusion The effectiveness of framed health communications depends on the message recipient’s current emotional state. Affective factors that are incidental to the behavior recommended in a health communication can affect the relative success of gain- and loss-framed appeals. PMID:21534679

Teaching Business Ethics through Service Learning Metaprojects

ERIC Educational Resources Information Center

Vega, Gina

2007-01-01

The urgent messages of good business include the importance of ethical management behaviors, focus on corporate citizenship, recognition of principled leadership, moral awareness, and participation in social change. This article describes the Service Learning Metaproject (a nested set of projects required of all students) and shows what students…

Leading Change through Cultural Competence

ERIC Educational Resources Information Center

Gregory, Richard A.

2009-01-01

Peter Senge's message during the 2005 American Association of School Administrators (AASA) conference reminded people that they live not only in a school system, but also within a highly diverse, global community. Their individual and organizational policies, practices, and behaviors, can and do impact the learning experience for those they…

Perceived Risk as a Moderator of the Effectiveness of Framed HIV Test Promotion Messages Among Women: A Randomized Controlled Trial

PubMed Central

Hull, Shawnika J

2014-01-01

Objective Researchers argue that gain framed messages should be more effective for prevention behaviors while loss frames should be more effective for detection behaviors (Rothman & Salovey, 1997). Evidence for this taxonomy has been mixed. This study examines whether the effects of gain and loss framed messages on HIV testing intentions is moderated by perceived risk of a positive result. Methods This experiment was conducted on-line and utilizes a single factor (frame: gain/loss) between subjects design, with a separate HIV test promotion control and a no message control to examine whether perceived risk of a positive test result moderates the effects of framed messages on intentions to seek an HIV test in the next 3 months. The sample (N=1052; age M = 22, SD = 2.22), recruited through Survey Sampling International, included 51% Black women (49% White women). Results HIV test promotion messages were more effective than no message but there were no other main effects for condition. Results also demonstrate a significant interaction between message frame and perceived risk, which is mediated through elaborative processing of the message. The interaction demonstrated an advantage for the loss framed message among women with some perceived risk and an advantage for the gain framed message among women with low perceived risk. Conclusion Results imply that the prevention/detection function of the behavior may be an inadequate distinction in the consideration of the effectiveness of framed messages promoting HIV testing. Rather, this study demonstrates that risk perceptions are an important moderator of framing effects. PMID:21767018

Perceived risk as a moderator of the effectiveness of framed HIV-test promotion messages among women: a randomized controlled trial.

PubMed

Hull, Shawnika J

2012-01-01

Researchers argue that gain-framed messages should be more effective for prevention behaviors, while loss frames should be more effective for detection behaviors (Rothman & Salovey, 1997). Evidence for this taxonomy has been mixed. This study examines whether the effects of gain- and loss-framed messages on HIV-testing intentions is moderated by perceived risk of a positive result. This experiment was conducted online and utilized a single factor (frame: gain/loss) between subjects design, with a separate HIV-test promotion control and a no message control to examine whether perceived risk of a positive test result moderates the effects of framed messages on intentions to seek an HIV test in the next 3 months. The sample (N = 1052; M age = 22, SD = 2.22), recruited through Survey Sampling International, included 51% Black women (49% White women). HIV-test promotion messages were more effective than no message, but there were no other main effects for condition. Results also demonstrated a significant interaction between message frame and perceived risk, which is mediated through elaborative processing of the message. The interaction demonstrated an advantage for the loss-framed message among women with some perceived risk and an advantage for the gain-framed message among women with low perceived risk. Results imply that the prevention/detection function of the behavior may be an inadequate distinction in the consideration of the effectiveness of framed messages promoting HIV testing. Rather, this study demonstrates that risk perceptions are an important moderator of framing effects.

Age differences in goals: implications for health promotion.

PubMed

Zhang, Xin; Fung, Helene; Ching, Bob Ho-hong

2009-05-01

Socioemotional selectivity theory postulates that, as people age, they prioritize emotionally meaningful goals. This study investigated whether these age differences in goals are reflected in how younger (aged 18-36, n = 111) and older adults (aged 62-86, n = 104) evaluated, remembered information from and were persuaded by health messages. Participants were randomly assigned to read health pamphlets with identical factual information but emphasizing emotional or non-emotional goals. Findings showed that health messages that emphasized emotional goals, but not those that emphasized future-oriented or neutral goals, were better remembered, were evaluated more positively and led to greater behavioral changes among older adults, but not younger adults. These findings suggest that health messages targeting older adults may be more effective if they are framed in ways that emphasize love and caring.

Human dynamic model co-driven by interest and social identity in the MicroBlog community

NASA Astrophysics Data System (ADS)

Yan, Qiang; Yi, Lanli; Wu, Lianren

2012-02-01

This paper analyzes the behavior of releasing messages in the MicroBlog community and presents a human dynamic model co-driven by interest and social identity. According to the empirical analysis and simulation results, the messaging interval distribution follows a power law, which is mainly influenced by the degree of users' interests. Meanwhile, social identity plays a significant role regarding the change of interests and may slow down the decline of the latter. A positive correlation between social identity and numbers of comments or forwarding of messages is illustrated. Besides, the analysis of data for each 24 h reveals obvious differences between micro-blogging and website visits, email, instant communication, and the use of mobile phones, reflecting how people use small amounts of time via mobile Internet technology.

"I Want to Walk with My Moko." The Application of Social Cognitive Theory in the Creation of a Diabetes Prevention Documentary with New Zealand Māori.

PubMed

Farmer, Alison; Edgar, Timothy; Gage, Jeffrey; Kirk, Ray

2018-01-01

Type 2 diabetes is almost three times more prevalent in the indigenous people of New Zealand (Māori) than non-Māori. Despite the high rate of diabetes there is a low level of diabetes knowledge and awareness in the Māori community. Several studies of Māori health identify a need for new health communication approaches to diabetes prevention in order to reduce the gap between Māori and non-Māori disease rates. We applied a Community-Based Participatory Research (CBPR) framework and behavioral theory to create a culturally appropriate documentary for Māori at risk for type 2 diabetes. We discuss how we utilized Bandura's social cognitive theory to provide a culturally sensitive theoretical basis for behavior change messaging. We outline why social cognitive theory was a culturally appropriate foundation and describe the role of the community in shaping the documentary messaging. A culture-centered approach utilizing participatory methodologies and culturally sensitive behavioral change theory might serve as a model for creating health communication resources in collaboration with other indigenous communities.

The use of messages in altering risky gambling behavior in college students: an experimental analogue study.

PubMed

Jardin, Bianca; Wulfert, Edelgard

2009-01-01

This study examined the effects of messages on altering risky gambling behavior in college students. While playing a chance-based computerized game with play money, three groups of participants either viewed occasional accurate messages that correctly described the contingencies of the game, neutral messages unrelated to the contingencies, or no messages. Participants in the accurate message condition spent overall less money gambling, played fewer trials in the final phase of the game when all trials resulted in losses, and were more likely to quit the game while they still had money remaining in the bank. The findings suggest that "reminders" about the random nature of games and the overall negative rate of return might lead to more responsible gaming.

A Review of International Cross-Cultural Mixed Messages and Their Implications for Human Resource Development

ERIC Educational Resources Information Center

Altman, Brian A.

2013-01-01

This paper presents a literature review on the concept of international cross-cultural mixed messages. Although there is limited literature on this topic, the review suggests that messages from one's home culture and a second culture can result in conflicting expectations for one's own behavior and for the behavior of others. Double bind theory is…

Student Response Behavior to Six Types of Caller/Sender When Smartphones Receive a Call or Text Message during University Lectures

ERIC Educational Resources Information Center

Chida, Kunihiro; Kato, Yuuki; Kato, Shogo

2016-01-01

This study, which targeted students in Japanese universities, used a written questionnaire to examine student response behavior when their smartphones received a call or message during university lectures. Phone and message transmissions were taken as the transmission media and six types of caller/sender were set. Survey results showed differences…

Communication for HIV/AIDS prevention in Kenya: social-cultural considerations.

PubMed

Muturi, Nancy

2005-01-01

The acquired immune deficiency syndrome (AIDS) epidemic is spreading fast in Africa in spite of the various efforts and resources put in place to prevent it. In Kenya, reproductive health programs have used the mass media and other communication interventions to inform and educate the public about the disease and to promote behavior change and healthy sexual practices. This effort has led to a discrepancy between awareness and behavioral change among people of reproductive age. In this article I examine the discrepancy in Kenya from a communications perspective addressing social cultural and related factors contributing to the lack of change in behavior and sexual practices. I draw on the theoretical framework of Grunig's model of excellence in communication, the importance of understanding and relationship building between programs and their stakeholders. Data were gathered qualitatively using focus groups and in-depth interviews among men and women in rural Kenya. Key findings indicate that although awareness of sexually transmitted diseases (STDs) including human immunodeficiency virus (HIV)/AIDS is high in Kenya, a majority of the population, particularly those in the rural communities, lack understanding of the communicated messages. They also lack the knowledge of other ways of transmitting HIV particularly among those not sexually involved. Cultural beliefs, values, norms, and myths have played a role in the rapidly increasing epidemic in the rural communities and yet HIV/AIDS communication programs have not addressed these factors adequately. I conclude that successful behavior change communication must include strategies that focus on increasing understanding of the communicated messages and understanding of the audience through application of appropriate methodologies. Building a relationship with the audience or stakeholders through dialogues and two-way symmetrical communication contributes toward this understanding and the maintenance of the newly adopted behaviors and practices.

Statistics of Epidemics in Networks by Passing Messages

NASA Astrophysics Data System (ADS)

Shrestha, Munik Kumar

Epidemic processes are common out-of-equilibrium phenomena of broad interdisciplinary interest. In this thesis, we show how message-passing approach can be a helpful tool for simulating epidemic models in disordered medium like networks, and in particular for estimating the probability that a given node will become infectious at a particular time. The sort of dynamics we consider are stochastic, where randomness can arise from the stochastic events or from the randomness of network structures. As in belief propagation, variables or messages in message-passing approach are defined on the directed edges of a network. However, unlike belief propagation, where the posterior distributions are updated according to Bayes' rule, in message-passing approach we write differential equations for the messages over time. It takes correlations between neighboring nodes into account while preventing causal signals from backtracking to their immediate source, and thus avoids "echo chamber effects" where a pair of adjacent nodes each amplify the probability that the other is infectious. In our first results, we develop a message-passing approach to threshold models of behavior popular in sociology. These are models, first proposed by Granovetter, where individuals have to hear about a trend or behavior from some number of neighbors before adopting it themselves. In thermodynamic limit of large random networks, we provide an exact analytic scheme while calculating the time dependence of the probabilities and thus learning about the whole dynamics of bootstrap percolation, which is a simple model known in statistical physics for exhibiting discontinuous phase transition. As an application, we apply a similar model to financial networks, studying when bankruptcies spread due to the sudden devaluation of shared assets in overlapping portfolios. We predict that although diversification may be good for individual institutions, it can create dangerous systemic effects, and as a result financial contagion gets worse with too much diversification. We also predict that financial system exhibits "robust yet fragile" behavior, with regions of the parameter space where contagion is rare but catastrophic whenever it occurs. In further results, we develop a message-passing approach to recurrent state epidemics like susceptible-infectious-susceptible and susceptible-infectious-recovered-susceptible where nodes can return to previously inhabited states and multiple waves of infection can pass through the population. Given that message-passing has been applied exclusively to models with one-way state changes like susceptible-infectious and susceptible-infectious-recovered, we develop message-passing for recurrent epidemics based on a new class of differential equations and demonstrate that our approach is simple and efficiently approximates results obtained from Monte Carlo simulation, and that the accuracy of message-passing is often superior to the pair approximation (which also takes second-order correlations into account).

Accounting for Sitting and Moving: An Analysis of Sedentary Behavior in Mass Media Campaigns.

PubMed

Knox, Emily; Biddle, Stuart; Esliger, Dale W; Piggin, Joe; Sherar, Lauren

2015-09-01

Mass media campaigns are an important tool for promoting health-related physical activity. The relevance of sedentary behavior to public health has propelled it to feature prominently in health campaigns across the world. This study explored the use of messages regarding sedentary behavior in health campaigns within the context of current debates surrounding the association between sedentary behavior and health, and messaging strategies to promote moderate-to-vigorous physical activity (MVPA). A web-based search of major campaigns in the United Kingdom, United States, Canada, and Australia was performed to identify the main campaign from each country. A directed content analysis was then conducted to analyze the inclusion of messages regarding sedentary behavior in health campaigns and to elucidate key themes. Important areas for future research were illustrated. Four key themes from the campaigns emerged: clinging to sedentary behavior guidelines, advocating reducing sedentary behavior as a first step on the activity continuum and the importance of light activity, confusing the promotion of MVPA, and the demonization of sedentary behavior. Strategies for managing sedentary behavior as an additional complicating factor in health promotion are urgently required. Lessons learned from previous health communication campaigns should stimulate research to inform future messaging strategies.

Dietary factors and cancers of breast, endometrium, and ovary: strategies for modifying fat intake in African American women.

PubMed

Hargreaves, M K; Buchowski, M S; Hardy, R E; Rossi, S R; Rossi, J S

1997-06-01

Modification of dietary fat and fiber could help prevent cancers of the breast, endometrium, and ovary that are prevalent in African-American women. Dietary intervention programs aimed at reducing fat intake have had mixed results in this population. The transtheoretic model is proposed for achieving dietary change. Strategies for changing health behaviors in African-American women include heightening sensitivity to cultural values among health educators and the use of multiple strategies to reinforce messages. To stimulate healthier eating, it is important to incorporate the distinct habitual eating patterns into innovative intervention methods, using effective behavioral change methods.

Effectiveness of message framing on women's intention to perform cytomegalovirus prevention behaviors: a cross-sectional study.

PubMed

Thackeray, Rosemary; Magnusson, Brianna M; Christensen, Emily M

2017-12-20

The purpose of this study was to evaluate the effect of message framing on women's intention to perform cytomegalovirus (CMV) prevention behaviors involving handwashing, not sharing food and eating utensils, not kissing a child on the lips and not placing a pacifier in the mouth after it was in a child's mouth. An online panel of women 18-40 years, who were pregnant or planning a pregnancy were randomized in a 2 × 2 factorial design to receive 1 of 4 CMV fact sheets. The fact sheets were framed as either what could be gained or be lost by following (or not) the recommendations and the likelihood of being affected by CMV (i.e., small chance or one of the most common infections in infants). The questionnaire measured CMV knowledge, participation in CMV risk or prevention behaviors, perceived severity of and susceptibly to CMV, and the perceived control over and the efficacy of recommended prevention behaviors. The dependent variable, intention to modify behavior, was an index score that ranged from 0 to 16 with higher values indicating greater intention. Linear regression was used to evaluate the association between all independent variables and overall behavioral intention. The sample included 840 women; 15.5% were familiar with CMV. Behavioral intention was high (M = 10.43; SD = 5.13) but did not differ across the message frames (p = 0.23). Overall, behavioral intention was predicted by CMV knowledge, message credibility, perceived severity of CMV, perceived behavioral control and response efficacy. Significant interactions with gain vs. loss frame were observed for perceived behavioral control (p = 0.03) and response efficacy (p = .003). Framing CMV messages by what women stand to gain or lose interacts with perceived behavioral control and response efficacy to influence behavioral intention. Perceived behavioral control and response efficacy were most predictive of behavioral intention overall regardless of frame. Messaging that focuses on these two variables, particularly for avoiding kissing a child on the lips and sharing food, cups and utensils, may result in greater gains in intention to participate in CMV prevention behaviors.

Does the Screening Status of Message Characters Affect Message Effects?

ERIC Educational Resources Information Center

Alber, Julia M.; Glanz, Karen

2018-01-01

Public health messages can be used to increase awareness about colorectal cancer screenings. Free or inexpensive images for creating health messages are readily available, yet little is known about how a pictured individual's engagement in the behavior of interest affects message outcomes. Participants (N = 360), aged 50 to 75 years, completed an…

Effects of tailored message education about breast cancer risk appraisal for obese Korean women.

PubMed

Park, Somi; Chung, ChaeWeon; Cochrane, Barbara B

2013-11-01

To examine the effects of tailored message education about breast cancer risk in obese Korean women. Pretest/post-test with two comparison treatments. Rural community settings in South Korea. Non-random sample of 64 obese women. Based on the Health Belief Model, tailored message education involved a one-session individual approach addressing cognitive, emotional, and behavioral domains. The comparison group received a one-time standard education group session. Data on breast cancer risk factors and mammography findings were recorded. Knowledge, awareness, emotional barriers, self-efficacy, and intent to screen and prevent breast cancer. Compared to standard education, tailored message education showed significantly higher score changes on awareness of personal risk (F = 5.21, p < 0.05), self-efficacy for breast self-examination (BSE) (F = 5.16, p < 0.001), intent to perform BSE (F = 6.24, p < 0.05), intent to have mammography (F = 5.45, p < 0.05), and intent to prevent breast cancer with eating habits (F = 7.28, p < 0.05) and exercising (F = 12.51, p < 0.001). Individually tailored education effectively enhanced awareness of personal risk for breast cancer, self-efficacy for BSE, and intent to screen and prevent breast cancer. Tailored message education targeting breast cancer and risk associated with obesity is useful in breast cancer screening education. Future studies should incorporate individualized messages on nutrition, exercise, and cultural barriers to reduce breast cancer risk in obese women. Individual educational strategies can effectively enhance breast cancer prevention and early screening. Public and preventive education should include a focus on cultural, cognitive, and emotional domains. For obese women, a heightened awareness and self-efficacy may influence screening behaviors.

Does Yik Yak Promote Risky Health Behavior on College Campuses?

PubMed

Wombacher, Kevin; Reno, Jenna E; Williams, Gregory A; Johnson, Lauren

2018-04-01

This study offers an analysis of how healthy and risky behaviors are discussed on an emerging social media platform. We sought to understand what behaviors are communicated and if they are encouraged or discouraged. We completed a content analysis of messages (n = 3,776) posted to Yik Yak captured three times a day on 4 days of the week across two separate weeks. We analyzed messages to determine the category of the behavior, an appraisal of the behavior, and normative voting feedback. Our results show that risky behaviors were discussed with greater frequency and received more user votes than healthy behaviors. Exposure to these messages could influence other students' perceptions of norms associated with these risky behaviors. We suggest further research to determine how Yik Yak may affect normative perceptions on college campuses.

Using Growth Curves To Determine the Timing of the Booster Sessions.

ERIC Educational Resources Information Center

Hennessy, Michael; Bolan, Gail A.; Hoxworth, Tamara; Iatesta, Michael; Rhodes, Fen; Zenilman, Jonathan M.

1999-01-01

Demonstrates an application of a method for using growth curves to determine the timing of booster sessions to reinforce the cognitive messages or behavior changes of interventions. Uses data from a multisite randomized experiment that compared three counseling and testing methods for preventing sexual disease transmission. Presents…

Self-Report and Psychophysiological Responses to Fear Appeals

ERIC Educational Resources Information Center

Ordonana, Juan R.; Gonzalez-Javier, Francisca; Espin-Lopez, Laura; Gomez-Amor, Jesus

2009-01-01

This study was designed to assess the relationship between self-report and psychophysiological responses to fear appeals and behavioral changes elicited by these. Ninety-two subjects watched one of four messages that varied in level of threat (high vs. low) and efficacy (high vs. low). Concomitantly, psychophysiological measures (heart rate and…

Key enablers to facilitate healthy behavior change: workshop summary.

PubMed

Teyhen, Deydre S; Aldag, Matt; Centola, Damon; Edinborough, Elton; Ghannadian, Jason D; Haught, Andrea; Jackson, Theresa; Kinn, Julie; Kunkler, Kevin J; Levine, Betty; Martindale, Valerie E; Neal, David; Snyder, Leslie B; Styn, Mindi A; Thorndike, Frances; Trabosh, Valerie; Parramore, David J

2014-05-01

The increases in preventable chronic diseases and the rising costs of health care are unsustainable. The US Army Surgeon General's vision to transition from a health care system to a system of health requires the identification of key health enablers to facilitate the adoption of healthy behaviors. In support of this vision, the US Army Telemedicine and Advanced Technology Research Center hosted a workshop in April 2013 titled "Incentives to Create and Sustain Change for Health." Members of government and academia participated to identify key health enablers that could ultimately be leveraged by technology. The key health enablers discussed included (1) public health messaging, (2) changing health habits and the environmental influence on health, (3) goal setting and tracking, (4) the role of incentives in behavior-change intervention, and (5) the role of peer and social networks on change. This report summarizes leading evidence and the group consensus on evidence-based practices with respect to the key enablers in creating healthy behavior change.

Streamlining Tsunami Messages (e.g., Warnings) of the US National Tsunami Warning Center, Palmer, Alaska

NASA Astrophysics Data System (ADS)

Gregg, C. E.; Sorensen, J. H.; Vogt Sorensen, B.; Whitmore, P.; Johnston, D. M.

2016-12-01

Spurred in part by world-wide interest in improving warning messaging for and response to tsunamis in the wake of several catastrophic tsunamis since 2004 and growing interest at the US National Weather Service (NWS) to integrate social science into their Tsunami Program, the NWS Tsunami Warning Centers in Alaska and Hawaii have made great progress toward enhancing tsunami messages. These include numerous products, among them being Tsunami Warnings, Tsunami Advisories and Tsunami Watches. Beginning in 2010 we have worked with US National Tsunami Hazard Mitigation Program (NTHMP) Warning Coordination and Mitigation and Education Subcommittee members; Tsunami Program administrators; and NWS Weather Forecast Officers to conduct a series of focus group meetings with stakeholders in coastal areas of Alaska, American Samoa, California, Hawaii, North Carolina, Oregon, US Virgin Islands and Washington to understand end-user perceptions of existing messages and their existing needs in message products. We also reviewed research literature on behavioral response to warnings to develop a Tsunami Warning Message Metric that could be used to guide revisions to tsunami warning messages of both warning centers. The message metric is divided into categories of Message Content, Style, Order, Formatting, and Receiver Characteristics. A sample message is evaluated by cross-referencing the message with the operational definitions of metric factors. Findings are then used to guide revisions of the message until the characteristics of each factor are met, whether the message is a full length or short message. Incrementally, this work contributed to revisions in the format, content and style of message products issued by the National Tsunami Warning Center (NTWC). Since that time, interest in short warning messages has continued to increase and in May 2016 the NTWC began efforts to revise message products to take advantage of recent NWS policy changes allowing use of mixed-case text format and expanded punctuation, a practice which the NWS first started in 2010. Here we describe our application of a modification of the warning message metric to develop new streamlined messages using mixed-case text. These messages reflect current state-of-the-art knowledge on warning message effectiveness.

Why culture matters in health interventions: lessons from HIV/AIDS stigma and NCDs.

PubMed

Airhihenbuwa, Collins O; Ford, Chandra L; Iwelunmor, Juliet I

2014-02-01

Theories about health behavior are commonly used in public health and often frame problems as ascribed or related to individuals' actions or inaction. This framing suggests that poor health occurs because individuals are unable or unwilling to heed preventive messages or recommended treatment actions. The recent United Nations call for strategies to reduce the global disease burden of noncommunicable diseases like diabetes requires a reassessment of individual-based approaches to behavior change. We argue that public health and health behavior intervention should focus more on culture than behavior to achieve meaningful and sustainable change resulting in positive health outcomes. To change negative health behaviors, one must first identify and promote positive health behaviors within the cultural logic of its contexts. To illustrate these points, we discuss stigma associated with obesity and human immunodeficiency virus and acquired immune deficiency syndrome. We conclude that focusing on positive behaviors and sustaining cultural and personal transformations requires a culturally grounded approach to public health interventions, such as that provided by the PEN-3 model.

Use of a Text Message Program to Raise Type 2 Diabetes Risk Awareness and Promote Health Behavior Change (Part II): Assessment of Participants' Perceptions on Efficacy

PubMed Central

Hirzel, Lindsey; Turske, Scott A; Des Jardins, Terrisca R; Yarandi, Hossein; Bondurant, Patricia

2013-01-01

Background Although there is great enthusiasm in both the public and private sector for the further development and use of large-scale consumer-facing public health applications for mobile platforms, little is known about user experience and satisfaction with this type of approach. As a part of the Beacon Community Cooperative Agreement Program, txt4health, a public-facing, mobile phone-based health information service targeting type 2 diabetes, was launched in 3 Beacon Communities: the Southeast Michigan Beacon Community in Detroit, MI, the Greater Cincinnati Beacon Community in Cincinnati, OH, and the Crescent City Beacon Community in New Orleans, LA. This program was marketed via large public health campaigns and drew many users within the respective communities. Objective The purpose of this investigation was to use the RE-AIM framework to document txt4health efficacy by focusing on perceptions of satisfaction, usage, and behavior change among individuals who used txt4health in pilot studies in Southeast Michigan and Greater Cincinnati. Methods We conducted a multimodal user survey with txt4health users recruited via text message through the program to understand participant perceptions of program use and satisfaction, as well as self-reported perceptions of behavior change as a result of using txt4health. Results Txt4health users reported very high levels of program satisfaction, with 67.1% (108/161) reporting satisfaction scores of ≥8 on a 10-point scale, with 10 equivalent to most satisfied (mean 8.2, SD 1.6). All survey participants agreed/strongly agreed that the messages included in txt4health were clear and easy to understand (100.0%, 160/160), and most found txt4health made them knowledgeable about their risk for type 2 diabetes (88.1%, 140/159) and made them conscious of their diet and physical activity (88.8%, 142/160). Most participants reported that txt4health helped them to make behavior changes related to diet; after having completed txt4health, most agreed/strongly agreed that they are more likely to replace sugary drinks, such as juice or soda, with water (78.0%, 124/159), have a piece of fresh fruit instead of dessert (74.2%, 118/159), substitute a small salad for chips or fries when dining out (76.1%, 121/159), buy healthier foods when grocery shopping (79.7%, 126/158), and eat more grilled, baked, or broiled foods instead of fried (75.5%, 120/159). Conclusions Results from this study suggest that participants in txt4health, a large-scale, public health–focused text message program targeting type 2 diabetes, have positive perceptions of the program and that participation has led to positive behavior change. PMID:24356359

Consumer Understanding, Preferences, and Responses to Different Versions of Drug Safety Messages in the United States: A Randomized Controlled Trial.

PubMed

McCormack, Lauren; Craig Lefebvre, R; Bann, Carla; Taylor, Olivia; Rausch, Paula

2016-02-01

As part of its mission, the US Food and Drug Administration (FDA) communicates with the public regularly about the benefits and risks of prescription and over-the-counter (OTC) drugs. Effectively communicating risk, however, is a significant public health challenge. To better understand how different populations understand information communicated by the FDA about drug safety, we conducted a randomized experiment to examine comprehension and other measures of effectiveness of drug safety messages that occurred in a post-market surveillance phase. We used an Internet panel survey of 1244 consumers, of whom 58% used prescription drugs in the past year. Half of the sample panel was randomized to read a previous FDA Drug Safety Communication (DSC) with the drug name changed, and the other half was randomized to read a revised version of the same DSC. We examined how making certain modifications to the way drug risk information is communicated has an impact on comprehension and behavioral intentions, including the user's likelihood of discontinuing the drug. We also studied how comprehension varied by respondent characteristics, health literacy skills, risk perceptions, and trust in the message. Based on a five-item comprehension index, the revised version of the message was associated with significantly greater comprehension of the information relative to the standard version (63 vs 52% correct, p < 0.001). Significantly more respondents found the revised version to be clear (82 vs 73%, p < 0.000), while fewer in that group reported learning something new (78% vs 84%, p = 0.015). No significant differences emerged between the two groups in terms of the message being informative, convincing, or helpful. We found no significant differences between the two groups in terms of behavioral intentions, risk perception, and trust. We found that making plain language changes to the DSC significantly increased consumers' level of comprehension of its content, providing support for ongoing use and further exploration of these strategies in pharmacovigilance communication research. The study findings have important implications for future drug safety and other communication messages related to prescription drugs.

Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh.

PubMed

Dreibelbis, Robert; Kroeger, Anne; Hossain, Kamal; Venkatesh, Mohini; Ram, Pavani K

2016-01-14

Behavior change communication for improving handwashing with soap can be labor and resource intensive, yet quality results are difficult to achieve. Nudges are environmental cues engaging unconscious decision-making processes to prompt behavior change. In this proof-of-concept study, we developed an inexpensive set of nudges to encourage handwashing with soap after toilet use in two primary schools in rural Bangladesh. We completed direct observation of behaviors at baseline, after providing traditional handwashing infrastructure, and at multiple time periods following targeted handwashing nudges (1 day, 2 weeks, and 6 weeks). No additional handwashing education or motivational messages were completed. Handwashing with soap among school children was low at baseline (4%), increasing to 68% the day after nudges were completed and 74% at both 2 weeks and 6 weeks post intervention. Results indicate that nudge-based interventions have the potential to improve handwashing with soap among school-aged children in Bangladesh and specific areas of further inquiry are discussed.

Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh

PubMed Central

Dreibelbis, Robert; Kroeger, Anne; Hossain, Kamal; Venkatesh, Mohini; Ram, Pavani K.

2016-01-01

Behavior change communication for improving handwashing with soap can be labor and resource intensive, yet quality results are difficult to achieve. Nudges are environmental cues engaging unconscious decision-making processes to prompt behavior change. In this proof-of-concept study, we developed an inexpensive set of nudges to encourage handwashing with soap after toilet use in two primary schools in rural Bangladesh. We completed direct observation of behaviors at baseline, after providing traditional handwashing infrastructure, and at multiple time periods following targeted handwashing nudges (1 day, 2 weeks, and 6 weeks). No additional handwashing education or motivational messages were completed. Handwashing with soap among school children was low at baseline (4%), increasing to 68% the day after nudges were completed and 74% at both 2 weeks and 6 weeks post intervention. Results indicate that nudge-based interventions have the potential to improve handwashing with soap among school-aged children in Bangladesh and specific areas of further inquiry are discussed. PMID:26784210

Mobile Link - a theory-based messaging intervention for improving sexual and reproductive health of female entertainment workers in Cambodia: study protocol of a randomized controlled trial.

PubMed

Brody, Carinne; Tuot, Sovannary; Chhoun, Pheak; Swendenman, Dallas; Kaplan, Kathryn C; Yi, Siyan

2018-04-19

In Cambodia, HIV prevalence is concentrated in key populations including among female entertainment workers (FEWs) who may engage in direct or indirect sex work. Reaching FEWs with sexual and reproductive health (SRH) services has been difficult because of their hidden and stigmatized nature. Mobile-phone-based interventions may be an effective way to reach this population and connect them with the existing services. This article describes study design and implementation of a randomized controlled trial (RCT) of a mobile health intervention (the Mobile Link) aiming to improve SRH and related outcomes among FEWs in Cambodia. A two-arm RCT will be used to determine the effectiveness of a mobile-phone-based text/voice messaging intervention. The intervention will be developed through a participatory process. Focus group discussions and in-depth interviews have been conducted to inform and tailor behavior change theory-based text and voice messages. During the implementation phase, 600 FEWs will be recruited and randomly assigned into one of the two arms: (1) a control group and (2) a mobile phone message group (either text messages [SMS] or voice messages [VM], a delivery method chosen by participants). Participants in the control group will also receive a weekly monitoring survey, which will provide real-time information to implementing partners to streamline outreach efforts and be able to quickly identify geographic trends. The primary outcome measures will include self-reported HIV and sexually transmitted infections (STI) testing and treatment, condom use, contraceptive use, and gender-based violence (GBV). If the Mobile Link trial is successful, participants will report an increase in condom use, linkages to screening and treatment for HIV and STI, and contraception use as well as a reduction in GBV. This trial is unique in a number of ways. First, the option of participation mode (SMS or VM) allows participants to choose the message medium that best links them to services. Second, this is the first RCT of a mobile-phone-based behavior change intervention using SMS/VMs to support linkage to SRH services in Cambodia. Lastly, we are working with a hidden, hard-to-reach, and dynamic population with which existing methods of outreach have not been fully successful. Clinical trials.gov, NCT03117842 . Registered on 31 March 2017.

Skinny Is Not Enough: A Content Analysis of Fitspiration on Pinterest.

PubMed

Simpson, Courtney C; Mazzeo, Suzanne E

2017-05-01

Fitspiration is a relatively new social media trend nominally intended to promote health and fitness. Fitspiration messages are presented as encouraging; however, they might also engender body dissatisfaction and compulsive exercise. This study analyzed fitspiration content (n = 1050) on the image-based social media platform Pinterest. Independent raters coded the images and text present in the posts. Messages were categorized as appearance- or health-related, and coded for Social Cognitive Theory constructs: standards, behaviors, and outcome expectancies. Messages encouraged appearance-related body image standards and weight management behaviors more frequently than health-related standards and behaviors, and emphasized attractiveness as motivation to partake in such behaviors. Results also indicated that fitspiration messages include a comparable amount of fit praise (i.e., emphasis on toned/defined muscles) and thin praise (i.e., emphasis on slenderness), suggesting that women are not only supposed to be thin but also fit. Considering the negative outcomes associated with both exposure to idealized body images and exercising for appearance reasons, findings suggest that fitspiration messages are problematic, especially for viewers with high risk of eating disorders and related issues.

Characteristics of a virtual community for individuals who are d/deaf and hard of hearing.

PubMed

Shoham, Snunith; Heber, Meital

2012-01-01

The content of 2,050 messages on a virtual forum for d/Deaf and hard of hearing people in Israel was analyzed. Interactions and behavior were monitored to determine if behavior on the forum expressed social support, and whether the community was an entirely virtual community or a real community whose members also met in other venues. Subjects discussed in messages included technical difficulties, coping with difficulties presented by hearing loss, adjusting to assistive devices, difficulties at school and work, accessibility issues, difficulties communicating with the hearing world, and rights. Messages were also used to initiate a range of social activities. Classification of behaviors per the Social Support Behavior Code (Cutrona & Suhr, 1992) showed that most were in the category of informational support. Other types of support in the model, tangible assistance, emotional support, social network support, and esteem support, were evident in fewer messages.

Messages for men: the efficacy of EPPM-based messages targeting men's physical activity.

PubMed

Hatchell, Alexandra C; Bassett-Gunter, Rebecca L; Clarke, Marie; Kimura, Stacey; Latimer-Cheung, Amy E

2013-01-01

The majority of men are insufficiently active. Men's tendencies to participate in risky behaviors and their inactivity likely contribute to their increased risk of morbidity and mortality. Physical activity decreases the risk of developing many chronic diseases and may be an optimal behavior to target in men's health interventions. However, educational resources promoting physical activity for men are lacking. To address this gap, we tested the efficacy of messages based upon the Extended Parallel Process Model (EPPM; Witte, 1992) to increase men's physical activity intentions and behaviors. Men who were not meeting physical activity guidelines (n = 611) were randomly assigned to read high or low efficacy physical activity messages paired with high or no health risk information. Participants read four brief messages on four consecutive days. Intentions were assessed at baseline and the first follow-up (Day 5). Manipulation check measures were assessed at Day 5. Behavior was assessed at baseline and the second follow-up (Day 14). Overall, the messages had small sized effects. A completer analysis revealed that although men's intentions to be active increased over the course of the study regardless of the messages they received, only men who received risk information significantly increased their physical activity. Men who received low efficacy and risk information were less likely to meet the physical activity guidelines at Day 14 than men who only received low efficacy information. From these results, we suggest preliminary recommendations for the development of physical activity messages for men and areas for future EPPM-based research. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Developing effective communication materials on the health effects of climate change for vulnerable groups: a mixed methods study.

PubMed

Kreslake, Jennifer M; Price, Katherine M; Sarfaty, Mona

2016-09-07

Individuals with chronic health conditions or low socioeconomic status (SES) are more vulnerable to the health impacts of climate change. Health communication can provide information on the management of these impacts. This study tested, among vulnerable audiences, whether viewing targeted materials increases knowledge about the health impacts of climate change and strength of climate change beliefs, and whether each are associated with stronger intentions to practice recommended behaviors. Low-SES respondents with chronic conditions were recruited for an online survey in six cities. Respondents were shown targeted materials illustrating the relationship between climate change and chronic conditions. Changes in knowledge and climate change beliefs (pre- and post-test) and behavioral intentions (post-test only) were tested using McNemar tests of marginal frequencies of two binary outcomes or paired t-tests, and multivariable linear regression. Qualitative interviews were conducted among target audiences to triangulate survey findings and make recommendations on the design of messages. Respondents (N = 122) reflected the target population regarding income, educational level and prevalence of household health conditions. (1) Knowledge. Significant increases in knowledge were found regarding: groups that are most vulnerable to heat (children [p < 0.001], individuals with heart disease [p < 0.001], or lung disease [p = 0.019]); and environmental conditions that increase allergy-producing pollen (increased heat [p = 0.003], increased carbon dioxide [p < 0.001]). (2) Strength of certainty that climate change is happening increased significantly between pre- and post-test (p < 0.001), as did belief that climate change affected respondents' health (p < 0.001). (3) Behavioral intention. At post-test, higher knowledge of heat vulnerabilities and environmental conditions that trigger pollen allergies were associated with greater behavioral intention scores (p = 0.001 and p = 0.002, respectively). In-depth interviews (N = 15) revealed that vulnerable audiences are interested in immediate-term advice on health management and protective behaviors related to their chronic conditions, but took less notice of messages about collective action to slow or stop climate change. Respondents identified both appealing and less favorable design elements in the materials. Individuals who are vulnerable to the health effects of climate change benefit from communication materials that explain, using graphics and concise language, how climate change affects health conditions and how to engage in protective adaptation behaviors.

Oklahoma Retailers' Perspectives on Mutual Benefit Exchange to Limit Point-of-Sale Tobacco Advertisements.

PubMed

Chan, Andie; Douglas, Malinda Reddish; Ling, Pamela M

2015-09-01

Businesses changing their practices in ways that support tobacco control efforts recently have gained interest, as demonstrated by CVS Health's voluntary policy to end tobacco sales. Point-of-sale (POS) advertisements are associated with youth smoking initiation, increased tobacco consumption, and reduced quit attempts among smokers. There is interest in encouraging retailers to limit tobacco POS advertisements voluntarily. This qualitative exploratory study describes Oklahoma tobacco retailers' perspectives on a mutual benefit exchange approach, and preferred message and messenger qualities that would entice them to take voluntary action to limit tobacco POS advertisements. This study found that mutual benefit exchange could be a viable option along with education and law as strategies to create behavior change among tobacco retailers. Many retailers stated that they would be willing to remove noncontractual POS advertisements for a 6-month commitment period when presented with mutual exchange benefit, tailored message, and appropriate messenger. Mutual benefit exchange, as a behavior change strategy to encourage voluntary removal of POS tobacco advertisements, was acceptable to retailers, could enhance local tobacco control in states with preemption, and may contribute to setting the foundation for broader legislative efforts. © 2015 Society for Public Health Education.

Oklahoma Retailers’ Perspectives on Mutual Benefit Exchange to Limit Point-of-Sale Tobacco Advertisements

PubMed Central

Chan, Andie; Douglas, Malinda Reddish; Ling, Pamela M.

2015-01-01

Businesses changing their practices in ways that support tobacco control efforts recently have gained interest, as demonstrated by CVS Health’s voluntary policy to end tobacco sales. Point of sale (POS) advertisements are associated with youth smoking initiation, increased tobacco consumption, and reduced quit attempts among smokers. There is interest in encouraging retailers to limit tobacco POS advertisements voluntarily. This qualitative exploratory study describes Oklahoma tobacco retailers’ perspectives on a mutual benefit exchange approach, and preferred message and messenger qualities that would entice them to take voluntary action to limit tobacco POS advertisements. This study found mutual benefit exchange could be a viable option along with education and law as strategies to create behavior change among tobacco retailers. Many retailers stated that they would be willing to remove non-contractual POS advertisements for a six-month commitment period when presented with mutual exchange benefit, tailored message, and appropriate messenger. Mutual benefit exchange, as a behavior change strategy to encourage voluntary removal of POS tobacco advertisements, was acceptable to retailers, could enhance local tobacco control in states with preemption, and may contribute to setting the foundation for broader legislative efforts. PMID:25767197

Limiting climate change: what’s most worth doing?

NASA Astrophysics Data System (ADS)

Stern, Paul C.; Wolske, Kimberly S.

2017-09-01

Wynes and Nicholas (2017 Environ. Res. Lett. 12 074024) claim that some of the most important actions individuals can take to mitigate climate change have been overlooked, particularly in educational messages for adolescents, and estimate the potential impact of some of these, including having fewer children and living car free. These estimates raise questions that deserve serious analysis, but they are based only on the technical potential of the actions and do not consider the plasticity of the behaviors and the feasibility of policies to support them. The actions identified as having the greatest potential are lifestyle changes that accrue benefits over a lifetime or longer, so are not realistic alternatives to actions that can be enacted immediately. But presenting lifestyle choices and the relative impacts of different actions as discussion starters for adolescents could be promising, especially if the discussions highlight issues of behavioral plasticity, policy plasticity, and time scale. Research has identified design principles for interventions to achieve the strongest emissions reductions at time scales up to the decadal. Design principles for achieving longer-lasting changes deserve careful analytic attention, as well as a stronger focus in adolescent textbooks and messages to the general population. Both adolescents and researchers would do well to think carefully about what could promote the generational changes needed to reach a climate change target such as ‘well below 2 °C’.

The development of effective message content for suicide intervention: theory of planned behavior.

PubMed

Shemanski Aldrich, Rosalie; Cerel, Julie

2009-01-01

Each year there are over 31,000 suicides in the United States, constituting a significant problem in every respect. It is important for research efforts to focus on the communication elements involved in suicide prevention because the messages produced by individuals close to those who have suicidal thoughts have the potential to save a life. The current manuscript presents the theory of planned behavior (TPB) as a foundation to increase understanding of what message content would be most effective to convince an individual to intervene when someone is suicidal. Suicide and suicidal behaviors are briefly reviewed, as is the TPB. Then it is argued how and why TPB can help construct persuasive messages. The authors suggest that TPB guide the content of persuasive messages. Messages created in combination of persuasive theories with TPB are likely to encourage an individual to intervene when someone is suicidal. A key element to suicide prevention is intervention by close others. Use of TPB provides an increased understanding of how to persuade close individuals to intervene when an individual is suicidal.

Addressing People and Place Microenvironments in Weight Loss Disparities (APP-Me): Design of a randomized controlled trial testing timely messages for weight loss behavior in low income black and white women

PubMed Central

Clark, Daniel O.; Srinivas, Preethi; Bodke, Kunal; Keith, NiCole; Hood, Sula; Tu, Wanzhu

2018-01-01

Background Behavioral interventions for weight loss have been less effective in lower income and black women. These poorer outcomes may in part be related to these women having more frequent exposures to social and physical situations that are obesogenic, i.e., eating and sedentary cues or situations. Objectives Working with obese, lower income black and white women, Addressing People and Place Microenvironments (APP-Me) was designed to create awareness of self-behavior at times and places of frequent eating and sedentary behavior. Design APP-Me is being evaluated in a randomized controlled trial with 240 participants recruited from federally qualified health centers located in a single Midwestern city. All participants complete four weeks of ecological momentary assessments (EMA) of situations and behavior. At the end of the four weeks, participants are randomized to enhanced usual care (UC) or UC plus APP-Me. Methods APP-Me is an automated short messaging system (SMS). Messages are text, image, audio, or a combination, and are delivered to participants’ mobile devices with the intent of creating awareness at the times and places of frequent eating or sedentary behavior. Summary This project aims to create and test timely awareness messages in a subpopulation that has not responded well to traditional behavioral interventions for weight loss. Novel aspects of the study include the involvement of a low income population, the use of data on time and place of obesogenic behavior, and message delivery time tailored to an individual’s behavioral patterns. PMID:29357313

Considerations for Community-Based mHealth Initiatives: Insights From Three Beacon Communities

PubMed Central

2013-01-01

Mobile health (mHealth) is gaining widespread attention for its potential to engage patients in their health and health care in their daily lives. Emerging evidence suggests that mHealth interventions can be used effectively to support behavior change, but numerous challenges remain when implementing these programs at the community level. This paper provides an overview of considerations when implementing community-based mHealth initiatives, based on the experiences of three Beacon Communities across the United States that have launched text messaging (short message service, SMS) pilot programs aimed at diabetes risk reduction and disease management. The paper addresses lessons learned and suggests strategies to overcome challenges related to developing text message content, conducting marketing and outreach, enrolling participants, engaging providers, evaluating program effectiveness, and sustaining and scaling the programs. PMID:24128406

Provision Increases Reported PPE Use for Mexican Immigrant Farmworkers: An mHealth Pilot Study.

PubMed

Snipes, Shedra Amy; Smyth, Joshua M; Murphy, Dennis; Miranda, Patricia Y; Ishino, Francisco Alejandro Montiel

2015-12-01

Personal protective equipment (PPE) reduces pesticide exposures, but many farmworkers complain that it is difficult to obtain. We examined if PPE provision increased usage. We also delivered motivational messaging aimed to promote PPE use. First, we delivered a daily survey through a mobile phone app to assess PPE use. Farmworkers subsequently received a daily, individualized motivational message based on their PPE use and reported difficulties. PPE use was evaluated at baseline and at the close of the study. PPE behaviors improved for gloves (P ≤ 0.01) and safety glasses (P ≤ 0.001). Use of long-sleeved shirts, hats, and long pants were already consistently used at baseline and did not exhibit significant change. Our findings demonstrate that PPE provision and delivery of motivational messaging through mobile phones may increase PPE usage for farmworkers.

Food compensation: do exercise ads change food intake?

PubMed

van Kleef, Ellen; Shimizu, Mitsuru; Wansink, Brian

2011-01-28

Past research has shown that promotional messages such as food advertising influence food consumption. However, what has gone largely unexplored is the effect of exercise advertising on food intake. This study experimentally tested the effects of exposure to exercise commercials on food intake at a lunch meal as compared to the effects of control commercials. Prior to eating lunch, 125 participants (71 women, 54 men) watched 8 commercials, either all related to exercise or fitness (n=67) or neutral products (i.e. car insurance) (n=58). The meal consisted of a pasta dish with tomato sauce, salad and chocolate pudding. The post-lunch questionnaire included questions about body mass index, exercise habits, motivation and dietary restraint. Participants exposed to exercise commercials reduced their caloric intake by 21.7% relative to the control condition. Additionally, watching exercise messages increased the perceived healthiness and liking of the meal. Although exercise habits and intentions did not moderate the effect of commercial condition on food intake, we also found that this intake reduction was driven by participants with higher body mass index levels. These results imply that exercise messages may serve as a reminder of the link between food and physical activity and affect food consumption. It also highlights the need for increased awareness that these messages have powerful influences not only on exercise behavior, but also on closely related behaviors such as eating.

Food compensation: do exercise ads change food intake?

PubMed Central

2011-01-01

Background Past research has shown that promotional messages such as food advertising influence food consumption. However, what has gone largely unexplored is the effect of exercise advertising on food intake. This study experimentally tested the effects of exposure to exercise commercials on food intake at a lunch meal as compared to the effects of control commercials. Methods Prior to eating lunch, 125 participants (71 women, 54 men) watched 8 commercials, either all related to exercise or fitness (n = 67) or neutral products (i.e. car insurance) (n = 58). The meal consisted of a pasta dish with tomato sauce, salad and chocolate pudding. The post-lunch questionnaire included questions about body mass index, exercise habits, motivation and dietary restraint. Results Participants exposed to exercise commercials reduced their caloric intake by 21.7% relative to the control condition. Additionally, watching exercise messages increased the perceived healthiness and liking of the meal. Although exercise habits and intentions did not moderate the effect of commercial condition on food intake, we also found that this intake reduction was driven by participants with higher body mass index levels. Conclusions These results imply that exercise messages may serve as a reminder of the link between food and physical activity and affect food consumption. It also highlights the need for increased awareness that these messages have powerful influences not only on exercise behavior, but also on closely related behaviors such as eating. PMID:21276218

Text Message and Internet Support for Coronary Heart Disease Self-Management: Results From the Text4Heart Randomized Controlled Trial.

PubMed

Pfaeffli Dale, Leila; Whittaker, Robyn; Jiang, Yannan; Stewart, Ralph; Rolleston, Anna; Maddison, Ralph

2015-10-21

Mobile technology has the potential to deliver behavior change interventions (mHealth) to reduce coronary heart disease (CHD) at modest cost. Previous studies have focused on single behaviors; however, cardiac rehabilitation (CR), a component of CHD self-management, needs to address multiple risk factors. The aim was to investigate the effectiveness of a mHealth-delivered comprehensive CR program (Text4Heart) to improve adherence to recommended lifestyle behaviors (smoking cessation, physical activity, healthy diet, and nonharmful alcohol use) in addition to usual care (traditional CR). A 2-arm, parallel, randomized controlled trial was conducted in New Zealand adults diagnosed with CHD. Participants were recruited in-hospital and were encouraged to attend center-based CR (usual care control). In addition, the intervention group received a personalized 24-week mHealth program, framed in social cognitive theory, sent by fully automated daily short message service (SMS) text messages and a supporting website. The primary outcome was adherence to healthy lifestyle behaviors measured using a self-reported composite health behavior score (≥3) at 3 and 6 months. Secondary outcomes included clinical outcomes, medication adherence score, self-efficacy, illness perceptions, and anxiety and/or depression at 6 months. Baseline and 6-month follow-up assessments (unblinded) were conducted in person. Eligible patients (N=123) recruited from 2 large metropolitan hospitals were randomized to the intervention (n=61) or the control (n=62) group. Participants were predominantly male (100/123, 81.3%), New Zealand European (73/123, 59.3%), with a mean age of 59.5 (SD 11.1) years. A significant treatment effect in favor of the intervention was observed for the primary outcome at 3 months (AOR 2.55, 95% CI 1.12-5.84; P=.03), but not at 6 months (AOR 1.93, 95% CI 0.83-4.53; P=.13). The intervention group reported significantly greater medication adherence score (mean difference: 0.58, 95% CI 0.19-0.97; P=.004). The majority of intervention participants reported reading all their text messages (52/61, 85%). The number of visits to the website per person ranged from zero to 100 (median 3) over the 6-month intervention period. A mHealth CR intervention plus usual care showed a positive effect on adherence to multiple lifestyle behavior changes at 3 months in New Zealand adults with CHD compared to usual care alone. The effect was not sustained to the end of the 6-month intervention. A larger study is needed to determine the size of the effect in the longer term and whether the change in behavior reduces adverse cardiovascular events. ACTRN 12613000901707; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364758&isReview=true (Archived by WebCite at http://www.webcitation.org/6c4qhcHKt).

Text Message and Internet Support for Coronary Heart Disease Self-Management: Results From the Text4Heart Randomized Controlled Trial

PubMed Central

Whittaker, Robyn; Jiang, Yannan; Stewart, Ralph; Rolleston, Anna; Maddison, Ralph

2015-01-01

Background Mobile technology has the potential to deliver behavior change interventions (mHealth) to reduce coronary heart disease (CHD) at modest cost. Previous studies have focused on single behaviors; however, cardiac rehabilitation (CR), a component of CHD self-management, needs to address multiple risk factors. Objective The aim was to investigate the effectiveness of a mHealth-delivered comprehensive CR program (Text4Heart) to improve adherence to recommended lifestyle behaviors (smoking cessation, physical activity, healthy diet, and nonharmful alcohol use) in addition to usual care (traditional CR). Methods A 2-arm, parallel, randomized controlled trial was conducted in New Zealand adults diagnosed with CHD. Participants were recruited in-hospital and were encouraged to attend center-based CR (usual care control). In addition, the intervention group received a personalized 24-week mHealth program, framed in social cognitive theory, sent by fully automated daily short message service (SMS) text messages and a supporting website. The primary outcome was adherence to healthy lifestyle behaviors measured using a self-reported composite health behavior score (≥3) at 3 and 6 months. Secondary outcomes included clinical outcomes, medication adherence score, self-efficacy, illness perceptions, and anxiety and/or depression at 6 months. Baseline and 6-month follow-up assessments (unblinded) were conducted in person. Results Eligible patients (N=123) recruited from 2 large metropolitan hospitals were randomized to the intervention (n=61) or the control (n=62) group. Participants were predominantly male (100/123, 81.3%), New Zealand European (73/123, 59.3%), with a mean age of 59.5 (SD 11.1) years. A significant treatment effect in favor of the intervention was observed for the primary outcome at 3 months (AOR 2.55, 95% CI 1.12-5.84; P=.03), but not at 6 months (AOR 1.93, 95% CI 0.83-4.53; P=.13). The intervention group reported significantly greater medication adherence score (mean difference: 0.58, 95% CI 0.19-0.97; P=.004). The majority of intervention participants reported reading all their text messages (52/61, 85%). The number of visits to the website per person ranged from zero to 100 (median 3) over the 6-month intervention period. Conclusions A mHealth CR intervention plus usual care showed a positive effect on adherence to multiple lifestyle behavior changes at 3 months in New Zealand adults with CHD compared to usual care alone. The effect was not sustained to the end of the 6-month intervention. A larger study is needed to determine the size of the effect in the longer term and whether the change in behavior reduces adverse cardiovascular events. Trial Registration ACTRN 12613000901707; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364758&isReview=true (Archived by WebCite at http://www.webcitation.org/6c4qhcHKt) PMID:26490012

Thinspiration: Self-Improvement Versus Self-Evaluation Social Comparisons with Thin-Ideal Media Portrayals.

PubMed

Knobloch-Westerwick, Silvia

2015-01-01

Much research has demonstrated negative impacts of idealized-body imagery exposure on body satisfaction. Yet, paradoxically, media with such imagery attract mass audiences. Few studies showed women's body satisfaction increased due to thin-ideal exposure. The kind of social comparison women engage in (self-evaluation vs. self-improvement) may explain these inconsistent findings and the paradoxical attraction to thin-ideal messages. Across 5 days, thin-ideal messages were presented to 51 women; self-evaluation and self-improvement social comparisons as well as body satisfaction were measured each day. A linear positive change in body satisfaction emerged. Greater self-improvement social comparisons increased this change, whereas greater self-evaluation social comparisons reduced it. Extent of both social comparison types changed during the prolonged exposure. A greater tendency to compare one's body with others' improved body satisfaction through self-improvement social comparisons and fostered weight-loss behaviors through self-evaluation social comparisons.

Using message framing to promote acceptance of the human papillomavirus vaccine.

PubMed

Gerend, Mary A; Shepherd, Janet E

2007-11-01

Use of message framing for encouraging vaccination, an increasingly common preventive health behavior, has received little empirical investigation. The authors examined the relative effectiveness of gain-versus loss-framed messages in promoting acceptance of a vaccine against human papillomavirus (HPV)-a virus responsible for virtually all cases of cervical cancer. Undergraduate women (N = 121) were randomly assigned to read a booklet describing the benefits of receiving (gain-framed message) or the costs of not receiving (loss-framed message) a prophylactic HPV vaccine. After reading the booklet, participants indicated their intent to obtain the HPV vaccine. A 5-item composite representing intentions to obtain the HPV vaccine. The effect of message framing on HPV vaccine acceptance was moderated by risky sexual behavior and approach avoidance motivation. A loss-framed message led to greater HPV vaccination intentions than a gain framed message but only among participants who had multiple sexual partners and participants who infrequently used condoms. The loss-frame advantage was also observed among participants high in avoidance motivation. Findings highlight characteristics of the message recipient that may affect the success of framed messages promoting vaccine acceptance. This study has practical implications for the development of health communications promoting vaccination.

Narrative and framing: a test of an integrated message strategy in the exercise context.

PubMed

Gray, Jennifer B; Harrington, Nancy G

2011-03-01

Health communication interventions encouraging exercise may aid in mitigating the obesity crisis in the United States. Although much research has investigated behavioral predictors of exercise, little work has explored message characteristics most persuasive in the exercise context. The purpose of this study, therefore, was to test a message strategy drawing on previous work in health behavior theory combined with persuasion theories (exemplification theory and prospect theory) to encourage positive exercise attitudes, control beliefs, and intentions. The authors report the results of a controlled experiment testing messages using gain or loss frames and narrative or statistical evidence. Results indicate that gain-framed messages are significantly more successful in promoting positive exercise variables and are perceived as more effective than are loss-framed or control messages. The authors discuss the implications of the results for future research.

Reaching rural women: breast cancer prevention information seeking behaviors and interest in Internet, cell phone, and text use.

PubMed

Kratzke, Cynthia; Wilson, Susan; Vilchis, Hugo

2013-02-01

The purpose of this study was to examine the breast cancer prevention information seeking behaviors among rural women, the prevalence of Internet, cell, and text use, and interest to receive breast cancer prevention information cell and text messages. While growing literature for breast cancer information sources supports the use of the Internet, little is known about breast cancer prevention information seeking behaviors among rural women and mobile technology. Using a cross-sectional study design, data were collected using a survey. McGuire's Input-Ouput Model was used as the framework. Self-reported data were obtained from a convenience sample of 157 women with a mean age of 60 (SD = 12.12) at a rural New Mexico imaging center. Common interpersonal information sources were doctors, nurses, and friends and common channel information sources were television, magazines, and Internet. Overall, 87% used cell phones, 20% had an interest to receive cell phone breast cancer prevention messages, 47% used text messaging, 36% had an interest to receive text breast cancer prevention messages, and 37% had an interest to receive mammogram reminder text messages. Bivariate analysis revealed significant differences between age, income, and race/ethnicity and use of cell phones or text messaging. There were no differences between age and receiving text messages or text mammogram reminders. Assessment of health information seeking behaviors is important for community health educators to target populations for program development. Future research may identify additional socio-cultural differences.

Is Provider Secure Messaging Associated With Patient Messaging Behavior? Evidence From the US Army.

PubMed

Wolcott, Vickee; Agarwal, Ritu; Nelson, D Alan

2017-04-06

Secure messaging with health care providers offers the promise of improved patient-provider relationships, potentially facilitating outcome improvements. But, will patients use messaging technology in the manner envisioned by policy-makers if their providers do not actively use it? We hypothesized that the level and type of secure messaging usage by providers might be associated with messaging initiation by their patients. The study employed a dataset of health care and secure messaging records of more than 81,000 US Army soldiers and nearly 3000 clinicians with access to a patient portal system. We used a negative binomial regression model on over 25 million observations to determine the adjusted association between provider-initiated and provider-response messaging and subsequent messaging by their patients in this population over a 4-year period. Prior provider-initiated and response messaging levels were associated with new patient messaging when controlling for the patient's health care utilization and diagnoses, with the strongest association for high provider-response messaging level. Patients whose providers were highly responsive to the messages of other patients initiated 334% more secure messages (P<.001) than patients with providers who did not personally respond to other patients' messages. Our results indicate that provider messaging usage levels and types thereof predict their patients' subsequent communication behavior. The findings suggest the need for more study into the factors associated with provider messaging to fully understand the mechanisms of this relationship. ©Vickee Wolcott, Ritu Agarwal, D. Alan Nelson. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.04.2017.

Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis

PubMed Central

Lantini, Ryan; Jennings, Ernestine G; Thind, Herpreet; Rosen, Rochelle K; Salmoirago-Blotcher, Elena; Bock, Beth C

2016-01-01

Background Tobacco use is one of the leading preventable global health problems producing nearly 6 million smoking-related deaths per year. Interventions delivered via text messaging (short message service, SMS) may increase access to educational and support services that promote smoking cessation across diverse populations. Objective The purpose of this meta-analysis is to (1) evaluate the efficacy of text messaging interventions on smoking outcomes, (2) determine the robustness of the evidence, and (3) identify moderators of intervention efficacy. Methods Electronic bibliographic databases were searched for records with relevant key terms. Studies were included if they used a randomized controlled trial (RCT) to examine a text messaging intervention focusing on smoking cessation. Raters coded sample and design characteristics, and intervention content. Summary effect sizes, using random-effects models, were calculated and potential moderators were examined. Results The meta-analysis included 20 manuscripts with 22 interventions (N=15,593; 8128 (54%) women; mean age=29) from 10 countries. Smokers who received a text messaging intervention were more likely to abstain from smoking relative to controls across a number of measures of smoking abstinence including 7-day point prevalence (odds ratio (OR)=1.38, 95% confidence interval (CI)=1.22, 1.55, k=16) and continuous abstinence (OR=1.63, 95% CI=1.19, 2.24, k=7). Text messaging interventions were also more successful in reducing cigarette consumption relative to controls (d+=0.14, 95% CI=0.05, 0.23, k=9). The effect size estimates were biased when participants who were lost to follow-up were excluded from the analyses. Cumulative meta-analysis using the 18 studies (k=19) measuring abstinence revealed that the benefits of using text message interventions were established only after only five RCTs (k=5) involving 8383 smokers (OR=1.39, 95% CI=1.15, 1.67, P<.001). The inclusion of the subsequent 13 RCTs (k=14) with 6870 smokers did not change the established efficacy of text message interventions for smoking abstinence (OR=1.37, 95% CI=1.25, 1.51, P<.001). Smoking abstinence rates were stronger when text messaging interventions (1) were conducted in Asia, North America, or Europe, (2) sampled fewer women, and (3) recruited participants via the Internet. Conclusions The evidence for the efficacy of text messaging interventions to reduce smoking behavior is well-established. Using text messaging to support quitting behavior, and ultimately long-term smoking abstinence, should be a public health priority. PMID:27207211

Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis.

PubMed

Scott-Sheldon, Lori A J; Lantini, Ryan; Jennings, Ernestine G; Thind, Herpreet; Rosen, Rochelle K; Salmoirago-Blotcher, Elena; Bock, Beth C

2016-05-20

Tobacco use is one of the leading preventable global health problems producing nearly 6 million smoking-related deaths per year. Interventions delivered via text messaging (short message service, SMS) may increase access to educational and support services that promote smoking cessation across diverse populations. The purpose of this meta-analysis is to (1) evaluate the efficacy of text messaging interventions on smoking outcomes, (2) determine the robustness of the evidence, and (3) identify moderators of intervention efficacy. Electronic bibliographic databases were searched for records with relevant key terms. Studies were included if they used a randomized controlled trial (RCT) to examine a text messaging intervention focusing on smoking cessation. Raters coded sample and design characteristics, and intervention content. Summary effect sizes, using random-effects models, were calculated and potential moderators were examined. The meta-analysis included 20 manuscripts with 22 interventions (N=15,593; 8128 (54%) women; mean age=29) from 10 countries. Smokers who received a text messaging intervention were more likely to abstain from smoking relative to controls across a number of measures of smoking abstinence including 7-day point prevalence (odds ratio (OR)=1.38, 95% confidence interval (CI)=1.22, 1.55, k=16) and continuous abstinence (OR=1.63, 95% CI=1.19, 2.24, k=7). Text messaging interventions were also more successful in reducing cigarette consumption relative to controls (d+=0.14, 95% CI=0.05, 0.23, k=9). The effect size estimates were biased when participants who were lost to follow-up were excluded from the analyses. Cumulative meta-analysis using the 18 studies (k=19) measuring abstinence revealed that the benefits of using text message interventions were established only after only five RCTs (k=5) involving 8383 smokers (OR=1.39, 95% CI=1.15, 1.67, P<.001). The inclusion of the subsequent 13 RCTs (k=14) with 6870 smokers did not change the established efficacy of text message interventions for smoking abstinence (OR=1.37, 95% CI=1.25, 1.51, P<.001). Smoking abstinence rates were stronger when text messaging interventions (1) were conducted in Asia, North America, or Europe, (2) sampled fewer women, and (3) recruited participants via the Internet. The evidence for the efficacy of text messaging interventions to reduce smoking behavior is well-established. Using text messaging to support quitting behavior, and ultimately long-term smoking abstinence, should be a public health priority.

Television and Childhood Education.

ERIC Educational Resources Information Center

Hilliard, Robert L.

To make adequate use of mass media for children's education, we must recognize that the medium is the message, that the conveyer is the content. The medium itself changes behavior, learning and growth patterns of the child. For example television itself teaches a special kind of visual awareness and enhances the ability to relate non-immediate…

Implementation of Health Promotion in the Older Adults in Bangkok, Thailand

ERIC Educational Resources Information Center

Assantachai, Prasert; Bunnag, Chaweewan; Piya-Anant, Manee; Thamlikitkul, Visanu

2006-01-01

Effective strategies that bring health promotion messages to older adults in a developing country are needed. To evaluate the impact of various education media upon changes in knowledge and health behavior, a double-blind, randomized controlled trial was conducted involving 1,268 older adults in a southwest Bangkok suburb. Group teaching…

Stigmatizing Images in Obesity Health Campaign Messages and Healthy Behavioral Intentions.

PubMed

Young, Rachel; Subramanian, Roma; Hinnant, Amanda

2016-08-01

Background Antiobesity campaigns blaming individual behaviors for obesity have sparked concern that an emphasis on individual behavior may lead to stigmatization of overweight or obese people. Past studies have shown that perpetuating stigma is not effective for influencing behavior. Purpose This study examined whether stigmatizing or nonstigmatizing images and text in antiobesity advertisements led to differences in health-related behavioral intentions. Method Participants in this experiment were 161 American adults. Measures included self-reported body mass index, weight satisfaction, antifat attitudes, and intention to increase healthy behaviors. Results Images in particular prompted intention to increase healthy behavior, but only among participants who were not overweight or obese. Conclusion Images and text emphasizing individual responsibility for obesity may influence behavioral intention among those who are not overweight, but they do not seem to be effective at altering behavioral intentions among overweight people, the target audience for many antiobesity messages. Images in antiobesity messages intended to alter behavior are influential and should be selected carefully. © 2015 Society for Public Health Education.

Using the Theory of Planned Behavior to Guide Focus Group Development of Messages Aimed at Increasing Compliance With a Tobacco-Free Policy.

PubMed

Record, Rachael A; Harrington, Nancy G; Helme, Donald W; Savage, Matthew W

2018-01-01

This study details the persuasive message development for a theory-based campaign designed to increase compliance with a university's tobacco-free policy. The theory of planned behavior (TPB) guided message design and evaluation for focus group-tested messages that were adapted to the context of complying with a tobacco-free policy. The study was conducted at a university located in the tobacco belt. Undergraduate focus group participants (n = 65) were mostly male (69%), white (82%), and freshman (62%) who smoked at least 1 cigarette in the last 30 days; on-campus smoking percentages were never/rare (60%), occasionally (23%), and often/frequently (16%). Data analysis used a theoretical thematic approach to identify how the TPB constructs related to perceptions of message effectiveness. Participants responded favorably to attitudinal strategies about health, respect, and university figures; they rejected approaches they considered juvenile and offensive. They also discussed the impact of noncompliance and avoiding overgeneralized statements for addressing subjective norms, suggesting shortening text, adjusting picture location, and emphasizing the importance of compliance to increase perceptions of behavioral control. Applying theory to preexisting messages is challenging. The design approach in this study is an evidence-based strategy that can be used as a universal process for message adaptation. Results offer health promotion suggestions for designing messages aimed at improving undergraduate smokers' willingness to comply with tobacco-free campus policies.

Family Sources of Sexual Health Information, Primary Messages, and Sexual Behavior of At-Risk, Urban Adolescents

ERIC Educational Resources Information Center

Rosengard, Cynthia; Tannis, Candace; Dove, David C.; van den Berg, Jacob J.; Lopez, Rosalie; Stein, L. A. R.; Morrow, Kathleen M.

2012-01-01

Background: Sources of sexual health information exert strong influence on adolescents' sexual behavior. Purpose: The current study was undertaken to understand how family serve as sexual information sources, the messages adolescents recall from family, and how family learning experiences affect sexual behavior among at-risk adolescents. Methods:…

Improving Immunization Rates Through Community-Based Participatory Research: Community Health Improvement for Milwaukee's Children Program.

PubMed

Willis, Earnestine; Sabnis, Svapna; Hamilton, Chelsea; Xiong, Fue; Coleman, Keli; Dellinger, Matt; Watts, Michelle; Cox, Richard; Harrell, Janice; Smith, Dorothy; Nugent, Melodee; Simpson, Pippa

2016-01-01

Nationally, immunization coverage for the DTaP/3HPV/1MMR/3HepB/3Hib/1VZV antigen series in children ages 19-35 months are near or above the Healthy People 2020 target (80%). However, children in lower socioeconomic families experience lower coverage rates. Using a community-based participatory research (CBPR) approach, Community Health Improvement for Milwaukee Children (CHIMC) intervened to reduce disparities in childhood immunizations. The CHIMC adopted a self-assessment to examine the effectiveness of adhering to CBPR principles. Using behavior change models, CHIMC implemented education, social marketing campaign, and theory of planned behavior interventions. Community residents and organizational representatives vetted all processes, messages, and data collection tools. Adherence to the principles of CBPR was consistently positive over the 8-year period. CHIMC enrolled 565 parents/caregivers with 1,533 children into educational and planned behavior change (PBC) interventions, and enrolled another 406 surveyed for the social marketing campaign. Retention rate was high (80%) with participants being predominately Black females (90%) and the unemployed (64%); children's median age was 6.2 years. Increased knowledge about immunizations was consistently observed among parents/caregivers. Social marketing data revealed high recognition (85%) of the community-developed message ("Take Control: Protect Your Child with Immunizations"). Barriers and facilitators to immunize children revealed protective factors positively correlated with up-to-date (UTD) status (p<0.007). Ultimately, children between the ages of 19 and 35 months whose parents/caregivers completed education sessions and benefitted from a community-wide social marketing message increased their immunization status from 45% baseline to 82% over 4 years. Using multilayered interventions, CHIMC contributed to the elimination of immunization disparities in children. A culturally tailored CBPR approach is effective to eliminate immunization disparities.

Developing actionable dietary guidance messages: dietary fat as a case study.

PubMed

Borra, S; Kelly, L; Tuttle, M; Neville, K

2001-06-01

Although consumers say they are concerned about nutrition and are aware that eating a healthful diet is important for good health, this knowledge does not always translate into healthful diet behaviors or motivate behavior change. In an effort to better understand consumer attitudes about nutrition and to explore alternatives for communicating dietary advice in language that is meaningful and motivates behavior change, the International Food Information Council (IFIC) conducted qualitative research with consumers (using focus groups) and registered dietitians (using telephone interviews) in 1998 and 1999. Results of the research are presented using dietary fat as a case study. Findings from the IFIC research were reported to the Dietary Guidelines Advisory Committee to assist the Committee in developing meaningful and action-oriented dietary advice related to dietary fat for inclusion in the 2000 Dietary Guidelines for Americans that would be motivating and easy for consumers to implement. The recommendation to moderate fat intake in the new dietary guideline, "Choose a diet that is low in saturated fat and cholesterol and moderate in total fat" is consistent with communication recommendations in the IFIC research. Further, the moderate fat message is empowering because it suggests an achievable dietary regimen and reduces guilt and worry about foods. It allows flexibility to enjoy desired foods and promotes using common sense when it comes to diet. Several issues emerged from the IFIC research that apply to general nutrition communications with consumers, whether it be through national nutrition recommendations or in one-on-one counseling situations: to be effective, messages to consumers about nutrition, and specifically dietary fat, must address sources of discomfort about dietary choices; they must engender a sense of empowerment; and they should motivate both by providing clear information that propels toward taking action and appeals to the need to make personal choices.

The persuasive power of oral health promotion messages: a theory of planned behavior approach to dental checkups among young adults.

PubMed

Anderson, Christina N; Noar, Seth M; Rogers, Brandi D

2013-01-01

Although routine dental checkups are important for both oral and overall health, several factors influence young adults' use or nonuse of dental services. The two studies included in this report tested the theory of reasoned action (TRA), the theory of planned behavior (TPB), and an expanded TPB model in predicting young adults' routine dental checkups. Additionally, the study tested the perceived message effectiveness of TPB-based messages. Results support the use of an expanded TPB model (particularly adding satisfaction with the dentist and environmental constraints to the traditional model) for an understanding of routine dental checkup intention and behavior, and, most notably, provide support for the use of subjective norm-based messages to prompt dental checkups. This study lays the groundwork for a health communication campaign encouraging routine dental checkups among young adults. The use of targeting and tailoring to design effective oral health media campaign messages is discussed.

A Cognitive Behavioral Therapy-Based Text Messaging Intervention for Methamphetamine Dependence

PubMed Central

Keoleian, Victoria; Stalcup, S. Alex; Polcin, Douglas L.; Brown, Michelle; Galloway, Gantt

2013-01-01

Psychosocial treatments for methamphetamine dependence are of limited effectiveness. Thus, a significant need exists for add-on therapy for this substance user disorder. The aim of this study was to develop and test a novel text messaging intervention for use as an adjunct to cognitive behavioral group therapy for methamphetamine users. Text messaging has the potential to support patients in real-time, around the clock. We convened 2 meetings of an expert panel, held 3 focus groups in current and former users, and conducted 15 semi-structured interviews with in-treatment users in order to develop a fully-automated, cognitive behavioral therapy-based text messaging intervention. We then conducted a randomized, crossover pre-test in 5 users seeking treatment. Participants’ ratings of ease of use and functionality of the system were high. During the pre-test we performed real-time assessments via text messaging on daily methamphetamine use, craving levels, and the perceived usefulness of messages; 79% of scheduled assessments were collected. The odds of messages being rated as “very” or “extremely” useful were 6.6 times [95% CI: 2.2, 19.4] higher in the active vs. placebo periods. The intervention is now ready for testing in randomized clinical trials. PMID:24592670

Reflecting and shaping the discourse: the role of music in AIDS communication in Tanzania.

PubMed

Bastien, Sheri

2009-04-01

Failure to recognize the importance of oral traditions in Africa and the potential of music and song for stimulating social and behavior change would represent a missed opportunity in HIV prevention strategies. Local narratives concerning AIDS are often utilized in popular songs and constitute rich sources of contextual information about the epidemic that have thus far been un- or underutilized in HIV prevention strategies. Endogenously conceived messages delivered via a channel such as music increase the likelihood of messages being contextually appropriate and culturally engaging. This form of media also presents the greatest opportunity for wide dissemination. Drawing on field work conducted in the Kilimanjaro region, this paper presents examples of how music and musicians in Tanzania reflect and potentially shape AIDS discourse. Three broad recurrent themes addressed in songs are discussed: AIDS metaphors, stigma and broader HIV prevention messages. By tapping into the wealth of information about AIDS discourse contained within popular songs, and by recognizing musicians as potential opinion leaders and agents of social change, the effectiveness of prevention strategies may be increased.

Uplifting Fear Appeals: Considering the Role of Hope in Fear-Based Persuasive Messages.

PubMed

Nabi, Robin L; Myrick, Jessica Gall

2018-01-09

Fear appeal research has focused, understandably, on fear as the primary emotion motivating attitude and behavior change. However, while the threat component of fear appeals associates with fear responses, a fear appeals' efficacy component likely associates with a different emotional experience: hope. Drawing from appraisal theories of emotion in particular, this article theorizes about the role of hope in fear appeals, testing hypotheses with two existing data sets collected within the context of sun safety messages. In both studies, significant interactions between hope and self-efficacy emerged to predict behavioral intentions. Notable main effects for hope also emerged, though with less consistency. Further, these effects persisted despite controlling for the four cognitions typically considered central to fear appeal effectiveness. These results, consistent across two samples, support the claim that feelings of hope in response to fear appeals contribute to their persuasive success. Implications for developing a recursive model of fear appeal processing are discussed.

Using negative emotional feedback to modify risky behavior of young moped riders.

PubMed

Megías, Alberto; Cortes, Abilio; Maldonado, Antonio; Cándido, Antonio

2017-05-19

The aim of this research was to investigate whether the use of messages with negative emotional content is effective in promoting safe behavior of moped riders and how exactly these messages modulate rider behavior. Participants received negative feedback when performing risky behaviors using a computer task. The effectiveness of this treatment was subsequently tested in a riding simulator. The results demonstrated how riders receiving negative feedback had a lower number of traffic accidents than a control group. The reduction in accidents was accompanied by a set of changes in the riding behavior. We observed a lower average speed and greater respect for speed limits. Furthermore, analysis of the steering wheel variance, throttle variance, and average braking force provided evidence for a more even and homogenous riding style. This greater abidance of traffic regulations and friendlier riding style could explain some of the causes behind the reduction in accidents. The use of negative emotional feedback in driving schools or advanced rider assistance systems could enhance riding performance, making riders aware of unsafe practices and helping them to establish more accurate riding habits. Moreover, the combination of riding simulators and feedback-for example, in the training of novice riders and traffic offenders-could be an efficient tool to improve their hazard perception skills and promote safer behaviors.

A Social Marketing Approach to 1% Milk Use: Resonance Is the Key.

PubMed

Finnell, Karla Jaye; John, Robert

2018-05-01

The U.S. Dietary Guidelines recommend low-fat milk consumption, and Supplemental Nutrition Assistance Program Education (SNAP-Ed) programs follow these guidelines to develop health education programs for SNAP recipients. This study evaluated a multilevel media intervention promoting low-fat milk use among Oklahoma SNAP recipients, a population often missed. Behavior change was measured with pre- and postintervention telephone interviews with SNAP recipients ( n = 860). Immediately following the intervention, self-reported purchases of 1% milk, the focus of behavior change, significantly increased to 7.9% from 4.1%-a relative improvement of 92.7%, χ 2 (1, n = 824) = 5.8, p = .02. Milk nutrition knowledge scores significantly improved as well, t(846) = 2.9, p = .004, and low-fat milk users exhibited more milk nutrition knowledge than high-fat milk users, t(437) = 4.0, p = .000. The intervention, which resonated with the priority audience, was well received ( Mdn = 6, 1, 7). Factors contributing to its success included a gain-based message strategy and clearly articulating the desired behavior. Salient messages personalized the issues and concerns raised by the priority audience-all the vitamins and minerals without the fat. Findings suggest that matching gender and ethnicity mediated the effect among those most resistant to substituting low-fat for high-fat milk.

HIV Prevention among Mexican Migrants at Different Migration Phases: Exposure to Prevention Messages and Association With Testing Behaviors

PubMed Central

Martinez-Donate, Ana P.; Rangel, M. Gudelia; Zhang, Xiao; Simon, Norma-Jean; Rhoads, Natalie; Gonzalez-Fagoaga, J. Eduardo; Gonzalez, Ahmed Asadi

2016-01-01

Mobile populations are at increased risk for HIV infection. Exposure to HIV prevention messages at all phases of the migration process may help decrease im/migrants’ HIV risk. We investigated levels of exposure to HIV prevention messages, factors associated with message exposure, and the association between exposure to prevention messages and HIV testing behavior among Mexican im/migrants at different phases of the migration process. We conducted a cross-sectional, probability survey of Mexican im/migrants (N=3,149) traveling through the border city of Tijuana, Mexico. The results indicate limited exposure to prevention messages (57%–75%) and suboptimal last 12-month HIV testing rates (14%–25%) across five migration phases. Compared to pre-departure levels (75%), exposure to messages decreases at all post-departure migration phases (57%–63%, p<.001). In general, exposure to prevention messages is positively associated with greater odds of HIV testing at the pre-departure, destination, and interception phases. Binational efforts need to be intensified to reach and deliver HIV prevention to Mexican im/migrants across the migration continuum. PMID:26595267

Using Teach-Back to Understand Participant Behavioral Self-Monitoring Skills Across Health Literacy Level and Behavioral Condition.

PubMed

Porter, Kathleen; Chen, Yvonnes; Estabrooks, Paul; Noel, Lauren; Bailey, Angela; Zoellner, Jamie

2016-01-01

To assess differences, by health literacy status and behavioral condition, in participants' abilities to self-monitor behaviors accurately and recall key behavioral messages using data from a teach-back call. Cross-sectional. Rural, southwestern Virginia. Adults (n = 301). The majority were female (81.1%), 31.9% had a high school education or less, 66.1% earned < $25,000/y, and 32.9% were low health literate. First class session of 2 community-based behavioral interventions: SIPsmartER (reduce sugar-sweetened beverage intake) or MoveMore (increase physical activity). Reported accuracy of behavioral diary completion, proportion of behavioral messages recalled during the first round of teach-back, and rounds of teach-back. Descriptive statistics and generalized linear model. Low health literate participants were significantly less accurate in diary completion (P < .001), recalled fewer behavioral messages correctly (P < .001), and needed more rounds of teach-back (P < .001) than high health literate participants. Compared with SIPsmartER participants, MoveMore participants more accurately completed diaries (P = .001) but recalled a lower proportion of behavioral messages correctly (P < .001) and required more rounds of teach-back (P < .001). Health literacy status and behavioral target affect the ability to self-monitor and recall key concepts. Researchers should consider using teach-back early in the intervention to assess and reinforce participants' ability to self-monitor. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Mobile Phone Interventions for the Secondary Prevention of Cardiovascular Disease.

PubMed

Park, Linda G; Beatty, Alexis; Stafford, Zoey; Whooley, Mary A

2016-01-01

Mobile health in the form of text messaging and mobile applications provides an innovative and effective approach to promote prevention and management of cardiovascular disease (CVD); however, the magnitude of these effects is unclear. Through a comprehensive search of databases from 2002-2016, we conducted a quantitative systematic review. The selected studies were critically evaluated to extract and summarize pertinent characteristics and outcomes. A large majority of studies (22 of 28, 79%) demonstrated text messaging, mobile applications, and telemonitoring via mobile phones were effective in improving outcomes. Some key factors associated with successful interventions included personalized messages with tailored advice, greater engagement (2-way text messaging, higher frequency of messages), and use of multiple modalities. Overall, text messaging appears more effective than smartphone-based interventions. Incorporating principles of behavioral activation will help promote and sustain healthy lifestyle behaviors in patients with CVD that result in improved clinical outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Mobile Phone Interventions for the Secondary Prevention of Cardiovascular Disease

PubMed Central

Park, Linda G.; Beatty, Alexis; Stafford, Zoey; Whooley, Mary A.

2016-01-01

Mobile health in the form of text messaging and mobile applications provides an innovative and effective approach to promote prevention and management of cardiovascular disease (CVD); however, the magnitude of these effects is unclear. Through a comprehensive search of databases from 2002–2016, we conducted a quantitative systematic review. The selected studies were critically evaluated to extract and summarize pertinent characteristics and outcomes. A large majority of studies (22 of 28, 79%) demonstrated text messaging, mobile applications, and telemonitoring via mobile phones were effective in improving outcomes. Some key factors associated with successful interventions included personalized messages with tailored advice, greater engagement (2-way text messaging, higher frequency of messages), and use of multiple modalities. Overall, text messaging appears more effective than smartphone-based interventions. Incorporating principles of behavioral activation will help promote and sustain healthy lifestyle behaviors in patients with CVD that result in improved clinical outcomes. PMID:27001245

Using Culturally Sensitive Media Messages to Reduce HIV-associated Sexual Behavior in High-risk African-American Adolescents: Results from a Randomized Trial

PubMed Central

Sznitman, Sharon; Vanable, Peter A.; Carey, Michael P.; Hennessy, Michael; Brown, Larry K.; Valois, Robert F.; Stanton, Bonita F.; Salazar, Laura F.; DiClemente, Ralph; Farber, Naomi; Romer, Daniel

2010-01-01

Purpose To test the long-term effects of a mass media intervention that used culturally and developmentally appropriate messages to enhance HIV-preventive beliefs and behavior of high-risk African-American adolescents. Methods Television and radio messages were delivered over three years in two cities (Syracuse, NY and Macon, GA) that were randomly selected within each of two regionally matched city pairs with the other cities (Providence, RI and Columbia, SC) serving as controls. African American adolescents ages 14 to 17 (N = 1710), recruited in the four cities over a 16-month period, completed audio computer-assisted self-interviews at recruitment and again at 3, 6, 12 and 18-months post-recruitment to assess the long-term effects of the media program. To identify the unique effects of the media intervention, youth who completed at least one follow-up and who did not test positive for any of three sexually transmitted infections at recruitment or at 6 and 12-month follow-up were retained for analysis (N=1346). Results The media intervention reached virtually all of the adolescents in the trial and produced a range of effects including improved normative condom-use negotiation expectancies and increased sex refusal self-efficacy. Most importantly, older adolescents (ages 16-17) exposed to the media program exhibited a less risky age trajectory of unprotected sex than those in the non-media cities. Conclusions Culturally tailored mass media messages delivered consistently over time have the potential to reach a large audience of high-risk adolescents, to support changes in HIV-preventive beliefs, and to reduce HIV-associated risk behaviors among older youth. PMID:21856515

Mobile Health Devices as Tools for Worldwide Cardiovascular Risk Reduction and Disease Management.

PubMed

Piette, John D; List, Justin; Rana, Gurpreet K; Townsend, Whitney; Striplin, Dana; Heisler, Michele

2015-11-24

We examined evidence on whether mobile health (mHealth) tools, including interactive voice response calls, short message service, or text messaging, and smartphones, can improve lifestyle behaviors and management related to cardiovascular diseases throughout the world. We conducted a state-of-the-art review and literature synthesis of peer-reviewed and gray literature published since 2004. The review prioritized randomized trials and studies focused on cardiovascular diseases and risk factors, but included other reports when they represented the best available evidence. The search emphasized reports on the potential benefits of mHealth interventions implemented in low- and middle-income countries. Interactive voice response and short message service interventions can improve cardiovascular preventive care in developed countries by addressing risk factors including weight, smoking, and physical activity. Interactive voice response and short message service-based interventions for cardiovascular disease management also have shown benefits with respect to hypertension management, hospital readmissions, and diabetic glycemic control. Multimodal interventions including Web-based communication with clinicians and mHealth-enabled clinical monitoring with feedback also have shown benefits. The evidence regarding the potential benefits of interventions using smartphones and social media is still developing. Studies of mHealth interventions have been conducted in >30 low- and middle-income countries, and evidence to date suggests that programs are feasible and may improve medication adherence and disease outcomes. Emerging evidence suggests that mHealth interventions may improve cardiovascular-related lifestyle behaviors and disease management. Next-generation mHealth programs developed worldwide should be based on evidence-based behavioral theories and incorporate advances in artificial intelligence for adapting systems automatically to patients' unique and changing needs. © 2015 American Heart Association, Inc.

Associations between coherent neural activity in the brain's value system during antismoking messages and reductions in smoking.

PubMed

Cooper, Nicole; Tompson, Steven; O'Donnell, Matthew B; Vettel, Jean M; Bassett, Danielle S; Falk, Emily B

2018-04-01

Worldwide, tobacco use is the leading cause of preventable death and illness. One common strategy for reducing the prevalence of cigarette smoking and other health risk behaviors is the use of graphic warning labels (GWLs). This has led to widespread interest from the perspective of health psychology in understanding the mechanisms of GWL effectiveness. Here we investigated differences in how the brain responds to negative, graphic warning label-inspired antismoking ads and neutral control ads, and we probed how this response related to future behavior. A group of smokers (N = 45) viewed GWL-inspired and control antismoking ads while undergoing fMRI, and their smoking behavior was assessed before and one month after the scan. We examined neural coherence between two regions in the brain's valuation network, the medial prefrontal cortex (MPFC) and ventral striatum (VS). We found that greater neural coherence in the brain's valuation network during GWL ads (relative to control ads) preceded later smoking reduction. Our results suggest that the integration of information about message value may be key for message influence. Understanding how the brain responds to health messaging and relates to future behavior could ultimately contribute to the design of effective messaging campaigns, as well as more broadly to theories of message effects and persuasion across domains. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The Canary in the Coal Mine Tweets: Social Media Reveals Public Perceptions of Non-Medical Use of Opioids.

PubMed

Chan, Brian; Lopez, Andrea; Sarkar, Urmimala

2015-01-01

Non-medical prescription opioid use is a growing public health concern. Social media is an emerging tool to understand health attitudes, beliefs, and behaviors. We retrieved a sample of publicly available Twitter messages in early 2014, using common opioid medication names and slang search terms. We used content analysis to code messages by user, context of message (personal vs general experiences), and key content themes. We reviewed 540 messages, of which 375 (69%) messages were related to opioid behaviors. Of these, 316 (84%) originated from individual user accounts; 125 messages expressed personal experience with opioids. The majority of personal messages referenced using opioids to obtain a "high", use for sleep, or other non-intended use (87,70%). General attitudes regarding opioid use included positive sentiment (52, 27%), comments on others peoples opioid use (57, 30%), and messages containing public health information or links (48, 25%). In a sample of social media messages mentioning opioid medications, the most common theme amongst English users related to various forms of opioid misuse. Social media can provide insights into the types of misuse of opioids that might aid public health efforts to reduce non-medical opioid use.

Mass media in health promotion: an analysis using an extended information-processing model.

PubMed

Flay, B R; DiTecco, D; Schlegel, R P

1980-01-01

The information-processing model of the attitude and behavior change process was critically examined and extended from six to 12 levels for a better analysis of change due to mass media campaigns. Findings from social psychology and communications research, and from evaluations of mass media health promotion programs, were reviewed to determine how source, message, channel, receiver, and destination variables affect each of the levels of change of major interest (knowledge, beliefs, attitudes, intentions and behavior). Factors found to most likely induce permanent attitude and behavior change (most important in health promotion) were: presentation and repetition over long time periods, via multiple sources, at different times (including "prime" or high-exposure times), by multiple sources, in novel and involving ways, with appeals to multiple motives, development of social support, and provisions of appropriate behavioral skills, alternatives, and reinforcement (preferably in ways that get the active participation of the audience). Suggestions for evaluation of mass media programs that take account of this complexity were advanced.

Text Messaging for Psychiatric Outpatients: Effect on Help-Seeking and Self-Harming Behaviors.

PubMed

Kodama, Toyohiko; Syouji, Hiroko; Takaki, Sachiko; Fujimoto, Hirokazu; Ishikawa, Shinichi; Fukutake, Masaaki; Taira, Masaru; Hashimoto, Takeshi

2016-04-01

A mobile phone intervention was developed and tested with 30 psychiatric outpatients with mental illness, who had high ideation for suicide. The intervention involved promoting help-seeking behaviors by sending text messages, including information about social welfare services and reminders about medical appointments, for 6 months. After the intervention period, the number of participants who used social services significantly increased, and more than 80% of participants reported that the text messaging service was helpful and useful. Compared to baseline, participants' self-harming behaviors decreased and the attending psychiatrists rated their suicide ideation as weaker. This is the first intervention study to promote psychiatric patients' help-seeking using text messaging, and although it was not a randomized controlled trial, this intervention has practical value and may lead to the prevention of suicide. Copyright 2016, SLACK Incorporated.

Effects of advice to drink 8 cups of water per day in adolescents with overweight or obesity: a randomized trial

PubMed Central

Wong, Julia MW; Ebbeling, Cara B; Robinson, Lisa; Feldman, Henry A; Ludwig, David S

2017-01-01

Importance Healthcare professionals commonly recommend increased water consumption, typically to 8 cups/d, as part of a weight-reducing diet. However, this recommendation is based on limited evidence and virtually no experimental data in the pediatric age range. Objective The aim of this study was to compare two standard weight-loss diets, either with (Water) or without (Control) additional advice and behavioral support to increase habitual water intake to 8 cups/d. Design 6-month randomized controlled parallel-group design. Setting The trial was conducted at Boston Children’s Hospital, Boston, Massachusetts, between February 2011 and June 2014. Participants 38 overweight and obese adolescents who reported drinking ≤4 cups of water/d. Intervention Both groups received similar weight-reducing interventions, differentiated by water messages but controlled for other dietary recommendations and treatment intensity. The interventions included dietary counseling, daily text messages, and a cookbook with health guides. To support adherence to 8 cups water/d, the Water group received well-defined water messages through counseling and daily text messages, a water bottle, and a water pitcher with filters. The Control group received no specific advice on water consumption. Main Outcome and Measures Primary outcome was 6-month change in body mass index (BMI) z-score. Results All randomized participants completed the study. Both groups reported drinking ~2 cups/d water at baseline. Self-reported change in water intake was greater in the Water Group compared to the Control Group (difference between groups, 1.6; 95% CI, 0.2 to 3.0 cups/d; P=0.03). The 6-month change in BMI z-score did not differ between groups (−0.0; 95% CI, −0.1 to 0.1; P=0.88). Conclusions and Relevance Contrary to hypothesis, advice and behavioral supports to consume 8 cups water/d in the context of a weight-reducing diet did not affect body weight among overweight and obese adolescents. Despite intensive behavior supports, few achieved the 8 cups/d water target. Environmental interventions to reduce barriers to water consumption at school may be necessary in future research of feasibility and effectiveness to achieve the target of an 8-cup/d intake of water in adolescents. Clinical Trial Registration ClinicalTrials.gov, NCT01044134, https://clinicaltrials.gov/ct2/show/NCT01044134 PMID:28264082

Weighing women down: messages on weight loss and body shaping in editorial content in popular women's health and fitness magazines.

PubMed

Willis, Laura E; Knobloch-Westerwick, Silvia

2014-01-01

Exposure to idealized body images has been shown to lower women's body satisfaction. Yet some studies found the opposite, possibly because real-life media (as opposed to image-only stimuli) often embed such imagery in messages that suggest thinness is attainable. Drawing on social cognitive theory, the current content analysis investigated editorial body-shaping and weight-loss messages in popular women's health and fitness magazines. About five thousand magazine pages published in top-selling U.S. women's health and fitness magazines in 2010 were examined. The findings suggest that body shaping and weight loss are a major topic in these magazines, contributing to roughly one-fifth of all editorial content. Assessing standards of motivation and conduct, as well as behaviors promoted by the messages, the findings reflect overemphasis on appearance over health and on exercise-related behaviors over caloric reduction behaviors and the combination of both behaviors. These accentuations are at odds with public health recommendations.

Facilitating social support: member-leader communication in a breast cancer support group.

PubMed

Beck, Stephenson J; Keyton, Joann

2014-01-01

Early detection and treatment have resulted in more women surviving breast cancer; increased survivorship has also increased the need for breast cancer support groups (BCSG). The ostensible goal of such groups is to provide support for the physical and emotional stressors that cancer survivors face, as well as provide information on coping and treatment options. Although scholars have examined the effects of support groups on their group members, the examination of group facilitator messages has been largely neglected. The goal of this study was to extend theory on group leader behavior, specifically investigating how member-leader messages create social support in support groups. The transcribed conversations of weekly meetings of a BCSG were examined using Interaction Process Analysis to discover how the member-leader facilitated the group's enactment and management of social support. Across the meetings, task talk dominated (primarily statements of orientation or information). Furthermore, analysis of interaction sequences between the support group facilitator and other members revealed 2 broad categories of task-oriented facilitation techniques (changing the focus, clarification) and 1 category of socioemotional facilitation techniques (showing support). Support group facilitators need the ability to facilitate both task and relational aspects of social support. Facilitator behaviors were highlighted as being instrumental to the creation of social support. The results from this study indicate that the ability to change the focus of interaction, to provide and require clarification on complex issues, and to show support through relational messages is needed in facilitator training.

Shaping perceptions to motivate healthy behavior: the role of message framing.

PubMed

Rothman, A J; Salovey, P

1997-01-01

Health-relevant communications can be framed in terms of the benefits (gains) or costs (losses) associated with a particular behavior, and the framing of such persuasive messages influences health decision making. Although to ask people to consider a health issue in terms of associated costs is considered an effective way to motivate behavior, empirical findings are inconsistent. In evaluating the effectiveness of framed health messages, investigators must appreciate the context in which health-related decisions are made. The influence of framed information on decision making is contingent on people, first, internalizing the advocated frame and, then, on the degree to which performing a health behavior is perceived as risky. The relative effectiveness of gain-framed or loss-framed appeals depends, in part, on whether a behavior serves an illness-detecting or a health-affirming function. Finally, the authors discuss the cognitive and affective processes that may mediate the influence of framed information on judgment and behavior.

A population survey on legislative measures to restrict smoking in Ontario: 4. Variables related to knowledge of active and passive smoking health effects and to predicted behavior of smokers and nonsmokers.

PubMed

Pederson, L L; Bull, S B; Ashley, M J; Lefcoe, N M

1989-01-01

Results from the further analysis of a population survey on legislative measures to restrict smoking revealed that identification of subgroups of smokers is more reliable than identification of subgroups of nonsmokers when a variety of attitudes were the measures of interest. A similar pattern emerged when analyses were carried out on knowledge of active and passive smoking health effects and on predicted personal and general compliance. Because distinct sets of variables were found to be related to distinct outcomes, program planning for changes in knowledge and behavior might, of necessity, have to be different. Media messages might be useful for changes in knowledge, while actual experience might be more important for attitude and behavior change.

Targeting and tailoring message-framing: the moderating effect of racial identity on receptivity to colorectal cancer screening among African-Americans.

PubMed

Lucas, Todd; Manning, Mark; Hayman, Lenwood W; Blessman, James

2018-06-07

This study demonstrates the potential of racial identity to moderate how gain and loss-framed messaging, as well as culturally-targeted messaging, can affect receptivity to preventive health screening. African-Americans (N = 132) who were noncompliant with recommended colorectal cancer (CRC) screening completed a measure of racial identity centrality-encompassing the extent to which racial identity is a core component of self-concept-and then participated in an online education module about CRC screening, during which either gain or loss-framed messaging was introduced. Half of African-Americans were also exposed to a culturally-targeted self-help message about preventing CRC. Theory of Planned Behavior measures of attitudes, normative beliefs, perceived behavioral control, and intentions to obtain a CRC screen served as outcomes. Results confirmed that effects of messaging on receptivity to CRC screening depended on racial identity. Among low racial identity African Americans, gain-framed messaging most effectively increased normative beliefs about obtaining CRC screening, whereas among high racial identity African Americans loss-framed messaging was most compelling. However, these effects most strongly emerged when culturally-targeted self-help messaging was included. We discuss implications for health disparities theory and research, including a potential to simultaneously deploy culturally-targeted and tailored messaging based on racial identity.

Videos to influence: a systematic review of effectiveness of video-based education in modifying health behaviors.

PubMed

Tuong, William; Larsen, Elizabeth R; Armstrong, April W

2014-04-01

This systematic review examines the effectiveness of videos in modifying health behaviors. We searched PubMed (1975-2012), PsycINFO (1975-2012), EMBASE (1975-2012), and CINAHL (1983-2012) for controlled clinical trials that examined the effectiveness of video interventions in changing health behaviors. Twenty-eight studies comprised of 12,703 subjects were included in the systematic review. Video interventions were variably effective for modifying health behaviors depending on the target behaviors to be influenced. Video interventions appear to be effective in breast self-examination, prostate cancer screening, sunscreen adherence, self-care in patients with heart failure, HIV testing, treatment adherence, and female condom use. However, videos have not shown to be effective in influencing addiction behaviors when they are not tailored. Compared to loss-framing, gain-framed messages may be more effective in promoting certain types of health behavior change. Also, video modeling may facilitate learning of new behaviors and can be an important consideration in future video interventions.

Tobacco: coopting our public health.

PubMed

Basil, M D

1996-01-01

Communication is a tool that can be used to promote public health. The case of tobacco illustrates, however, that behavior change can only be advocated, not ensured. The tobacco industry has focused on individual- and societal-level actions that effectively sabotage antismoking campaigns. Health communication researchers should pay special attention to how politics is subverted, the principle of freedom of speech is abused, message framing encourages the continued marketing of cigarettes, and tobacco advertising swamps public health messages in both quantity and style. The field of health communication should do two things to help counter this campaign. First, we should make a concerted effort to refute the arguments offered by the tobacco companies. Second, we should continue to take action on four levels--as individuals, as responsible citizens, in support of organizations, and to create societal changes that will reduce the use of tobacco.

Evidence-Based Support for the Characteristics of Tsunami Warning Messages for Local, Regional and Distant Sources

NASA Astrophysics Data System (ADS)

Gregg, C. E.; Johnston, D. M.; Sorensen, J. H.; Vogt Sorensen, B.; Whitmore, P.

2014-12-01

Many studies since 2004 have documented the dissemination and receipt of risk information for local to distant tsunamis and factors influencing people's responses. A few earlier tsunami studies and numerous studies of other hazards provide additional support for developing effective tsunami messages. This study explores evidence-based approaches to developing such messages for the Pacific and National Tsunami Warning Centers in the US. It extends a message metric developed for the NWS Tsunami Program. People at risk to tsunamis receive information from multiple sources through multiple channels. Sources are official and informal and environmental and social cues. Traditionally, official tsunami messages followed a linear dissemination path through relatively few channels from warning center to emergency management to public and media. However, the digital age has brought about a fundamental change in the dissemination and receipt of official and informal communications. Information is now disseminated in very non-linear paths and all end-user groups may receive the same message simultaneously. Research has demonstrated a range of factors that influence rapid respond to an initial real or perceived threat. Immediate response is less common than one involving delayed protective actions where people first engage in "milling behavior" to exchange information and confirm the warning before taking protective action. The most important message factors to achieve rapid response focus on the content and style of the message and the frequency of dissemination. Previously we developed a tsunami message metric consisting of 21 factors divided into message content and style and receiver characteristics. Initially, each factor was equally weighted to identify gaps, but here we extend the work by weighting specific factors. This utilizes recent research that identifies the most important determinants of protective action. We then discuss the prioritization of message information in the context of potentially limited space in evolving tsunami messages issued by the warning centers.

A towel less: social norms enhance pro-environmental behavior in hotels.

PubMed

Reese, Gerhard; Loew, Kristina; Steffgen, Georges

2014-01-01

Previous research has shown that normative appeals to engage in environmentally friendly behavior were most effective when they were accompanied by a provincial norm (e.g., when norms matched individuals' immediate situational circumstances). Analyzing hotel guests' towel-use during their stay, the current study tests whether messages employing provincial norms were more effective in reducing towel-use than standard environmental messages. In line with previous findings, guests of two hotels used significantly fewer towels when provincial normative appeals--rather than standard environmental messages--were communicated. These findings corroborate to the body of research demonstrating the power of social norms on environmental behavior.

Health promotion communications system: a model for a dispersed population.

PubMed

Foran, M; Campanelli, L C

1995-11-01

1. Corporations with geographically dispersed populations need to provide flexible health promotion programs tailored to meet specific employee interests and needs. 2. Bell Atlantic developed a dispersed model approach based on the transtheoretical model of behavior change. The key to this model is to identify at which stage the individual is operating and provide appropriate information and behavior change programs. 3. Components of the program include: health risk appraisal; exercise/activity tracking system; on line nurse health information service; network of fitness facilities; employee assistance programs; health library available by fax; health film library; network of health promotion volunteers; and targeted health and marketing messaged via corporate media.

The Environment as Information--An Examination of the Mechanism of Environmental Effect on Behavior.

ERIC Educational Resources Information Center

Biggers, Thompson; Walker, Barbara

1984-01-01

Exposed subjects (N=96) to environments pretested to elicit feelings of pleasure or displeasure while hearing or reading a message. Results showed attitude change was significantly higher in pleasant environments than in unpleasant environments. The environmental effect was only found when subjects were allowed time to soak in the environment. (BH)

Motivating Parent Support for Physical Activity: The Role of Framed Persuasive Messages

ERIC Educational Resources Information Center

Bassett-Gunter, Rebecca; Stone, Rachael; Jarvis, Jocelyn; Latimer-Cheung, Amy

2017-01-01

Parent support for physical activity (PA) is a behavior unto itself that requires motivation. Persuasive messages may be one method for motivating parent support for their children's PA. Message framing is one strategy for optimizing the impact of messages. The current study examined the relative effectiveness of gain- versus loss-framed messages…

Texting for Health: The Use of Participatory Methods to Develop Healthy Lifestyle Messages for Teens

ERIC Educational Resources Information Center

Hingle, Melanie; Nichter, Mimi; Medeiros, Melanie; Grace, Samantha

2013-01-01

Objective: To develop and test messages and a mobile phone delivery protocol designed to influence the nutrition and physical activity knowledge, attitudes, and behavior of adolescents. Design: Nine focus groups, 4 classroom discussions, and an 8-week pilot study exploring message content, format, origin, and message delivery were conducted over…

Instructional design strategies for health behavior change.

PubMed

Kinzie, Mable B

2005-01-01

To help health educators build upon the best of different health behavior change theories, this paper offers a unified set of instructional design strategies for health education interventions. This set draws upon the recommendations of Rosenstock (Health Belief Model), Bandura (Social Cognitive Theory), and Dearing (Diffusion Theory), and uses a modified Events of Instruction framework (adapted from Robert Gagne): gain attention (convey health threats and benefits), present stimulus material (tailor message to audience knowledge and values, demonstrate observable effectiveness, make behaviors easy-to-understand and do), provide guidance (use trustworthy models to demonstrate), elicit performance and provide feedback (to enhance trialability, develop proficiency and self-efficacy), enhance retention and transfer (provide social supports and deliver behavioral cues). Sample applications of these strategies are provided. A brief review of research on adolescent smoking prevention enables consideration of the frequency with which these strategies are used, and possible patterns between strategy use and behavioral outcomes.

Fear appeals for individuals in different stages of change: intended and unintended effects and implications on public health campaigns.

PubMed

Cho, Hyunyi; Salmon, Charles T

2006-01-01

This study represents an initial attempt to examine the intended and unintended effects of fear appeals among individuals in different stages of change. Toward this end, a pilot study investigated the effects of fear appeals promoting skin cancer preventive behavior among college students. After being exposed to fear appeals, individuals who were in the precontemplation stage indicated a greater likelihood of thinking defensively and fatalistically regarding the facts on health risk than those who had intended to engage in or who had previously engaged in preventive behavior. Concurrently, after being exposed to fear appeals, those who were in the precontemplation stage reported less favorable attitudes toward message recommendations, weaker intentions to engage in recommended behavior, and less performance of preventive behavior than those who had contemplated or had previously engaged in preventive behavior. Implications of these results on future public health campaigns are discussed.

Increasing evidence for the efficacy of tobacco control mass media communication programming in low- and middle-income countries.

PubMed

Mullin, Sandra; Prasad, Vinayak; Kaur, Jagdish; Turk, Tahir

2011-08-01

Antitobacco mass media campaigns have had good success at changing knowledge, attitudes, and behaviors with respect to smoking in high-income countries provided they are sustained. Mass media campaigns should be a critical component of tobacco control programs in low- and lower-middle-income countries. Mounting evidence shows that graphic campaigns and those that evoke negative emotions run over long periods of time have achieved the most influence. These types of campaigns are now being implemented in low- and middle-income countries. The authors provide 3 case studies of first-ever graphic warning mass media campaigns in China, India, and Russia, 3 priority high-burden countries in the global Bloomberg Initiative to Reduce Tobacco Use. In each of these countries, message testing of core messages provided confidence in messages, and evaluations demonstrated message uptake. The authors argue that given the initial success of these campaigns, governments in low- and middle-income countries should consider resourcing and sustaining these interventions as key components of their tobacco control strategies and programs.

Excessive and addictive gaming control using counselling agent in online game design

NASA Astrophysics Data System (ADS)

Ididi, Italumeh O.; Hassan, Sa'adah; Ghani, Abdul Azim Abd; Ali, Norhayati Mohd

2017-10-01

In recent times, online game play has become a food for thought to concerned individuals, researchers and authorities of various countries due to its excessive and addictive usage. Although, various government have taken certain measures such as shutting down internet cafe at certain hours of the day, censoring the most brutal, offensive and aggressive sections of certain games before they are released. Researchers have advised developers on ways of limiting harm on players by suggesting design changes on time limit. Furthermore, researchers have also suggested that online game distributors ought to make available appropriate referral services. The impart of the above are yet to make any remarkable impact on players. In this paper, we have proposed a Counseling Agent model integrating informative and self-appraisal messages in online game design as a control measure. Informative and self-appraisal messaging in games have proven optimistic through making positive impact on player's thoughts and behavior towards gaming. These messages are expected to remind players about the negative impact of excessive and addictive gaming habits, as well as suggesting possible reductive solutions through message streaming.

Text Messaging Interventions on Cancer Screening Rates: A Systematic Review

PubMed Central

Trinh-Shevrin, Chau; Kwon, Simona C; Sherman, Scott E

2017-01-01

Background Despite high-quality evidence demonstrating that screening reduces mortality from breast, cervical, colorectal, and lung cancers, a substantial portion of the population remains inadequately screened. There is a critical need to identify interventions that increase the uptake and adoption of evidence-based screening guidelines for preventable cancers at the community practice level. Text messaging (short message service, SMS) has been effective in promoting behavioral change in various clinical settings, but the overall impact and reach of text messaging interventions on cancer screening are unknown. Objective The objective of this systematic review was to assess the effect of text messaging interventions on screening for breast, cervical, colorectal, and lung cancers. Methods We searched multiple databases for studies published between the years 2000 and 2017, including PubMed, EMBASE, and the Cochrane Library, to identify controlled trials that measured the effect of text messaging on screening for breast, cervical, colorectal, or lung cancers. Study quality was evaluated using the Cochrane risk of bias tool. Results Our search yielded 2238 citations, of which 31 underwent full review and 9 met inclusion criteria. Five studies examined screening for breast cancer, one for cervical cancer, and three for colorectal cancer. No studies were found for lung cancer screening. Absolute screening rates for individuals who received text message interventions were 0.6% to 15.0% higher than for controls. Unadjusted relative screening rates for text message recipients were 4% to 63% higher compared with controls. Conclusions Text messaging interventions appear to moderately increase screening rates for breast and cervical cancer and may have a small effect on colorectal cancer screening. Benefit was observed in various countries, including resource-poor and non-English-speaking populations. Given the paucity of data, additional research is needed to better quantify the effectiveness of this promising intervention. PMID:28838885

Modeling and testing maternal and newborn care mHealth interventions: a pilot impact evaluation and follow-up qualitative study in Guatemala

PubMed Central

Zuleta, Clara; Rodríguez, Jorge Tulio

2017-01-01

Objective: To develop a descriptive model of structural characteristics of mHealth in the context of newborn nutrition, and to assess the effects of illustrative interventions through a mixed-methods study consisting of an impact evaluation and a qualitative assessment. Materials and Methods: We conducted a 23-week intervention with 100 mothers in rural Guatemala in 2013 and 2014. In group 1 (n = 24), participants received health-promoting text messages. In group 2 (n = 32), peer-to-peer groups were formed. In group 3 (n = 30), peer-to-peer groups were formed, a health professional participated in the discussions, and participants received health-promoting messages. In the control group (n = 14), participants were simply given a mobile phone. We measured changes in knowledge and self-reported behavior. Four focus groups in 2015 showed the perceptions of 44 additional women and the potential of the previously tested interventions in other marginalized areas. Results: Significant relationships were found between group membership and changes in knowledge (P < .001), and between changes in knowledge and self-reported behavior (P = .010). Within peer-to-peer groups, 3665 text messages were shared; discussions covered topics such as breastfeeding practices, health concerns, and emotional issues. Focus groups revealed a deficit of support for mothers, a precariousness of public services, different cultural barriers affecting access to care, and the potential for scaling up. Discussion: The complementarity of structural arrangements of mHealth interventions can play an important role in helping to encourage recommended breastfeeding attitudes along with providing rich information about challenges in rural areas. Conclusion: A mixed-methods study was appropriate to compare the effects and assess the potential of mHealth strategies in a complex rural setting. PMID:27474102

Pharmacy students' perceptions of the usefulness of motivational interviewing and the use of mobile health applications on patient counseling in the future.

PubMed

Owensby, Justin K; Kavookjian, Jan

2017-07-01

To explore student pharmacists' perceptions of 1) future patient counseling, 2) use of mobile health applications (mHealth apps), and 3) usefulness of motivational interviewing (MI) in patient encounters and potential app messaging. A cross-sectional design with first and second year pharmacy students (n=315) at a multi-campus university after exposure to mHealth app and MI curricular content. A questionnaire assessed perceptions of 1) future patient counseling, 2) using apps for personal use and professional encounters, and 3) potential practicality and usefulness of MI principles/skills in apps messaging. Over 70% of students perceived they will be counseling future patients for medication therapy/comprehensive disease management; 91% believed it is an important role as a future pharmacist. A majority own a smartphone (98%), have used an mHealth app to monitor/change a health behavior (73%), and are likely to recommend an mHealth app in future patient encounters (90%). Perceptions of counseling importance and likelihood to recommend an mHealth app varied by gender (women higher than men, p<0.01, p<0.01) and previous mHealth app use (yes higher than no, p<0.05, p<0.001). Most students reported a high likelihood of incorporating MI into current (88%) and future (91%) patient encounters and particularly noted 'supporting self-efficacy' as a useful MI principle to incorporate into mHealth app messaging. Those using apps for personal health behavior change(s) perceived future patient counseling as important and were more likely to recommend mHealth apps during those future encounters. Results may inform curricular development to prepare future pharmacists for the high-tech, patient-centered practice that is inevitable. Copyright © 2017 Elsevier Inc. All rights reserved.

Active8! Technology-Based Intervention to Promote Physical Activity in Hospital Employees.

PubMed

Blake, Holly; Suggs, L Suzanne; Coman, Emil; Aguirre, Lucia; Batt, Mark E

2017-03-01

Increase physical activity in health care employees using health messaging, and compare e-mail with mobile phone short-message service (SMS) as delivery channels. Randomized controlled trial Setting. U.K. hospital workplace. Two hundred ninety-six employees (19-67 years, 53% of study Web site visitors). Twelve-week messaging intervention designed to increase physical activity and delivered via SMS (n =147) or e-mail (n =149); content tailored using theory of planned behavior (TPB) and limited to 160 characters. Baseline and 6, 12, and 16 weeks. Online measures included TPB constructs, physical activity behavior on the Global Physical Activity Questionnaire, and health-related quality of life on the Short-Form 12. General linear models for repeated measures. Increase in duration (mean h/d) of moderate work-related activity and moderate recreational activity from baseline to 16 weeks. Short-lived increase in frequency (d/wk) of vigorous recreational activity from baseline to 6 weeks. Increase in duration and frequency of active travel from baseline to 16 weeks. E-mails generated greater changes than SMS in active travel and moderate activity (work and recreational). Minimal physical activity promotion delivered by SMS or e-mail can increase frequency and duration of active travel and duration of moderate intensity physical activity at work and for leisure, which is maintained up to 1 month after messaging ends. Both channels were useful platforms for health communication; e-mails were particularly beneficial with hospital employees.

The enter-educate approach.

PubMed

Piotrow, P T; Coleman, P L

1992-03-01

This article describes how the Population Communication Services (PCS) has seized on the "enter-educate" approach, the blending of popular entertainment with social messages, to change reproductive health behavior. The enter-educate approach spreads its message through songs, soap operas, variety shows, and other types of popular entertainment mediums. Because they entertain, enter-educate projects can capture the attention of an audience -- such as young people -- who would otherwise scorn social messages. And the use of population mediums makes it possible to reach a variety of audiences. Funded by USAID, PCS began its first enter-educate project in response to the increasing number of teenage pregnancies in Latin America. PCS developed 2 songs and videos, which featured popular teenage singers to serve as role models, to urge abstinence. The songs became instant hits. Since then, PCS has mounted more then 80 major projects in some 40 countries. Highlights of programs range from a successful multi-media family planning campaign in Turkey to humorous television ads in Brazil promoting vasectomy. Recently, PCS initiated projects to teach AIDS awareness. At the core of the enter-educate approach is the social learning theory which holds that much behavior is learned through the observation of role-models. Health professionals work alongside entertainers to produce works that have audience appeal and factual social messages. The enter-educate approach works because it is popular, pervasive, personal, persuasive, and profitable. PCS has found that enter-educate programs pay for themselves through cost sharing and cost recovery.

The Effects of Message Framing on College Students' Career Decision Making

ERIC Educational Resources Information Center

Tansley, Denny P.; Jome, LaRae M.; Haase, Richard F.; Martens, Matthew P.

2007-01-01

Social cognitive career theory posits that verbal persuasion can affect individuals' career self-efficacy, outcome expectations, goals and/or intentions, and behaviors. Prospect theory holds that negatively framed messages can have a powerful effect on people's cognitions related to adopting particular behaviors in situations of uncertainty.…

Marketing responsible drinking behavior: comparing the effectiveness of responsible drinking messages tailored to three possible "personality" conceptualizations.

PubMed

York, Valerie K; Brannon, Laura A; Miller, Megan M

2012-01-01

We investigated whether a thoroughly personalized message (tailored to a person's "Big Five" personality traits) or a message matched to an alternate form of self-schema (ideal self-schema) would be more influential than a self-schema matched message (that has been found to be effective) at marketing responsible drinking. We expected the more thoroughly personalized Big Five matched message to be more effective than the self-schema matched message. However, neither the Big Five message nor the ideal self-schema message was more effective than the actual self-schema message. Therefore, research examining self-schema matching should be pursued rather than more complex Big Five matching.

The Moderating Role of Mood and Personal Relevance on Persuasive Effects of Gain- and Loss-Framed Health Messages.

PubMed

Wirtz, John G; Sar, Sela; Ghuge, Shreyas

2015-01-01

We predicted that mood would moderate the relation between message framing and two outcome variables, message evaluation and behavioral intention, when the message was personally relevant to the target audience. Participants (N = 242) were randomly assigned to an experimental condition in which a positive or negative mood was induced. Participants then read and evaluated a health message that emphasized potential benefits or risks associated with a vaccine. As predicted, participants who received a loss-framed message reported higher message evaluation and intention scores but only when the message was personally relevant and they were in a positive mood.

Using the Theory of Planned Behavior to predict intention to comply with a food recall message.

PubMed

Freberg, Karen

2013-01-01

The Theory of Planned Behavior (TPB) has provided considerable insight into the public's intention to comply with many different health-related messages, but has not been applied previously to intention to comply with food safety recommendations and recalls ( Hallman & Cuite, 2010 ). Because food recalls can differ from other health messages in their urgency, timing, and cessation, the applicability of the TPB in this domain is unknown. The research reported here attempted to address this gap using a nationally representative consumer panel. Results showed that, consistent with the theory's predictions, attitudes and subjective norms were predictive of the intention to comply with a food recall message, with attitudes having a much greater impact on intent to comply than subjective norms. Perceived behavioral control failed to predict intention to comply. Implications of these results for health public relations and crisis communications and recommendations for future research were discussed.

Self-Deprecating Humor Versus Other-Deprecating Humor in Health Messages

PubMed Central

LEE, JI YOUNG; SLATER, MICHAEL D.; TCHERNEV, JOHN

2016-01-01

Humor is sometimes employed in health messages. However, little is known about contingencies under which different types of humor may or may not be effective. This experiment crossed humorous vs. non-humorous and self- vs. other-deprecating messages about binge drinking, and tested how differences in personal investment in alcohol use moderates the effects of such messages on college binge drinkers. Results showed significant three-way interaction effects on subjective norms and behavioral intentions largely consistent with hypotheses. Assessment of significant differences in the interactions indicated that for binge drinkers who weren’t high in personal investment in alcohol use, other-deprecating humor tended to reduce their perceived subjective norms about the acceptability of binge drinking behavior and their behavioral intentions. The effect of the experimental manipulation on subjective norms among these binge drinkers was shown to mediate the effect on intentions to binge drink in the future. Theoretical and practical implications are discussed. PMID:26020507

Social media as a sensor of air quality and public response in China.

PubMed

Wang, Shiliang; Paul, Michael J; Dredze, Mark

2015-03-26

Recent studies have demonstrated the utility of social media data sources for a wide range of public health goals, including disease surveillance, mental health trends, and health perceptions and sentiment. Most such research has focused on English-language social media for the task of disease surveillance. We investigated the value of Chinese social media for monitoring air quality trends and related public perceptions and response. The goal was to determine if this data is suitable for learning actionable information about pollution levels and public response. We mined a collection of 93 million messages from Sina Weibo, China's largest microblogging service. We experimented with different filters to identify messages relevant to air quality, based on keyword matching and topic modeling. We evaluated the reliability of the data filters by comparing message volume per city to air particle pollution rates obtained from the Chinese government for 74 cities. Additionally, we performed a qualitative study of the content of pollution-related messages by coding a sample of 170 messages for relevance to air quality, and whether the message included details such as a reactive behavior or a health concern. The volume of pollution-related messages is highly correlated with particle pollution levels, with Pearson correlation values up to .718 (n=74, P<.001). Our qualitative results found that 67.1% (114/170) of messages were relevant to air quality and of those, 78.9% (90/114) were a firsthand report. Of firsthand reports, 28% (32/90) indicated a reactive behavior and 19% (17/90) expressed a health concern. Additionally, 3 messages of 170 requested that action be taken to improve quality. We have found quantitatively that message volume in Sina Weibo is indicative of true particle pollution levels, and we have found qualitatively that messages contain rich details including perceptions, behaviors, and self-reported health effects. Social media data can augment existing air pollution surveillance data, especially perception and health-related data that traditionally requires expensive surveys or interviews.

Process evaluation of a mHealth program: lessons learned from Stop My Smoking USA, a text messaging-based smoking cessation program for young adults.

PubMed

Ybarra, Michele L; Holtrop, Jodi Summers; Prescott, Tonya L; Strong, David

2014-11-01

Report lessons learned in an RCT of Stop My Smoking (SMS) USA, a mHealth smoking cessation program for young adult smokers. 164 18-24-year-olds were recruited nationally, online in 2011. Program evaluation data were provided at 12-week post-Quit Day. (1) Inviting participants to complete a brief text messaging survey and then asking them to complete a longer online survey resulted in the highest response rate (89%). (2) The positive tone of program messages was the most commonly noted program strength. (3) Suggested improvements included more social connectivity and additional assistance overcoming stressful situations. (4) Half of intervention participants moved through the program linearly and half went through various paths that reflected multiple relapses. Suggestions to use pharmacotherapy resulted in 22% of heavy smokers to utilize it. Participant feedback provided concrete ways in which this and other young adult-focused interventions can improve messaging and program features to be even more salient. Future young adult mHealth interventions could: Integrate models that are flexible to different "paths" of behavior change; address stressful life events directly and comprehensively; integrate proactive messaging that promotes pharmacotherapy options; and use text messaging as a gateway to longer online surveys. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Use of a Nutrition Behavior Change Counseling Tool: Lessons from a Rapid Qualitative Assessment in Eastern Zambia

PubMed Central

Weiss, Ingrid; Stepanovic, Serena; Chinyemba, Ulembe; Bateman, Jessica; Hemminger, Carolyn; Burrows, Emily

2016-01-01

The U.S. Agency for International Development Feed the Future Mawa Project – led by Catholic Relief Services – aims to improve food and economic security for farming households in Zambia’s Eastern Province. Mawa employs social and behavior change (SBC) strategies with households and communities to improve nutrition and reduce stunting among children under two (CU2). To support these strategies, sub-partner University Research Co., LLC employed a participatory process to develop a series of 35 action cards, each illustrating one project-promoted behavior, that are used at household and community group levels. Caregivers of CU2 are given a full set of action cards to promote household dialogue and support for the promoted behaviors. As a final step in the action card tool development process, a qualitative rapid assessment was conducted 1 month after implementation to investigate preliminary ways action cards were being used, and if the methods of using the cards had the potential to impact behavior change. The research team conducted nine key informant interviews and four focus group discussions with Mawa staff and administered 41 qualitative interview questionnaires with project participants in the Chipata and Lundazi districts. Although not based on a representative sampling frame, the assessment produced valuable results for program improvement purposes. It also provided a feedback mechanism for community-based staff and project participants, a crucial step in the participatory tool development process. The assessment found that Mawa staff at every level use action cards combined with at least one other social behavior change tool for each nutrition intervention. Our results suggest that Mawa staff and project participants share a common understanding of the cards’ purpose. Each group noted that the cards provide a visual cue for action and reinforce previous Mawa nutrition messages. Intended uses confirmed by the assessment include encouraging household cooperation, negotiating behavior change, telling stories, and integrating messages with other project sectors. Based on the findings, recommendations for future project activities include aligning efforts against a theory of change to optimize use of all SBC tools; leveraging action card use to strengthen cross-sectoral integration within Mawa; and specific ongoing monitoring of action card use to improve activity implementation. PMID:27630980

PowerON: the use of instant message counseling and the Internet to facilitate HIV/STD education and prevention.

PubMed

Moskowitz, David A; Melton, Dan; Owczarzak, Jill

2009-10-01

In recent years, Internet-based or online counseling has emerged as an effective way to assess psychological disorders and discuss destructive behaviors with individuals or groups of individuals. This study explores the application of online counseling to HIV/STD risk-taking behavior among men who have sex with men (MSM). PowerON, an organization that provides sexual health information to MSM exclusively online, used instant message technology to counsel MSM in real time through computer-mediated means. A sample of 279 transcripts of instant message exchanges between PowerON counselors and Gay.com users were recorded and qualitatively analyzed. Approximately 43% of the instant message sessions discussed information about HIV/STD testing. Risk-taking behaviors were addressed in 39% of the sessions. Information about HIV/STDs and general counseling were given in 23% and 18% of the counseling sessions, respectively. The data showed these instant message sessions to be a potentially feasible forum for HIV/STD counseling. Information ordinarily disseminated at health clinics could be successfully distributed through the Internet to MSM. 2009 Elsevier Ireland Ltd.

PowerON: The use of instant message counseling and the Internet to facilitate HIV/STD education and prevention

PubMed Central

Moskowitz, David A.; Melton, Dan; Owczarzak, Jill

2015-01-01

Objective In recent years, Internet-based or online counseling has emerged as an effective way to assess psychological disorders and discuss destructive behaviors with individuals or groups of individuals. This study explores the application of online counseling to HIV/STD risk-taking behavior among men who have sex with men (MSM). Methods PowerON, an organization that provides sexual health information to MSM exclusively online, used instant message technology to counsel MSM in real time through computer-mediated means. A sample of 279 transcripts of instant message exchanges between PowerON counselors and Gay.com users were recorded and qualitatively analyzed. Results Approximately 43% of the instant message sessions discussed information about HIV/STD testing. Risk-taking behaviors were addressed in 39% of the sessions. Information about HIV/STDs and general counseling were given in 23% and 18% of the counseling sessions respectively. Conclusion The data showed these instant message sessions to be a potentially feasible forum for HIV/STD counseling. Practice Implications Information ordinarily disseminated at health clinics could be successfully distributed through the Internet to MSM. PMID:19217742

[The 2009 Nobel Prize in Medicine and its surprising message: lifestyle is associated with telomerase activity].

PubMed

Falus, András; Marton, István; Borbényi, Erika; Tahy, Adám; Karádi, Pál; Aradi, János; Stauder, Adrienne; Kopp, Mária

2010-06-13

The 2009 Nobel Prize in Physiology and Medicine was awarded to three scientists for their pioneer research on telomeres - and the enzyme that forms them - telomerase. Their work highlighted the considerable connection between the length of telomeres and intensive changes in lifestyle and nutrition (Ornish method) as well as behavioral and psychological factors. In this review the various elements of molecular, cell biological, nutritional and lifestyle changes are introduced and discussed.

"Good for You TV": Using Storyboarding for Health-Related Television Public Service Announcements to Analyze Messages and Influence Positive Health Choices

ERIC Educational Resources Information Center

Cox, Carol

2008-01-01

Many external and societal factors influence health choices and behaviors, including health-related media messages. What people, especially youth, see and hear in health-related media messages often influences their overall health. Students, highly vulnerable to such messages, need opportunities to become media literate to reduce the effects of…

Using deviance regulation theory to target marijuana use intentions among college students.

PubMed

Dvorak, Robert D; Raeder, Cody A; Kramer, Matthew P; Sargent, Emily; Stevenson, Brittany L; Helmy, Mai

2018-02-01

Several large epidemiological studies have shown increasing trends on a number of indices of marijuana use among college age samples. This may be due to changing attitudes about marijuana use linked to legalization efforts. Interventions that can target problematic use on a broad scale are lacking. Recent research has shown that deviance regulation theory (DRT) can be used to design effective web-based substance use interventions. DRT relies on the interplay between perceived norms and an appropriately framed message about the given behavior. The current study examines the use of DRT to change marijuana use intentions. Participants (n = 694 college students) completed measures of marijuana use and marijuana use norms. They were then assigned to receive a positively framed message about marijuana abstainers or a negatively framed message about marijuana users. Following the manipulation, participants rated intentions to use marijuana over the next three months. Consistent with DRT, there was an interaction between message frame and marijuana use norms. The positive frame attenuated the association between marijuana use norms and use intentions. A negative frame resulted in the lowest levels of use intentions among those with low use norms. Results suggest that DRT may be used to modify use intentions in college students, a population that has shown increasing rates of use. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Effect of a Counseling Session Bolstered by Text Messaging on Self-Selected Health Behaviors in College Students: A Preliminary Randomized Controlled Trial.

PubMed

Sandrick, Janice; Tracy, Doreen; Eliasson, Arn; Roth, Ashley; Bartel, Jeffrey; Simko, Melanie; Bowman, Tracy; Harouse-Bell, Karen; Kashani, Mariam; Vernalis, Marina

2017-05-17

The college experience is often the first time when young adults live independently and make their own lifestyle choices. These choices affect dietary behaviors, exercise habits, techniques to deal with stress, and decisions on sleep time, all of which direct the trajectory of future health. There is a need for effective strategies that will encourage healthy lifestyle choices in young adults attending college. This preliminary randomized controlled trial tested the effect of coaching and text messages (short message service, SMS) on self-selected health behaviors in the domains of diet, exercise, stress, and sleep. A second analysis measured the ripple effect of the intervention on health behaviors not specifically selected as a goal by participants. Full-time students aged 18-30 years were recruited by word of mouth and campuswide advertisements (flyers, posters, mailings, university website) at a small university in western Pennsylvania from January to May 2015. Exclusions included pregnancy, eating disorders, chronic medical diagnoses, and prescription medications other than birth control. Of 60 participants, 30 were randomized to receive a single face-to-face meeting with a health coach to review results of behavioral questionnaires and to set a health behavior goal for the 8-week study period. The face-to-face meeting was followed by SMS text messages designed to encourage achievement of the behavioral goal. A total of 30 control subjects underwent the same health and behavioral assessments at intake and program end but did not receive coaching or SMS text messages. The texting app showed that 87.31% (2187/2505) of messages were viewed by intervention participants. Furthermore, 28 of the 30 intervention participants and all 30 control participants provided outcome data. Among intervention participants, 22 of 30 (73%) showed improvement in health behavior goal attainment, with the whole group (n=30) showing a mean improvement of 88% (95% CI 39-136). Mean improvement in any behavioral domains was not seen in the control group. Intervention participants also increased their exercise significantly compared with controls, regardless of their self-selected goal category. The increased exercise was paralleled by significantly lower fasting glucose levels. The health coaching session plus tailored SMS text messages improved self-selected health behaviors with a modest ripple effect to include unselected health behaviors. Clinicaltrials.gov NCT02476604; https://clinicaltrials.gov/ct2/show/NCT02476604 (Archived by WebCite at http://www.webcitation.org/6qAAryS5t). ©Janice Sandrick, Doreen Tracy, Arn Eliasson, Ashley Roth, Jeffrey Bartel, Melanie Simko, Tracy Bowman, Karen Harouse-Bell, Mariam Kashani, Marina Vernalis. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 17.05.2017.

Neural effects of environmental advertising: An fMRI analysis of voice age and temporal framing.

PubMed

Casado-Aranda, Luis-Alberto; Martínez-Fiestas, Myriam; Sánchez-Fernández, Juan

2018-01-15

Ecological information offered to society through advertising enhances awareness of environmental issues, encourages development of sustainable attitudes and intentions, and can even alter behavior. This paper, by means of functional Magnetic Resonance Imaging (fMRI) and self-reports, explores the underlying mechanisms of processing ecological messages. The study specifically examines brain and behavioral responses to persuasive ecological messages that differ in temporal framing and in the age of the voice pronouncing them. The findings reveal that attitudes are more positive toward future-framed messages presented by young voices. The whole-brain analysis reveals that future-framed (FF) ecological messages trigger activation in brain areas related to imagery, prospective memories and episodic events, thus reflecting the involvement of past behaviors in future ecological actions. Past-framed messages (PF), in turn, elicit brain activations within the episodic system. Young voices (YV), in addition to triggering stronger activation in areas involved with the processing of high-timbre, high-pitched and high-intensity voices, are perceived as more emotional and motivational than old voices (OV) as activations in anterior cingulate cortex and amygdala. Messages expressed by older voices, in turn, exhibit stronger activation in areas formerly linked to low-pitched voices and voice gender perception. Interestingly, a link is identified between neural and self-report responses indicating that certain brain activations in response to future-framed messages and young voices predicted higher attitudes toward future-framed and young voice advertisements, respectively. The results of this study provide invaluable insight into the unconscious origin of attitudes toward environmental messages and indicate which voice and temporal frame of a message generate the greatest subconscious value. Copyright © 2017 Elsevier Ltd. All rights reserved.

Improving Refill Adherence in Medicare Patients With Tailored and Interactive Mobile Text Messaging: Pilot Study

PubMed Central

Jeong, Erwin W; Feger, Erin; Noble, Harmony K; Kmiec, Magdalen; Prayaga, Ram S

2018-01-01

Background Nonadherence is a major concern in the management of chronic conditions such as hypertension, cardiovascular disease, and diabetes where patients may discontinue or interrupt their medication for a variety of reasons. Text message reminders have been used to improve adherence. However, few programs or studies have explored the benefits of text messaging with older populations and at scale. In this paper, we present a program design using tailored and interactive text messaging to improve refill rates of partially adherent or nonadherent Medicare members of a large integrated health plan. Objective The aim of this 3-month program was to gain an understanding of whether tailored interactive text message dialogues could be used to improve medication refills in Medicare patients with one or more chronic diseases. Methods We used the mPulse Mobile interactive text messaging solution with partially adherent and nonadherent Medicare patients (ie, over age 65 years or younger with disabilities) of Kaiser Permanente Southern California (KP), a large integrated health plan, and compared refill rates of the text messaging group (n=12,272) to a group of partially adherent or nonadherent Medicare patients at KP who did not receive text messages (nontext messaging group, n=76,068). Both groups were exposed to other forms of refill and adherence outreach including phone calls, secure emails, and robo-calls from December 2016 to February 2017. Results The text messaging group and nontext messaging group were compared using an independent samples t test to test difference in group average of refill rates. There was a significant difference in medication refill rates between the 2 groups, with a 14.07 percentage points higher refill rate in the text messaging group (P<.001). Conclusions The results showed a strong benefit of using this text messaging solution to improve medication refill rates among Medicare patients. These findings also support using interactive text messaging as a cost-effective, convenient, and user-friendly solution for patient engagement. Program outcomes and insights can be used to enhance the design of future text-based solutions to improve health outcomes and promote adherence and long-term behavior change. PMID:29382623

The Canary in the Coal Mine Tweets: Social Media Reveals Public Perceptions of Non-Medical Use of Opioids

PubMed Central

Chan, Brian; Lopez, Andrea; Sarkar, Urmimala

2015-01-01

Objective Non-medical prescription opioid use is a growing public health concern. Social media is an emerging tool to understand health attitudes, beliefs, and behaviors. Methods We retrieved a sample of publicly available Twitter messages in early 2014, using common opioid medication names and slang search terms. We used content analysis to code messages by user, context of message (personal vs general experiences), and key content themes. Results We reviewed 540 messages, of which 375 (69%) messages were related to opioid behaviors. Of these, 316 (84%) originated from individual user accounts; 125 messages expressed personal experience with opioids. The majority of personal messages referenced using opioids to obtain a “high”, use for sleep, or other non-intended use (87,70%). General attitudes regarding opioid use included positive sentiment (52, 27%), comments on others peoples opioid use (57, 30%), and messages containing public health information or links (48, 25%). Conclusions In a sample of social media messages mentioning opioid medications, the most common theme amongst English users related to various forms of opioid misuse. Social media can provide insights into the types of misuse of opioids that might aid public health efforts to reduce non-medical opioid use. PMID:26252774

Media Messages About Cancer: What Do People Understand?

PubMed Central

MAZOR, KATHLEEN M.; CALVI, JOSEPHINE; COWAN, REBECCA; COSTANZA, MARY E.; HAN, PAUL K. J.; GREENE, SARAH M.; SACCOCCIO, LAURA; COVE, ERICA; ROBLIN, DOUGLAS; WILLIAMS, ANDREW

2010-01-01

Health messages on television and other mass media have the potential to significantly influence the public’s health-related knowledge and behaviors, but little is known about people’s ability to comprehend such messages. To investigate whether people understood the spoken information in media messages about cancer prevention and screening, we recruited 44 adults from 3 sites to view 6 messages aired on television and the internet. Participants were asked to paraphrase main points and selected phrases. Qualitative analysis methods were used to identify what content was correctly and accurately recalled and paraphrased, and to describe misunderstandings and misconceptions. While most participants accurately recalled and paraphrased the gist of the messages used here, over-generalization (e.g., believing preventative behaviors to be more protective than stated), loss of details (e.g., misremembering the recommended age for screening) and confusion or misunderstandings around specific concepts (e.g., interpreting “early stage” as the stage in one’s life rather than cancer stage) were common. Variability in the public’s ability to understand spoken media messages may limit the effectiveness of both pubic health campaigns and provider-patient communication. Additional research is needed to identify message characteristics which enhance understandability and improve comprehension of spoken media messages around cancer. PMID:20845199

The impact of tailored text messages on health beliefs and medication adherence in adults with diabetes: A randomized pilot study.

PubMed

Gatwood, Justin; Balkrishnan, Rajesh; Erickson, Steven R; An, Lawrence C; Piette, John D; Farris, Karen B

2016-01-01

Inadequate medication adherence reduces optimal health outcomes and can lead to increased costs, particularly in patients with diabetes. Efforts to improve adherence have resulted in limited effects; approaches leveraging mobile technology have emerged, but their focus has mainly been limited to simple reminder messages. The purpose of this pilot study was to test the effectiveness of tailored text messages focusing on improving medication adherence and health beliefs in adults with diabetes. Adults aged 21-64, with uncontrolled diabetes, and taking at least one anti-diabetic medication were recruited and randomized into 2 study arms: daily tailored text messaging for 90 days or standard care. Comparing baseline and endpoint survey responses, changes in theory-driven health beliefs and attitudes were assessed. The impact on medication adherence was evaluated using pharmacy claims by calculating the percent of days covered (PDC). A total of 75 subjects were consented, and 48 were randomized. Mean PDC at baseline were comparable between cohorts (84.4% and 87.1%, respectively). Declines in adherence were observed in both groups over time but no significant differences were observed between groups or from baseline to the end of the active study period. Unadjusted tests suggested that perceived benefits and competence might have improved in the intervention arm. Tailoring mobile phone text messages is a novel way to address medication nonadherence and health beliefs; further investigation to this combined technique is needed to better understand its impact on behavior change in adults with diabetes. Copyright © 2016 Elsevier Inc. All rights reserved.

Communication-based regulated freedom of response in bacterial colonies

NASA Astrophysics Data System (ADS)

Ben-Jacob, Eshel; Shapira, Yoash; Becker, Israela; Raichman, Nadav; Volman, Vladislav; Hulata, Eyal; Baruchi, Itay

2003-12-01

Bacteria have developed intricate communication capabilities on all levels-the genome, the individual bacteria, the colony, and multi-colonial eco-systems of different bacterial species. All manner of biochemical messages are utilized for communication, including simple and complex abiotic molecules, peptides, proteins and even genetic sequences. These communication capabilities are required for bacterial cooperative self-organization into multicellular hierarchically structured colonies with complex spatio-temporal patterning. A colonial higher complexity is required for better colonial adaptability in a dynamic environment. The communication-based cooperative self-organization goes hand in hand with changes in cell structure and behavior. We identify two classes of such changes: (1) automatic and predetermined changes, which are triggered by inducive messages. (2) Regulated “decision-making” changes, which represent cellular regulated freedom of response to informative (semantic) messages. Each bacterium has internal degrees of freedom and informatics capabilities (storage, processing and interpretation of information). These features are required for the freedom of response in self-alteration (self-plasticity). Additionally, the cell can send messages to alter other bacteria in a self-regulated manner. To convert the above seemingly blurred notions into testable concepts we present the first steps towards quantification of colonial features associated with “regulated freedom”. For this we extract a binary representation of the observed patterns to show the existence of Lévy distributions with parameters that range from near the Cauchy limit to the Gaussian limit. The assumption about bacterial “regulated freedom” or “decision-making” appears in contradict the fundamental principle of time causality. We propose, that this apparent difficulty might be resolved by applying the recent understandings of biotic and abiotic self-organization, to the dynamics of the cells’ internal biochemical gel.

Factors associated with communication-based sedentary behaviors among youth: are talking on the phone, texting, and instant messaging new sedentary behaviors to be concerned about?

PubMed

Leatherdale, Scott T

2010-09-01

Sedentary behavior research typically only examines screen time activities and not communication time activities, such as talking on the phone, texting, or instant messaging. Data from 2,449 grade 5 to 8 students were used to examine factors associated with the time youth spent in communication-based sedentary behaviors. Screen time, physical activity, grade, and gender were associated with moderate and high communication time. Future research on sedentary behavior should include measures of communication time.

Relational Messages Associated with Nonverbal Behaviors.

ERIC Educational Resources Information Center

Burgoon, Judee K.; And Others

Based on the assumptions that relational messages are multidimensional and that they are largely communicated by nonverbal cues, this experiment manipulated five nonverbal cues--eye contact, proximity, body lean, smiling, and touch--to determine what meanings they convey along four relational message dimensions: emotionality/arousal/composure,…

Randomized controlled trial of a messaging intervention to increase fruit and vegetable intake in adolescents: Affective versus instrumental messages.

PubMed

Carfora, Valentina; Caso, Daniela; Conner, Mark

2016-11-01

The present research aimed to test the efficacy of affective and instrumental text messages compared with a no-message control as a strategy to increase fruit and vegetable intake (FVI) in adolescents. A randomized controlled trial was used test impact of different text messages compared with no message on FVI over a 2-week period. A total of 1,065 adolescents (14-19 years) from a high school of the South of Italy completed the baseline questionnaire and were randomly allocated to one of three conditions: instrumental messages (N = 238), affective messages (N = 300), and no messages (N = 521). Students in the message conditions received one message each day over a 2-week period. The messages targeted affective (affective benefits) or instrumental (instrumental benefits) information about FVI. Self-reported FVI at 2 weeks was the key dependent variable. Analyses were based on the N = 634 who completed all aspects of the study. Findings showed that messages significantly increased FVI, particularly in the affective condition and this effect was partially mediated by changes in affective attitude and intentions towards FVI. Text messages can be used to increase FVI in adolescents. Text messages based on affective benefits are more effective than text messages based on instrumental benefits. Statement of contribution What is already known on this subject? Text messages have been shown to promote positive change in health behaviours. However, the most appropriate target for such text messages is less clear although targeting attitudes may be effective. What does this study add? This randomized controlled study shows that text messages targeting instrumental or affective attitudes produce changes in fruit and vegetable intake (FVI) in adolescents. Text messages targeting affective attitudes are shown to be more effective than text messages targeting instrumental attitudes. The effect of affective text messages on FVI was partially mediated by changes in affective attitudes. © 2016 The British Psychological Society.

Adolescents' Perspectives on Personalized E-Feedback in the Context of Health Risk Behavior Screening for Primary Care: Qualitative Study.

PubMed

Zieve, Garret G; Richardson, Laura P; Katzman, Katherine; Spielvogle, Heather; Whitehouse, Sandy; McCarty, Carolyn A

2017-07-20

Electronic health screening tools for primary care present an opportunity to go beyond data collection to provide education and feedback to adolescents in order to motivate behavior change. However, there is limited research to guide feedback message development. The aim of this study was to explore youth perceptions of and preferences for receiving personalized feedback for multiple health risk behaviors and reinforcement for health promoting behaviors from an electronic health screening tool for primary care settings, using qualitative methodology. In total, 31 adolescents aged 13-18 years completed the screening tool, received the electronic feedback, and subsequently participated in individual, semistructured, qualitative interviews lasting approximately 60 min. Participants were queried about their overall impressions of the tool, perceptions regarding various types of feedback messages, and additional features that would help motivate health behavior change. Using thematic analysis, interview transcripts were coded to identify common themes expressed across participants. Overall, the tool was well-received by participants who perceived it as a way to enhance-but not replace-their interactions with providers. They appreciated receiving nonjudgmental feedback from the tool and responded positively to information regarding the consequences of behaviors, comparisons with peer norms and health guidelines, tips for behavior change, and reinforcement of healthy choices. A small but noteworthy minority of participants dismissed the peer norms as not real or relevant and national guidelines as not valid or reasonable. When prompted for possible adaptations to the tool, adolescents expressed interest in receiving follow-up information, setting health-related goals, tracking their behaviors over time, and communicating with providers electronically between appointments. Adolescents in this qualitative study desired feedback that validates their healthy behavior choices and supports them as independent decision makers by neutrally presenting health information, facilitating goal setting, and offering ongoing technological supports. ©Garret G Zieve, Laura P Richardson, Katherine Katzman, Heather Spielvogle, Sandy Whitehouse, Carolyn A McCarty. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 20.07.2017.

"Just Take a Moment and Breathe and Think": Young Women with Depression Talk about the Development of an Ecological Momentary Intervention to Reduce Their Sexual Risk.

PubMed

Shrier, Lydia A; Spalding, Allegra

2017-02-01

Depressed young women are at increased risk for adverse outcomes related to sexual behavior, including unintended pregnancy, HIV, and other sexually transmitted infections. Brief sexual risk reduction interventions have not targeted depressed young women's specific needs for affect management and impulse control. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We interviewed depressed young women ages 15-23 years engaging in sexual risk behavior about a proposed intervention approach. The approach was described as in-person counseling and cognitive-behavioral skills training, followed by an ecological momentary intervention (EMI) delivered via smartphone application for 4 weeks. The EMI would include reporting multiple times a day on affective states, self-efficacy for safer sex behavior, and sexual behavior, and receiving responsive messages to provide support and prompt use of cognitive-behavioral skills. Participants provided their perspectives on comfort, usability, burden, confidentiality, and potential efficacy of the EMI and recommended message content. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Thematic saturation was reached with 16 interviews. Participants expressed positive opinions about the EMI. They believed that reporting at random times would help them to recognize their feelings, receiving the messages would be reassuring, and overall the smartphone application would be experienced as therapeutic. They desired a high degree of personalization of the message quality, style, and voice, and provided a wide variety of message content. Depressed young women believed that a flexible, personalized approach to mobile momentary intervention for addressing the link between their symptoms and behavior would be acceptable, supportive, and effective in reducing sexual risk. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Promoting healthy spacing between pregnancies in India: need for differential education campaigns.

PubMed

Sebastian, Mary Philip; Khan, M E; Roychowdhury, Sohini

2010-12-01

Birth spacing intervals are relatively short in India. Healthy spacing of 3-5 years between births is an effective way to prevent maternal and child mortality and morbidities. Socio-cultural and structural barriers, including limited awareness, socio-cultural norms, and misconceptions need to be addressed for behavior change. Hence the objective was to understand these barriers and accordingly develop separate messages for young women, her husband and her mother-in-law. Data were collected from young women, husbands and mothers-in-law using qualitative methods. Altogether 16 Focus Group Discussions and 30 in-depth interviews were conducted. Beliefs related to need of spacing, disadvantages of closely spaced pregnancies and messages considered suitable for different stakeholders were investigated. Messages were identified for women, husband and mother-in-law; communication aids prepared and community workers trained to appropriately communicate the messages to stakeholders. Quantitative data were collected to measure the effect of the intervention. Educational campaign resulted in higher use of contraceptives for spacing among registered pregnant women from experimental area compared to control area. Differential audience specific educational campaign is feasible and effective. For an effective communication in the community, workers should know how exactly to convey the different health messages to different target population. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Health Beliefs regarding Dietary Behavior and Physical Activity of Surinamese Immigrants of Indian Descent in The Netherlands: A Qualitative Study

PubMed Central

Hendriks, A.-M.; Gubbels, J. S.; Jansen, M. W. J.; Kremers, S. P. J.

2012-01-01

This study explored the health beliefs about eating habits and physical activity (PA) of Surinamese immigrants of Indian (Hindustani) descent to examine how health education messages to prevent obesity can be made more culturally sensitive. Indians are known for their increasing obesity incidence and are highly vulnerable for obesity-related consequences such as cardiovascular diseases and diabetes. Therefore they might benefit from culturally sensitive health education messages that stimulate healthy eating habits and increase PA levels. In order to examine how health education messages aimed at preventing obesity could be adapted to Indian culture, we interviewed eight Hindustanis living in The Netherland, and conducted two focus groups (n = 19) with members from a Surinamese Hindustani community. Results showed cultural implications that might affect the effectiveness of health education messages: karma has a role in explaining the onset of illness, traditional eating habits are perceived as difficult to change, and PA was generally disliked. We conclude that health education messages aimed at Hindustani immigrants should recognize the role of karma in explaining the onset of illness, include more healthy alternatives for traditional foods, pay attention to the symbolic meaning of food, and suggest more enjoyable and culturally sensitive forms of PA for women. PMID:24533213

Phenomenological Behavior-Exchange Models of Marital Success.

ERIC Educational Resources Information Center

Gottman, John; And Others

The objective of two studies was to devise an assessment procedure for the evaluation of therapy with distressed marriages. An extension of behavior exchange theory was proposed to include phenomenological ratings by the couple of the intent of messages sent and the impact of messages received. Convergent criteria were used to select 14…

Supportive Distortions: An Analysis of Posts on a Pedophile Internet Message Board

ERIC Educational Resources Information Center

Malesky, L. Alvin, Jr.; Ennis, Liam

2004-01-01

A covert observation of posts on a pro-pedophile Internet message board investigated evidence of distorted cognitions that were supportive of sexually abusive behavior. Implications for the treatment and supervision of members of online communities that support pedophilic interests and behaviors are discussed. The purpose of the present study was…

Impact of an Australian mass media campaign targeting physical activity in 1998.

PubMed

Bauman, A E; Bellew, B; Owen, N; Vita, P

2001-07-01

Physical activity is now a public health priority, but there is only limited evidence on the effectiveness of mass-reach campaigns. Paid and unpaid television and print-media advertising, physician mail-outs, and community-level support programs and strategies. A mass-media statewide campaign to promote regular moderate-intensity activity was conducted during February 1998. The target group was adults aged 25 to 60 who were motivated but insufficiently active. Cohort and independent-sample, cross-sectional representative population surveys, before and after the campaign. The intervention was conducted in the state of New South Wales, with the other states of Australia as the comparison region. Telephone survey items on physical activity, media message awareness, physical activity knowledge, self-efficacy, and intentions. Unprompted recall of the activity messages in the campaign state increased substantially from 2.1% to 20.9% (p<0.01), with small changes elsewhere in Australia (1.2% to 2.6%). There were large changes in prompted awareness from 12.9% to 50.7% (p<0.0001), much larger than changes elsewhere (14.1% to 16%, p=0.06). Knowledge of appropriate moderate-intensity activity and physical activity self-efficacy increased significantly and only in the campaign state. Compared to all others, those in the target group who recalled the media message were 2.08 times more likely to increase their activity by at least an hour per week (95% confidence interval = 1.51-2.86). This integrated campaign positively influenced short-term physical activity message recall, knowledge, and behavior of the target population, compared to the population in the region who were not exposed.

Hispanic-American Students' Attitudes toward Enrolling in High School Chemistry: A Study of Planned Behavior and Belief-Based Change.

ERIC Educational Resources Information Center

Crawley, Frank E.; Koballa, Thomas R., Jr.

1992-01-01

Inquired 69 students' beliefs about registering for high school chemistry. The information was used to develop a questionnaire and persuasive messages. Among 598 target students, chemistry enrollment was higher than expected for those receiving in-class student-only materials and lower than expected for those receiving student/parent take-home…

Communication Aimed at Changing Cognitions about Sexual Intimidation: Comparing the Impact of a Perpetrator-Focused Versus a Victim-Focused Persuasive Strategy.

ERIC Educational Resources Information Center

Winkel, Frans Willem; De Kleuver, Esther

1997-01-01

Examines the impact of a campaign-related video aimed at discouraging various forms of sexual intimidation. Results based on 198 students revealed several Communication x Sex interactions, suggesting that certain messages may inadvertently foster boys' positive evaluations of macho behavior, strengthening their ideas that coerced sex can be…

The importance of campaign saliency as a predictor of attitude and behavior change: A pilot evaluation of social marketing campaign Fat Talk Free Week.

PubMed

Garnett, Bernice Raveche; Buelow, Robert; Franko, Debra L; Becker, Carolyn; Rodgers, Rachel F; Austin, S Bryn

2014-01-01

Fat Talk Free Week (FTFW), a social marketing campaign designed to decrease self-disparaging talk about body and weight, has not yet been evaluated. We conducted a theory-informed pilot evaluation of FTFW with two college samples using a pre- and posttest design. Aligned with the central tenets of the Elaboration Likelihood Model (ELM), we investigated the importance of FTFW saliency as a predictor of fat talk behavior change. Our analytic sample consisted of 118 female participants (83% of original sample). Approximately 76% of the sample was non-Hispanic White, 14% Asian, and 8% Hispanic. At baseline, more than 50% of respondents reported engaging in frequent self fat talk; at posttest, this number dropped to 34% of respondents. Multivariable regression models supported campaign saliency as the single strongest predictor of a decrease in self fat talk. Our results support the social diffusion of campaign messages among shared communities, as we found significant decreases in fat talk among campaign attenders and nonattenders. FTFW may be a promising short-term health communication campaign to reduce fat talk, as campaign messages are salient among university women and may encourage interpersonal communication.

The design of a community-based health education intervention for the control of Aedes aegypti.

PubMed

Lloyd, L S; Winch, P; Ortega-Canto, J; Kendall, C

1994-04-01

This report describes the process used to develop locally appropriate educational materials and to implement the education component of a community-based Aedes aegypti control program in Merida, Yucatan, Mexico. The process is broken into five stages: formative research, developing recommendations for behavior change, development of educational messages, development and production of educational materials, and distribution of the materials. Appropriate terminology and taxonomies for dengue were obtained from open in-depth interviews; baseline data from a knowledge, beliefs, and practices questionnaire served to confirm this information. A larval survey of house lots was carried out to identify the Ae. aegypti larval production sites found on individual house lots. This enabled the program to target the most important larval habitats. Community groups were organized to work on the development of messages and production of the educational materials to be used. The education intervention was successful in stimulating changes in both knowledge and behavior, which were measured in the evaluations of the intervention. To be successful, community-based strategies must be flexible and adapted to the local setting because of ecologic, cultural, and social differences between localities.

Effectiveness of HIV prevention social marketing with injecting drug users.

PubMed

Gibson, David R; Zhang, Guili; Cassady, Diana; Pappas, Les; Mitchell, Joyce; Kegeles, Susan M

2010-10-01

Social marketing involves applying marketing principles to promote social goods. In the context of health behavior, it has been used successfully to reduce alcohol-related car crashes, smoking among youths, and malaria transmission, among other goals. Features of social marketing, such as audience segmentation and repeated exposure to prevention messages, distinguish it from traditional health promotion programs. A recent review found 8 of 10 rigorously evaluated social marketing interventions responsible for changes in HIV-related behavior or behavioral intentions. We studied 479 injection drug users to evaluate a community-based social marketing campaign to reduce injection risk behavior among drug users in Sacramento, California. Injecting drugs is associated with HIV infection in more than 130 countries worldwide.

M matters: What's social marketing and media got to do with it?

PubMed

Yu, Pattie; Waller, Karen

2010-01-01

For years now, social change leaders have applied marketing principles to move and motivate their target audiences to change attitudes and ultimately and ideally behavior. By making the consumer the focus of the program, understanding the benefits and barriers for participating, and engaging in the marketing mix of product, price, promotion, and place, social marketers have been successful in applying this framework to clinical trial recruitment. A comprehensive recruitment plan will address the goal, objective,target, strategy, tactics, and evaluation that center around tested messages, disseminated through a host of communications channels including media and the "new" news media. The heart of social marketing, whether a public engagement campaign or a clinical trial recruitment effort, is always about them, not about you. Keeping focused on the target audience, their desires and concerns and channeling compelling messages through creative, motivating ways to engage them will help ensure a successful effort.

Reactions to framing of cessation messages: insights from dual-smoker couples.

PubMed

Lipkus, Isaac M; Ranby, Krista W; Lewis, Megan A; Toll, Benjamin

2013-12-01

Couples in which both members smoke (dual-smoker couples) have not been the explicit target of cessation interventions. Quit rates are lower and relapse rates are higher among individuals in dual-smoker couples. A potentially effective strategy to motivate dual-smoker couples to quit is to convey messages that highlight how the positive outcomes of quitting (gain frame) or the negative outcomes of continued smoking (loss frame) affect the couple rather than the individual smoker. We explored whether dual-smoker couples' smoking behaviors (e.g., amount smoked) and desire to quit would differ as a function of message frame (gain vs. loss) or outcome focus (individual vs. couple). Dual-smoker couples (N = 40) completed a baseline survey and were then randomized to review gain- or loss-framed messages that varied whether the outcomes influenced the individual or the couple. Main outcomes were desire to quit after reading messages and smoking behaviors at a 1-month follow-up. Couple-focused messages produced the strongest desire to quit and decreased amount of cigarettes smoked at follow-up. The latter effect was mediated by desire to quit. Loss-framed messages produced inconsistent effects on desire to quit. There were no significant interactions between outcome focus and message framing. Findings suggest that messages emphasizing how smoking affects both partners can motivate cessation among dual-smoker couples. Contrary to findings showing that gain-framed messages motivate cessation targeting individual smokers, results suggest that loss-framed messages may be more persuasive than gain-framed messages when the target of the outcome involves significant others.

Message Framing and Physical Activity Promotion in Colorectal Cancer Survivors.

PubMed

Hirschey, Rachel; Lipkus, Isaac; Jones, Lee; Mantyh, Christopher; Sloane, Richard; Demark-Wahnefried, Wendy

2016-11-01

To test effects of gain-framed versus loss-framed mailed brochures on increasing physical activity (PA) among colorectal cancer (CRC) survivors.
. Randomized trial with repeated measures at baseline, 1 month, and 12 months postintervention.
. Mail recruitment from tumor registries.
. 148 inactive CRC survivors who had completed primary therapy. 
. PA and constructs from the Theory of Planned Behavior (TPB) were assessed at baseline, 1 month, and 12 months. Participants were randomized to receive pamphlets describing PA benefits (gain framed) or disadvantages of not being physically active (loss framed). Baseline characteristics were compared using descriptive statistics. Repeated measures linear models were used to test PA changes.
. Minutes of PA and TPB constructs.
. Significant PA increases were observed in both study arms. Results did not differ by message frame. At one month, about 25% of previously inactive participants increased activity to national recommendations. Those who increased PA compared to those who did not had higher baseline scores on subjective norms, perceived behavioral control, and PA intentions. 
. Independent of message framing, mailed brochures are highly effective in producing within-subject short- and long-term increases in PA.
. CRC survivors may increase short- and long-term levels of PA by receiving inexpensive print brochures.

A Qualitative Study of Client-Clinician Text Exchanges in a Mobile Health Intervention for Individuals With Psychotic Disorders and Substance Use.

PubMed

Aschbrenner, Kelly A; Naslund, John A; Gill, Lydia E; Bartels, Stephen J; Ben-Zeev, Dror

2016-01-01

Mobile health (mHealth) approaches have the potential to transform prevention, wellness, and illness management for people with dual diagnosis consisting of co-occurring mental illness and substance use disorders by providing timely and cost-effective interventions in clients' natural environments. However, little is known about how clients interact with mHealth interventions to manage their illness. This qualitative study explored the content of mobile phone text messages between clients with dual diagnosis and a clinician who engaged them in daily assessment and intervention text exchanges. Seventeen participants with psychotic disorders and substance use were enrolled in a 12-week single-arm trial of an mHealth intervention focusing on illness management. The clinician (i.e., mobile interventionist) sent daily text messages to participants' privately owned mobile phones to assess their medication adherence and clinical status. The clinician provided other illness management and wellness suggestions flexibly, in response to participants' needs and preferences. In this qualitative study we conducted a thematic analysis of the client-clinician text exchanges that occurred over the course of the intervention. Seven major content themes in client-clinician text message exchanges were identified: mental health symptoms; mental health coping strategies; mental health treatment and management; lifestyle behaviors; social relationships and leisure activities; motivation and personal goal setting; and independent living. Participants were interested in discussing strategies for coping with mental health symptoms (e.g., cognitive restructuring, social support) and health behavior change (e.g., increased physical activity, dietary changes). Our findings suggest that client-centered text messaging has the potential to be an important component of illness management for people with dual diagnosis. This approach is able to offer coping strategies that are tailored to clients' needs and preferences in real time when help is needed.

Method for distributed agent-based non-expert simulation of manufacturing process behavior

DOEpatents

Ivezic, Nenad; Potok, Thomas E.

2004-11-30

A method for distributed agent based non-expert simulation of manufacturing process behavior on a single-processor computer comprises the steps of: object modeling a manufacturing technique having a plurality of processes; associating a distributed agent with each the process; and, programming each the agent to respond to discrete events corresponding to the manufacturing technique, wherein each discrete event triggers a programmed response. The method can further comprise the step of transmitting the discrete events to each agent in a message loop. In addition, the programming step comprises the step of conditioning each agent to respond to a discrete event selected from the group consisting of a clock tick message, a resources received message, and a request for output production message.

How Communication Goals Determine when Audience Tuning Biases Memory

ERIC Educational Resources Information Center

Echterhoff, Gerald; Higgins, E. Tory; Kopietz, Rene; Groll, Stephan

2008-01-01

After tuning their message to suit their audience's attitude, communicators' own memories for the original information (e.g., a target person's behaviors) often reflect the biased view expressed in their message--producing an audience-congruent memory bias. Exploring the motivational circumstances of message production, the authors investigated…

Fear Appeals, Individual Differences, and Environmental Concern.

ERIC Educational Resources Information Center

Hine, Donald W.; Gifford, Robert

1991-01-01

A study examines the effect of a brief but intense antipollution message, compared to a control message, on verbal commitment and on three forms of immediate behavioral commitment of college student volunteers (n=104). Exposure to the antipollution message produced significantly more verbal commitment and financial donations but not more time…

Evidence-informed recommendations for constructing and disseminating messages supplementing the new Canadian Physical Activity Guidelines

PubMed Central

2013-01-01

Background Few validated guidelines exist for developing messages in health promotion practice. In clinical practice, the Appraisal of Guidelines, Research, and Evaluation II (AGREE II) Instrument is the international gold standard for guideline assessment, development, and reporting. In a case study format, this paper describes the application of the AGREE II principles to guide the development of health promotion guidelines for constructing messages to supplement the new Canadian Physical Activity Guidelines (CPAG) released in 2011. Methods The AGREE II items were modified to suit the objectives of developing messages that (1) clarify key components of the new CPAG and (2) motivate Canadians to meet the CPAG. The adapted AGREE II Instrument was used as a systematic guide for the recommendation development process. Over a two-day meeting, five workgroups (one for each CPAG – child, youth, adult, older adult – and one overarching group) of five to six experts (including behavior change, messaging, and exercise physiology researchers, key stakeholders, and end users) reviewed and discussed evidence for creating and targeting messages to supplement the new CPAG. Recommendations were summarized and reviewed by workgroup experts. The recommendations were pilot tested among end users and then finalized by the workgroup. Results The AGREE II was a useful tool in guiding the development of evidence-based specific recommendations for constructing and disseminating messages that supplement and increase awareness of the new CPAG (child, youth, adults, and older adults). The process also led to the development of sample messages and provision of a rationale alongside the recommendations. Conclusions To our knowledge, these are the first set of evidence-informed recommendations for constructing and disseminating messages supplementing physical activity guidelines. This project also represents the first application of international standards for guideline development (i.e., AGREE II) to the creation of practical recommendations specifically aimed to inform health promotion and public health practice. The messaging recommendations have the potential to increase the public health impact of evidence-based guidelines. PMID:23634998

Increasingly artful. Applying commercial marketing communication techniques to family planning communication.

PubMed

Williams, J R

1992-08-01

Family planning (FP) and social marketing messages must utilize the rules concerning artfulness developed in the private sector for effective communication in the mass media around the world. They have to compete for the attention of television program viewers accustomed to receiving hundreds of 30-second messages. There are some rules essential to any effective communication program: 1) Command attention. In the US over 1350 different mass media messages vie for attention every single day. FP messages are sensitive, but dullness and passivity is not a requisite. 2) Clarify the message, and keep it simple and direct. Mixed messages equal less effective communication. 3) Communicate a benefit. Consumers do not only buy products, they buy expectations of benefits. 4) Consistency counts. The central message should remain consistent to allow the evaluation of its effectiveness, but execution should vary from time to time and medium to medium. 5) Cater to the heart and the head. Effective communication offers real emotional values. 6) Create trust. Words, graphics, sounds, and casting in the campaign should support 1 central key promise to a single prime prospect. 7) Call for action. Both commercial and social marketing campaigns can calculate results by quantifiable measurement of sales (of condoms) transactions (the number of IUD insertions), floor traffic (clinic visits), attitude shifts, and behavior change. The PRO-PATER Vasectomy Campaign of 1988 in Sao Paulo, Brazil successfully used the above rules for effective communication. During the 1st 2 months of the campaign, phone calls increased by over 300%, new clients by 97%, and actual vasectomies performed by 79%.

Family Sources of Sexual Health Information, Primary Messages, and Sexual Behavior of At-Risk, Urban Adolescents

PubMed Central

Rosengard, Cynthia; Tannis, Candace; Dove, David C.; van den Berg, Jacob J.; Lopez, Rosalie; Stein, L. A. R.; Morrow, Kathleen M.

2016-01-01

Background Sources of sexual health information exert strong influence on adolescents’ sexual behavior. Purpose The current study was undertaken to understand how family serve as sexual information sources, the messages adolescents recall from family, and how family learning experiences affect sexual behavior among at-risk adolescents. Methods Individual interviews were conducted with 69 teens, ages 15–18 years, from an alternative high school and a juvenile correctional facility to capture adolescents’ early sexual health learning experiences involving family and evaluate their association with teens’ recent sexual behavior. Sexual learning narratives were compared among gender and sexual experience groups. Results Many participants identified family as sexual health information sources. Primary messages recalled: risks of sex, protection, and relationship advice. Many adolescents portrayed learning experiences as negative, cautionary, lacking detail and not always balanced with positive messages. Participants who reported four or more sexual risks were the only group to identify pornography as a sexual health information source. Participants who reported fewer than four sexual risks were most likely to identify family sexual health information sources. Discussion Participants identified family members as sources of sexual health information, with variations by gender. Negative/cautionary messages require teens to seek additional sexual information elsewhere (primarily friends/media). Males, in particular, appear to often lack familial guidance/education. Translation to Health Education Practice Sexual health messages should be tailored to adolescents’ needs for practical and sex-positive guidance regarding mechanics of sex and formation of healthy relationships, and balanced with cautions regarding negative consequences. PMID:27882190

Understanding the failure of a behavior change intervention to reduce risk behaviors for avian influenza transmission among backyard poultry raisers in rural Bangladesh: a focused ethnography.

PubMed

Rimi, Nadia Ali; Sultana, Rebeca; Ishtiak-Ahmed, Kazi; Rahman, Md Zahidur; Hasin, Marufa; Islam, M Saiful; Azziz-Baumgartner, Eduardo; Nahar, Nazmun; Gurley, Emily S; Luby, Stephen P

2016-08-24

The spread of the highly pathogenic avian influenza (HPAI) H5N1 virus among poultry and humans has raised global concerns and has motivated government and public health organizations to initiate interventions to prevent the transmission of HPAI. In Bangladesh, H5N1 became endemic in poultry and seven human H5N1 cases have been reported since 2007, including one fatality. This study piloted messages to increase awareness about avian influenza and its prevention in two rural communities, and explored change in villagers' awareness and behaviors attributable to the intervention. During 2009-10, a research team implemented the study in two rural villages in two districts of Bangladesh. The team used a focused ethnographic approach for data collection, including informal interviews and observations to provide detailed contextual information about community response to a newly emerging disease. They collected pre-intervention qualitative data for one month. Then another team disseminated preventive messages focused on safe slaughtering methods, through courtyard meetings and affixed posters in every household. After dissemination, the research team collected post-intervention data for one month. More villagers reported hearing about 'bird flu' after the intervention compared to before the intervention. After the intervention, villagers commonly recalled changes in the color of combs and shanks of poultry as signs of avian influenza, and perceived zoonotic transmission of avian influenza through direct contact and through inhalation. Consequently the villagers valued covering the nose and mouth while handling sick and dead poultry as a preventive measure. Nevertheless, the team did not observe noticeable change in villagers' behavior after the intervention. Villagers reported not following the recommended behaviors because of the perceived absence of avian influenza in their flocks, low risk of avian influenza, cost, inconvenience, personal discomfort, fear of being rebuked or ridiculed, and doubt about the necessity of the intervention. The villagers' awareness about avian influenza improved after the intervention, however, the intervention did not result in any measurable improvement in preventive behaviors. Low cost approaches that promote financial benefits and minimize personal discomfort should be developed and piloted.

eHealth Interventions for HIV Prevention in High-Risk Men Who Have Sex With Men: A Systematic Review

PubMed Central

Travers, Jasmine; Rojas, Marlene; Carballo-Diéguez, Alex

2014-01-01

Background While the human immunodeficiency virus (HIV) incidence rate has remained steady in most groups, the overall incidence of HIV among men who have sex with men (MSM) has been steadily increasing in the United States. eHealth is a platform for health behavior change interventions and provides new opportunities for the delivery of HIV prevention messages. Objective The purpose of this systematic review was to examine the use of eHealth interventions for HIV prevention in high-risk MSM. Methods We systematically searched PubMed, OVID, ISI Web of Knowledge, Google Scholar, and Google for articles and grey literature reporting the original results of any studies related to HIV prevention in MSM and developed a standard data collection form to extract information on study characteristics and outcome data. Results In total, 13 articles met the inclusion criteria, of which five articles targeted HIV testing behaviors and eight focused on decreasing HIV risk behaviors. Interventions included Web-based education modules, text messaging (SMS, short message service), chat rooms, and social networking. The methodological quality of articles ranged from 49.4-94.6%. Wide variation in the interventions meant synthesis of the results using meta-analysis would not be appropriate. Conclusions This review shows evidence that eHealth for HIV prevention in high-risk MSM has the potential to be effective in the short term for reducing HIV risk behaviors and increasing testing rates. Given that many of these studies were short term and had other limitations, but showed strong preliminary evidence of improving outcomes, additional work needs to rigorously assess the use of eHealth strategies for HIV prevention in high-risk MSM. PMID:24862459

Inspiration from role models and advice for moving forward.

PubMed

Newman, Michelle G; McGinn, Lata K

2012-12-01

This Behavior Therapy series on overcoming the glass ceiling followed from a highly attended panel at ABCT on the same topic. The current paper summarizes the common themes across the various papers in this series with respect to obstacles prominent women have faced, and how we can learn from their stories to help inform the future. These themes include the importance of role models, messages from a supportive environment, difficulties balancing careers with children, coordinating careers with family, importance of taking charge of one's career, moving forward despite negative internal and external messages, and questions about whether things have changed substantially. In addition, this paper contains a summary of the helpful advice from accomplished women in academia for navigating the academic waters. It is our aspiration that going forward this series will stimulate other conversations as well as increase thought, behavior, solidarity, and awareness about this topic so that we can continue to work toward a future when things will continue to improve for women. Copyright © 2012. Published by Elsevier Ltd.

Teens Share Sexually Explicit Messages: Simple Rebellion or Dangerous Behavior?

ERIC Educational Resources Information Center

Curriculum Review, 2009

2009-01-01

An increasingly popular form of communication among teenagers is "sexting," sending nude photos via text messaging, reported The Orange County Register (3/20/09). This "flirtation" technique has sparked quite a bit of debate: is this simply a form of rebellion or is it dangerous behavior that could have adverse penalties? Although many teens say…

Forecasted economic change and the self-fulfilling prophecy in economic decision-making

PubMed Central

2017-01-01

This study addresses the self-fulfilling prophecy effect, in the domain of economic decision-making. We present experimental data in support of the hypothesis that speculative forecasts of economic change can impact individuals’ economic decision behavior, prior to any realized changes. In a within-subjects experiment, participants (N = 40) played 180 trials in a Balloon Analogue Risk Talk (BART) in which they could make actual profit. Simple messages about possible (positive and negative) changes in outcome probabilities of future trials had significant effects on measures of risk taking (number of inflations) and actual profits in the game. These effects were enduring, even though no systematic changes in actual outcome probabilities took place following any of the messages. Risk taking also found to be reflected in reaction times revealing increasing reaction times with riskier decisions. Positive and negative economic forecasts affected reaction times slopes differently, with negative forecasts resulting in increased reaction time slopes as a function of risk. These findings suggest that forecasted positive or negative economic change can bias people’s mental model of the economy and reduce or stimulate risk taking. Possible implications for media-fulfilling prophecies in the domain of the economy are considered. PMID:28334031

Message framing and parents' intentions to have their children vaccinated against HPV.

PubMed

Gainforth, Heather L; Cao, Wei; Latimer-Cheung, Amy E

2012-11-01

Framing a message in terms of the benefits of engaging in the behavior (gain frame), the costs of failing to engage in the behavior (loss frame), or both the benefits and the costs (mixed frame) can impact parents' decisions about their childrens' and adolescents' health. This study, investigated the effect of framed messages on parents' intentions to have their children vaccinated against human papillomavirus (HPV). The study employed a 2 (gender of the parent) × 2 (gender of the child) × 3 (message frame) between-groups, quasi-experimental design. A convenience sample of 367 parents with children in Grade 5, 6, or 7 who had at least one child who had not been vaccinated against HPV. Social-cognitive variables relating to intentions to vaccinate a child were assessed. Participants were randomly assigned to read one of three framed messages about the HPV vaccine (gain, loss, or mixed). Gain-framed messages seemed to persuade mothers of sons to speak to a doctor about the vaccine (p < .05). Framing effects were not significant for other outcomes. Findings provide preliminary evidence that certain vaccination messages may be more effective for different parent-child dyads. © 2012 Wiley Periodicals, Inc.

Using a health message with a testimonial to motivate colon cancer screening: associations with perceived identification and vividness.

PubMed

Dillard, Amanda J; Main, Jackie L

2013-12-01

Research suggests that testimonials, or first-person narratives, influence health behavior and health-related decision making, but few studies have examined conceptual factors that may be responsible for these effects. In the current study, older adults who were due for colorectal cancer screening read a message about screening that included a testimonial from a similar other who had previously made the screening decision. We assessed participants' identification with the testimonial character and the degree to which they found the message to be vivid. We explored associations between these factors and participants' knowledge following the message, mood, certainty about screening, and their behavioral intentions to look for more information about screening and to have a test in the next year. In bivariate analyses, identification and vividness were both significantly, positively associated with knowledge and behavioral intentions to have screening in the next year. However, multivariate analyses revealed that only vividness remained significantly associated with knowledge and intentions to be screened.

Automated Behavioral Text Messaging and Face-to-Face Intervention for Parents of Overweight or Obese Preschool Children: Results From a Pilot Study.

PubMed

Militello, Lisa; Melnyk, Bernadette Mazurek; Hekler, Eric B; Small, Leigh; Jacobson, Diana

2016-03-14

Children are 5 times more likely to be overweight at the age of 12 years if they are overweight during the preschool period. The purpose of this study was to establish the feasibility, acceptability, and preliminary effects of a cognitive behavioral intervention (TEXT2COPE) synergized with tailored mobile technology (mHealth) on the healthy lifestyle behaviors of parents of overweight and obese preschoolers delivered in a primary care setting. Fifteen preschooler-parent dyads recruited through primary care clinics completed a manualized 7-week cognitive behavioral skills building intervention. Beck's Cognitive Theory guided the TEXT2COPE intervention content and Fogg's Behavior Model guided the implementation. The intervention employed a combination of face-to-face clinic visits and ecological momentary interventions using text messaging (short message service, SMS). To enhance the intervention's relevance to the family's needs, parents dictated the wording of the text messages and also were able to adapt the frequency and timing of delivery throughout program implementation. Self-reported findings indicate that the program is feasible and acceptable in this population. The intervention showed preliminary effects with significant improvements on parental knowledge about nutrition (P=.001) and physical activity (P=.012) for their children, parental beliefs (P=.001) toward healthy lifestyles, and parental behaviors (P=.040) toward engaging in healthy lifestyle choices for their children. Effect sizes were medium to large for all variables. The timing, frequency, and wording of the text messages were tailored to the individual families, with 69% of parents (9/13) increasing the frequency of the tailored SMS from being sent once weekly to as many as 5 times a week. Utilizing a cognitive behavioral skills intervention with SMS has great potential for supporting clinical care of overweight and obese preschool children and their families. Further exploration of the potential effects on health and behavioral outcomes is warranted.

"Please Don't Send Us Spam!" A Participative, Theory-Based Methodology for Developing an mHealth Intervention.

PubMed

Toefy, Yoesrie; Skinner, Donald; Thomsen, Sarah

2016-08-17

Mobile health solutions have the potential of reducing burdens on health systems and empowering patients with important information. However, there is a lack of theory-based mHealth interventions. The purpose of our study was to develop a participative, theory-based, mobile phone, audio messaging intervention attractive to recently circumcised men at voluntary medical male circumcision (VMMC) clinics in the Cape Town area in South Africa. We aimed to shift some of the tasks related to postoperative counselling on wound management and goal setting on safe sex. We place an emphasis on describing the full method of message generation to allow for replication. We developed an mHealth intervention using a staggered qualitative methodology: (1) focus group discussions with 52 recently circumcised men and their partners to develop initial voice messages they felt were relevant and appropriate, (2) thematic analysis and expert consultation to select the final messages for pilot testing, and (3) cognitive interviews with 12 recent VMMC patients to judge message comprehension and rank the messages. Message content and phasing were guided by the theory of planned behavior and the health action process approach. Patients and their partners came up with 245 messages they thought would help men during the wound-healing period. Thematic analysis revealed 42 different themes. Expert review and cognitive interviews with more patients resulted in 42 messages with a clear division in terms of needs and expectations between the initial wound-healing recovery phase (weeks 1-3) and the adjustment phase (weeks 4-6). Discussions with patients also revealed potential barriers to voice messaging, such as lack of technical knowledge of mobile phones and concerns about the invasive nature of the intervention. Patients' own suggested messages confirmed Ajzen's theory of planned behavior that if a health promotion intervention can build trust and be relevant to the recipient's needs in the first contacts, then the same recipients will perceive subsequent motivational messages more favorably. The health action process approach was also a useful tool for guiding the phasing of the messages. Participants were more positive and salutogenic than public health experts. The system showed how a process of consultation can work with a set of potential recipients of an mHealth service to ensure that their needs are included. Classic behavioral theories can and should be used to design modern mHealth interventions. We also believe that patients are the best source of messaging, ensuring that messages are culturally relevant and interesting to the recipient.

Reactions to threatening health messages.

PubMed

Ten Hoor, Gill A; Peters, Gjalt-Jorn Y; Kalagi, Janice; de Groot, Lianne; Grootjans, Karlijne; Huschens, Alexander; Köhninger, Constanze; Kölgen, Lizan; Pelssers, Isabelle; Schütt, Toby; Thomas, Sophia; Ruiter, Robert A C; Kok, Gerjo

2012-11-21

Threatening health messages that focus on severity are popular, but frequently have no effect or even a counterproductive effect on behavior change. This paradox (i.e. wide application despite low effectiveness) may be partly explained by the intuitive appeal of threatening communication: it may be hard to predict the defensive reactions occurring in response to fear appeals. We examine this hypothesis by using two studies by Brown and colleagues, which provide evidence that threatening health messages in the form of distressing imagery in anti-smoking and anti-alcohol campaigns cause defensive reactions. We simulated both Brown et al. experiments, asking participants to estimate the reactions of the original study subjects to the threatening health information (n = 93). Afterwards, we presented the actual original study outcomes. One week later, we assessed whether this knowledge of the actual study outcomes helped participants to more successfully estimate the effectiveness of the threatening health information (n = 72). Results showed that participants were initially convinced of the effectiveness of threatening health messages and were unable to anticipate the defensive reactions that in fact occurred. Furthermore, these estimates did not improve after participants had been explained the dynamics of threatening communication as well as what the effects of the threatening communication had been in reality. These findings are consistent with the hypothesis that the effectiveness of threatening health messages is intuitively appealing. What is more, providing empirical evidence against the use of threatening health messages has very little effect on this intuitive appeal.

Reactions to threatening health messages

PubMed Central

2012-01-01

Background Threatening health messages that focus on severity are popular, but frequently have no effect or even a counterproductive effect on behavior change. This paradox (i.e. wide application despite low effectiveness) may be partly explained by the intuitive appeal of threatening communication: it may be hard to predict the defensive reactions occurring in response to fear appeals. We examine this hypothesis by using two studies by Brown and colleagues, which provide evidence that threatening health messages in the form of distressing imagery in anti-smoking and anti-alcohol campaigns cause defensive reactions. Methods We simulated both Brown et al. experiments, asking participants to estimate the reactions of the original study subjects to the threatening health information (n = 93). Afterwards, we presented the actual original study outcomes. One week later, we assessed whether this knowledge of the actual study outcomes helped participants to more successfully estimate the effectiveness of the threatening health information (n = 72). Results Results showed that participants were initially convinced of the effectiveness of threatening health messages and were unable to anticipate the defensive reactions that in fact occurred. Furthermore, these estimates did not improve after participants had been explained the dynamics of threatening communication as well as what the effects of the threatening communication had been in reality. Conclusions These findings are consistent with the hypothesis that the effectiveness of threatening health messages is intuitively appealing. What is more, providing empirical evidence against the use of threatening health messages has very little effect on this intuitive appeal. PMID:23171445

Effects of Issue Involvement and Framing of a Responsible Drinking Message on Attitudes, Intentions, and Behavior.

PubMed

de Graaf, Anneke; van den Putte, Bas; de Bruijn, Gert-Jan

2015-08-01

To decrease the prevalence and the amount of alcohol consumption among students, health messages advocating responsible alcohol behavior can be used. However, it is unclear whether responsible drinking messages are most effective when they use a gain frame, presenting the advantages of responsible drinking, or a loss frame, presenting the disadvantages of irresponsible drinking. This study tests the effects of framing and the moderating role of involvement with the issue of responsible drinking. A three-wave, between-subjects, experimental study was conducted, in which participants (N = 90) were exposed to either a gain- or loss-framed message about responsible drinking behavior at Wave 2. At all three waves, attitudes, intentions and behavior toward responsible drinking were measured. Results showed that for participants with low issue- involvement, a gain frame led to more positive attitudes and intentions toward responsible alcohol use, whereas a loss frame did not have any effects for them. For participants with high issue involvement, a loss frame led to more positive attitudes and intentions toward responsible alcohol use, whereas a gain frame did not have an effect on attitude and only a delayed effect on intention. However, there were no effects of frame and issue involvement on adhering to the guideline of responsible alcohol use and average drinking behavior.

The urgent matter of online pro-eating disorder content and children: clinical practice.

PubMed

Custers, Kathleen

2015-04-01

During the last decade, much concern has been expressed about online pro-eating disorder communities (e.g., pro-anorexia websites and blogs) which encourage their users to engage in disordered eating behavior. The aim of the current paper is to reemphasize the importance of pro-eating disorder communities in light of the recent changes in the media landscape. With the increase of social networking sites, pro-anorexia messages have transplanted to more volatile and constantly changing media, such as Snapchat, Twitter, Facebook, Instagram, Pinterest, and many others. Most parents, educators, and health professionals are unaware of the sheer scope and nature of such pro-anorexia messages in these new contexts. The current paper will provide a review of pro-eating disorder websites, overview the effects of such websites on young people's health, examine the emergence of these messages on social media platforms, and highlight a number of guidelines for clinicians and parents. The dissemination of online pro-eating disorder content to different types of social networking sites is becoming an urgent issue. • Existing research on pro-eating disorder websites examines the prevalence and the content of these websites, and the effects of pro-eating disorder content on both clinical (eating disordered individuals) and non-clinical samples (non-eating disordered individuals). • The scope and nature of such anorexia messages is unknown to most adults, and many people (including parents and medical professionals) are insufficiently aware of the ease with which young people access, navigate, and use a wide range of online platforms. • Pro-anorexia messages are no longer limited to websites that can be easily monitored, but instead have been transplanted to more volatile and constantly changing media such as Snapchat, Twitter, Facebook, Pinterest, and Tumblr which makes pro-eating disorder content much more easily accessible. • This paper wants to emphasize the implications of the presence of pro-eating disorder content on websites and social media. A number of guidelines for parents and clinicians are provided.

Using the Clear Communication Index to Improve Materials for a Behavioral Intervention.

PubMed

Porter, Kathleen J; Alexander, Ramine; Perzynski, Katelynn M; Kruzliakova, Natalie; Zoellner, Jamie M

2018-02-08

Ensuring that written materials used in behavioral interventions are clear is important to support behavior change. This study used the Clear Communication Index (CCI) to assess the original and revised versions of three types of written participant materials from the SIPsmartER intervention. Materials were revised based on original scoring. Scores for the entire index were significantly higher among revised versions than originals (57% versus 41%, p < 0.001); however, few revised materials (n = 2 of 53) achieved the benchmark of ≥90%. Handouts scored higher than worksheets and slide sets for both versions. The proportion of materials scored as having "a single main message" significantly increased between versions for worksheets (7% to 57%, p = 0.003) and slide sets (33% to 67%, p = 0.004). Across individual items, most significant improvements were in Core, with four-items related to the material having a single main message. Findings demonstrate that SIPsmartER's revised materials improved after CCI-informed edits. They advance the evidence and application of the CCI, suggesting it can be effectively used to support improvement in clarity of different types of written materials used in behavioral interventions. Implications for practical considerations of using the tool and suggestions for modifications for specific types of materials are presented.

“I Wouldn’t Be this Firm if I Didn’t Care”: Preventive Clinical Counseling for Reproductive Health

PubMed Central

Henderson, Jillian T.; Raine, Tina; Schalet, Amy; Blum, Maya; Harper, Cynthia C.

2010-01-01

Objective This qualitative study of the health care clinicians serving women at heightened risk of sexually transmitted infections and unintended pregnancy was undertaken to explore concepts underlying reproductive health counseling messages in clinical encounters. Methods In-depth interviews were conducted with 31 clinicians, including physicians and advanced practice clinicians serving primarily low-income patients in high-risk communities throughout the U.S. Results Most of the clinicians describe their influence on patients and protective behaviors as derived from medical authority and the presentation of information. The use of a parental style of authority, particularly for young or vulnerable patients, and emotional appeals to evoke negative emotions, such as fear, were also used to motivate protective behaviors. Many clinicians highlighted the importance of empathy, and understanding the cultural and social context of health behaviors. A few clinicians described innovative efforts to empower women to protect themselves and exert more control in relationships. Conclusion Some of the reproductive health counseling approaches described by clinicians are not consistent with leading health behavior change theories or patient-centered counseling. To improve counseling, these messages and concepts need to be evaluated for effectiveness, and possibly used to inform the development of novel theories for use in reproductive health counseling. PMID:20558024

"I wouldn't be this firm if I didn't care": preventive clinical counseling for reproductive health.

PubMed

Henderson, Jillian T; Raine, Tina; Schalet, Amy; Blum, Maya; Harper, Cynthia C

2011-02-01

This qualitative study of health care clinicians serving women at heightened risk of sexually transmitted infections and unintended pregnancy was undertaken to explore concepts underlying reproductive health counseling messages in clinical encounters. In-depth interviews were conducted with 31 clinicians, including physicians and advanced practice nurses serving primarily low-income patients in high-risk communities throughout the U.S. Most of the clinicians describe their influence on patients and protective behaviors as derived from medical authority and the presentation of information. The use of a parental style of authority, particularly for young or vulnerable patients, and emotional appeals to evoke negative emotions, such as fear, were also used to motivate protective behaviors. Many clinicians highlighted the importance of empathy, and understanding the cultural and social context of health behaviors. A few clinicians described innovative efforts to empower women to protect themselves and exert more control in relationships. Some of the reproductive health counseling approaches described by clinicians are not consistent with leading health behavior change theories or patient-centered counseling. To improve counseling, these messages and concepts need to be evaluated for effectiveness, and possibly used to inform the development of novel theories for use in reproductive health counseling. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

A content analysis of visual cancer information: prevalence and use of photographs and illustrations in printed health materials.

PubMed

King, Andy J

2015-01-01

Researchers and practitioners have an increasing interest in visual components of health information and health communication messages. This study contributes to this evolving body of research by providing an account of the visual images and information featured in printed cancer communication materials. Using content analysis, 147 pamphlets and 858 images were examined to determine how frequently images are used in printed materials, what types of images are used, what information is conveyed visually, and whether or not current recommendations for the inclusion of visual content were being followed. Although visual messages were found to be common in printed health materials, existing recommendations about the inclusion of visual content were only partially followed. Results are discussed in terms of how relevant theoretical frameworks in the areas of behavior change and visual persuasion seem to be used in these materials, as well as how more theory-oriented research is necessary in visual messaging efforts.

Peeling Lead Paint Turns into Poisonous Dust. Guess Where It Ends Up? A Media Campaign to Prevent Childhood Lead Poisoning in New York City

ERIC Educational Resources Information Center

Greene, Danielle; Tehranifar, Parisa; DeMartini, Diana P.; Faciano, Andrew; Nagin, Deborah

2015-01-01

Successful public health media campaigns promote messages, increase awareness, engage the public, and encourage behavior change. Between 2004 and 2006, the Lead Poisoning Prevention Program of the New York City Department of Health and Mental Hygiene conducted a media campaign grounded in social learning theory and the social marketing model to…

The domestic servant as family planning innovator: an Indian case study.

PubMed

Basu, A M; Sundar, R

1988-01-01

This paper reports on the relatively low fertility of female domestic servants in India. domestic servant have fewer numbers of ever-born and living children than women working in other occupations and women who are unemployed. This low fertility, which appears to be volitional, may have its roots in the incompatibility between the servant's reproductive and the productive roles, as well as in the changing values generated by continued exposure to a wealthier lifestyle. It is suggested that family planning messages aimed at and elicited by more "elite" classes may have a greater impact on fertility behavior than message from prompters with a socioeconomic background similar to the clients', which tend to concentrate on the harsher day-to-day realities of poverty.

A Tale of Two Stories: An Exploration of Identification, Message Recall, and Narrative Preferences Among Low-Income, Mexican American Women.

PubMed

Davis, Rachel E; Dal Cin, Sonya; Cole, Suzanne M; Reyes, Ligia I; McKenney-Shubert, Shannon J; Fleischer, Nancy L; Densen, Lynna Chung; Peterson, Karen E

2017-11-01

Additional research is needed to guide the design of narratives for use in practice-oriented, naturalistic settings to maximize health behavior change, particularly among populations affected by health disparities. This mixed-methods study explored the influence of cultural tailoring and emotional arousal on identification and message recall in narratives promoting childhood obesity prevention among 40 Mexican American mothers. Participants were also asked about narrative exposure, narrative preferences, and beliefs about the purpose of a story. Participants were randomly assigned to listen to two stories: (a) a story tailored on noncultural or cultural variables, and (b) a story designed to enhance or minimize emotional arousal. Participants reported high engagement and identification with all stories. Participants generally envisioned protagonists as Latina, despite limited cues, and identified with protagonists in four ways: sharing personal characteristics; having similar thoughts and feelings; engaging in similar actions; and experiencing similar situations. Mothers were most interested in narratives that helped them to improve their lives. Findings from this study yield several hypotheses for consideration in future study, including ways in which story setting and message enactment may moderate message recall.

"Love me, parents!": impact evaluation of a national social and behavioral change communication campaign on maternal health outcomes in Tanzania.

PubMed

Kaufman, Michelle R; Harman, Jennifer J; Smelyanskaya, Marina; Orkis, Jennifer; Ainslie, Robert

2017-09-15

Despite marked improvements over the last few decades, maternal mortality in Tanzania remains among the world's highest at 454 maternal deaths per 100,000 live births. Many factors contribute to this disparity, such as a lack of attendance at antenatal care (ANC) services and low rates of delivery at a health facility with a skilled provider. The Wazazi Nipendeni (Love me, parents) social and behavioral change communication campaign was launched in Tanzania in 2012 to improve a range of maternal health outcomes, including individual birth planning, timely ANC attendance, and giving birth in a healthcare facility. An evaluation to determine the impact of the national Wazazi Nipendeni campaign was conducted in five purposively selected regions of Tanzania using exit interviews with pregnant and post-natal women attending ANC clinics. A total of 1708 women were interviewed regarding campaign exposure, ANC attendance, and individual birth planning. Over one third of interviewed women (35.1%) reported exposure to the campaign in the last month. The more sources from which women reported hearing the Wazazi Nipendeni message, the more they planned for the birth of their child (β = 0.08, p = .001). Greater numbers of types of exposure to the Wazazi Nipendeni message was associated with an increase in ANC visits (β = 0.05, p = .004). Intervention exposure did not significantly predict the timing of the first ANC visit or HIV testing in the adjusted model, however, findings showed that exposure did predict whether women delivered at a health care facility (or not) and whether they tested for HIV with a partner in the unadjusted models. The Wazazi Nipendeni campaign shows promise that such a behavior change communication intervention could lead to better pregnancy and childbirth outcomes for women in low resource settings. For outcomes such as HIV testing, message exposure showed some promising effects, but demographic variables such as age and socioeconomic status appear to be important as well.

Actions speak louder than words: Outsiders' perceptions of diversity mixed messages.

PubMed

Windscheid, Leon; Bowes-Sperry, Lynn; Kidder, Deborah L; Cheung, Ho Kwan; Morner, Michèle; Lievens, Filip

2016-09-01

To attract a gender diverse workforce, many employers use diversity statements to publicly signal that they value gender diversity. However, this often represents a misalignment between words and actions (i.e., a diversity mixed message) because most organizations are male dominated, especially in board positions. We conducted 3 studies to investigate the potentially indirect effect of such diversity mixed messages through perceived behavioral integrity on employer attractiveness. In Study 1, following a 2 × 2 design, participants (N = 225) were either shown a pro gender diversity statement or a neutral statement, in combination with a gender diverse board (4 men and 4 women) or a uniform all-male board (8 men). Participants' perceived behavioral integrity of the organization was assessed. In Study 2, participants (N = 251) either read positive or negative reviews of the organization's behavioral integrity. Employer attractiveness was then assessed. Study 3 (N = 427) investigated the impact of board gender composition on perceived behavioral integrity and employer attractiveness using a bootstrapping procedure. Both the causal-chain design of Study 1 and 2, as well as the significance test of the proposed indirect relationship in Study 3, revealed that a diversity mixed message negatively affected an organization's perceived behavioral integrity, and low behavioral integrity in turn negatively impacted employer attractiveness. In Study 3, there was also evidence for a tipping point (more than 1 woman on the board was needed) with regard to participants' perceptions of the organization's behavioral integrity. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Steady Diet of Confusion: Contradictory Nutrition Messages in the Public Information Environment

ERIC Educational Resources Information Center

Nagler, Rebekah H.

2010-01-01

Nutrition researchers, clinicians, and communication scholars have assumed that contradictory health and nutrition messages exist in the news media, and that exposure to these messages negatively influences public understanding and health behavior. This dissertation does not take issue with these claims, but rather with the evidence base that…

Associations Between Message Features and Subjective Evaluations of the Sensation Value of Antidrug Public Service Announcements.

ERIC Educational Resources Information Center

Morgan, Susan E.; Palmgreen, Philip; Stephenson, Michael T.; Hoyle, Rick H.; Lorch, Elizabeth P.

2003-01-01

Identifies message design features that show the greatest promise for developing message high in sensation value for anti-drug campaigns and other interventions aimed at sensation-seeking risky behaviors. Investigates certain features of drug prevention Public Service Announcements (PSAs) associated with viewers' subjective responses to them.…

A serial mediation model of message framing on intentions to receive the human papillomavirus (HPV) vaccine: revisiting the role of threat and efficacy perceptions.

PubMed

Krieger, Janice L; Sarge, Melanie A

2013-01-01

Previous research has yielded mixed findings regarding the potential for message framing to influence HPV vaccine-related intentions. Drawing on the Extended Parallel Process Model (EPPM), the current study focuses on the role of threat and efficacy as serial mediators linking message framing and HPV vaccine-related intentions. College-age females and their parents participated in a between-subjects, posttest only experiment to investigate whether behavioral intentions to talk to a doctor about the HPV vaccine differ as a function of framing messages in terms of disease prevention. For young women, framing messages as preventing genital warts (as compared to cancer prevention) significantly increased perceptions of self-efficacy, which enhanced response efficacy perceptions that, in turn, increased intentions to talk to a doctor about the HPV vaccine. There were no effects of message framing among parents. However, response efficacy was a significant mediator of self-efficacy and behavioral intentions for both the college-age females and their parents. The results of this study suggest new approaches for considering the relationship among EPPM constructs.

Improving Immunization Rates Through Community-Based Participatory Research: Community Health Improvement for Milwaukee’s Children Program

PubMed Central

Willis, Earnestine; Sabnis, Svapna; Hamilton, Chelsea; Xiong, Fue; Coleman, Keli; Dellinger, Matt; Watts, Michelle; Cox, Richard; Harrell, Janice; Smith, Dorothy; Nugent, Melodee; Simpson, Pippa

2016-01-01

Background Nationally, immunization coverage for the DTaP/3HPV/1MMR/3HepB/3Hib/1VZV antigen series in children ages 19–35 months are near or above the Healthy People 2020 target (80%). However, children in lower socioeconomic families experience lower coverage rates. Objective Using a community-based participatory research (CBPR) approach, Community Health Improvement for Milwaukee Children (CHIMC) intervened to reduce disparities in childhood immunizations. Methods The CHIMC adopted a self-assessment to examine the effectiveness of adhering to CBPR principles. Using behavior change models, CHIMC implemented education, social marketing campaign, and theory of planned behavior interventions. Community residents and organizational representatives vetted all processes, messages, and data collection tools. Results Adherence to the principles of CBPR was consistently positive over the 8-year period. CHIMC enrolled 565 parents/caregivers with 1,533 children into educational and planned behavior change (PBC) interventions, and enrolled another 406 surveyed for the social marketing campaign. Retention rate was high (80%) with participants being predominately Black females (90%) and the unemployed (64%); children’s median age was 6.2 years. Increased knowledge about immunizations was consistently observed among parents/caregivers. Social marketing data revealed high recognition (85%) of the community-developed message (“Take Control: Protect Your Child with Immunizations”). Barriers and facilitators to immunize children revealed protective factors positively correlated with up-to-date (UTD) status (p < 0.007). Ultimately, children between the ages of 19 and 35 months whose parents/caregivers completed education sessions and benefitted from a community-wide social marketing message increased their immunization status from 45% baseline to 82% over 4 years. Conclusions Using multilayered interventions, CHIMC contributed to the elimination of immunization disparities in children. A culturally tailored CBPR approach is effective to eliminate immunization disparities. PMID:27018351

Feasibility of Smartphone-Based Education Modules and Ecological Momentary Assessment/Intervention in Pre-bariatric Surgery Patients.

PubMed

Mundi, Manpreet S; Lorentz, Paul A; Grothe, Karen; Kellogg, Todd A; Collazo-Clavell, Maria L

2015-10-01

Bariatric surgery is the most effective means of long-term weight loss. Knowledge gaps and lack of engagement in pre-operative patients can result in suboptimal outcome after surgery. Mobile technology, utilizing ecological momentary assessment (EMA)/intervention (EMI), has shown tremendous promise in changing behaviors. The primary objective of the study is to assess feasibility of using smartphone app with EMA/EMI functionality to prepare patients for bariatric surgery. Subjects seeking primary bariatric surgery were provided a smartphone app containing video-based education modules with linked assessments to evaluate mastery of topic. Subjects received algorithmic EMA text messages soliciting a response regarding lifestyle behavior. Upon answering, subjects received tailored EMI text messaging supporting healthy lifestyle. Thirty subjects (27 female and 3 male), with age of 41.3 ± 11.4 years and BMI of 46.3 ± 7.4 kg/m(2) were enrolled. Twenty subjects completed the study. Ten subjects withdrew. On average, seven out of nine education modules were completed (70.9 ± 27.3%), and 37.8/123 EMA were answered (30.7 ± 21.7%), with response time of 17.4 ± 4.4 min. Subjects reported high satisfaction with the app. Many felt that the app fit into their routine "somewhat easily" or "very easily" (n = 12), had "perfect" amount of EMA messages (n = 8), and was very helpful in preparing for surgery (n = 7). This study is the first to reveal the feasibility of using a smartphone app in the education and engagement of patients prior to bariatric surgery. The app was well-received based on subject satisfaction scores and revealed trends toward positive behavior change and increased weight loss. Randomized trials are necessary to delineate true efficacy.

The influence of affective and cognitive arguments on message judgement and attitude change: The moderating effects of meta-bases and structural bases.

PubMed

Keer, Mario; van den Putte, Bas; Neijens, Peter; de Wit, John

2013-01-01

This study investigated whether the efficacy of affective vs. cognitive persuasive messages was moderated by (1) individuals' subjective assessments of whether their attitudes were based on affect or cognition (i.e. meta-bases) and (2) the degree individuals' attitudes were correlated with affect and cognition (i.e. structural bases). Participants (N = 97) were randomly exposed to a message containing either affective or cognitive arguments discouraging binge drinking. The results demonstrated that meta-bases and not structural bases moderated the influence of argument type on message judgement. Affective (cognitive) messages were judged more positively when individuals' meta-bases were more affective (cognitive). In contrast, structural bases and not meta-bases moderated the influence of argument type on attitude and intention change following exposure to the message. Surprisingly, change was greater among individuals who read a message that mismatched their structural attitude base. Affective messages were more effective as attitudes were more cognition-based, and vice versa. Thus, although individuals prefer messages that match their meta-base, attitude and intention change regarding binge drinking are best established by mismatching their structural base.

Effect of news coverage on the prevalence of drunk-driving behavior: evidence from a longitudinal study.

PubMed

Yanovitzky, Itzhak

2002-05-01

To examine the proposition that antidrunk driving messages in the news media contributed indirectly to the decline in drunk driving over the past two decades through their impact on related policy making processes. Time series regression techniques are applied to longitudinal data to examine the causal association between drivers' involvement in drunk-driving behavior, the volume of news coverage devoted to the drunk driving issue, and related policy making. Results show a significant contribution of news coverage to drunk-driving-related policy actions, which in turn are associated with a reduction in drunk driving among young and high-risk drivers. There was no evidence of a direct causal association between news coverage and change in drunk-driving behavior. News coverage of alcohol-related risky behaviors seems to provide a cost-effective way of reducing the prevalence of these practices by attracting institutional attention and prompting related environmental changes. Future interventions may benefit from actively seeking to influence news coverage of risky behaviors.

Communicating minimum impact behavior with trailside bulletin boards: Visitor characteristics associated with effectiveness

Treesearch

Stephen F. McCool; David N. Cole

2000-01-01

Bulletin boards are a frequently used method of communicating minimum impact behaviors to wilderness visitors. But how effective are they? What types of visitors are most likely to pay attention to the messages posted there? This study used a field experiment to identify visitor characteristics associated with attention to minimum impact messages posted on a bulletin...

Anticipated Guilt as Behavioral Motivation: An Examination of Appeals to Help Unknown Others through Bone Marrow Donation

ERIC Educational Resources Information Center

Lindsey, Lisa L. Massi

2005-01-01

The current study posits that messages used to elicit behaviors to help unknown others must present substantial perceptions of a threat and efficacy to be successful. Given that many prosocial helping messages depict a threat to unknown others, the current investigation proposed that anticipated guilt is a motivating force behind individuals'…

Daily text messaging for weight control among racial and ethnic minority women: randomized controlled pilot study.

PubMed

Steinberg, Dori M; Levine, Erica L; Askew, Sandy; Foley, Perry; Bennett, Gary G

2013-11-18

Daily self-monitoring of diet and physical activity behaviors is a strong predictor of weight loss success. Text messaging holds promise as a viable self-monitoring modality, particularly among racial/ethnic minority populations. This pilot study evaluated the feasibility of a text messaging intervention for weight loss among predominantly black women. Fifty obese women were randomized to either a 6-month intervention using a fully automated system that included daily text messages for self-monitoring tailored behavioral goals (eg, 10,000 steps per day, no sugary drinks) along with brief feedback and tips (n=26) or to an education control arm (n=24). Weight was objectively measured at baseline and at 6 months. Adherence was defined as the proportion of text messages received in response to self-monitoring prompts. The average daily text messaging adherence rate was 49% (SD 27.9) with 85% (22/26) texting self-monitored behavioral goals 2 or more days per week. Approximately 70% (16/23) strongly agreed that daily texting was easy and helpful and 76% (16/21) felt the frequency of texting was appropriate. At 6 months, the intervention arm lost a mean of 1.27 kg (SD 6.51), and the control arm gained a mean of 1.14 kg (SD 2.53; mean difference -2.41 kg, 95% CI -5.22 to 0.39; P=.09). There was a trend toward greater text messaging adherence being associated with greater percent weight loss (r=-.36; P=.08), but this did not reach statistical significance. There was no significant association between goal attainment and text messaging adherence and no significant predictors of adherence. Given the increasing penetration of mobile devices, text messaging may be a useful self-monitoring tool for weight control, particularly among populations most in need of intervention. Clinicaltrials.gov: NCT00939081; http://clinicaltrials.gov/show/NCT00939081 (Archived by WebCite at http://www.webcitation.org/6KiIIcnk1).

Effect of audio in-vehicle red light-running warning message on driving behavior based on a driving simulator experiment.

PubMed

Yan, Xuedong; Liu, Yang; Xu, Yongcun

2015-01-01

Drivers' incorrect decisions of crossing signalized intersections at the onset of the yellow change may lead to red light running (RLR), and RLR crashes result in substantial numbers of severe injuries and property damage. In recent years, some Intelligent Transport System (ITS) concepts have focused on reducing RLR by alerting drivers that they are about to violate the signal. The objective of this study is to conduct an experimental investigation on the effectiveness of the red light violation warning system using a voice message. In this study, the prototype concept of the RLR audio warning system was modeled and tested in a high-fidelity driving simulator. According to the concept, when a vehicle is approaching an intersection at the onset of yellow and the time to the intersection is longer than the yellow interval, the in-vehicle warning system can activate the following audio message "The red light is impending. Please decelerate!" The intent of the warning design is to encourage drivers who cannot clear an intersection during the yellow change interval to stop at the intersection. The experimental results showed that the warning message could decrease red light running violations by 84.3 percent. Based on the logistic regression analyses, drivers without a warning were about 86 times more likely to make go decisions at the onset of yellow and about 15 times more likely to run red lights than those with a warning. Additionally, it was found that the audio warning message could significantly reduce RLR severity because the RLR drivers' red-entry times without a warning were longer than those with a warning. This driving simulator study showed a promising effect of the audio in-vehicle warning message on reducing RLR violations and crashes. It is worthwhile to further develop the proposed technology in field applications.

Safer Sex Media Messages and Adolescent Sexual Behavior: 3-Year Follow-Up Results From Project iMPPACS

PubMed Central

Romer, Daniel; Valois, Robert F.; Vanable, Peter; Carey, Michael P.; Stanton, Bonita; Brown, Larry; DiClemente, Ralph; Salazar, Laura F.

2013-01-01

Objectives. We estimated the long-term (36-month) effects of Project iMPPACS, a multisite randomized controlled trial of mass media and small-group intervention for African American adolescents. Methods. We collected 6 waves of longitudinal data on program participants aged 14 to 17 years (n = 1139) in Providence, Rhode Island; Syracuse, New York; Columbia, South Carolina; and Macon, Georgia, 36 months (December 2009–December 2010) after the intervention began (August 2006–January 2008). Seemingly unrelated regressions at each wave estimated the effects of 3 types of mass media messages (the thematic mediators: selection, pleasure, and negotiation) on condom use intention and self-reported unprotected vaginal sex events. Results. All 3 mediators of behavior change that were introduced during the media intervention were sustained at the follow-up assessments at least 18 months after the intervention ended, with intention having the largest correlation. Unprotected vaginal sex increased with each wave of the study, although cities receiving media exposure had smaller increases. Conclusions. Project iMPPACS demonstrates that mass media influence delivered over an extended period, when adolescents were beginning to learn patterns of behavior associated with sex, persisted after the media program ended. PMID:23153149

Safer sex media messages and adolescent sexual behavior: 3-year follow-up results from project iMPPACS.

PubMed

Hennessy, Michael; Romer, Daniel; Valois, Robert F; Vanable, Peter; Carey, Michael P; Stanton, Bonita; Brown, Larry; DiClemente, Ralph; Salazar, Laura F

2013-01-01

We estimated the long-term (36-month) effects of Project iMPPACS, a multisite randomized controlled trial of mass media and small-group intervention for African American adolescents. We collected 6 waves of longitudinal data on program participants aged 14 to 17 years (n = 1139) in Providence, Rhode Island; Syracuse, New York; Columbia, South Carolina; and Macon, Georgia, 36 months (December 2009-December 2010) after the intervention began (August 2006-January 2008). Seemingly unrelated regressions at each wave estimated the effects of 3 types of mass media messages (the thematic mediators: selection, pleasure, and negotiation) on condom use intention and self-reported unprotected vaginal sex events. All 3 mediators of behavior change that were introduced during the media intervention were sustained at the follow-up assessments at least 18 months after the intervention ended, with intention having the largest correlation. Unprotected vaginal sex increased with each wave of the study, although cities receiving media exposure had smaller increases. Project iMPPACS demonstrates that mass media influence delivered over an extended period, when adolescents were beginning to learn patterns of behavior associated with sex, persisted after the media program ended.

Audience reactions and receptivity to HIV prevention message concepts for people living with HIV.

PubMed

Uhrig, Jennifer D; Bann, Carla M; Wasserman, Jill; Guenther-Grey, Carolyn; Eroğlu, Doğan

2010-04-01

This study measured audience reactions and receptivity to five draft HIV prevention messages developed for people living with HIV (PLWH) to inform future HIV message choice and audience targeting decisions. Our premise was that message concepts that receive wide audience appeal constitute a strong starting point for designing future HIV prevention messages, program activities, and health communication and marketing campaigns for PLWH. The majority of participants indicated agreement with evaluative statements that expressed favorable attitudes toward all five of the message concepts we evaluated. Participants gave the lowest approval to the message promoting sero-sorting. Sociodemographic characteristics played less of a role in predicting differences in message perceptions than attitudes, beliefs and sexual behavior. The general appeal for these messages is encouraging given that messages were expressed in plain text without the support of other creative elements that are commonly used in message execution. These results confirm the utility of systematic efforts to generate and screen message concepts prior to large-scale testing.

Improving Refill Adherence in Medicare Patients With Tailored and Interactive Mobile Text Messaging: Pilot Study.

PubMed

Brar Prayaga, Rena; Jeong, Erwin W; Feger, Erin; Noble, Harmony K; Kmiec, Magdalen; Prayaga, Ram S

2018-01-30

Nonadherence is a major concern in the management of chronic conditions such as hypertension, cardiovascular disease, and diabetes where patients may discontinue or interrupt their medication for a variety of reasons. Text message reminders have been used to improve adherence. However, few programs or studies have explored the benefits of text messaging with older populations and at scale. In this paper, we present a program design using tailored and interactive text messaging to improve refill rates of partially adherent or nonadherent Medicare members of a large integrated health plan. The aim of this 3-month program was to gain an understanding of whether tailored interactive text message dialogues could be used to improve medication refills in Medicare patients with one or more chronic diseases. We used the mPulse Mobile interactive text messaging solution with partially adherent and nonadherent Medicare patients (ie, over age 65 years or younger with disabilities) of Kaiser Permanente Southern California (KP), a large integrated health plan, and compared refill rates of the text messaging group (n=12,272) to a group of partially adherent or nonadherent Medicare patients at KP who did not receive text messages (nontext messaging group, n=76,068). Both groups were exposed to other forms of refill and adherence outreach including phone calls, secure emails, and robo-calls from December 2016 to February 2017. The text messaging group and nontext messaging group were compared using an independent samples t test to test difference in group average of refill rates. There was a significant difference in medication refill rates between the 2 groups, with a 14.07 percentage points higher refill rate in the text messaging group (P<.001). The results showed a strong benefit of using this text messaging solution to improve medication refill rates among Medicare patients. These findings also support using interactive text messaging as a cost-effective, convenient, and user-friendly solution for patient engagement. Program outcomes and insights can be used to enhance the design of future text-based solutions to improve health outcomes and promote adherence and long-term behavior change. ©Rena Brar Prayaga, Erwin W Jeong, Erin Feger, Harmony K Noble, Magdalen Kmiec, Ram S Prayaga. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 30.01.2018.

Effects of message framing in anti-binge drinking PSAs: the moderating role of counterfactual thinking.

PubMed

Baek, Tae Hyun; Shen, Lijiang; Reid, Leonard N

2013-01-01

This experiment examined the interaction effects of message framing and counterfactual thinking on attitudes toward binge drinking and behavioral intentions. Data from a 2 (message framing: gain vs. loss) × 2 (counterfactual thinking priming: additive vs. subtractive) between-subjects factorial design showed that a gain-framed message resulted in lower binge drinking intentions than did a loss-framed message after subjects engaged in additive counterfactual thinking. The effects of a loss-framed message on binge drinking intentions occurred when subtractive counterfactual thinking was induced. Theoretical and practical implications for anti-binge drinking public service announcements are discussed.

Effectiveness of HIV Prevention Social Marketing With Injecting Drug Users

PubMed Central

Zhang, Guili; Cassady, Diana; Pappas, Les; Mitchell, Joyce; Kegeles, Susan M.

2010-01-01

Social marketing involves applying marketing principles to promote social goods. In the context of health behavior, it has been used successfully to reduce alcohol-related car crashes, smoking among youths, and malaria transmission, among other goals. Features of social marketing, such as audience segmentation and repeated exposure to prevention messages, distinguish it from traditional health promotion programs. A recent review found 8 of 10 rigorously evaluated social marketing interventions responsible for changes in HIV-related behavior or behavioral intentions. We studied 479 injection drug users to evaluate a community-based social marketing campaign to reduce injection risk behavior among drug users in Sacramento, California. Injecting drugs is associated with HIV infection in more than 130 countries worldwide. PMID:20724686

Sensation Seeking as a Moderator of Gain- and Loss-Framed HIV-Test Promotion Message Effects.

PubMed

Hull, Shawnika J; Hong, Yangsun

2016-01-01

This study used an experiment (N = 504) to test whether the fit between sensation-seeking disposition and frame enhances the persuasiveness of gain- and loss-framed HIV test promotion messages. Gain- and loss-framed messages may be consistent with low and high sensation seekers' disposition with respect to risk behavior. We hypothesized that a loss-framed message would be more persuasive for high sensation seekers and that a gain-framed message should be more effective for low sensation seekers. We also expected elaboration to mediate the interaction. Results demonstrated the hypothesized interaction. When the message frame fit with the viewer's way of thinking, the persuasive power of the message was enhanced. The mediation hypothesis was not supported. Practical implications for targeting and message design are discussed.

SmartMom Text Messaging for Prenatal Education: A Qualitative Focus Group Study to Explore Canadian Women’s Perceptions

PubMed Central

Munro, Sarah; Hui, Amber; Salmons, Vanessa; Solomon, Carolyn; Gemmell, Emily; Torabi, Nahal

2017-01-01

Background We engaged Canadian women in the development of a prenatal education program delivered via one-way text messaging called SmartMom. SmartMom is the first peer-reviewed, evidence-based mHealth program for prenatal education in Canada and the first to be endorsed by the Society of Obstetricians and Gynaecologists of Canada. Objective To explore women’s preferences for a prenatal education program by text messaging. Methods We conducted a qualitative focus group study in three Canadian communities in the Northern Health Authority. Women completed a demographic questionnaire, participated in a guided discussion about their pregnancy information-seeking behavior, reviewed a printed copy of the SmartMom text messages, and then engaged in a moderated discussion about their perceptions of the usability of the SmartMom program. Open-ended questions explored women’s perceptions regarding the message content, acceptability of receiving information by text message, positive health behaviors they might engage in after receiving a message, modifiable program factors, and intention to use the program. Thematic analysis of transcribed audio recordings was undertaken and modifications were made to the SmartMom program based on these findings. Results A total of 40 women participated in seven focus groups in three rural northern communities. The vast majority had a mobile phone (39/40, 98%), used text messages “all the time” (28/40, 70%), and surfed the Internet on their phone (37/40, 93%). Participants perceived SmartMom to be highly acceptable and relevant. The text message modality reflected how participants currently sought pregnancy-related information and provided them with local information tailored to their gestational age, which they had not received through other pregnancy resources. Women recommended adding the opportunity to receive supplemental streams of messages tailored to their individual needs, for example, depression, pregnancy after previous cesarean, >35 years of age, new immigrants, and harm reduction for smoking and alcohol. Conclusions This formative qualitative evaluation provides evidence that a prenatal education program by text messaging, SmartMom, is acceptable to the end users. These findings support the usability of the SmartMom program at a population level and the development of an evaluation program exploring the effects of the text messages on adoption of health-promoting behaviors and maternal-child health outcomes. PMID:28174149

Text Messaging Interventions on Cancer Screening Rates: A Systematic Review.

PubMed

Uy, Catherine; Lopez, Jennifer; Trinh-Shevrin, Chau; Kwon, Simona C; Sherman, Scott E; Liang, Peter S

2017-08-24

Despite high-quality evidence demonstrating that screening reduces mortality from breast, cervical, colorectal, and lung cancers, a substantial portion of the population remains inadequately screened. There is a critical need to identify interventions that increase the uptake and adoption of evidence-based screening guidelines for preventable cancers at the community practice level. Text messaging (short message service, SMS) has been effective in promoting behavioral change in various clinical settings, but the overall impact and reach of text messaging interventions on cancer screening are unknown. The objective of this systematic review was to assess the effect of text messaging interventions on screening for breast, cervical, colorectal, and lung cancers. We searched multiple databases for studies published between the years 2000 and 2017, including PubMed, EMBASE, and the Cochrane Library, to identify controlled trials that measured the effect of text messaging on screening for breast, cervical, colorectal, or lung cancers. Study quality was evaluated using the Cochrane risk of bias tool. Our search yielded 2238 citations, of which 31 underwent full review and 9 met inclusion criteria. Five studies examined screening for breast cancer, one for cervical cancer, and three for colorectal cancer. No studies were found for lung cancer screening. Absolute screening rates for individuals who received text message interventions were 0.6% to 15.0% higher than for controls. Unadjusted relative screening rates for text message recipients were 4% to 63% higher compared with controls. Text messaging interventions appear to moderately increase screening rates for breast and cervical cancer and may have a small effect on colorectal cancer screening. Benefit was observed in various countries, including resource-poor and non-English-speaking populations. Given the paucity of data, additional research is needed to better quantify the effectiveness of this promising intervention. ©Catherine Uy, Jennifer Lopez, Chau Trinh-Shevrin, Simona C Kwon, Scott E Sherman, Peter S Liang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 24.08.2017.

Challenges and Facilitators to Promoting a Healthy Food Environment and Communicating Effectively with Parents to Improve Food Behaviors of School Children.

PubMed

Luesse, Hiershenee B; Paul, Rachel; Gray, Heewon L; Koch, Pamela; Contento, Isobel; Marsick, Victoria

2018-02-14

Background Childhood obesity is a major public health concern and families play an important role. Improving strategies to reach parents and directing tailored nutrition education to them is needed. Purpose To investigate the challenges and facilitators to promoting a healthy environment at home and to identify communication preferences to inform intervention strategies for effectively reaching low-income urban minority families. Procedure Semi-structured focus group interviews were conducted with four groups involving 16 low-income urban parents (94% female; 88% Hispanic/Latino, 12% African American) of elementary school children. Interviews were transcribed and analyzed applying Social Cognitive Theory and using in-vivo coding. Main Findings The most common barriers to parents providing healthy foods to their children were accommodating child preferences and familial opposition. Parents showed intentionality to engage in healthy behaviors, and often shared procedural knowledge for reaching health goals. The analyses of desired communication channels yielded major preferences: tailored information, information provided through multiple mediums, appropriate duration/frequency of messages, and presented from a voice of authority. Conclusion and Implication While parents expressed desires to be healthy, the home food environment presented substantial challenges. Multi-media supports such as workshops, flyers, and text messaging may be useful to facilitate the sharing of information to minimize the tensions between intentionality and reaching desired goals to be healthy. Some parents thought that information received through text messaging could be easily shared and would act as a voice of authority to support child behavior change.

Impact of a Text-Messaging Program on Adolescent Reproductive Health: A Cluster-Randomized Trial in Ghana.

PubMed

Rokicki, Slawa; Cohen, Jessica; Salomon, Joshua A; Fink, Günther

2017-02-01

To evaluate whether text-messaging programs can improve reproductive health among adolescent girls in low- and middle-income countries. We conducted a cluster-randomized controlled trial among 756 female students aged 14 to 24 years in Accra, Ghana, in 2014. We randomized 38 schools to unidirectional intervention (n = 12), interactive intervention (n = 12), and control (n = 14). The unidirectional intervention sent participants text messages with reproductive health information. The interactive intervention engaged adolescents in text-messaging reproductive health quizzes. The primary study outcome was reproductive health knowledge at 3 and 15 months. Additional outcomes included self-reported pregnancy and sexual behavior. Analysis was by intent-to-treat. From baseline to 3 months, the unidirectional intervention increased knowledge by 11 percentage points (95% confidence interval [CI] = 7, 15) and the interactive intervention by 24 percentage points (95% CI = 19, 28), from a control baseline of 26%. Although we found no changes in reproductive health outcomes overall, both unidirectional (odds ratio [OR] = 0.14; 95% CI = 0.03, 0.71) and interactive interventions (OR = 0.15; 95% CI = 0.03, 0.86) lowered odds of self-reported pregnancy for sexually active participants. Text-messaging programs can lead to large improvements in reproductive health knowledge and have the potential to lower pregnancy risk for sexually active adolescent girls.

Care by cell phone: text messaging for chronic disease management.

PubMed

Fischer, Henry H; Moore, Susan L; Ginosar, David; Davidson, Arthur J; Rice-Peterson, Cecilia M; Durfee, Michael J; MacKenzie, Thomas D; Estacio, Raymond O; Steele, Andrew W

2012-02-01

To assess the feasibility of engaging adults with diabetes in self management behaviors between clinic visits by using cell phone text messaging to provide blood sugar measurement prompts and appointment reminders. Quasi-experimental pilot among adult diabetic patients with cell phones who receive regular care at a federally qualified community health center in Denver, Colorado, which serves a population that is predominantly either uninsured (41%) or on Medicaid or Medicare (56%). Patients (N = 47) received text message prompts over a 3-month period. Blood sugar readings were requested 3 times per week (Monday, Wednesday, and Friday). Reminders were sent 7, 3, and 1 day(s) before each scheduled appointment. Acknowledgments were returned for all patient-sent messages. Focus groups were conducted in English and Spanish with selected patients (n = 8). Patients of all ages were active participants. Correctly formatted responses were received for 67.3% of 1585 prompts. More than three-fourths (79%) of the cohort responded to more than 50% of their prompts. The appointment analysis was underpowered to detect significant changes in attendance. Participants reported increased social support, feelings that the program "made them accountable," and increased awareness of health information. Two-thirds (66%) of patients provided glucose readings when prompted during the study, compared with 12% at 2 preceding clinic visits. For certain patients, cell phone-based text messaging may enhance chronic disease management support and patient-provider communications beyond the clinic setting.

Impact of a parent-child sexual communication campaign: results from a controlled efficacy trial of parents.

PubMed

Davis, Kevin C; Blitstein, Jonathan L; Evans, W Douglas; Kamyab, Kian

2010-07-21

Prior research supports the notion that parents have the ability to influence their children's decisions regarding sexual behavior. Yet parent-based approaches to curbing teen pregnancy and STDs have been relatively unexplored. The Parents Speak Up National Campaign (PSUNC) is a multimedia campaign that attempts to fill this void by targeting parents of teens to encourage parent-child communication about waiting to have sex. The campaign follows a theoretical framework that identifies cognitions that are targeted in campaign messages and theorized to influence parent-child communication. While a previous experimental study showed PSUNC messages to be effective in increasing parent-child communication, it did not address how these effects manifest through the PSUNC theoretical framework. The current study examines the PSUNC theoretical framework by 1) estimating the impact of PSUNC on specific cognitions identified in the theoretical framework and 2) examining whether those cognitions are indeed associated with parent-child communication Our study consists of a randomized efficacy trial of PSUNC messages under controlled conditions. A sample of 1,969 parents was randomly assigned to treatment (PSUNC exposure) and control (no exposure) conditions. Parents were surveyed at baseline, 4 weeks, 6 months, 12 months, and 18 months post-baseline. Linear regression procedures were used in our analyses. Outcome variables included self-efficacy to communicate with child, long-term outcome expectations that communication would be successful, and norms on appropriate age for sexual initiation. We first estimated multivariable models to test whether these cognitive variables predict parent-child communication longitudinally. Longitudinal change in each cognitive variable was then estimated as a function of treatment condition, controlling for baseline individual characteristics. Norms related to appropriate age for sexual initiation and outcome expectations that communication would be successful were predictive of parent-child communication among both mothers and fathers. Treatment condition mothers exhibited larger changes than control mothers in both of these cognitive variables. Fathers exhibited no exposure effects. Results suggest that within a controlled setting, the "wait until older norm" and long-term outcome expectations were appropriate cognitions to target and the PSUNC media materials were successful in impacting them, particularly among mothers. This study highlights the importance of theoretical frameworks for parent-focused campaigns that identify appropriate behavioral precursors that are both predictive of a campaign's distal behavioral outcome and sensitive to campaign messages.

Evidence-Based Identification of Key Beliefs Explaining Infant Male Circumcision Motivation Among Expectant Parents in Zimbabwe: Targets for Behavior Change Messaging.

PubMed

Montaño, Daniel E; Tshimanga, Mufuta; Hamilton, Deven T; Gorn, Gerald; Kasprzyk, Danuta

2018-02-01

Slow adult male circumcision uptake is one factor leading some to recommend increased priority for infant male circumcision (IMC) in sub-Saharan African countries. This research, guided by the integrated behavioral model (IBM), was carried out to identify key beliefs that best explain Zimbabwean parents' motivation to have their infant sons circumcised. A quantitative survey, designed from qualitative elicitation study results, was administered to independent representative samples of 800 expectant mothers and 795 expectant fathers in two urban and two rural areas in Zimbabwe. Multiple regression analyses found IMC motivation among fathers was explained by instrumental attitude, descriptive norm and self-efficacy; while motivation among mothers was explained by instrumental attitude, injunctive norm, descriptive norm, self-efficacy, and perceived control. Regression analyses of beliefs underlying IBM constructs found some overlap but many differences in key beliefs explaining IMC motivation among mothers and fathers. We found differences in key beliefs among urban and rural parents. Urban fathers' IMC motivation was explained best by behavioral beliefs, while rural fathers' motivation was explained by both behavioral and efficacy beliefs. Urban mothers' IMC motivation was explained primarily by behavioral and normative beliefs, while rural mothers' motivation was explained mostly by behavioral beliefs. The key beliefs we identified should serve as targets for developing messages to improve demand and maximize parent uptake as IMC programs are rolled out. These targets need to be different among urban and rural expectant mothers and fathers.

Message frames interact with motivational systems to determine depth of message processing.

PubMed

Shen, Lijiang; Dillard, James Price

2009-09-01

Although several theoretical perspectives predict that negatively framed messages will be processed more deeply than positively framed messages, a recent meta-analysis found no such difference. In this article, the authors explore 2 explanations for this inconsistency. One possibility is methodological: the statistics used in the primary studies underestimated framing effects on depth of message processing because the data were maldistributed. The other is theoretical: the absence of a main effect is veridical, but framing interacts with individual differences that predispose individuals to greater or lesser depth of processing. Data from 2 experiments (Ns = 286 and 252) were analyzed via tobit regression, a technique designed to overcome the limitations of maldistributed data. One study showed the predicted main effect for framing, but the other did not. Both studies showed the anticipated interaction: Depth of processing correlated positively with a measure of the behavioral activation system in the advantage framing condition, whereas depth of processing correlated positively with the behavioral inhibition system in the disadvantage framing condition.

Interarrival times of message propagation on directed networks.

PubMed

Mihaljev, Tamara; de Arcangelis, Lucilla; Herrmann, Hans J

2011-08-01

One of the challenges in fighting cybercrime is to understand the dynamics of message propagation on botnets, networks of infected computers used to send viruses, unsolicited commercial emails (SPAM) or denial of service attacks. We map this problem to the propagation of multiple random walkers on directed networks and we evaluate the interarrival time distribution between successive walkers arriving at a target. We show that the temporal organization of this process, which models information propagation on unstructured peer to peer networks, has the same features as SPAM reaching a single user. We study the behavior of the message interarrival time distribution on three different network topologies using two different rules for sending messages. In all networks the propagation is not a pure Poisson process. It shows universal features on Poissonian networks and a more complex behavior on scale free networks. Results open the possibility to indirectly learn about the process of sending messages on networks with unknown topologies, by studying interarrival times at any node of the network.

Interarrival times of message propagation on directed networks

NASA Astrophysics Data System (ADS)

Mihaljev, Tamara; de Arcangelis, Lucilla; Herrmann, Hans J.

2011-08-01

One of the challenges in fighting cybercrime is to understand the dynamics of message propagation on botnets, networks of infected computers used to send viruses, unsolicited commercial emails (SPAM) or denial of service attacks. We map this problem to the propagation of multiple random walkers on directed networks and we evaluate the interarrival time distribution between successive walkers arriving at a target. We show that the temporal organization of this process, which models information propagation on unstructured peer to peer networks, has the same features as SPAM reaching a single user. We study the behavior of the message interarrival time distribution on three different network topologies using two different rules for sending messages. In all networks the propagation is not a pure Poisson process. It shows universal features on Poissonian networks and a more complex behavior on scale free networks. Results open the possibility to indirectly learn about the process of sending messages on networks with unknown topologies, by studying interarrival times at any node of the network.

The Effect of Locus of Control on Message Acceptance and Recall.

ERIC Educational Resources Information Center

Cole, Catherine A.; Singh, Surendra

Locus of control is a personality trait that influences human behavior in many situations. Internal-external control reactions to a persuasive message and the recall of the message were examined in two studies. In the first study, 35 undergraduate students' locus of control was measured using Duttweiler's Internal Control Measure. On the basis of…

Acceptability and Feasibility of a Sexual Health Intervention for Young Adult Black Women.

PubMed

Montgomery, Tiffany M; Mays, Vickie M; Heilemann, MarySue V; Nyamathi, Adey; Bauermeister, Jose A; Koniak-Griffin, Deborah

2018-05-16

To assess the acceptability and feasibility of S2S, a newly adapted behavior intervention to address high-risk sexual behavior. Pilot randomized controlled trial. The Internet and text messages with no in-person interactions. Eighty-eight Black women, ages 18 to 24 years, were randomly assigned to the intervention or control groups and self-enrolled in the respective text message program. Participants in the intervention group were sent text messages about sexual health, whereas those in the control group were sent text messages about diet and/or exercise. Participants in each group received 24 text messages, including text-only messages, memes, and infopics. Participants in the intervention group also received videos links. All text messages were sent three times per week for 8 weeks. Quantitative methods were used to analyze data from the message and video platform reports. Quantitative and qualitative methods were used to analyze participants' responses to an acceptability and feasibility survey. Overall, the delivery of health promotion text messages was viewed as acceptable and feasible by participants in both groups. Most of the short answer responses from participants were favorable, and responses to the acceptability and feasibility survey yielded a total mean score of 4.01 on a 5-point scale. Results from this study support the idea that evidence-based interventions can be adapted for delivery by text message. This delivery modality is acceptable to young adult Black women and may help decrease barriers that would otherwise prevent them from receiving health promotion messages. Copyright © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Changing doping-related attitudes in soccer players: how can we get stable and persistent changes?

PubMed

Horcajo, Javier; de la Vega, Ricardo

2014-01-01

The aim of this experiment was to analyse the consequences of changing attitudes related to doping through thoughtful versus non-thoughtful processes. Participants were young soccer players. They received a persuasive message either against or in favour of the legalisation of several doping behaviours in soccer (e.g., the use of anabolic androgenic steroid - AAS), and participants' level of elaboration (i.e., deliberative thinking) was manipulated in two different experimental (high vs. low) conditions. Attitudes towards the legalisation proposal were assessed immediately following the message and one week later. Results showed attitude change was a function of message direction and was relatively equivalent for both high and low elaboration participants immediately after reading the message. That is, those who received the message against legalisation showed significantly more unfavourable attitudes towards the proposal than did those who received the message in favour of legalisation regardless of the extent of elaboration. However, attitude change was found to be persistent only for high elaboration participants one week after message exposure. In the present paper, we discuss implications of changing attitudes related to doping depending on whether the change occurred through psychological processes that require either extensive or small amounts of deliberative thinking and elaboration.

Social Issue Entertainment 2.0: How pop culture, behavioral science and impact evaluation can motivate social and environmental change (Invited)

NASA Astrophysics Data System (ADS)

Shome, D.

2010-12-01

Mainstream entertainment’s influence on our cognition, emotions, and behavior is often profound. Mass media permeates both the public and private spheres of society, saturating communities with messages from a diverse range of sources. While advertisers regularly take advantage of the extensive reach and influence of the media, social scientists, policy makers, and nonprofits have seen little success in incorporating social and environmental messaging into entertainment. Harmony Institute’s goal is to harness the power of mainstream media to provide US audiences with entertainment that educates on social and environmental issues and increases both individual and community action. The entertainment the Institute helps to produce connects with viewers on both a cognitive and emotional level. The Institute uses innovative methods across disciplines in order to measure entertainment’s impact and influence. Since its founding two years ago, the Institute has worked on a wide range of projects that have helped to establish its methodology for measured impact that applies behavioral science theory and entertainment to social and environmental issues. Projects spanning media platforms and social/environmental issues have included a web serial drama incorporating issues of water conservation and ocean stewardship into the narrative and a fotonovela for Hispanic youth in Houston focused on local environmental issues. In summer 2010, the Harmony Institute released FTW! Net Neutrality For The Win: How Entertainment and the Science of Influence Can Save Your Internet, an issue-specific communications guide about open Internet access that explains how to craft a communications strategy that connects with audiences using behavioral science research findings. In 2010-2011, the Institute will focus on measuring the impact and influence that media can have on social and environmental issues. The Institute has developed a comprehensive media evaluation methodology that employs three broad categories (comprehension, attitude, response) for evaluation. This framework accommodates evaluation standards developed across the academic, policy, nonprofit, and commercial worlds and offers a framework for assessing the outcomes and impact of media. I will discuss why narrative and storytelling are the missing links to impactful messaging, why impact evaluation is vital, and how the Harmony Institute’s unique methodology incorporates social and environmental messaging into narrative using behavioral science theory.

Between likes and shares: effects of emotional appeal and virality on the persuasiveness of anticyberbullying messages on Facebook.

PubMed

Alhabash, Saleem; McAlister, Anna R; Hagerstrom, Amy; Quilliam, Elizabeth Taylor; Rifon, Nora J; Richards, Jef I

2013-03-01

Growth in the popularity of social networking sites (SNSs) such as Facebook has been accompanied by unintended negative results (e.g., cyberbullying). SNSs could offer solutions, as well. In this article, we explore the persuasive effects of the emotional appeal and message virality of Facebook status updates. Using status updates for a fictitious anticyberbullying organization, we conducted a 3×2×2×3 (emotional tone × affective evaluation × viral reach × message repetition) mixed factorial experiment (N=365). Positive messages resulted in more positive message evaluations and stronger anticyberbullying attitudes and viral behavioral intentions. Further, low message virality led to the most favorable message evaluations, while high virality resulted in stronger anticyberbullying attitudes.

The Impact of Personal and/or Close Relationship Experience on Memorable Messages about Breast Cancer and the Perceived Speech Acts of the Sender

PubMed Central

Smith, Sandi W.; Atkin, Charles; Skubisz, Christine M.; Munday, Samantha; Stohl, Cynthia

2009-01-01

Background Memorable messages and their speech acts (purposes of the messages) can promote protection against breast cancer and guide health behaviors. Methods Participants reported their personal, friends’, and relatives’ experiences with breast cancer and a memorable message about breast cancer if one came to mind. Those with a memorable message reported its perceived speech acts. Results Individuals who had personal and friend or relative experience with breast cancer were significantly more likely to recall memorable messages than other respondents. The most frequently perceived speech acts were providing facts, providing advice, and giving hope. Conclusion This information should be used to form messages in future breast cancer protection campaigns. PMID:19431030

Roles of guilt and culture in normative influence: testing moderated mediation in the anti-secondhand smoking context.

PubMed

Lee, Hyegyu; Paek, Hye-Jin

2014-01-01

This study simultaneously explored direct, indirect, and joint effects of types of norm messages, guilt, and culture on smokers' behavioral intentions in the anti-secondhand smoking context. An online study among 310 smoking students in an individualistic (United States) and a collectivistic (Korea) country indicated that (1) norm messages had no conditional indirect effects on behavioral intention, (2) guilt arousal had a strong and direct impact on behavioral intention, and (3) guilt arousal and its impact on behavioral intention were stronger among Korean smokers than among US smokers.

The Prime Time Diet: A Content Analysis of Eating Behavior and Food Messages in Television Program Content and Commercials.

ERIC Educational Resources Information Center

Story, Mary; Faulkner, Patricia

1990-01-01

Identifies and analyzes messages related to food and eating behavior as presented on prime time television programing and commercials. Finds that food references occur an average of 4.8 times per 30 minutes and that over half of all food references were for low nutrient beverages and sweets, which is inconsistent with healthy dietary guidelines.…

Do you want the good news or the bad news? Gain- versus loss-framed messages following health risk information: The effects on leisure time physical activity beliefs and cognitions.

PubMed

Bassett-Gunter, Rebecca L; Martin Ginis, Kathleen A; Latimer-Cheung, Amy E

2013-12-01

The primary purpose was to examine the relative effectiveness of chronic disease and psychological health risk information combined with gain- versus loss-framed leisure time physical activity (LTPA) messages for changing perceived personal risk, LTPA response efficacy (i.e., the belief that LTPA can effectively reduce risk), and LTPA intentions. A secondary purpose was to explore the relationship between message framing and cognitive processing. Baseline assessments of perceived risk for inactivity-related disease and psychological health problems, LTPA response efficacy, and intentions were measured among 96 individuals with spinal cord injury (SCI). Participants read population-specific information about the risk for inactivity-related disease and psychological health problems following SCI, and perceived risk was reassessed. Participants were then randomized to read LTPA response efficacy messages emphasizing the benefits of LTPA (gain framed) or the risks of inactivity (loss framed). Immediately following message exposure, cognitive processing (i.e., thought listing and message recall), LTPA response efficacy, and LTPA intentions were assessed. Changes in perceived risk were observed following exposure to health risk information. Changes in LTPA response efficacy and intentions were greater following loss-framed messages targeting psychological health compared with gain-framed messages. Greater cognitive processing was observed following loss-framed messages compared with gain-framed messages. Following exposure to psychological health risk information, loss-framed messages may be more effective than gain-framed messages for eliciting cognitive processing and changing LTPA beliefs and intentions.