Connecting with The Biggest Loser: an extended model of parasocial interaction and identification in health-related reality TV shows

Celebrity Identification and Reasoned Action: An Integrative Model of the Relationship Between Media Use and Breast Cancer Screening Intention

This study investigates the relationship between media use and breast cancer screening intentions by integrating the celebrity identification model and the theory of reasoned action. It tests an integrative model with survey data from 315 U.S. adult women. The study found that media use for breast cancer information was positively associated with parasocial interaction (PSI) and identification with celebrities who have or have had breast cancer; PSI was positively associated with attitudes, descriptive and injunctive norms in breast cancer screening, while identification with celebrities was positively associated with descriptive norms; attitudes, injunctive norms and descriptive norms were positively associated with breast cancer screening intentions. The study supports the mediating effect of PSI, identification, attitudes, and descriptive and injunctive norms on the association between media use and breast cancer prevention intentions.

A Longitudinal Study on the Effects of Parasocial Relationships and Breakups With Characters of a Health-Related TV Show on Self-Efficacy and Exercise Behavior: The Case of The Biggest Loser

Overweight is one of the major health-related challenges in industrialized countries and mostly preventable through a healthy diet and regular engagement in physical activity. Health communication practitioners and researchers, therefore, started using the media's persuasive potential by creating entertainment-education (E-E) programs that promote healthy nutrition and exercise. By observing the characters in E-E programs, audience members can learn vicariously and eventually develop personal bonds with them. The current study investigates the effects of parasocial relationships (PSRs) with characters of a health-related E-E show, as well as the impact of parasocial breakups (PSBUs) on health-relevant outcomes. Using the setting of the show The Biggest Loser (TBL), we conducted a quasi-experimental longitudinal field study. Participants (N = 149) watched shortened episodes of the show once a week for 5 weeks. Results showed that PSRs with the reality TV characters did not increase over time and after repeated exposure. Findings furthermore suggest that PSR did not influence self-efficacy perceptions or exercise behavior over time. Parasocial breakup distress intensity was neither related to self-efficacy nor to exercise behavior. Interpretations of these findings and implications for better understanding the effects of PSRs and PSBUs are discussed.

Testing Narrative Persuasion of a Culturally Grounded, School-Based "Dale Se REAL" Entertainment-Education Intervention and Peer Communication on Nicaraguan Adolescent Substance Use

Guided by narrative engagement theory and social cognitive theory, the present study investigates effects of narrative persuasion and peer communication on Nicaraguan adolescent substance use. Eighth-grade students in Nicaragua were recruited to participate in the culturally grounded, school-based prevention intervention Dale se REAL and to watch five entertainment-education intervention videos that teach drug refusal communication strategies. Using the cross-sectional survey (N = 224), a path analysis was run to examine the mediated moderation effects of narrative engagement (e.g., interest, realism, and identification with main characters) and peer communication about the intervention videos (e.g., frequency and valence of communication) on adolescent refusal self-efficacy and substance use behaviors. Results revealed that realism was significantly related to adolescent refusal self-efficacy and frequent peer communication moderated the association between refusal self-efficacy and the past 30-day marijuana use. Findings suggest that health communication scholars should take into consideration social factors and cultural contexts for adolescent substance use prevention research.

Continuance Intention of Online Healthcare Communities- The Mediation Mechanism of Social Interaction Ties

The purpose of this research is to evaluate the continuance usage intention on online healthcare community (OHC) platform for patients and examine the "doctor-OHC-patient" relationship. The proposed model attempted to integrate social interaction ties, shared value, trust with the indirect effects on the relationship between the determinants and continuous usage intention of the OHC platform. The empirical results showed that perceived critical mass, social identity, and para-social interaction would strengthen continuance intention via the social interaction ties. In addition, this study found that the shared values and trust increase users' willingness to continue usage of OHC. This study provides OHC platform managers with an in-depth understanding of the "doctor-OHC-patient" online social interaction. The results of this study may also help hospitals, health policy makers, and related healthcare practitioners to improve the way they use the web for advocacy and guidance, and provide insight into the intent of promoting the ongoing use of OHC platforms.

Medical Drama Viewing and Medical Trust: A Moderated Mediation Approach

This study investigates the relationship between medical drama viewing and medical trust, applying the cultivation theory and using a moderated mediation approach. A multigroup Structural Equation Modeling analysis of survey data on 983 U.S. adults indicates that exposure to medical dramas is positively associated with perceived realism of medical dramas, which in turn is positively associated with trust in physicians in medical dramas, and this trust in physicians in medical dramas is positively associated with trust in physicians in the real world. The study suggests that perceived realism of and trust in physicians in medical dramas mediate the relationship between medical drama viewing and medical trust, with health literacy moderating this cultivation process. Implications and future research directions are discussed.

Audience Responses to Physical Activity in the Biggest Loser Australia

The popular reality television show The Biggest Loser Australia (TBL) is a significant source of media content about physical activity. This study examined audience responses to and interpretations of physical activity in TBL. A qualitative study using in-depth interviews was conducted in New South Wales, Australia. A sample of 46 viewers of TBL was recruited, stratified by gender, age group, area of residence, and body mass index. Interview data were thematically analyzed to identify how viewers evaluated TBL. Respondents were most positive about TBL as public health education, premised on personal responsibility, the need for extreme action, and the possibilities of human agency (individually and collectively). Conversely, they were critical about whether the portrayal of physical activity could guide and inspire them personally. They expressed feelings of disgust and fear in response to the exercise challenges, questioned the practicality of the behavior change process in light of their own experience, and were skeptical about the purpose of the program itself. TBL's representation of physical activity may be limited in its capacity to encourage physical activity. Despite the wide viewership of this program, encouraging physical requires innovation in the development of practical, persuasive and evidence based media messages about physical activity.

The Influence of Information Appraisals and Information Behaviors on the Acceptance of Health Information: A Study of Television Medical Talk Shows in South Korea

As television medical talk shows have become an increasingly popular source of health information, it is important to understand the processes by which people come to accept, at times unconditionally, the information presented by these shows. Based on the heuristic-systematic model (HSM), this study explores the way by which individuals process health information from television medical talk shows. Specifically, this study examines the relationship between information exposure, information appraisals (e.g., appropriateness and incoherence), information behaviors (e.g., information seeking and sharing), and unconditional acceptance of health information. Results from a survey of 588 women in South Korean indicate that an individual's appraisal of information as being appropriate or incoherent influences unconditional acceptance of health information. Both types of information appraisals are positively associated with information seeking, which is negatively associated with unconditional acceptance of information. In contrast, neither of these appraisals have an impact on unconditional acceptance via information sharing. Notably, when information appraisals are not considered, information exposure is positively associated with information sharing, which is then positively associated with unconditional acceptance. Implications for health information consumers and practitioners are discussed.

Entertainment-Education Videos as a Persuasive Tool in the Substance Use Prevention Intervention "keepin' it REAL"

Based on social cognitive theory and narrative engagement theory, the current study examined hypothesized indirect effects of engagement with keepin' it REAL (kiR) curriculum entertainment-education (E-E) videos on youth alcohol use via youth drug offer refusal efficacy. Students in 7th grade (N = 1,464) at 25 public schools in two Midwestern states were randomly assigned to one of the two versions of the kiR curriculum, the kiR urban version and the kiR rural version. Each version had their own set of five culturally-grounded E-E videos depicting communicative skills to refuse drug offers. Differential effects for engagement components were expected depending on the degree of cultural matching. Pre/post surveys were administered at the beginning and the end of 7th grade. Structural equation modeling analysis resulted in partial support for the research hypotheses. Rural youth receiving the urban curriculum who reported higher interest in the E-E videos were more likely to report having higher refusal efficacy, and in turn, less likely to use alcohol. Rural youth receiving the rural curriculum who identified with the E-E video main characters were more likely to report having higher refusal efficacy, and in turn, less likely to use alcohol. Implications for E-E health promotion are discussed.

Perceived Efficacy and Intentions Regarding Seeking Mental Healthcare: Impact of Deepika Padukone, A Bollywood Celebrity's Public Announcement of Struggle with Depression

The current research examines the impact of Deepika Padukone's (one of the most popular Bollywood celebrities) public announcement of struggle with depression on people's perceived efficacy and intentions to seek help for mental healthcare. A survey conducted with 206 participants from India, the country with the highest depression rates in the world, revealed that parasocial interaction with the celebrity mediated the effect of exposure on intentions and efficacy perceptions regarding seeking mental healthcare. Our study expands the research on celebrity influence on health conditions in an international realm and in a mental health context. The findings have immense practical implications and may raise awareness about mental health in India given the popularity and reach of Bollywood among audiences in India and beyond, the level of stigmatization attached to mental health issues in India, and the lack of available resources for care. Theoretically, the study explores processes and effects of involvement with a celebrity and discusses potential implications for the behaviors related to health.

Celebrity Influence and Identification: A Test of the Angelina Effect

Angelina Jolie's announcement that she is a BRCA1 carrier and has had a prophylactic bilateral mastectomy was met with widespread support as well as speculation about its possible impact on the public. These speculations were the subject of a Time magazine cover story titled "The Angelina Effect" (Kluger et al., 2013 ). Although there is anecdotal evidence to support this hypothesized Angelina effect, empirical tests are lacking. To explore possible links between Angelina's announcement and public health, we surveyed 356 adults immediately after the announcement. Guided by a model of celebrity influence, the survey assessed participants' demographics and health history, identification and parasocial interaction with Jolie, and genetic testing intentions. Results supported the model's predictions and provided preliminary evidence of an Angelina effect.