Which messages about healthy and sustainable eating resonate best with consumers with low socio-economic status?

Consumers with low socioeconomic status (SES) eat less healthy and sustainable diets than consumers with higher status. This is attributed, at least in part, to inequalities in health communication. An online survey with 134 socioeconomically disadvantaged consumers in Italy was conducted to test the effectiveness of tailor-made communication material (infographics) about healthy and sustainable eating (HSE). Participants were recruited at two social supermarkets by a social service organisation as well as via a crowdsourcing platform. Participants found information about HSE delivered through infographics moderately effective in increasing motivation, capability, and opportunity for HSE, and moderately useful and likely to impact their behaviour. Certain messages were more effective than others for native consumers, while migrants showed more indifferent responses to the various messages and manifested lower motivation to shift towards HSE, limited access to and seeking of nutrition-related information, and lower trust in information sources. Selecting which messages to deliver strategically, while also considering differences between segments of the target audience and their preferred sources and channels for communication, is promising; yet, structural changes related to food's affordability and availability are also needed to facilitate an effective communication.

"Trust Me, I'm a Doctor." How TikTok Videos from Different Sources Influence Clinical Trial Participation

This study experiments with TikTok videos to promote clinical trial participation. More specifically, it examines how short-form video sources (doctors vs. prior volunteers for clinical trials) influence perceived source credibility, self-efficacy, and behavioral intention to participate in clinical trials. Findings from this online experiment (N = 396) showed that doctor sources led to greater behavioral intention through enhancing source credibility compared to prior volunteer sources. Alternatively, prior volunteer sources increased behavioral intention via enhanced self-efficacy for participants with low trust in doctors. These findings contribute to the understanding of how short-form video sources act as heuristic cues, leading to persuasion outcomes. Overall, we recommend featuring doctors when using video-based messages to promote clinical trial participation. Also, this study emphasizes the need for health communication practitioners to consider prior volunteers as spokespersons when targeting populations with low baseline trust in doctors.

A Content Analysis of Online Messages about Sugar-Sweetened Beverages

Media campaigns can reduce or promote the consumption of sugar-sweetened beverages (SSBs). Brief, US-based English-language online messages were gathered from searchable media platforms, a process that yielded 112 anti-SSB videos and 29 pro-SSB commercials. Using a combination of inductive and deductive methods, a content analysis of those messages was conducted to identify their properties. They were coded for the direction (pro vs. anti), target of the advocacy (e.g., consumption vs. policy), actor demographics (gender, age, and ethnicity), persuasive theme (e.g., excessive sugar, nurturing), and message sensation value. Anti-SSB appeals primarily targeted individual-level consumption behavior. They utilized six persuasive themes and often included more than one theme in a single message. Pro-SSB messages used feel-good themes and utilized only one theme per message. The proportions of adults, adolescents, and children differed by the direction of the advocacy. Black, Hispanic, and Asian actors were under-represented in the anti-SSB sample relative to Whites. Pro-SSB appeals were slightly higher than anti-SSB appeals in message sensation value (p = 0.09). The findings illuminate the message features that characterize the universe of brief anti-SSB appeals available online, highlight messaging disparities, and reveal the absence of certain common, effective persuasive themes.

Exploring the Influence of YouTube on Digital Health Literacy and Health Exercise Intentions: The Role of Parasocial Relationships

The purpose of this study was to analyze the mediating role of digital health literacy and the moderating effect of parasocial relationships on the relationship between the viewing experience of health exercise-related YouTube content and the intention for health exercise behavior. Based on the health action process approach, this study established a foundational theoretical model to analyze how digital health literacy mediates the impact of media viewing experience on health exercise behavior intention. Additionally, this study examined the moderating effect of parasocial relationships with YouTube creators. For empirical analysis, variables were measured using a self-administration method among 409 randomly sampled consumers of YouTube health exercise content. The collected data were analyzed using a structural equation model incorporating mediation parameters, and a multigroup model analysis was conducted to understand differences based on parasocial relationships. The results revealed that increased YouTube viewing experience enhanced cognitive, skill, and evaluative components of digital health literacy, which were significant factors in increasing health exercise behavior intention. Notably, the mediating effect of cognition played a crucial role, and the strengthening effect of parasocial relationships on this relationship was confirmed. These findings can be utilized as practical foundational data for designing digital health communication strategies, particularly in developing motivational mechanisms that encourage consumers to engage voluntarily and consistently in health behaviors based on online health information.

Parasocial interactions with media characters: the role of perceived and actual sociodemographic and psychological similarity

Introduction

Similarity between media character and viewer is an important predictor of parasocial interactions. Thereby, similarities are often limited to single characteristics or to the similarities viewers perceive between themselves and characters. This article expands the existing literature in two ways. First, the effects of actual and perceived similarity on parasocial interactions are compared. Second, similarity is understood in a broad way. With age, gender, job, relationship, and living situation are assessed for sociodemographic similarities. Psychological similarities are considered with the Big Five personality traits, loneliness, and self-esteem.

Methods

The study employs a multimethod design with a field study using tracking data, experience sampling surveys, and content analysis. With the content analysis, characters' characteristics can be indicated independent from the viewers to assess actual similarity in a more objective way.

Results

In these everyday viewing settings, parasocial interactions increased with similarities in extraversion and perceived Big Five traits and decreased with similarities in age and consciousness. The other assessed similarity types did not influence parasocial interactions.

Discussion

Taken together, the study underlines the importance of differentiating between actual and perceived similarity when analyzing viewer PSI with media characters, and to specify the particular type of similarity.

How Resources Combining Expertise and Social Support Help Breastfeeding Women Address Self-Doubt and Increase Breastfeeding Self-Efficacy: A Mixed-Methods Study

Existing research on parental information literacy focuses on parents' ability to evaluate information. This approach does not account for conflicting or unwanted information and obscures the emotional impact of unsought information. We aimed to (1) document the sources women use most frequently for accessing breastfeeding information, (2) explore the reasons women choose some sources over others, (3) test the relationship between source characteristics and breastfeeding self-efficacy, and (4) determine the extent to which four source characteristics - competence, trustworthiness, goodwill, and social support - predict breastfeeding self-efficacy. This study was conducted in two phases. The first phase consisted of interviews and focus groups, which we analyzed inductively using a grounded theory approach. In phase two, we conducted a cross-sectional survey of women who were currently breastfeeding, collecting data on the source credibility and social support associated with the source they use most frequently and the participants' breastfeeding self-efficacy. We used multiple regression to analyze our survey data. The frequency with which our participants encountered conflicting and unsought prompted them to view sources that combine expertise and social support as ideal. However, these sources are often difficult to access, leading to a reliance on online sources. This compromise has implications for breastfeeding tenure, as both competence and social support predicted breastfeeding self-efficacy. This study demonstrates how emotional aspects of information seeking shape women's preferred sources, how accessibility limits the use of preferred sources, and how source competence and social support influence breastfeeding self-efficacy.

An extension of the extended parallel process model to promote heart-healthy exercise behavior: An experimental study

Background: The prevalence of heart disease has increased and is a leading cause of death in the U.S. Despite the importance of physical activity, only one-third of adults in the United States meet the amount of physical activity recommended by the Centers for Disease Control and Prevention (CDC). The purpose of this study was to extend the extended parallel process model (EPPM) by adding a 'barrier' (a construct from Health Belief Model) and exploring the roles of threat, efficacy, and barrier on participants' self-efficacy, attitudes, and intentions toward exercise. Methods: A between-subject experimental design was conducted online in 2018 in the U.S. A total of 446 participants were recruited from the Amazon Mechanical Turk age 18 or above. The participants were first provided with stimuli messages about physical activity behaviors. Then participants' responses to self-efficacy, intention, and attitudes toward exercise were assessed. Results: The results found an interaction between efficacy and barrier to participants' attitudes toward exercise [F(1,435)=4.35, P=0.038, η² _part=0.01]. The results also showed that there was a statistically significant effect of barriers on participants' self-efficacy regarding exercise behavior [F(1,442)=4.21, P=0.04, η² _part=0.009]. However, three-way interactions of threat, efficacy, and barrier were not found in attitudes or intentions to exercise. Conclusion: The findings suggested that addressing an individual's perceived barrier regarding a health behavior may lead to an increase in self-confidence ensuing in higher physical activity. Future studies should further explore how addressing barriers may influence other health behaviors to design unique and effective health messages.

Message Source Credibility and E-Cigarette Harm Perceptions among Young Adults

This study examined the effect of message source credibility on e-cigarette harm perceptions among U.S. young adults. An online experimental study was conducted where young adults (n = 302, Mage = 23.7) were randomized to an e-cigarette public health education message from an expert or a peer young adult. Then, participants answered questions about their perceptions about the message source and e-cigarettes. Results suggest that young adults rated experts as a more credible source (vs. peer) (b = −0.39, SE = 0.15, 95% CI [−0.67, −0.10], p < 0.01). Young adults reported greater perceived credibility of the expert message (vs. peer), which was associated with increased e-cigarette harm perceptions. Increased perceived source credibility mediated the association of increased e-cigarette absolute harm perceptions from viewing an expert message (b = −0.11, SE = 0.04, 95% CI: −0.20, −0.02). Source credibility should be considered when designing e-cigarette education messages for young adults.

Toward a Recipe for Deep versus Surface Level Tailoring: Mixed-Methods Validation of Message Features to Reduce Sugary Beverage Consumption

Targeted marketing contributes to the overconsumption of sugary beverages, which contributes to obesity and diabetes disparities among African American and Latino populations in the U.S. Health communicators can similarly use culturally tailored messages to decrease sugary beverage consumption among these groups, yet the specific strategies to operationalize cultural tailoring-the message components essential for such tailoring-are ill-described. We sought to identify and validate authentically created, culturally tailored messages using a multiple step mixed-methods approach. First, we used a snowball approach to identify nutrition education messages targeting ethnic minorities about reducing sugary beverage consumption (N = 85). Via content analysis, we assessed message features (character gender and race/ethnicity), level of change of the appeal (individual or social), and level of cultural tailoring (surface level tailoring in the form of matching character gender and race/ethnicity with target audience versus deep structural tailoring in the form of appealing to values is an effective message strategy). The highest-rated videos were then validated by a sample of the target audience using a quantitative survey and qualitative comments (N = 76). The results inform theorizing on message tailoring and provide a validated pool of culturally relevant messages intended both to reduce intentions to consume sugary beverages and to engage in social change actions.

Protocol: Effectiveness of message content and format on individual and collective efficacy in reducing the intention to consume sugar-sweetened beverages

The strategic use of media is a common approach to promote health. A large body of evidence identifies specific features that increase message efficacy, including tailoring messages to the target audience and using a storytelling format. Yet most message testing research has focused on individual-level outcomes, ignoring the social and environmental determinants of health behaviors, which require collective action and political will to change. Grounded in an ecological approach to communication, we will carry out two double-blinded randomized experiments to test the relative effectiveness of message tailoring (culturally-tailored vs. standard) and format (narrative vs. didactic) to increase the intention to reduce individual sugar-sweetened beverage consumption, the understanding of social and commercial determinants of health, and the sense of empowerment among young adult Latinas. Based on power analyses (80% power at alpha = 0.05), we will randomize 438 participants to two groups (traditional standard infographic and culturally-tailored infographic) in the first study, and 662 participants to two groups (culturally-tailored infographic and culturally-tailored comic book) in the second study. All participants will be measured by a pre-treatment test and an immediate post-treatment test. We hypothesize that culturally-tailored comic book will be most effective, and traditional standard infographic will be least effective, on all levels of outcomes. This study will provide empirical evidence in communication strategies to help young Latinos or other racial/ethnic minority young people to pursue positive dietary behaviors that both benefit themselves and contribute to change of social norms.

How Does the Implicit Awareness of Consumers Influence the Effectiveness of Public Service Announcements? A Functional Near-Infrared Spectroscopy Study

A large number of scholars have conducted detailed studies on the effectiveness of commercial advertising by using neuroimaging methods, but only a few scholars have used this method to study the effectiveness of public service announcements (PSAs). To research the relationship between the effectiveness of PSAs and the audience’s implicit awareness, functional near-infrared spectroscopy (fNIRS) was employed to record the neural activity data of participants in this study. The results showed that there was a correlation between activation of dorsolateral prefrontal cortex (dlPFC) and the effectiveness of PSAs; The activation of the dlPFC could also be used as an indicator to represent the appeal of advertising content. The results means that neuroimaging tool can also be used to investigate the effectiveness of PSAs, not just commercial advertisements and a few PSAs study, and that neural activity can predict and improve the effectiveness of PSAs before they are released.

The Power of Unrequited Love: The Parasocial Relationship, Trust, and Organizational Identification Between Middle-Level Managers and CEOs

Previous studies have found that CEOs manage their firms through traditional methods such as leadership and management practices. In this study, we investigate how the parasocial relationship (PSR) between middle-level managers and CEOs affects the organizational trust and the organizational identification (OI) of middle managers. We find that the PSR between middle managers and CEOs has a positive effect on the OI of middle managers, which is mediated by the organizational trust of middle managers.

Purpose: Middle managers and CEOs are the key components of a firm and are crucial to firm strategies and control systems. Middle managers play a vital role in information transmission like in the organizational hierarchy while CEOs influence low-level employees through middle managers. In this study, we investigate how the PSR between middle managers and CEOs affects organizational trust and OI.

Design/Methodology: In this study, the data concerning OI, integrity perception, and organizational trust are derived from a survey conducted by the internal control research group of the China Securities Regulatory Commission (CSRC). The research group began the survey on September 5, 2014, for the firms listed in the A-share market, accounting firms with securities and future practice qualifications, and institutional investors through the accounting department of the CSRC, the Shanghai Stock Exchange, the Shenzhen Stock Exchange, and the Asset Management Association of China. The research group members surveyed 2,536 A-share firms listed on the Shanghai Stock Exchange and Shenzhen Stock Exchange. As of October 31, 2014, 2,154 sets of questionnaires with a total of 12,551 questionnaires were received, with a response rate of 84.95%. The financial and accounting data are from the China Stock Market and Accounting Research (CSMAR) database.

Findings: We find that the PSR between middle managers and CEOs has a positive effect on the OI of middle managers, which is mediated by the organizational trust of middle managers. This study extends the application of the parasocial interaction (PSI) theory, organizational trust theory, and social identity theory in listed firms.

Practical Implication: There are practical implications for internal relationship management, corporate governance, and performance management. CEOs should value the influence of organizational trust and improve his/her own social and work abilities on middle-level managers as the organizational trust of middle-level managers has a significant positive impact on their sense of responsibility, ethical behavior, organizational commitment, job satisfaction, and performance. CEOs should adopt various methods to influence different managers because organizational trust mediates the relationship between the PSR and OI.

Originality/Value: Our study is one of the first attempts to apply the PSI theory to the corporate world. Given the dynamics of present-day markets and changing stakeholder demands, there is little insight into how this relationship affects organizational health and functioning. Much less what a PSR between CEO and middle management looks like in practice. Our study attempts to fill the gap by investigating how CEOs might come to affect middle managers through their practices and behaviors.

Community-Led Action to Reduce Menthol Cigarette Use in the African American Community

Background. African Americans suffer a disproportionate burden of tobacco harm and researchers have posited that menthol cigarettes are a key contributor to this disparity. In 2015, a county health department and African American community-based organization (CBO) in Minnesota partnered to educate and engage the African American community on menthol and its role in tobacco-related health disparities. The following case study describes successes, challenges, and recommendations from this work. We focus on the role of a public health and community partnership in menthol policy adoption so others can more effectively implement a community-driven approach in their own communities. Methods. Interviews were conducted with local and state public health staff, leadership from the CBO, youth coordinators, and change agents-that is, leaders in the African American community recruited to educate and engage the community on menthol. Interviews were transcribed verbatim and analyzed in Atlas.ti using thematic analysis. Results. Participants identified several successes: (1) assessment data from community members helped inform policy decision making, (2) collaboration between local public health and CBO was powerful and a key to success, and (3) change agents were trusted communicators and effectively engaged and provided education to the community. Participants faced challenges related to stylistic and cultural differences in communication. Participants recommended engaging youth and incorporating cessation into the broader context of issues systemically affecting African American communities (e.g., economic inequity, police violence, incarceration). Implications. Menthol tobacco restrictions have the potential to reduce tobacco-related health inequities for African Americans. Findings highlight the role that public health and community partnerships can play in supporting this critical work to effect policy change.

OTC drug advertising in Japan: the role of need for cognition and celebrity endorser credibility

This research explores how the level of consumers' need for cognition (NFC) is associated with celebrity endorser credibility and examines its effects on advertising-related attitudes. A 3 (endorser types: actor/actress, athlete, TV personality/talent) × 2 (endorser's gender) factorial experiment with 435 Japanese consumers was conducted. Concerning Japanese OTC drug advertising, lower NFC individuals perceived celebrity endorsers as more credible in comparison to higher NFC individuals. The main effects of NFC and endorser type on endorser credibility existed; however, no interaction between the two variables was found. The endorser type had an influence on attitudes toward ads and the advertised brand.

The interplay between endorser social status and normative appeals on the endorsement effectiveness of pro-environmental behaviors

Employing message endorser is a popular strategy in encouraging consumers to protect the environment. This research explores how the social status of endorsers and the forms of normative messages can influence the effectiveness of endorsement for pro-environmental behaviors. Drawing on the focus theory of normative conduct and the match-up hypothesis, the authors propose that the effects of endorser social status on consumers’ responses to green advertising are contingent on whether the normative messages is framed as injunctive norms or descriptive norms. In three experiments, the results indicate that participants show more positive attitudes toward the advertisement and higher intentions to act environmentally friendly when endorsers with high social status are presented in combination with injunctive norm appeals. In contrast, ordinary consumer endorsers produce stronger impact on attitudes and behavioral intentions when descriptive norm appeals are used. These findings show that marketers using endorsers to promote pro-environmental behaviors should develop normative message accordingly.

Congruence and celebrity endorser credibility in Japanese OTC drug advertising

Purpose

Based on congruency theory, this study aims to examine the effects of celebrity endorsement on endorser credibility in Japanese over-the-counter (OTC) drug advertising using multiple celebrity categories. In particular, this research explored brand–endorser congruence and endorser–consumer congruence and their roles in attitude formation.

Design/methodology/approach

A 3 (endorser categories: actor/actress, athlete and talent/TV personality) × 2 (endorser’s gender) factorial experimental design with 480 Japanese consumers was used in the study.

Findings

In Japanese OTC drug advertising, actors/actresses and athletes were regarded as more credible than talents (TV personalities) by Japanese consumers. Endorser categories also had a significant influence on identification with the endorser through ideal self-congruency. Additionally, endorser credibility mediated the relationship between identification and advertising evaluations. However, it did not mediate the relationship between perceived similarity with the endorser and advertising responses.

Originality/value

Little is known about the effectiveness of celebrity endorsers in OTC drug advertising from a source credibility perspective. This study attempted to shed light on the role of endorser fit in the framework of source credibility in drug advertising that usually places an emphasis on informational cues rather than peripheral cues such as source effects.