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Quick BL, Morrow E, Bigman CA, Reynolds-Tylus T, Williamson LD. An evaluation of the license to save lives program to promote organ, eye, and tissue donation among teenagers. Clin Transplant 2024; 38:e15183. [PMID: 37943531 DOI: 10.1111/ctr.15183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023]
Abstract
As the number of designated organ donors continues to lag behind the number of waiting list patients, teenagers remain a promising demographic of potential organ donors. The current study enlisted Michigan and Ohio driver education students to participate in an online digital learning intervention, License to Save Lives (LTSL). Students were randomly assigned to either an interactive or noninteractive LTSL intervention. Across both states, the pretest-posttest design revealed greater knowledge among students following exposure to either the interactive or noninteractive LTSL program. No attitudinal or behavioral differences emerged between the interactive and noninteractive conditions. Michigan (39.82%) and Ohio (58.10%) students registered to be organ donors at a respectable rate. The results are discussed with an emphasis on feasibility and sustainability as well as the promise for digital games to promote organ donation knowledge, attitude, and registration among teenagers.
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Affiliation(s)
- Brian L Quick
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Ethan Morrow
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Cabral A Bigman
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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2
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Reynolds-Tylus T, Quick BL, Bigman CA, Williamson LD. An examination of teenagers' beliefs toward organ donor registration. Clin Transplant 2021; 35:e14237. [PMID: 33527535 DOI: 10.1111/ctr.14237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 12/10/2020] [Accepted: 01/23/2021] [Indexed: 11/29/2022]
Abstract
Teenagers represent a promising target population for organ donor registration efforts, as in the US teenagers age 15-17 may register their intent for organ donation, which later translates to consent at age 18. However, teenagers constitute a relatively understudied population in the organ donation literature. A sample of teenagers (N = 466) ranging in age from 13 to 19 was recruited from driver's education schools in Ohio and Michigan in order to learn more about their perceived reasons for and against registering as an organ donor. A coding scheme was developed, and responses were coded by two trained coders. In line with previous work in adult samples, our results revealed the three most common reasons for registering were prosocial benefits, rational arguments, and personal experience. In contrast to previous work among adults, the two most common reasons for not registering were bodily integrity and religious reasons. Several novel beliefs among teenagers that were both supportive and non-supportive of organ donor registration were identified. Findings from the current study are discussed with an emphasis on implications for practitioners working to promote organ donor registration among teenage audiences.
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Affiliation(s)
| | - Brian L Quick
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Cabral A Bigman
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Lillie D Williamson
- Department of Communication Arts, University of Wisconsin-Madison, Madison, WI, USA
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3
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Tan ASL, Bigman CA. Misinformation About Commercial Tobacco Products on Social Media-Implications and Research Opportunities for Reducing Tobacco-Related Health Disparities. Am J Public Health 2020; 110:S281-S283. [PMID: 33001728 DOI: 10.2105/ajph.2020.305910] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Andy S L Tan
- Andy S. L. Tan is with the Annenberg School for Communication, University of Pennsylvania, Philadelphia. Cabral A. Bigman is with the Department of Communication, University of Illinois at Urbana-Champaign
| | - Cabral A Bigman
- Andy S. L. Tan is with the Annenberg School for Communication, University of Pennsylvania, Philadelphia. Cabral A. Bigman is with the Department of Communication, University of Illinois at Urbana-Champaign
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4
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Mello S, Stifano S, Tan AS, Sanders-Jackson A, Bigman CA. Gendered Conceptions of Preconception Health: A Thematic Analysis of Men's and Women's Beliefs about Responsibility for Preconception Health Behavior. J Health Commun 2020; 25:374-384. [PMID: 32602417 DOI: 10.1080/10810730.2020.1775728] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Preconception health (PCH) focuses on taking steps before a pregnancy to safeguard the health of the woman and future baby. Although recommendations to improve PCH target all people of reproductive age, research shows most interventions and messages focus primarily on women, which may contribute to existing normative beliefs that women are more responsible for protecting children's health. In this study, we explore society's gendered expectations of responsibility for engaging in recommended PCH behaviors (i.e., avoiding smoking, drinking, and environmental toxins). An applied thematic analysis of online survey responses from U.S. men and women (N = 573) identified five main themes and related subthemes: body and health, shared responsibility, choice and moral obligation, gender stereotypes, and doubt and uncertainty. Both men and women frequently referenced biological connections between prospective parents and offspring as justification for PCH behaviors. When challenging PCH recommendations, respondents mentioned excessive control of women and men's secondary role in reproduction. Overall, gender stereotypes were more commonly expressed in relation to men yet reflected both traditional and contemporary male roles (i.e., as supporters, co-parents). When judging personal responsibility, women commonly viewed PCH behaviors as the 'duty of a good mother'. Implications for PCH communication research and practice are discussed.
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Affiliation(s)
- Susan Mello
- Communication Studies Department, Northeastern University , Boston, MA, USA
| | - Sara Stifano
- Department of Communication, University of Connecticut , Storrs, CT, USA
| | - Andy Sl Tan
- Dana-Farber Cancer Institute, Population Sciences Division, Center for Community Based Research , Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health , Boston, MA, USA
| | - Ashley Sanders-Jackson
- Department of Advertising and Public Relations, Michigan State University , East Lansing, MI, USA
| | - Cabral A Bigman
- Department of Communication, University of Illinois at Urbana-Champaign , Urbana, IL, USA
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5
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Luo M, Wang N, Bigman CA. Effects of Opinion Climate, Efficacy Messages, and Publicness of Social Media on Intentions to Retransmit Anti-Binge Drinking Messages on Facebook. Cyberpsychol Behav Soc Netw 2020; 22:677-683. [PMID: 31697597 DOI: 10.1089/cyber.2019.0119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Reducing the rate of college binge drinking is a major public health goal. Social media sites such as Facebook serve as platforms for young adults' online communication, so they could potentially extend the reach of health campaign messages via retransmission. Thus, it is important to identify the factors that predict intentions to share health-related messages on social media. Drawing on the Spiral of Silence framework, the current research examined the effects of opinion climate, message efficacy, and publicness of social media on message retransmission intentions for anti-binge drinking "how-to" messages-messages that include advice and recommendations that target beliefs about efficacy. A 2 × 2 × 2 (efficacy: high vs. low × opinion climate: support vs. oppose × channel: public vs. private) between-subjects experiment was conducted. Data from 245 participants on Amazon Mechanical Turk demonstrated that people were more willing to share when they had an anti- rather than a pro-binge drinking opinion climate, when the messages were more useful, and when they were asked to share via private messaging rather than via public status updates. Theoretical and practical implications for the psychological mechanisms underlying message retransmission on social media are discussed.
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Affiliation(s)
- Mufan Luo
- Department of Communication, Stanford University, Stanford, California
| | - Ningxin Wang
- Department of Management and Organization, Business School, National University of Singapore, Singapore, Singapore
| | - Cabral A Bigman
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, Illinois
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Tan ASL, Bigman CA, Mello S, Sanders-Jackson A. Trends in the Prevalence of Exposure to e-Cigarette Aerosol in Public Places Among US Middle and High School Students, 2015 to 2018. JAMA Netw Open 2019; 2:e1910184. [PMID: 31461145 PMCID: PMC6716292 DOI: 10.1001/jamanetworkopen.2019.10184] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This survey study examines trends in and factors associated with exposure to secondhand smoke from combusted tobacco and secondhand aerosol from electronic cigarettes (e-cigarettes) among US youth from 2015 to 2018.
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Affiliation(s)
- Andy S L Tan
- Center for Community Based Research, Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Cabral A Bigman
- Department of Communication, College of Liberal Arts and Sciences, University of Illinois Urbana-Champaign, Urbana
| | - Susan Mello
- College of Arts, Media and Design, Department of Communication Studies, Northeastern University, Boston, Massachusetts
| | - Ashley Sanders-Jackson
- College of Communication Arts and Science, Department of Advertising and Public Relations, Michigan State University, East Lansing
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7
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Bekalu MA, Ramanadhan S, Bigman CA, Nagler RH, Viswanath K. Graphic and Arousing? Emotional and Cognitive Reactions to Tobacco Graphic Health Warnings and Associated Quit-Related Outcomes Among Low SEP Population Groups. Health Communication 2019; 34:726-734. [PMID: 29388802 DOI: 10.1080/10410236.2018.1434733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Research on graphic health warnings (GHWs) indicates that beyond changing cognitions about the health effects of smoking, GHWs evoke emotional reactions that can influence quit-related outcomes. Emotions can be classified based on valence (positive or negative) and arousal (calm or excited). However, although considerable research has examined the differential effectiveness of positive versus negative GHW-evoked emotions, research investigating the role of arousal activation in quit-related behaviors is scarce. This study examined associations between quit-related outcomes (intention and attempt to quit) and GHWs-evoked negative emotions classified as high and low in arousal activation as well as cognitive reactions among smokers of low socioeconomic position (SEP). It also examined whether perceived health risks of smoking moderate the relationship between emotional and cognitive reactions to GHWs and quit-related outcomes. Data were collected from low SEP smokers in three Massachusetts communities. Participants were screened and randomized to view one of the nine GHWs initially proposed for use by the U.S. Food and Drug Administration (FDA) and answered pre- and post-exposure questions. Results showed that GHW-evoked negative emotions high in arousal activation and cognitive reactions were both significantly associated with intention to quit during immediate post-test, controlling for age, warning label difference, and prior quit intention. However, these associations did not hold for quit attempts at follow-up. Perceived health risks of smoking moderated the association between cognitive reactions to GHWs and quit attempts at follow-up. The findings suggest that not all negative emotions evoked by GHWs are effective. Negative emotions high in arousal activation may be more effective in influencing quit-related behavioral intentions in low SEP groups. Additionally, unlike emotional reactions, cognitive reactions to GHWs may have effects that last relatively longer, but only among smokers who had low levels of perceived health risks of smoking at baseline.
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Affiliation(s)
- Mesfin Awoke Bekalu
- a Department of Social and Behavioral Sciences , Harvard T.H. Chan School of Public Health; Center for Community-Based Research, Dana-Farber Cancer Institute
| | - Shoba Ramanadhan
- a Department of Social and Behavioral Sciences , Harvard T.H. Chan School of Public Health; Center for Community-Based Research, Dana-Farber Cancer Institute
| | - Cabral A Bigman
- b Department of Communication , University of Illinois at Urbana-Champaign
| | - Rebekah H Nagler
- c School of Journalism & Mass Communication; School of Public Health , University of Minnesota
| | - Kasisomayajula Viswanath
- a Department of Social and Behavioral Sciences , Harvard T.H. Chan School of Public Health; Center for Community-Based Research, Dana-Farber Cancer Institute
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Bigman CA, Mello S, Sanders-Jackson A, Tan ASL. Speaking up about Lighting up in Public: Examining Psychosocial Correlates of Smoking and Vaping Assertive Communication Intentions among U.S. Adults. Health Commun 2019; 34:500-510. [PMID: 29364737 PMCID: PMC6501571 DOI: 10.1080/10410236.2018.1428849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Against a backdrop of increasing smoke-free policies, electronic cigarette use, and discussion about public health risks posed by smoking and vaping, this study examines psychosocial predictors of intentions to ask others not to use e-cigarettes (vape) and smoke - i.e., assertive communication intentions. A national sample of U.S. adults (n = 474) reported assertive communication intentions for public venues. Psychosocial correlates included perceived risks of exposure to secondhand smoke (SHSe) and secondhand vapor (SHVe), SHSe and SHVe attitudes, subjective norms, and perceived self-efficacy. Separate linear regression models were conducted for smoking and vaping assertive communication intention outcomes. Perceived risks and self-efficacy were associated with greater vaping and smoking assertive communication intentions; subjective norms were only significant for vaping assertive communication intentions. Although a majority of respondents indicated they were unlikely to intervene to voice objections about SHSe and SHVe in public venues, this study suggests that incidental or intentional messages and policies that influence perceptions of risk, norms, and efficacy could affect willingness to voice objections about others' vaping and smoking in public.
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Affiliation(s)
- Cabral A Bigman
- a Department of Communication , University of Illinois Urbana-Champaign
| | - Susan Mello
- b Department of Communication Studies , Northeastern University
| | | | - Andy S L Tan
- d Department of Social and Behavioral Sciences , Harvard University T.H. Chan School of Public Health and Division of Population Sciences, Center for Community-Based Research, Dana-Farber Cancer Institute
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9
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Williamson LD, Smith MA, Bigman CA. Does Discrimination Breed Mistrust? Examining the Role of Mediated and Non-Mediated Discrimination Experiences in Medical Mistrust. J Health Commun 2019; 24:791-799. [PMID: 31559916 DOI: 10.1080/10810730.2019.1669742] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Medical mistrust is associated with a decreased likelihood of engaging in various health behaviors, including health utilization and preventive screening. Despite calls for research to address medical mistrust, few studies have explicitly delved into antecedents to medical mistrust. The current study a) examines the relationship between discrimination experiences and medical mistrust and b) experimentally tests the influence of mediated vicarious discrimination on reported levels of medical mistrust. Participants (N = 198) were randomly assigned to view news stories in one of four experimental conditions: no exposure, no discrimination control, implicit racial discrimination, and explicit racial discrimination. Results indicated prior personal and vicarious discrimination experiences were related to medical mistrust. Furthermore, exposure to mediated discrimination influenced medical mistrust in different ways for Black and White participants. Among Black participants, medical mistrust was significantly higher for those exposed to the implicit racial discrimination condition than the control condition. Marginal differences were found for White participants such that those exposed to both explicit and implicit racial discrimination conditions reported higher medical mistrust than those exposed to the control condition. Our findings are discussed in terms of the theoretical and practical implications for health communication scholars seeking to examine and influence health behaviors.
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Affiliation(s)
- Lillie D Williamson
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Marisa A Smith
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Cabral A Bigman
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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10
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Williamson LD, Bigman CA. A systematic review of medical mistrust measures. Patient Educ Couns 2018; 101:1786-1794. [PMID: 29861339 DOI: 10.1016/j.pec.2018.05.007] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 05/04/2018] [Accepted: 05/05/2018] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Medical mistrust is seen as a barrier to health promotion and addressing health disparities among marginalized populations. This study seeks to examine how medical mistrust has been measured as a step towards informing related health promotion efforts. METHODS A systematic review of medical mistrust scales was conducted using four major databases: PubMed, PsycINFO, ERIC, and Communication & Mass Media Complete. Databases were searched using the terms "medical mistrust scale" "medical mistrust" and "medical distrust." RESULTS The search returned 1595 non-duplicate citations; after inclusion and exclusion criteria were applied, 185 articles were retained and coded. Almost a quarter of studies used a single-item or a few items. Among validated scales, the Group-Based Medical Mistrust Scale, Medical Mistrust Index, and Health Care System Distrust Scale were most frequently used. There were important differences among these scales such as the object of mistrust (e.g., system, individual physician) and referent specificity (e.g., group). The measurement of medical mistrust varied by health topic and sample population. CONCLUSION These differences in scales and measurement should be considered in the context of intervention goals. PRACTICE IMPLICATIONS Researchers should be aware of differences in measures and choose appropriate measures for a given research question or intervention.
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Affiliation(s)
- Lillie D Williamson
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
| | - Cabral A Bigman
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
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11
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Molina Y, Zimmermann K, Carnahan LR, Paulsey E, Bigman CA, Khare MM, Zahnd W, Jenkins WD. Rural Women's Perceptions About Cancer Disparities and Contributing Factors: a Call to Communication. J Cancer Educ 2018; 33:749-756. [PMID: 28243956 PMCID: PMC5572753 DOI: 10.1007/s13187-017-1196-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Rural cancer disparities are increasingly documented in the USA. Research has identified and begun to address rural residents' cancer knowledge and behaviors, especially among women. Little, however, is known about rural female residents' awareness of cancer inequities and perceived contributing factors affecting them and their families. The purpose of this study was to address these gaps in the literature via a secondary analysis of qualitative needs assessment in Illinois' rural southernmost seven counties, a geographic region with relatively high rates of cancer incidence, morbidity, and mortality. A convenience sample of 202 rural adult female residents was recruited and participated in 26 focus groups, with 3-13 women per group. Inductive content analysis, guided by the principle of constant comparison, was used to analyze the qualitative data. Most respondents indicated their awareness of disproportionate cancer burden in their communities. Individual-level behaviors and environmental toxins were identified as contributing factors. Interestingly, however, environmental toxins were more often discussed as factors contributing to geographic differences, whereas individual-level behaviors were noted as important for overall cancer prevention and control. This study provides important insight into female rural residents' perspectives and offers novel venues for educational programs and research in the context of communication to eliminate disparities.
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Affiliation(s)
- Yamile Molina
- University of Illinois at Chicago, 1603 West Taylor Street (MC923), Chicago, IL, 60612, USA.
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| | - Kristine Zimmermann
- University of Illinois at Chicago, 1603 West Taylor Street (MC923), Chicago, IL, 60612, USA
| | - Leslie R Carnahan
- University of Illinois at Chicago, 1603 West Taylor Street (MC923), Chicago, IL, 60612, USA
| | - Ellen Paulsey
- University of Illinois at Chicago, 1603 West Taylor Street (MC923), Chicago, IL, 60612, USA
| | | | | | - Whitney Zahnd
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Wiley D Jenkins
- Southern Illinois University School of Medicine, Springfield, IL, USA
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12
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Bekalu MA, Bigman CA, McCloud RF, Lin LK, Viswanath K. The relative persuasiveness of narrative versus non-narrative health messages in public health emergency communication: Evidence from a field experiment. Prev Med 2018; 111:284-290. [PMID: 29154794 PMCID: PMC6118116 DOI: 10.1016/j.ypmed.2017.11.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 11/08/2017] [Accepted: 11/10/2017] [Indexed: 11/17/2022]
Abstract
Previous studies indicated that narrative health messages are more effective than non-narrative messages in influencing health outcomes. However, this body of evidence does not account for differences in health domain, and little is known about the effectiveness of this message execution strategy during public health emergencies. In this study, we examined the relative effectiveness of the two formats in influencing knowledge and perceived response efficacy related to prevention of pandemic influenza, and determined whether effects of message format vary across population sub-groups. Data for the study come from an experiment fielded in 2013 that involved a nationally representative sample of 627 American adults. Participants were randomly assigned to view either a narrative (n=322) or a non-narrative (n=305) video clip containing closely matched information about knowledge and preventive actions related to pandemic influenza, and completed pre- and post-viewing questions assessing knowledge and perceived response efficacy related to the prevention of pandemic influenza. Results indicated that participants in the non-narrative condition reported greater knowledge and rated pandemic influenza prevention measures as more effective compared with those in the narrative condition. Message format effects did not vary across population sub-groups; post-viewing scores of knowledge and perceptions related to pandemic influenza were consistently higher in the non-narrative condition compared with the narrative condition across five socio-demographic groups: age, gender, education, race/ethnicity and income. We concluded that didactic, non-narrative messages may be more effective than narrative messages to influence knowledge and perceptions during public health emergencies.
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Affiliation(s)
- Mesfin A Bekalu
- Harvard T.H. Chan School of Public Health, 450 Brookline Avenue, LW 601, Boston, MA 02215, United States.
| | - Cabral A Bigman
- Department of Communication, University of Illinois at Urbana-Champaign, USA
| | - Rachel F McCloud
- Harvard T.H. Chan School of Public Health, 450 Brookline Avenue, LW 601, Boston, MA 02215, United States
| | - Leesa K Lin
- Harvard T.H. Chan School of Public Health, 450 Brookline Avenue, LW 601, Boston, MA 02215, United States
| | - K Viswanath
- Harvard T.H. Chan School of Public Health, 450 Brookline Avenue, LW 601, Boston, MA 02215, United States
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Lin L, McCloud RF, Bigman CA, Viswanath K. Tuning in and catching on? Examining the relationship between pandemic communication and awareness and knowledge of MERS in the USA. J Public Health (Oxf) 2018; 39:282-289. [PMID: 27084759 PMCID: PMC7107521 DOI: 10.1093/pubmed/fdw028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Large-scale influenza outbreaks over the last decade, such as SARS and H1N1, have brought to global attention the importance of emergency risk communication and prompted the international community to develop communication responses. Since pandemic outbreaks are relatively infrequent, there is a dearth of evidence addressing the following questions: (i) Have the resources invested in strategic and routine communication for past pandemic outbreaks yielded public health preparedness benefits? (ii) Have past efforts sensitized people to pay attention to new pandemic threats? The Middle East Respiratory Syndrome (MERS) that was followed closely by major media outlets in the USA provides an opportunity to examine the relationship between exposure to public communication about epidemics and public awareness and knowledge about new risks. Methods In December, 2013, we surveyed a nationally representative sample of 627 American adults and examined the associations between people's awareness to prior pandemics and their awareness of and knowledge about MERS. Results Awareness of prior pandemics was significantly associated with awareness and knowledge of MERS. The most common sources from which people first heard about MERS were also identified. Conclusions Communication inequalities were observed between racial/ethnic and socioeconomic positions, suggesting a need for more effective pandemic communication.
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Affiliation(s)
- Leesa Lin
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, USA.,Division of Policy Translation and Leadership Development, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rachel F McCloud
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Cabral A Bigman
- Department of Communication, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Kasisomayajula Viswanath
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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14
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Tan ASL, Lee CJ, Nagler RH, Bigman CA. To vape or not to vape? Effects of exposure to conflicting news headlines on beliefs about harms and benefits of electronic cigarette use: Results from a randomized controlled experiment. Prev Med 2017; 105:97-103. [PMID: 28882742 PMCID: PMC5653463 DOI: 10.1016/j.ypmed.2017.08.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 08/16/2017] [Accepted: 08/27/2017] [Indexed: 11/30/2022]
Abstract
News coverage of novel tobacco products including e-cigarettes has framed the use of these products with both positive and negative slants. Conflicting information may shape public knowledge, perceptions of e-cigarettes, and their harms. The objective of this study is to assess effects of exposure to conflicting news coverage on US adults' beliefs about harms and benefits of e-cigarette use. We conducted a one-way between-subjects randomized controlled experiment in 2016 to compare the effects of viewing either 1) positive, 2) negative, 3) both positive and negative (conflicting) news headlines about the safety of using e-cigarettes, or 4) no-message. Participants were 2056 adults aged 18 and older from an online survey panel. Outcomes were beliefs about harms (3-item scale, α=0.76) and benefits (3-item scale, α=0.82) of using e-cigarettes. Participants who viewed negative headlines reported increased beliefs about harms (B=0.164, p=0.039) and lower beliefs about benefits of e-cigarette use (B=-0.216, p=0.009), compared with those in the positive headlines condition. These differences were replicated in subgroup analyses among never e-cigarette users. In addition, never e-cigarette users who viewed conflicting headlines reported lower beliefs about benefits of e-cigarette use (B=-0.221, p=0.030) than the positive headlines condition. Valence of news coverage about e-cigarettes (positive, negative, or conflicting) could influence people's beliefs about harms and benefits of e-cigarette use.
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Affiliation(s)
- Andy S L Tan
- Dana-Farber Cancer Institute, Population Sciences Division, Center for Community Based Research, Boston, USA; Harvard TH Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, USA.
| | - Chul-Joo Lee
- Seoul National University, Department of Communication, Seoul, Republic of Korea
| | - Rebekah H Nagler
- University of Minnesota, Hubbard School of Journalism and Mass Communication, Minneapolis, USA
| | - Cabral A Bigman
- University of Illinois at Urbana-Champaign, Department of Communication, Urbana, USA
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Tan ASL, Bigman CA, Nagler RH, Minsky S, Viswanath K. Comparing perceived effectiveness of FDA-proposed cigarette packaging graphic health warnings between sexual and gender minorities and heterosexual adults. Cancer Causes Control 2017; 28:1143-1155. [PMID: 28866791 DOI: 10.1007/s10552-017-0954-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/29/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND In 2012, the U.S. Food and Drug Administration proposed nine graphic health warnings (GHWs) on cigarette packaging that were rated equally effective across racial/ethnic, education, or income groups of adult smokers. However, data on GHW effectiveness among sexual and gender minority (SGM) adults, who have higher smoking prevalence, are currently lacking. This study analyzed whether perceived effectiveness of GHWs differed by gender and sexual orientation. METHODS Data came from a randomized experiment among 1,200 adults with an oversample from low socioeconomic status groups, conducted between 2013 and 2014 in three Massachusetts communities. Participants viewed and rated the effectiveness of nine GHWs. Mixed effects regression models predicted perceived effectiveness with gender and sexual orientation, adjusting for repeated measurements, GHWs viewed, age, race, ethnicity, smoking status, and health status. RESULTS Female heterosexuals rated GHWs as more effective than male heterosexual, lesbian, and transgender and other gender respondents. There was no significant difference between female and male heterosexuals versus gay, male bisexual, or female bisexual respondents. Differences by gender and sexual orientation were consistent across all nine GHWs. Significant correlates of higher perceived effectiveness included certain GHWs, older age, being African-American (vs white), being Hispanic (vs non-Hispanic), having less than high school education (vs associate degree or higher), and being current smokers (vs non-smokers). CONCLUSIONS Perceived effectiveness of GHWs was lower in certain SGM groups. We recommend further studies to understand the underlying mechanisms for these findings and investments in research and policy to communicate anti-smoking messages more effectively to SGM populations.
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Affiliation(s)
- Andy S L Tan
- Population Sciences Division, Center for Community Based Research, Dana-Farber Cancer Institute, Boston, MA, USA. .,Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA.
| | - Cabral A Bigman
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Rebekah H Nagler
- Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis, MN, USA
| | - Sara Minsky
- Population Sciences Division, Center for Community Based Research, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Kasisomayajula Viswanath
- Population Sciences Division, Center for Community Based Research, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
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Tan ASL, Mello S, Sanders-Jackson A, Bigman CA. Knowledge about Chemicals in e-Cigarette Secondhand Vapor and Perceived Harms of Exposure among a National Sample of U.S. Adults. Risk Anal 2017; 37:1170-1180. [PMID: 27595498 PMCID: PMC5567734 DOI: 10.1111/risa.12676] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 06/27/2016] [Accepted: 07/05/2016] [Indexed: 06/06/2023]
Abstract
Potentially harmful chemicals are detectable in e-cigarette secondhand vapor (hereafter SHV), contrary to advertising and marketing claims that it contains "only water vapor." We assessed public knowledge about the presence of chemicals in SHV and associations between knowledge and perceived harms of exposure to SHV. We conducted an online survey of a nationally representative sample of 1,449 U.S. adults (GfK's KnowledgePanel) from October to December 2013. Respondents were asked whether e-cigarette vapor contains only water vapor, contains tar, or contains formaldehyde (true/ false/ do not know). Responses to these three items were recoded (1 = incorrect, 2 = do not know, and 3 = correct) and averaged into a knowledge scale. They were also asked if they perceived breathing SHV to be harmful to one's health (two-item scale) and comparative harm of breathing SHV versus breathing secondhand smoke (SHS). Multiple regression analyses were weighted to the U.S. adult population and adjusted for potential confounders. Most respondents (58-75%) reported not knowing whether SHV contained only water vapor, if SHV contained tar, and if it contained formaldehyde. African-American respondents (vs. white) and current smokers (vs. nonsmokers) had lower levels of knowledge about chemicals in SHV. Adjusting for covariates, correct knowledge about chemicals in SHV was associated with higher perceived harms about SHV for one's health and perceived comparative harm of SHV versus SHS. These findings suggest a need to provide accurate information about the presence of chemicals in SHV (e.g., using product ingredient labels or public education).
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Affiliation(s)
- Andy SL Tan
- Dana-Farber Cancer Institute, Population Sciences Division, Center for Community Based Research, Boston, USA
- Harvard School of Public Health, Department of Social and Behavioral Sciences, Boston, USA
| | - Susan Mello
- Northeastern University, Department of Communication Studies, Boston, USA
| | | | - Cabral A. Bigman
- University of Illinois at Urbana-Champaign, Department of Communication, Urbana, USA
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Nagler RH, Bigman CA, Ramanadhan S, Ramamurthi D, Viswanath K. Prevalence and Framing of Health Disparities in Local Print News: Implications for Multilevel Interventions to Address Cancer Inequalities. Cancer Epidemiol Biomarkers Prev 2017; 25:603-12. [PMID: 27196094 DOI: 10.1158/1055-9965.epi-15-1247] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 02/09/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Americans remain under-informed about cancer and other health disparities and the social determinants of health (SDH). The news media may be contributing to this knowledge deficit, whether by discussing these issues narrowly or ignoring them altogether. Because local media are particularly important in influencing public opinion and support for public policies, this study examines the prevalence and framing of disparities/SDH in local mainstream and ethnic print news. METHODS We conducted a multi-method content analysis of local mainstream (English language) and ethnic (Spanish language) print news in two lower income cities in New England with substantial racial/ethnic minority populations. After establishing intercoder reliability (κ = 0.63-0.88), coders reviewed the primary English and Spanish language newspaper in each city, identifying both disparities and non-disparities health stories published between February 2010 and January 2011. RESULTS Local print news coverage of cancer and other health disparities was rare. Of 650 health stories published across four newspapers during the one-year study period, only 21 (3.2%) discussed disparities/SDH. Although some stories identified causes of and solutions for disparities, these were often framed in individual (e.g., poor dietary habits) rather than social contextual terms (e.g., lack of food availability/affordability). Cancer and other health stories routinely missed opportunities to discuss disparities/SDH. CONCLUSION Local mainstream and ethnic media may be ideal targets for multilevel interventions designed to address cancer and other health inequalities. IMPACT By increasing media attention to and framing of health disparities, we may observe important downstream effects on public opinion and support for structural solutions to disparities, particularly at the local level. Cancer Epidemiol Biomarkers Prev; 25(4); 603-12. ©2016 AACR SEE ALL ARTICLES IN THIS CEBP FOCUS SECTION, "MULTILEVEL APPROACHES TO ADDRESSING CANCER HEALTH DISPARITIES".
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Affiliation(s)
- Rebekah H Nagler
- School of Journalism & Mass Communication, University of Minnesota, Minneapolis, Minnesota.
| | - Cabral A Bigman
- Department of Communication, University of Illinois, Urbana-Champaign, Illinois
| | - Shoba Ramanadhan
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Divya Ramamurthi
- Stanford Research into the Impact of Tobacco Advertising, Stanford School of Medicine, Palo Alto, California
| | - K Viswanath
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Sanders-Jackson A, Tan ASL, Bigman CA, Mello S, Niederdeppe J. To Regulate or Not to Regulate? Views on Electronic Cigarette Regulations and Beliefs about the Reasons for and against Regulation. PLoS One 2016; 11:e0161124. [PMID: 27517716 PMCID: PMC4982617 DOI: 10.1371/journal.pone.0161124] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/30/2016] [Indexed: 01/28/2023] Open
Abstract
Background Policies designed to restrict marketing, access to, and public use of electronic cigarettes (e-cigarettes) are increasingly under debate in various jurisdictions in the US. Little is known about public perceptions of these policies and factors that predict their support or opposition. Methods Using a sample of US adults from Amazon Mechanical Turk in May 2015, this paper identifies beliefs about the benefits and costs of regulating e-cigarettes and identifies which of these beliefs predict support for e-cigarette restricting policies. Results A higher proportion of respondents agreed with 8 different reasons to regulate e-cigarettes (48.5% to 83.3% agreement) versus 7 reasons not to regulate e-cigarettes (11.5% to 18.9%). The majority of participants agreed with 7 out of 8 reasons for regulation. When all reasons to regulate or not were included in a final multivariable model, beliefs about protecting people from secondhand vapor and protecting youth from trying e-cigarettes significantly predicted stronger support for e-cigarette restricting policies, whereas concern about government intrusion into individual choices was associated with reduced support. Discussion This research identifies key beliefs that may underlie public support or opposition to policies designed to regulate the marketing and use of e-cigarettes. Advocates on both sides of the issue may find this research valuable in developing strategic campaigns related to the issue. Implications Specific beliefs of potential benefits and costs of e-cigarette regulation (protecting youth, preventing exposure to secondhand vapor, and government intrusion into individual choices) may be effectively deployed by policy makers or health advocates in communicating with the public.
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Affiliation(s)
- Ashley Sanders-Jackson
- Michigan State University, Department of Advertising and Public Relations, College of Communication Arts and Science, 404 Wilson Road, Lansing, Michigan, United States of America
- * E-mail:
| | - Andy S. L. Tan
- Harvard University, TH Chan School of Public Health, Department of Social and Behavioral Sciences, Kresge Building, 677 Huntington Avenue, Boston, Massachusetts, United States of America
| | - Cabral A. Bigman
- University of Illinois Urbana-Champaign, College of Liberal Arts and Sciences, Department of Communication, 3001 Lincoln Hall, 702 S. Wright Street Urbana, Illinois, United States of America
| | - Susan Mello
- Northeastern University, Department of Communication Studies, College of Arts, Media and Design, 360 Huntington Ave., Boston, Massachusetts, United States of America
| | - Jeff Niederdeppe
- Cornell University, College of Agriculture and Life Sciences, Department of Communication, 476 Mann Library Building, Ithaca, New York, United States of America
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Bigman CA, Nagler RH, Viswanath K. Representation, Exemplification, and Risk: Resonance of Tobacco Graphic Health Warnings Across Diverse Populations. Health Commun 2016; 31:974-87. [PMID: 26757354 DOI: 10.1080/10410236.2015.1026430] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
As countries implement Article 11 of the World Health Organization (WHO) Framework Convention on Tobacco Control, graphic warning labels that use images of people and their body parts to illustrate the consequences of smoking are being added to cigarette packs. According to exemplification theory, these case examples-exemplars-can shape perceptions about risk and may resonate differently among demographic subpopulations. Drawing on data from eight focus groups (N = 63) with smokers and nonsmokers from vulnerable populations, this qualitative study explores whether people considered exemplars in their reactions to and evaluations of U.S. graphic health warning labels initially proposed by the Food and Drug Administration. Participants made reference to prior and concurrent mass media messages and exemplars during the focus groups and used demographic cues in making sense of the images on the warning labels. Participants were particularly sensitive to age of the exemplars and how it might affect label effectiveness and beliefs about smoking. Race and socioeconomic status also were salient for some participants. We recommend that exemplars and exemplification be considered when selecting and evaluating graphic health warnings for tobacco labels and associated media campaigns.
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Affiliation(s)
- Cabral A Bigman
- a Department of Communication , University of Illinois at Urbana-Champaign
| | - Rebekah H Nagler
- b School of Journalism & Mass Communication , University of Minnesota
| | - K Viswanath
- c Department of Social and Behavioral Sciences , Harvard T. H. Chan School of Public Health; Center for Community-Based Research and Dana-Farber Cancer Institute
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Tan ASL, Bigman CA, Sanders-Jackson A. Sociodemographic correlates of self-reported exposure to e-cigarette communications and its association with public support for smoke-free and vape-free policies: results from a national survey of US adults. Tob Control 2015; 24:574-81. [PMID: 25015372 PMCID: PMC4289647 DOI: 10.1136/tobaccocontrol-2014-051685] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 06/21/2014] [Indexed: 11/03/2022]
Abstract
BACKGROUND Exposure to e-cigarette communications (eg, advertisements, news and entertainment media, and interpersonal discussion) may influence support for smoke-free or vape-free policies. This study examined the sociodemographic correlates of self-reported exposure to e-cigarette communications and their relationships with support for restricting vaping and smoking in public venues. METHOD Online survey data was collected from a representative sample of US adults (n=1449) between October and December 2013 (mean age=50 years, 51% female, 8% African-American, 10% Hispanic, 6% other races) and weighted to match the US adult population. We fitted multiple regression models, adjusting for demographic variables, to examine associations between support for policies to restrict vaping and smoking in public venues and self-reported frequency of exposure to e-cigarette communications in the preceding month. We fitted separate models to assess associations between policy support and frequency of exposures weighted by whether each category of e-cigarette communications was perceived as positive or negative. RESULTS Higher self-reported exposure to advertising (B=-0.022, p=0.006), other media (B=-0.022, p=0.043) and interpersonal discussion (B=-0.071, p<0.0005) perceived as positive were associated with lower support for vaping restrictions, adjusting for covariates. Exposure to e-cigarette communications was associated with lower support for smoking restrictions in bivariate analyses but was not significant after adjusting for covariates. CONCLUSIONS Further research is needed to assess whether messages portraying e-cigarettes as a way to circumvent smoking restrictions from advertisements and other media are influencing public support for vape-free policies. These findings provide empirical evidence to inform the policy debate over regulating specific e-cigarette advertising claims.
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Affiliation(s)
- Andy SL Tan
- University of Pennsylvania, Annenberg School for Communication, Philadelphia, USA
| | - Cabral A. Bigman
- University of Illinois at Urbana-Champaign, Department of Communication, Urbana, USA
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Mello S, Bigman CA, Sanders-Jackson A, Tan ASL. Perceived Harm of Secondhand Electronic Cigarette Vapors and Policy Support to Restrict Public Vaping: Results From a National Survey of US Adults. Nicotine Tob Res 2015; 18:686-93. [PMID: 26470722 DOI: 10.1093/ntr/ntv232] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/01/2015] [Indexed: 12/25/2022]
Abstract
INTRODUCTION There is ongoing debate over banning electronic cigarette (e-cigarette) use (vaping) in public places. Many people perceive secondhand e-cigarette vapors (SHV) to be relatively harmless, which may affect their support for policies to restrict vaping in public places. Given that awareness of secondhand cigarette smoke risks predicts public support for clean air policies, we hypothesized that greater perceived harm of SHV to personal health would be associated with stronger support for vaping restrictions. METHODS Data from 1449 US adults in a national online panel was collected from October to December 2013. Using multiple regressions, we predict a three-item scale of support for e-cigarette restricting policies in restaurants, bars/casinos/clubs, and parks using a two-item scale measuring concern and perceptions of harm to personal health from breathing SHV. Analyses adjusted for demographic covariates, smoking status and e-cigarette use, and were weighted to represent the US adult population. RESULTS Overall, respondents considered SHV exposure to be moderately harmful to their health and tended to favor restricting vaping in public places. Perceived harm of SHV to personal health was associated with support for vaping restrictions in public spaces (unstandardized regression coefficient, B = 0.18, 95% CI = 0.16, 0.20). Current smokers (vs. nonsmokers), those who ever tried e-cigarettes (vs. never), those who directly observed others vaping, and those with some college education (vs. high school or less) demonstrated less support for such policies. IMPLICATIONS This study shows that support for banning vaping in public spaces in the United States is positively associated with perceived health harms of SHV exposure. The findings suggest that continued monitoring of public perception of SHV harm and the accuracy of e-cigarette marketing claims about reduced harm would be needed to guide clean air policy decisions. With the emergence of new scientific evidence of the potential effects of SHV exposure, these results will serve as an important baseline of public perceptions and opinion during a time when such evidence was particularly limited.
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Affiliation(s)
- Susan Mello
- Department of Communication Studies, Northeastern University, Boston, MA;
| | - Cabral A Bigman
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL
| | - Ashley Sanders-Jackson
- Department of Advertising and Public Relations, Michigan State University, East Lansing, MI
| | - Andy S L Tan
- Population Sciences Division, Center for Community Based Research, Dana-Farber Cancer Institute, Boston, MA; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA
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Sanders-Jackson AN, Tan ASL, Bigman CA, Henriksen L. Knowledge About E-Cigarette Constituents and Regulation: Results From a National Survey of U.S. Young Adults. Nicotine Tob Res 2015; 17:1247-54. [PMID: 25542915 PMCID: PMC4592338 DOI: 10.1093/ntr/ntu276] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 12/08/2014] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To examine young adults' knowledge of e-cigarette constituents and regulation and its association with product use and self-reported exposure to marketing. METHODS Young adults (18-34 years, N = 1,247) from a U.S. web panel were surveyed in March 2014. Using multinomial logistic regressions, self-reported exposure to marketing was examined as a predictor of whether participants responded correctly (reference category), incorrectly, or "don't know" to four knowledge items-whether e-cigarettes contain nicotine, contain toxic chemicals, are regulated by government for safety, and are regulated for use as a cessation aid. Analyses adjusted for demographics and smoking status and were weighted to match the U.S. young adult population. RESULTS Most respondents did not know if e-cigarettes, contain toxic chemicals (48%), are regulated for safety (61%), and are regulated as cessation aids (68%); fewer than 37% answered all of these items correctly. Current users of e-cigarettes (past 30 days) had a lower likelihood of being incorrect about safety testing (p = .006) and being regulated as a cessation aid (p = .017). Higher exposure to e-cigarette marketing was associated with a lower likelihood of responding "don't know" than being correct, and with a higher likelihood of being incorrect as opposed to correct about e-cigarettes containing nicotine. CONCLUSIONS Knowledge about e-cigarette constituents and regulation was low among young adults, who are the largest consumer group for these products. Interventions, such as warning labels or information campaigns, may be necessary to educate and correct misinformation about these products.
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Affiliation(s)
| | - Andy S L Tan
- Center of Excellence in Cancer Communication Research, Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
| | - Cabral A Bigman
- Department of Communication, College of Liberal Arts and Sciences, University of Illinois at Urbana-Champaign, Urbana, IL
| | - Lisa Henriksen
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA
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Tan ASL, Bigman CA, Mello S, Sanders-Jackson A. Is exposure to e-cigarette communication associated with perceived harms of e-cigarette secondhand vapour? Results from a national survey of US adults. BMJ Open 2015; 5:e007134. [PMID: 25814497 PMCID: PMC4386241 DOI: 10.1136/bmjopen-2014-007134] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES E-cigarettes are frequently advertised and portrayed in the media as less harmful compared with regular cigarettes. Earlier surveys reported public perceptions of harms to people using e-cigarettes; however, public perceptions of harms from exposure to secondhand vapour (SHV) have not been studied. We examined associations between self-reported exposure to e-cigarette advertising, media coverage, and interpersonal discussion and perceived harms of SHV. DESIGN Observational study. SETTING National online sample of US adults aged ≥18 years. PARTICIPANTS 1449 US adults (mean age 49.5 years), 51.3% female, 76.6% non-Hispanic Caucasian, 7.5% African-American, 10.0% Hispanic and 5.9% other races. OUTCOMES Perceived harm measures included (1) harmfulness of SHV to one's health, (2) concern about health impact of breathing SHV and (3) comparative harm of SHV versus secondhand smoke (SHS). Predictors were (1) self-reported frequency of exposure to e-cigarette advertising, media coverage and interpersonal discussion (close friends or family) and (2) perceived valence of exposure from each source. Covariates were demographic characteristics, cigarette smoking status and e-cigarette use, and were weighted to the general US adult population. RESULTS More frequent interpersonal discussion was associated with lower perceived harmfulness of SHV to one's health and lower perceived comparative harm of SHV versus SHS. Frequency of e-cigarette ad and other media exposure were not significant predictors. Perceived negative valence of ad exposure and interpersonal discussion (vs no exposure) was associated with higher perceived harm across all three outcomes, while negative valence of media coverage was associated with higher concern about health impact of breathing SHV. Perceived positive valence (vs no exposure) of interpersonal discussion was associated with lower perceived harm across all three outcomes about health impact of breathing SHV. CONCLUSIONS Exposure to information about e-cigarettes through advertising, media coverage and interpersonal discussion could play a role in shaping public perceptions of the harmfulness of SHV.
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Affiliation(s)
- Andy S L Tan
- Population Sciences Division, Dana-Farber Cancer Institute, Center for Community Based Research, Boston, USA Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Boston, USA
| | - Cabral A Bigman
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, USA
| | - Susan Mello
- Department of Communication Studies, Northeastern University, Boston, USA
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Abstract
News about health disparities often compares health risks faced by different demographic groups. Does this social comparison produce a contrast effect? It was hypothesized that when two racial groups are compared, people would perceive the relatively more at-risk group to be more, and the less at-risk group to be less, at-risk than if the same risk information was presented without the comparative reference group. Three experiments with Black and White respondents tested effects of intergroup social comparison framing (SCF) on perceptions of risk for sexually transmitted infections and skin cancer. SCF (including one White and two Black disparity frames) did not raise respondents' perceived risk regarding the more at-risk racial group, but consistently lowered respondents' risk ratings for the less at-risk racial group. The finding that the same statistic was perceived differently in comparative and noncomparative contexts underscores the importance of considering effects of communication about disparities.
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Affiliation(s)
- Cabral A Bigman
- a School of Public Health, Harvard University, Dana-Farber Cancer Institute
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Kim HS, Bigman CA, Leader AE, Lerman C, Cappella JN. Narrative Health Communication and Behavior Change: The Influence of Exemplars in the News on Intention to Quit Smoking. J Commun 2012; 62:473-492. [PMID: 22736808 PMCID: PMC3377164 DOI: 10.1111/j.1460-2466.2012.01644.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
This study investigated psychological mechanisms underlying the effect of narrative health communication on behavioral intention. Specifically, the study examined how exemplification in news about successful smoking cessation affects recipients' narrative engagement, thereby changing their intention to quit smoking. Nationally representative samples of U.S. adult smokers participated in 2 experiments. The results from the 2 experiments consistently showed that smokers reading a news article with an exemplar experienced greater narrative engagement compared to those reading an article without an exemplar. Those who reported more engagement were in turn more likely to report greater smoking cessation intentions.
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Affiliation(s)
- Hyun Suk Kim
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Cabral A. Bigman
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Amy E. Leader
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Caryn Lerman
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Joseph N. Cappella
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104, USA
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Bigman CA, Cappella JN, Hornik RC. Effective or ineffective: attribute framing and the human papillomavirus (HPV) vaccine. Patient Educ Couns 2010; 81 Suppl:S70-6. [PMID: 20851560 PMCID: PMC2993779 DOI: 10.1016/j.pec.2010.08.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 08/16/2010] [Accepted: 08/18/2010] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To experimentally test whether presenting logically equivalent, but differently valenced effectiveness information (i.e. attribute framing) affects perceived effectiveness of the human papillomavirus (HPV) vaccine, vaccine-related intentions and policy opinions. METHODS A survey-based experiment (N=334) was fielded in August and September 2007 as part of a larger ongoing web-enabled monthly survey, the Annenberg National Health Communication Survey. Participants were randomly assigned to read a short passage about the HPV vaccine that framed vaccine effectiveness information in one of five ways. Afterward, they rated the vaccine and related opinion questions. Main statistical methods included ANOVA and t-tests. RESULTS On average, respondents exposed to positive framing (70% effective) rated the HPV vaccine as more effective and were more supportive of vaccine mandate policy than those exposed to the negative frame (30% ineffective) or the control frame. Mixed valence frames showed some evidence for order effects; phrasing that ended by emphasizing vaccine ineffectiveness showed similar vaccine ratings to the negative frame. CONCLUSION The experiment finds that logically equivalent information about vaccine effectiveness not only influences perceived effectiveness, but can in some cases influence support for policies mandating vaccine use. PRACTICE IMPLICATIONS These framing effects should be considered when designing messages.
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Affiliation(s)
- Cabral A Bigman
- Center of Excellence in Cancer Communication Research, Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA.
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