Why Do Smokers Talk About Antismoking Campaigns? Predictors of the Occurrence and Content of Campaign-Generated Conversations

Smokers often talk about antismoking campaigns, and these conversations can contribute to campaign effectiveness. However, little is known about the predictors and content of naturally occurring campaign-generated conversations. In two studies (Study 1, N = 480; Study 2, N = 232), we systematically examined whether the occurrence and content of smokers’ conversations after exposure to one of eight antismoking television advertisements were predicted by characteristics of (a) the message, (b) intrapersonal responses to the message, (c) the individual, and (d) the social context in which exposure occurred. In multivariable models, we found that conversations were more likely to occur when advertisement exposure occurred in the presence of others, and as the amount of anxiety elicited by the advertisement increased. Conversations were more likely to contain a favorable appraisal of the advertisement when the message elicited higher levels of sadness, and less likely to contain favorable appraisals when the respondent had finished secondary education (vs. lower levels of education). Stronger feelings of guilt reduced the likelihood that conversations contained unfavorable appraisals, and increased the likelihood that they contained quitting talk. These findings suggest several promising avenues for future investigations into why smokers talk and talk in particular ways.     

Assessing the validity of confirmed AD recall measures for public health communication campaign evaluation

Evidence strongly suggests that public health communication campaigns can succeed in changing health-related cognitions and behaviors. For many evaluation studies, however, inferences of campaign effects are only valid to the extent that measures of campaign exposure are themselves valid. This study compares the validity of "aided" and "confirmed" ad recall measures in the context of a statewide tobacco countermarketing campaign using data from the Florida Anti-Tobacco Media Evaluation (FAME) surveys. Both aided and confirmed ad recall measures exhibited positive associations with cumulative gross ratings points (GRPs), a measure of the relative availability of specific countermarketing ads on broadcast television. In addition, both recall measures were significant predictors of campaign-targeted beliefs. Confirmed ad recall, however, was not a significantly better predictor of cumulative GRPs or campaign-targeted beliefs than aided ad recall, and the magnitude of association between both recall measures and targeted beliefs was quite small. These findings raise questions about the marginal utility of confirmed ad recall measures, compared with aided ad recall, in public health communication campaign evaluations. Nevertheless, results do provide evidence that both aided and confirmed ad recall measures are valid measures of campaign exposure.     

Assessing the Validity of Confirmed Ad Recall Measures for Public Health Communication Campaign Evaluation

ABSTRACT

Evidence strongly suggests that public health communication campaigns can succeed in changing health-related cognitions and behaviors. For many evaluation studies, however, inferences of campaign effects are only valid to the extent that measures of campaign exposure are themselves valid. This study compares the validity of “aided” and “confirmed” ad recall measures in the context of a statewide tobacco countermarketing campaign using data from the Florida Anti-Tobacco Media Evaluation (FAME) surveys. Both aided and confirmed ad recall measures exhibited positive associations with cumulative gross ratings points (GRPs), a measure of the relative availability of specific countermarketing ads on broadcast television. In addition, both recall measures were significant predictors of campaign-targeted beliefs. Confirmed ad recall, however, was not a significantly better predictor of cumulative GRPs or campaign-targeted beliefs than aided ad recall, and the magnitude of association between both recall measures and targeted beliefs was quite small. These findings raise questions about the marginal utility of confirmed ad recall measures, compared with aided ad recall, in public health communication campaign evaluations. Nevertheless, results do provide evidence that both aided and confirmed ad recall measures are valid measures of campaign exposure.     

Recall of “The Real Cost” Anti-Smoking Campaign Is Specifically Associated With Endorsement of Campaign-Targeted Beliefs

Though previous research suggests the FDA’s “The Real Cost” anti-smoking campaign has reduced smoking initiation, the theorized pathway of effects (through targeted beliefs) has not been evaluated. This study assesses the relationship between recall of campaign television advertisements and ad-specific anti-smoking beliefs. Respondents in a nationally representative survey of nonsmoking youths age 13–17 (n = 4,831) reported exposure to four The Real Cost advertisements and a fake ad, smoking-relevant beliefs, and nonsmoking intentions. Analyses separately predicted each targeted belief from specific ad recall, adjusting for potential confounders and survey weights. Parallel analyses with non-targeted beliefs showed smaller effects, strengthening claims of campaign effects. Recall of four campaign ads (but not the fake ad) significantly predicted endorsement of the ad-targeted belief (Mean β = .13). Two-sided sign tests indicated stronger ad recall associations with the targeted belief relative to the non-targeted belief (p < .05). Logistic regression analyses indicated that respondents who endorsed campaign-targeted beliefs were more likely to have no intention to smoke (p < .01). This study is the first to demonstrate a relationship between recall of ads from The Real Cost campaign and the theorized pathway of effects (through targeted beliefs). These analyses also provide a methodological template for showing campaign effects despite limitations of available data.     

Association Between End-of-Life Conversations in Nursing Homes and End-of-Life Care Outcomes: A Systematic Review and Meta-analysis

Objective

Less aggressive end-of-life (EOL) care has been observed when health care professionals discuss approaching EOL and preferences about life-sustaining treatments with nursing home (NH) residents or their families. We performed a comprehensive systematic review to evaluate the association between health care professionals–residents and health care professionals–family EOL conversations and EOL care outcomes.

Anger Expression Moderates the Effects of Psychological Reactance to Sexual Health Messages

This study examined how anger expression tendencies moderate the negative consequences of state reactance. An experiment was conducted whereby participants (N = 226) read a health public service announcement (PSA) that encouraged conversations about sexual health history prior to sexual encounters with new partners and that varied in freedom-threatening language. As hypothesized, the freedom-threatening appeal increased perceived threat to freedom and subsequent reactance. However, the negative relationship between reactance and attitude was mitigated for people who were lower in dispositional anger expression. The results showed that the extent to which state reactance resulted in unhealthy outcomes depended on the degree to which people tend to communicate anger. These findings are discussed in terms of theoretical implications for reactance scholars and practical utility for health message designers.     

Confirming "truth": more evidence of a successful tobacco countermarketing campaign in Florida

This study provides additional evidence that Florida's "truth" tobacco countermarketing campaign was successful in reducing smoking among Florida teens. Smoking rates were substantially lower among Florida teens between fall 2001 and spring 2002, whereas previous studies found that smoking rates were comparable before the launch of "truth." Florida teens had higher levels of "truth" campaign awareness and were more likely to agree with campaign-targeted beliefs; 2 of these beliefs were the only items associated with current smoking.     

Talking “truth”: Predictors and Consequences of Conversations about a Youth Antismoking Campaign for Smokers and Nonsmokers

Using data from the Legacy Media Tracking Survey II, this study investigated relations among youth's evaluations of the “truth” antismoking campaign, campaign-related interpersonal discussion, and campaign-relevant outcomes (n = 8,000). Regression analyses showed that smokers were less likely to have discussed the campaign than nonsmokers, and this effect was mediated by negative campaign evaluation. However, smokers with a negative evaluation of the campaign were more likely to talk about it than were nonsmokers reporting negative evaluation. Nonsmokers who talked about the campaign had beliefs, attitudes, and intentions in greater agreement with campaign messages than those who did not talk about the campaign. For smokers, talking about the campaign was associated with beliefs, attitudes, and intentions in greater agreement with campaign messages, but only if associated with positive campaign evaluation. For smokers with a negative campaign evaluation, talking about the campaign was associated with beliefs and attitudes counter to the campaign messages.     

The Effect of Health Beliefs,Media Perceptions,and Communicative Behaviors on Health Behavioral Intention: An Integrated Health Campaign Model on Social Media

ABSTRACT

Social media have recently gained attention as a potential health campaign tool. This study examines this line of expectation concerning the role social media may play in health campaigns by testing an integrated health campaign model that combines insights from research on social media-specific perceptions and communicative behaviors in order to predict health behaviors. Specifically, this study aims to (a) develop a more holistic social media campaign model for predicting health behaviors in the social media context, (b) investigate how social media channel-related perceptions affect preventive health behaviors, and (c) investigate how communicative behaviors mediate perceptions and behavioral intention. The study conducted an online survey of 498 females who followed the Purple Ribbon Twitter campaign (@pprb), a cervical cancer prevention campaign. The results indicated that information acquisition mediated perceived risk’s effect on intention. Information acquisition also mediated the relationships between intention and information selection and information transmission. On the other hand, social media-related perceptions indirectly impacted behavioral intention through communicative behaviors. The findings’ theoretical and practical implications are discussed.     

Evaluation of a Social Norms Approach to a Suicide Prevention Campaign

Suicide is a leading cause of death for college-aged youth, and university counseling centers (UCC) strive to educate students about mental health issues and available campus services. The current research evaluates a college campus social norms campaign that used both peer and celebrity sources to promote help seeking among college students as a suicide prevention strategy. Postcampaign surveys of this quasi-experiment (n = 391) revealed that compared to students in the control neighborhood condition, students exposed to the campaign messages in the experimental neighborhood conditions were more likely to perceive students would refer a friend to the UCC and more likely to visit the UCC for a mental health concern. Students living in the intervention neighborhood with a peer message source reported a greater willingness to refer friends to the UCC compared to those who lived in the celebrity and control neighborhoods. Regardless of condition, students who reported seeing UCC messages reported greater effects than those who reported not viewing the messages (e.g., greater intentions to seek help and to talk to others about the UCC). Results of this study are discussed within a social norms framework and support the need for continued exposure to campaign messages to impact health outcomes.     

Evaluation of ‘The Father Effect’ Media Campaign to Increase Awareness of,and Participation in,an Online Father-Inclusive Parenting Program

ABSTRACT

There is substantial evidence that parenting programs are effective in improving parenting and child mental health outcomes. While there is increasing focus on delivering parenting interventions online to increase their reach and dissemination, fathers are underrepresented in all formats of parenting programs. However, research suggests that father participation is important for intervention effectiveness. This study evaluated the effectiveness of a media campaign for increasing awareness of, and participation in, an online father-inclusive parenting program called ‘ParentWorks’. An 8-week campaign was conducted in Australia via social media channels, digital display advertising, digital television, and radio. To assess the impact of the campaign, data were obtained from caregivers registering for ParentWorks during the campaign period (n = 848) and an 8-week comparison period that occurred 3 months later (n = 254). Additionally, a nationally representative sample of 2021 caregivers of children aged 2–16 years completed an online survey. Survey questions asked about exposure to the campaign, registration for participation in ParentWorks, and knowledge of the importance of father participation in parenting programs. Three times as many caregivers registered during the 8-week media campaign compared to the comparison period, and a significantly greater proportion of male caregivers registered in the campaign versus the comparison period. The online survey found that 11% of caregivers reported exposure to the campaign, and significantly more fathers than mothers reported exposure. Results showed that those who were exposed to the campaign were significantly more likely to endorse the importance of father participation in parenting programs, than those not exposed to the campaign. The findings indicate that media campaigns appear to be an effective method of increasing awareness of online parenting programs and enhancing rates of father involvement.     

A Smoking Cessation Campaign on Twitter: Understanding the Use of Twitter and Identifying Major Players in a Health Campaign

The current study examined the use of online social media for a health campaign. Collecting tweets (N = 1,790) about the recent smoking cessation campaign by the Centers for Disease Control and Prevention, the current study investigated the dissemination of health campaign messages on Twitter and answered questions from the process evaluation of health campaigns: who tweeted about the campaign, who played central roles in disseminating health campaign messages, and how various features of Twitter were used for sharing of campaign messages. Results showed that individuals and nonprofit organizations posted frequently about the campaign: Individuals and nonprofit organizations posted about 40% and 30% of campaign-related tweets, respectively. Although the campaign under investigation was steered by a government agency, nonprofit organizations played a vital role as mediators who disseminated campaign messages. The culture of retweeting demonstrated its particular usefulness for the dissemination of campaign messages. Despite the expectation that the use of social media would expand opportunities for engagement, actual two-way interactions were few or minimal. Drawn from the results, practical suggestions on how to strategize the use of Twitter for future health campaigns are discussed.     

The effect of communication skills training on patient-pharmacist communication in pharmacy education: a meta-analysis

Communication skills in pharmacy education and practice are increasingly regarded as a crucial component. However, thus far, estimating of the overall communication skills training (CST) effects in a variety of outcomes is lacking. The aim of this study was to synthesize the effects of CST in pharmacy education by performing a meta-analysis of CST studies. We searched MEDLINE, EMBASE, ERIC, CINAHL, PsycINFO, Cochrane Library, Web of Science, Communication and Mass Media Complete (CMMC), key journals, and bibliographic databases. The effect sizes (ESs) were extracted and pooled in random effects meta-analyses. We assessed the quality of the study using the Medical Education Research Study Quality Instrument (MERSQI). From 34,737 articles, 9 studies were included in this meta-analysis. The overall effect size for CST was 0.611 (95% CI 0.327–0.895), and it was statistically significant (p = 0.000). We found based on the subgroup analyses that CST has a large effect size when it used stand-alone courses, lecture-lab based courses, video recordings, feedback, training for 2 or more semesters, hours per week ≥5 h and external assessments. For the CST effect, the effect sizes were ranked in order of confidence, knowledge, skills, and attitudes. The result of the meta-regression is that the total number of attendees is significantly negatively correlated with the effect sizes of the CST. The findings of the present meta-analysis provide evidence that CST in pharmacy education may act as an efficient way to improve the communication competency of students, and it may serve as a guide for pharmacy educators.     

The Long Live Kids Campaign: Awareness of Campaign Messages

Media interventions are one strategy used to promote physical activity, but little is known about their effectiveness with children. As part of a larger evaluation, the purpose of this study was to assess the short-term effect of a private industry sponsored media literacy campaign, Long Live Kids, aimed at children in Canada. Specifically, we investigated children's awareness of the campaign and its correlates. Using a cohort design, a national sample (N = 331, male = 171; mean age = 10.81, SD = 0.99) completed a telephone survey two weeks prior to the campaign release, and again 1 year later. Only 3% of the children were able to recall the Long Live Kids campaign unprompted and 57% had prompted recall. Logistic regression found family income (Wald χ² = 11.06, p < .05), and free-time physical activity (Wald χ² = 5.67, p < .01) significantly predicted campaign awareness. Active children (≥3 days/week) were twice as likely to have recalled the campaign compared with inactive children (<3 days/week), whereas children living in high-income households (>$60,000/yr) were between 3.5 to 5 times more likely to have campaign recall compared with children living in a low-income households (<$20,000/yr). These findings suggest that media campaigns developed by industry may have a role in promoting physical activity to children although our findings identified a knowledge gap between children living in high- and low-income households. Future research needs to examine how children become aware of such media campaigns and how this mediated information is being used by children.     

A meta-analysis of the effect of mediated health communication campaigns on behavior change in the United States

A meta-analysis was performed of studies of mediated health campaigns in the United States in order to examine the effects of the campaigns on behavior change. Mediated health campaigns have small measurable effects in the short-term. Campaign effect sizes varied by the type of behavior: r=.15 for seat belt use, r=.13 for oral health, r=.09 for alcohol use reduction, r=.05 for heart disease prevention, r=.05 for smoking, r=.04 for mammography and cervical cancer screening, and r=.04 for sexual behaviors. Campaigns with an enforcement component were more effective than those without. To predict campaign effect sizes for topics other than those listed above, researchers can take into account whether the behavior in a cessation campaign was addictive, and whether the campaign promoted the commencement of a new behavior, versus cessation of an old behavior, or prevention of a new undesirable behavior. Given the small campaign effect sizes, campaign planners should set modest goals for future campaigns. The results can also be useful to evaluators as a benchmark for campaign effects and to help estimate necessary sample size.     

Predicting Health: The Interplay Between Interpersonal Communication and Health Campaigns

The present study experimentally investigated the interplay between interpersonal communication and health message exposure in relation to alcohol consumption intentions. Participants were 174 students who took part in a study on the effects of an antialcohol message. At baseline, the authors assessed intention to refrain from binge drinking. At the second wave (2 weeks later), participants were assigned to the conditions of a 2 (antialcohol message or no-alcohol message) × 2 (alcohol conversation or control conversation) between-subjects design, after which intention was again assessed. Results showed that when participants talked about alcohol (instead of the control topic) and were not exposed to an antialcohol message, they were less inclined to refrain from binge drinking, an effect that was not visible when participants talked about alcohol after viewing an antialcohol message. These findings suggest that health campaign exposure moderates the influence of interpersonal communication on health variables.     

Economic effectiveness of disease management programs: a meta-analysis.

The economic effectiveness of disease management programs, which are designed to improve the clinical and economic outcomes for chronically ill individuals, has been evaluated extensively. A literature search was performed with MEDLINE and other published sources for the period covering January 1995 to September 2003. The search was limited to empirical articles that measured the direct economic outcomes for asthma, diabetes, and heart disease management programs. Of the 360 articles and presentations evaluated, only 67 met the selection criteria for meta-analysis, which included 32,041 subjects. Although some studies contained multiple measurements of direct economic outcomes, only one average effect size per study was included in the meta-analysis. Based on the studies included in the research, a meta-analysis provided a statistically significant answer to the question of whether disease management programs are economically effective. The magnitude of the observed average effect size for equally weighted studies was 0.311 (95% CI = 0.272-0.350). Statistically significant differences of effect sizes by study design, disease type and intensity of disease management program interventions were not found after a moderating variable, disease severity, was taken into consideration. The results suggest that disease management programs are more effective economically with severely ill enrollees and that chronic disease program interventions are most effective when coordinated with the overall level of disease severity. The findings can be generalized, which may assist health care policy makers and practitioners in addressing the issue of providing economically effective care for the growing number of individuals with chronic illness.