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Editor’s Note:

 It is estimated that over 30% of Gross Domestic Product will be spent on health in the United States by the middle of this century. We should all be aware of the consequences of this forecast. This has impact on how we allocate resources, value health, and advance society. Leaders, policymakers, and citizens need to understand the benefits that arise from an investment to develop better practices, new treatments, and technologies for health outcomes. The post-modern global society in which we live continues to have environmental and societal stress that will challenge us in areas of mental health, chronic disease, and new emerging and rapidly spreading infectious diseases. Yet, the health sector is often amongst the slowest to adapt. Translating our knowledge and research with communication and information with ‘‘post-genomic,’’ population, and personalized medicine may require a new set of mechanisms and incentives. If we stay the current course health care spending will increase without the concomitant rise in health outcomes. Voices from academia, practitioners, policymakers, and the public will advance what we all strive for: a health competent society with not only new knowledge, but also creativity and innovation to help diffuse such progress into action at all levels.

Read more in my recent editorial.

Scott C. Ratzan, MD, MPA

Editor-in-Chief, Journal of Health Communication

Vice President, Government Affairs, Europe

Johnson & Johnson

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Table of Contents 

• Recent Articles in JHC
  • Volume 13, Issue 1
  • Volume 13, Issue 2
  • Volume 13, Issue 3
• Featured Book Review
• Meetings and Conferences
  

Recent Article in JHC:

Volume 13 Issue 1 (January/February 2008)
Click on the title to read a short summary of the article

• Intentions of Becoming a Living Organ Donor Among Hispanics
  - Jason T. Siegel;  Eusebio M. Alvaro;  Andrew Lac;  William D. Crano; and Alexander Dominick
  Living organ donation has the potential to alleviate the current, and growing, donor shortage among Hispanics. Regarding living and non-living donor intentions, Vested Interest Theory accounted for a significant portion of variance over and above the Theory of Planned Behavior. Future interventions should encourage family discussions concerning the topic, elucidate the process of how to become a living donor, and inform people that most religions encourage living donation. In addition, efforts ought to focus on correcting the erroneous belief that most family members are unsupportive of living donation.  Specific to the issue of living organ donation are educational interventions that will inform potential living donors that they can choose their recipient. Doing so will alleviate fears that organs will not be distributed equally within their community, and also may increase potential donors’ perceived stake in living organ donation.  

• Risk Perceptions and Worry About Cancer: Does Gender Make a Difference
  - Amy McQueen; Sally W. Vernon;  Helen I. Meissner; and William Rakowski
  McQueen, Vernon, Meissner, and Rakowski conducted exploratory, hypothesis-generating analyses and made the following suggestions for future prospective research. That is, investigators should confirm the gender differences reported here and explore potential mediators of the effect of gender on perceived risk and cancer worry. Additional research should examine gender as a moderator to understand whether the same risk messages are relevant and effective for both males and females.  For example, different risk messages and intervention strategies may be more influential for males e.g., those addressing the role of cancer information seeking. Health communication interventions may improve colorectal cancer screening rates by addressing gender differences in the predictors of risk perceptions and worry about colorectal cancer and by making comparisons with gender-specific cancer screening tests. The combination of perceived risk measures (absolute vs. comparative) is not advised given their associations with different factors.

• Increasing Mental Health Literacy via Narrative Advertising
  - Chingching Chang
  Chang conducted an experiment to explore the effectiveness of narrative advertising and argument advertising in increasing mental illness (depression) literacy. Based on her findings, she recommends that public health campaigners and researchers remember that mental health literacy is more effectively promoted by employing narrative advertising rather than facts-based argument advertising. Narrative ads that present a story about depression immerse the target audience in the message and generate more sympathy toward individuals suffering from depression than argument ads. Narrative advertising involves the target audience to a greater extent than argument advertising so that they are more motivated to elaborate on the problems associated with the health issue of depression and are more willing to seek professional help and comply with health care recommendations. The vivid imagery depicted in narrative advertising increases the target audience’s perceived efficacy in correctly identifying friends or family who may suffer from depression.

• The Role of Emotion and Issue Involvement in Predicting Entertainment-Education Viewers’ Intention to Register as Cornea Donors: A Test of the Elaboration Likelihood Model and the Theory of Planned Behavior
  - Hyuhn-Suhck Bae
  Bae examined the role of emotional responses and viewer’s level of issue involvement to an Entertainment-Education show about cornea donation in order to predict intention to register as cornea donors. The result suggested that elicitation of sympathetic and empathic sentiment by an organ donation message is an effective cue for expressing helping behavior. Sympathy and empathy arousal cues are effective in provoking heightened concern about donation which then fuels the high-involvement decision to sign an organ donor card; E-E interventions should consider the cultural variables of the host country.  A reality show E-E format could be adapted for the more common dramatic formats such as telenovelas by enhancing its ability to generate sympathy and empathy and issue involvement for audiences and thus stimulate behavior change. E-E interventions may have a different impact on audiences in terms of their choice of behavior.
  FULL TEXT

• A Comprehensive Analysis of Breast Cancer News Coverage in Leading Media Outlets
  - Charles K. Atkin;  Sandi W. Smith;  Courtnay McFeters; and Vanessa Ferguson
  Atkin, Smith, McFeters and Ferguson completed a comprehensive content analysis describing news media coverage of breast cancer in nine leading newspapers, newsmagazines, and TV networks in 2003 and 2004.  Findings suggest that media information about preventive behaviors related to lifestyle practices and contaminants is needed to help the audience learn steps for self-protection. Although the general topics of diet and obesity receive heavy media coverage, stories should give greater emphasize to the role of healthy eating and exercising in breast cancer prevention.  Due to the heavy flow of optimistic stories about medical progress in treating breast cancer, there is a need to caution women about developing complacency regarding risks behavior.  Organizations seeking to secure news or feature coverage of breast cancer topics should recognize the following key journalistic priorities: medical experts are cited in two-thirds of all news media stories; almost half of the TV newscast items portray personal narrative storylines; and print media are more likely to present prevention material while TV newscasts give greater attention to treatment information.

• Absolute and Comparative Risk Perceptions as Predictors of Cancer Worry: Moderating Effects of Gender and Psychological Distress
  Laura E. Zajac;  William M. P. Klein; Kevin D. McCaul. Volume 11, Issue 1, Supplement 1, 2006, Pages 37-49.

• Does Entertainment-Education Work With Latinos in the United States? Identification and the Effects of a Telenovela Breast Cancer Storyline
  Holley A. Wilkin;  Thomas W. Valente;  Sheila Murphy;  Michael J. Cody;  Grace Huang; Vicki Beck. Volume 12, Issue 5, 2007, Pages 455 – 469.

• Cancer News Coverage and Information Seeking
  - Jeff Niederdeppe;  Dominick L. Frosch; and Robert C. Hornik 
  Niederdeppe, Frosch, and Hornik examined the relationship between cancer news coverage and information seeking by combining data from a large news database with a national survey of American adults. Results suggest that a notable segment of the population actively responds to periods of elevated cancer news coverage by seeking additional information. However, study findings also raise concerns about the potential for widened gaps in cancer knowledge and preventive behaviors between large segments of the population over time. Many adults, particularly those with fewer years of education, may require continued active efforts by public health advocates and medical practitioners to disseminate cancer prevention information. As patients are increasingly expected to play a more active role in making healthcare decisions, innovative interventions may be warranted to help a greater part of the population become more informed healthcare consumers.
  FULL TEXT

• The 2005 British Columbia Antismoking Mass Media Campaign and Short Term Changes in Smokers Attitudes
  - Lynda Gagne   
  Gagne evaluated the effect of the 2005 British Columbia smoking cessation mass media campaign on a panel of 20-30 year old smokers attitudes. Small impacts on the panel's attitudes towards the adverse impacts of smoking were found, with greater impacts found for those with no plans to quit smoking at the initial interview. Evidence was found that media ad recall mediates unobserved predictors of attitudes towards smoking.

• Questions about Structure, Referent, and Bias In Judgments of the Effectiveness of Persuasive Messages
  - James Dillard and Sun Ye
  Dillard and Ye report on a study intended to address a series of questions about perceived effectiveness (PE). From their findings, they suggest that an expanded network of theoretically-derived reference variables will be necessary to make a final determination of the conceptual value the attribute/impact distinction. Until that knowledge becomes available, applied researchers should construct their PE measures as broadly as possible by ensuring that those measures include both attribute and impact items. Applied researchers should measure and control for referent usage and prior behavior when estimating the perceived effectiveness of messages prior to campaign implementation. Whereas the creation of valid data on PE for specific target audiences may require a combination of screening and experimental instruction, there are also potential benefits to gathering data on non-target recipients of the message. Appreciation of this point suggests that applied researchers would do well to consider the perceived and actual effects of messages beyond the bounds of their target audience. The results underscore the importance of measuring and controlling for order of presentation when assessing the PE of candidate campaign messages.   

• Alternate Methods of Framing Information About Medication Side Effects: Incremental Risk Versus Total Risk of Occurrence
  - Brian J. Zikmund-Fisher; Angela Fagerlin; Todd R. Roberts;  Holly A. Derry; and Peter A. Ubel
  Zikmund-Fisher, Fagerlin, Roberts, Derry, and Ubel compared two methods communicating medication side effect risks: reporting total rates of adverse events (the current standard) versus reporting the incremental risk caused by medications.  In two randomized experimental studies, they show that using incremental risk framing (e.g., describing the "additional risk" of complications) appears to facilitate recognition of how much risk already exists at baseline, thereby lowering participants' worry about complications and reducing biases caused by variations in the risk denominator.

• Getting to Know the Competition: A Content Analysis of Publicly and Corporate Funded Physical Activity Advertisements
  - Tanya R. Berry;  Ron E. McCarville; and Ryan E. Rhodes
  Berry, McCarville and Rhodes examined the content of all advertisements in top circulation Canadian magazines that contained references to physical activity for features designed to gain attention. They found a paucity of publicly funded health promotion advertisements and a large number of commercially sponsored advertisements that used physical activity to sell a product. The commercial advertisements were those most likely to contain features that would draw attention. This research underlines the importance of examining the many sources and purposes behind advertisements that compete with health promotion initiatives.

Related Articles

• Advertising and Obesity: A Behavioral Perspective
  Janet Hoek; Philip Gendall. Volume 11, Issue 4, 2006, Pages 409 – 423

• Riskier Than We Think? The Relationship Between Risk Statement Completeness and Perceptions of Direct to Consumer Advertised Prescription Drugs.
  Joel J. Davis. Volume 5, Issue 4, 2000, Pages 349 – 369

Volume 13 Issue 3 (April/May 2008)

• Formative research to develop a mass media campaign to increase physical activity and nutrition in a multiethnic state
  - Jay Maddock, Alice Silbanuz, and Bill Reger-Nash
  Formative research steps were addressed to develop a mass media campaign based on the Theory of Planned Behavior to increase physical activity and fruit and vegetable consumption in 35-55 year old adults in the state of Hawaii.  For the walking campaign, our results identified time, a control belief, as the major barrier.  For fruits and vegetable, the data suggested social norm (if others around me ate them) and control (if they were available).  These data were then used to develop a mass media campaign based on these principals.
  

• Experimental Pretesting of Public Health Campaigns: A Case Study
  - Jill Whittingham
  Whittingham pretested new campaign materials intended for distribution in a national STI/AIDS prevention campaign in the Netherlands.. The results show that exposure to the storyline of the television commercial produced a positive effect on risk perception. The storyline also had a positive effect on the intention to buy and carry condoms and on the intention to take initiative in discussing condom use before having sex. These findings suggest a positive effect of the exposure of the television commercial on important determinants of safe sex behavior among young people. The advantages, practical implications and limitations of experimental pretesting are discussed.  

• Adolescents' Responses to Peer Smoking Offers: The Role of Sensation Seeking and Self-Esteem
  - Kathryn Greene and Smita Banerjee
  Greene and Benerjee classified adolescent reports of their responses to cigarette smoking offers utilizing four drug refusal strategies of Refuse, Explain, Avoid, and Leave (REAL) and explored how personality factors explain adolescents’ use of cigarette refusal strategies. Results revealed that the strategy of explain was reported most frequently for initial and follow-up smoking offers. Adolescents with greater number of friends who smoked were more likely to use the avoid strategy for initial smoking offers. Sensation seeking was positively related with the use of leave and avoid strategies for initial smoking offers and leave strategy for follow-up smoking offers. No association was found between self-esteem and use of smoking refusal strategies.
  

• Randomized Trial on the 5 a Day, the Rio Grande Way Website: A Web-based Program to Improve Fruit and Vegetable Consumption in Rural Communities
  - David Buller, W. Gill Woodall, Donald E. Zimmerman, and Michael D. Slater, et. al.
  Buller and colleagues evaluated The 5 a Day, the Rio Grande Way website intended to increase fruits and vegetables (FV) consumption in a rural region.  Websites may be successful in community settings only when used enough by adults to influence them. In the end, it can be said that a website such as 5 a Day, the Rio Grande Way may provide some benefit to adults in rural communities.  But, many residents may not visit it enough to be broadly effective, even with concerted promotional efforts.  Internet interventions may function best when combined with more proactive means of reaching participants, such as with community health workers or where individuals can be accessed more readily to achieve higher usage such as at health care clinics or in worksite wellness programs.
  

• The Contribution of Anti-Smoking Advertising to Quitting: Intra-and Inter-Personal Processes
  - Sally Dunlop and Melanie Wakefield
  Dunlop, Wakefield and Kashima used a population survey to explore the roles of transportability – the tendency to become absorbed in a narrative – and interpersonal discussion in the use of televised anti-smoking advertising in attempts to quit smoking. The results indicated that smokers and ex-smokers who were more transportable were more likely to recall anti-smoking advertising and to report that they such advertising helped in their attempts to quit smoking. Results also showed that smokers and ex-smokers who reported talking about the advertisement that they recalled were more likely to have made an attempt to quit smoking than those who recalled an advertisement but did not talk about it.
  

• Health Literacy of HIV-Infected Individuals Enrolled in an Outreach Intervention: Results of a Cross-Site Analysis
  - Mari-Lynn Drainoni
  Drainoni examines health literacy among a group a HIV-positive persons at risk for receiving sub-optimal health care due histories of substance abuse, mental illness, incarceration and unstable housing or homelessness. The goal of this analysis was to identify demographics, risk factors and health indicators associated with different levels of health literacy. Results indicated that although less than 30% of the sample scored in the marginal or inadequate range for health literacy, participants with these lower levels of health literacy were more likely to be African American or Latino/a, heterosexual, speak Spanish as their primary language, and have less than a high school education. The disparities in health literacy found in this study point to a need to assess level of health literacy and provide culturally-sensitive health literacy interventions for persons with chronic diseases such as HIV.  ealth care and support service providers must also become aware of the importance of health literacy when caring for all patients with HIV, particularly those most likely to have low health literacy.

Related Articles

• Lack of Acknowledgment of Fruit and Vegetable Recommendations Among Nonadherent Individuals: Associations With Information Processing and Cancer Cognitions. William M. P. Klein; Kevin D. McCaul. Volume 11, Issue 1, Supplement 1, 2006, Pages 103 – 115

• A Randomized Controlled Trial of Multiple Tailored Messages for Smoking Cessation Among Callers to the Cancer Information Service. 
  Victor J. Strecher;  Al Marcus;  Kathy Bishop;  Linda Fleisher;  William Stengle;  Arnold Levinson;  Diane L. Fairclough;  Pam Wolfe;  Marion Morra;  Sharon Davis;  Richard Warnecke;  Jerianne Heimendinger; Mike Nowak . Volume 10, Issue 7, Supplement 1, 2005, Pages 105 – 118

• A Qualitative Study of Literacy and Patient Response to HIV Medication Adherence Questionnaires.  Michael S. Wolf;  Charles L. Bennett;  Terry C. Davis;  Estela Marin; Connie Arnold. Volume 10, Issue 6, 2005, Pages 509 – 517

Featured Book Review

Corcoran, N. (Ed.). (2007). Communicating health: Strategies for health promotion. Reviewed by Seth M. Noar Click here to read the entire review

Meetings and Conferences

National Conference on Health Communication, Marketing, and Media 2008
The 2nd Annual National Conference on Health Communication, Marketing, and Media will be held August 12-14, 2008 in Atlanta, Georgia. The conference provides a scientific and professional forum for researchers and practitioners to share insights, research findings, and best practices to advance the fields of health communication, marketing and media. The conference is an excellent opportunity to meet with colleagues and shape the future of health communication and marketing practice. http://www.cdc.gov/healthmarketing/conference2008.htm

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